Sildenafil, sold as the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.[3] It is unclear if it is effective for treating sexual dysfunction in women.[3] It is taken by mouth or injection into a vein.[3] Onset is typically within 20 minutes and lasts for about 2 hours.[3]
Common side effects include headaches, heartburn, and flushed skin.[3] Caution is advised in those with cardiovascular disease.[3] Rare but serious side effects include a prolonged erection that can lead to damage to the penis, vision problems, and hearing loss.[3] Sildenafil should not be taken by people on nitrates such as nitroglycerin (glycerin trinitrate), as this may result in a serious drop in blood pressure.[3]
Sildenafil acts by blocking phosphodiesterase 5 (PDE5), an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis.[3] It requires sexual arousal, however, to work.[3] It also results in dilation of the blood vessels in the lungs.[3]
Pfizer originally discovered the medication in 1989 while looking for a treatment for heart-related chest pain.[4] It was approved for medical use in the United States and Europe in 1998.[3][4] In the United States about 2 million prescriptions were written for sildenafil in 2016.[5] In 2017 it became available as a generic medication.[6] In the United Kingdom it is available over the counter.[7] As of 2018 in the United States the wholesale cost is less than US$1 per dose.[8]
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