If you need help remembering to take your dose of Viagra before sex, try setting an alarm or downloading a reminder app. Or ask your partner to remind you to take your dose about an hour before sex. Do not use more Viagra than your doctor prescribes. Using more than this can lead to serious side effects. Call your doctor right away if you think you’ve taken too much Viagra. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room. The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Viagra for you, they will prescribe the dosage that’s right for you. Remember, you should not change your dosage of Viagra without your doctor’s recommendation. Talk with your doctor if you have questions or concerns about your current dosage.

The original sildenafil formulation was developed in the 1980s and approved in the 1990s.
Sildenafil is also marketed for pulmonary arterial hypertension under different brand names.
The 100g dose is not standard; typical prescriptions are measured per tablet.
Misuse or abuse of sildenafil can lead to psychological dependency or health risks.
Always consult a healthcare provider to determine if sildenafil is appropriate for your condition.

Here are some questions you may want to discuss with your doctor: How long should I give Viagra to work before my dosage should be increased? Should I take a lower dosage of Viagra because of my other medications? Would a higher dosage of Viagra increase my risk for side effects? To learn more about Viagra, see these articles: Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. The prescribing information for sildenafil citrate (VIAGRA, Pfizer, New York, NY, USA) recommends flexible dosing (50 mg initially, adjusted to 100 or 25 mg based on effectiveness and tolerability) in most men with erectile dysfunction (ED). In many men, however, 100 mg may be the most appropriate initial dose because it would reduce the need for titration and could prevent discouragement and treatment abandonment should 50 mg be insufficient.

Sildenafil is a phosphodiesterase type 5 inhibitor specific to erectile dysfunction.
It has been proven effective in improving sexual performance in men with ED.
The medication is contraindicated for men taking certain antihypertensives or antidepressants.
The onset of action varies depending on whether taken on an empty stomach.
Always adhere to the prescribed amount; excess intake can reduce efficacy or cause harm.

Results of two previously published double-blind, placebo-controlled sildenafil trials of similar design except for a fixed-dose vs flexible-dose regimen were analyzed. Relative to the flexible-dose, approximately one-third more men were satisfied with an initial and fixed dose of 100 mg. In addition, tolerability was similar, and improvements from baseline in outcomes on validated, ED-specific, patient-reported questionnaires were either similar (erectile function and the percentage of completely hard and fully rigid erections) or greater (emotional well-being and the overall sexual experience). The similarity in outcomes is not surprising given that almost 90% of the men in the flexible-dose trial titrated to 100 mg after 2 weeks. These data suggest prescription of an initial dose of 100 mg for men with ED, except in those for whom it is inappropriate. For most men with erectile dysfunction (ED), the prescribing information for sildenafil citrate (VIAGRA, Pfizer) recommends an initial dose of 50 mg, increased to 100 mg or decreased to 25 mg based on effectiveness and tolerability (flexible dose).1 However, 100 mg sildenafil produced optimal erection hardness (fully hard and rigid) in a substantial proportion of men with ED.2 In addition, in dose-optimization studies3, 4 and at the end of double-blind, placebo-controlled (DBPC) treatment in recent reports of flexible-dose trials,5, 6 100 mg was the dose that was used by most men. Thus, the 100-mg dose may provide some additional benefit beyond that achieved with the 50-mg dose and may be the most appropriate choice for initiation of therapy in many men. This report assesses erection hardness, erectile function, emotional well-being, satisfaction (disease related and treatment related) and the overall sexual experience in men treated with 100 mg fixed-dose sildenafil and in men treated with flexible-dose sildenafil (50 and 100 mg), using data from two DBPC trials that were similarly designed except for a fixed-dose vs flexible-dose regimen.7, 8 The objective was to assess the efficacy and tolerability of an initial dose of sildenafil 100 mg relative to the flexible-dosage regimen recommended in the prescribing information. One trial was a multinational (Republic of Korea, Russian Federation, Spain and Sweden), parallel-group, randomized (1:1:1) DBPC trial of fixed-dose sildenafil (50 or 100 mg) or placebo administered on demand over an 8-week treatment period.7 The other trial was a multicenter (United States), parallel-group, randomized (1:1) DBPC trial of flexible-dose sildenafil (50 or 100 mg) administered on demand over a 10-week treatment period.8 In both trials, ⩽1 dose of study medication was to be taken per day. Details of the patients and methods of the two trials have been published previously.7, 8 As described previously,7, 8 several efficacy assessments were conducted, including the Erection Hardness Score (EHS9), the International Index of Erectile Function (IIEF),10 the Self-Esteem And Relationship (SEAR) questionnaire,11, 12, 13 the Sexual Experience Questionnaire (SEX-Q),14 the Quality of Erection Questionnaire,15 the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS)16 and three global efficacy assessment questions. Except for the global efficacy assessment questions, all assessment tools are validated, and a higher score indicates better outcome. Safety data included all adverse events sildenafil 45 mg chewable tablets (AE) reports from the original trials.

Sildenafil's effectiveness depends on regular health check-ups and appropriate use.
Patients should avoid high-fat meals before taking sildenafil, which can delay absorption.
Report any vision changes, including blurred vision or color discrimination issues.
Sildenafil's popularity has led to a wide range of counterfeit products online.
Proper treatment involves addressing underlying causes of erectile dysfunction alongside medication.

In this study, analyses were conducted on data from the intent-to-treat population for each study, which was defined as men who took at least one dose of study medication and who provided sufficient efficacy data for at least one efficacy analysis. Treatment effects were estimated using least square means from an analysis of covariance model for change scores from baseline to DBPC end of treatment on the IIEF, SEAR and SEX-Q, and the end-of-treatment EDITS Index score.

Tips for taking Viagra

What Is the Maximum Safe Sildenafil Dosage?

You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room. The sections above describe the typical dosages provided by the drug’s manufacturer. If your doctor recommends Viagra for you, they will prescribe the dosage that’s right for you. Remember, you should not change your dosage of Viagra without your doctor’s recommendation.

Does Viagra work to treat ED?

Talk with your doctor if you have questions or concerns about your current dosage. Here are some questions you may want to discuss with your doctor: How long should I give Viagra to work before my dosage should be increased? Should I take a lower dosage of Viagra because of my other medications? Would a higher dosage of Viagra increase my risk for side effects? To learn more about Viagra, see these articles: Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. The model used terms of baseline value, treatment group, investigator site and prognostic factors (age, ED duration, ED etiology) with P values calculated at the 5% significance level for the test of treatment group differences. Logistic regression (terms of treatment group, age, ED duration and ED etiology) was used to analyze the proportion of men who were satisfied with treatment (dichotomized EDITS score). The percentages of EHS 3, EHS 4 and EHS 3 or 4 erections based on all of the event log data since the previous visit were analyzed as clustered binomial data using a logistic regression (terms for baseline percentage, treatment group, age, ED duration and ED etiology), with a scale adjustment for overdispersion (estimated by Williams method) and model; treatment effects were estimated using predicted percentages from the model.

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Pearson correlations were computed between the SEX-Q change from baseline scores and all other outcomes (change from baseline or end of treatment); 95% confidence intervals for the correlation coefficient were constructed using Fisher's Z-transformation. In both trials, each treatment group comprised ∼100 men, most of whom had ED that was of organic or mixed etiology and that was mild to moderate in severity (Table 1). At week 2, 88% (92/104) of patients randomized to flexible-dose sildenafil and 92% (97/105) randomized to flexible-dose placebo increased their dose from 50 mg to 100 mg; at the end of the DBPC treatment, 87% (90/104) and 92% (97/105), respectively, remained on the higher dose. During the DBPC phase of each trial, patients in each treatment group received an average of seven or eight doses per month. Across both trials, only one man discontinued sildenafil (flexible dose) because of lack of efficacy and only two men discontinued sildenafil because of treatment-related AEs: moderate dyspepsia (100-mg fixed dose) and moderate headache (100-mg flexible dose). Sildenafil, whether initiated at a fixed dose of 50 or 100 mg, or initiated at a dose of 50 mg and titrated as needed up to 100 mg, was significantly more effective than placebo (Table 2).

Side Effects

The prescribing information for sildenafil citrate (VIAGRA, Pfizer, New York, NY, USA) recommends flexible dosing (50 mg initially, adjusted to 100 or 25 mg based on effectiveness and tolerability) in most men with erectile dysfunction (ED). In many men, however, 100 mg may be the most appropriate initial dose because it would reduce the need for titration and could prevent discouragement and treatment abandonment should 50 mg be insufficient. Results of two previously published double-blind, placebo-controlled sildenafil trials of similar design except for a fixed-dose vs flexible-dose regimen were analyzed. Relative to the flexible-dose, approximately one-third more men were satisfied with an initial and fixed dose of 100 mg. In addition, tolerability was similar, and improvements from baseline in outcomes on validated, ED-specific, patient-reported questionnaires were either similar (erectile function and the percentage of completely hard and fully rigid erections) or greater (emotional well-being and the overall sexual experience).

Viagra Tablets

The similarity in outcomes is not surprising given that almost 90% of the men in the flexible-dose trial titrated to 100 mg after 2 weeks. These data suggest prescription of an initial dose of 100 mg for men with ED, except in those for whom it is inappropriate. For most men with erectile dysfunction (ED), the prescribing information for sildenafil citrate (VIAGRA, Pfizer) recommends an initial dose of 50 mg, increased to 100 mg or decreased to 25 mg based on effectiveness and tolerability (flexible dose).1 However, 100 mg sildenafil produced optimal erection hardness (fully hard and rigid) in a substantial proportion of men with ED.2 In addition, in dose-optimization studies3, 4 and at the end of double-blind, placebo-controlled (DBPC) treatment in recent reports of flexible-dose trials,5, 6 100 mg was the dose that was used by most men. Thus, the 100-mg dose may provide some additional benefit beyond that achieved with the 50-mg dose and may be the most appropriate choice for initiation of therapy in many men. This report assesses erection hardness, erectile function, emotional well-being, satisfaction (disease related and treatment related) and the overall sexual experience in men treated with 100 mg fixed-dose sildenafil and in men treated with flexible-dose sildenafil (50 and 100 mg), using data from two DBPC trials that were similarly designed except for a fixed-dose vs flexible-dose regimen.7, 8 The objective was to assess the efficacy and tolerability of an initial dose of sildenafil 100 mg relative to the flexible-dosage regimen recommended in the prescribing information.

What happens if I take too much sildenafil?

One trial was a multinational (Republic of Korea, Russian Federation, Spain and Sweden), parallel-group, randomized (1:1:1) DBPC trial of fixed-dose sildenafil (50 or 100 mg) or placebo administered on demand over an 8-week treatment period.7 The other trial was a multicenter (United States), parallel-group, randomized (1:1) DBPC trial of flexible-dose sildenafil (50 or 100 mg) administered on demand over a 10-week treatment period.8 In both trials, ⩽1 dose of study medication was to be taken per day. Details of the patients and methods of the two trials have been published previously.7, 8 As described previously,7, 8 several efficacy assessments were conducted, including the Erection Hardness Score (EHS9), the International Index of Erectile Function (IIEF),10 the Self-Esteem And Relationship (SEAR) questionnaire,11, 12, 13 the Sexual Experience Questionnaire (SEX-Q),14 the Quality of Erection Questionnaire,15 the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS)16 and three global efficacy assessment questions. Except for the global efficacy assessment questions, all assessment tools are validated, and a higher score indicates better outcome. Safety data included all adverse events sildenafil 45 mg chewable tablets (AE) reports from the original trials. In this study, analyses were conducted on data from the intent-to-treat population for each study, which was defined as men who took at least one dose of study medication and who provided sufficient efficacy data for at least one efficacy analysis. The 100-mg fixed dose was significantly more effective than the 50-mg fixed dose in improving the IIEF Overall Satisfaction domain score; the SEAR Sexual Relationship Satisfaction domain, Overall Relationship Satisfaction subscale and Total scores; all SEX-Q domain scores; and the SEX-Q total score (Table 2). In addition, the EDITS Index was significantly higher in the fixed-dose sildenafil 100-mg group vs the fixed-dose sildenafil 50-mg group, although the difference between the dosage groups in the estimated percentage of men who were satisfied with sildenafil treatment (dichotomized EDITS scores: 93 vs 88%) was not statistically significant (Table 2).

Key takeaways

Treatment effects were estimated using least square means from an analysis of covariance model for change scores from baseline to DBPC end of treatment on the IIEF, SEAR and SEX-Q, and the end-of-treatment EDITS Index score. The model used terms of baseline value, treatment group, investigator site and prognostic factors (age, ED duration, ED etiology) with P values calculated at the 5% significance level for the test of treatment group differences. Logistic regression (terms of treatment group, age, ED duration and ED etiology) was used to analyze the proportion of men who were satisfied with treatment (dichotomized EDITS score). The percentages of EHS 3, EHS 4 and EHS 3 or 4 erections based on all of the event log data since the previous visit were analyzed as clustered binomial data using a logistic regression (terms for baseline percentage, treatment group, age, ED duration and ED etiology), with a scale adjustment for overdispersion (estimated by Williams method) and model; treatment effects were estimated using predicted percentages from the model. Pearson correlations were computed between the SEX-Q change from baseline scores and all other outcomes (change from baseline or end of treatment); 95% confidence intervals for the correlation coefficient were constructed using Fisher's Z-transformation.

Authors and Affiliations

In both trials, each treatment group comprised ∼100 men, most of whom had ED that was of organic or mixed etiology and that was mild to moderate in severity (Table 1). At week 2, 88% (92/104) of patients randomized to flexible-dose sildenafil and 92% (97/105) randomized to flexible-dose placebo increased their dose from 50 mg to 100 mg; at the end of the DBPC treatment, 87% (90/104) and 92% (97/105), respectively, remained on the higher dose. During the DBPC phase of each trial, patients in each treatment group received an average of seven or eight doses per month. Across both trials, only one man discontinued sildenafil (flexible dose) because of lack of efficacy and only two men discontinued sildenafil because of treatment-related AEs: moderate dyspepsia (100-mg fixed dose) and moderate headache (100-mg flexible dose). Sildenafil, whether initiated at a fixed dose of 50 or 100 mg, or initiated at a dose of 50 mg and titrated as needed up to 100 mg, was significantly more effective than placebo (Table 2).

Professional resources

The 100-mg fixed dose was significantly more effective than the 50-mg fixed dose in improving the IIEF Overall Satisfaction domain score; the SEAR Sexual Relationship Satisfaction domain, Overall Relationship Satisfaction subscale and Total scores; all SEX-Q domain scores; and the SEX-Q total score (Table 2). In addition, the EDITS Index was significantly higher in the fixed-dose sildenafil 100-mg group vs the fixed-dose sildenafil 50-mg group, although the difference between the dosage groups in the estimated percentage of men who were satisfied with sildenafil treatment (dichotomized EDITS scores: 93 vs 88%) was not statistically significant (Table 2). For the fixed-dose sildenafil 100-mg group relative to the flexible-dose sildenafil group (Table 2), there was a similar improvement from baseline in the percentage of EHS 4 erections (33 and 35%, respectively), EHS 3 or 4 erections (36 and 35%, respectively) and IIEF scores (⩽1 point difference between the groups across IIEF domains). However, for the fixed-dose sildenafil 100-mg group relative to the flexible-dose sildenafil group there was a greater improvement from baseline in SEAR scores (8–16 point difference between the groups across SEAR components) and in SEX-Q scores (3–7 point difference between the groups across SEX-Q domains), a greater least square mean±s.e. EDITS Index (78.4±2.0 and 66.5±3.3, respectively), and a larger estimated percentage of men who were satisfied with sildenafil treatment (dichotomized EDITS scores: 93 vs 69%). For the fixed-dose sildenafil 100-mg group relative to the flexible-dose sildenafil group (Table 2), there was a similar improvement from baseline in the percentage of EHS 4 erections (33 and 35%, respectively), EHS 3 or 4 erections (36 and 35%, respectively) and IIEF scores (⩽1 point difference between the groups across IIEF domains).

What happens if I overdose?

The SEX-Q total score, which assesses the sexual experience overall in the domains of erection, individual satisfaction and couples satisfaction, correlated positively with all other outcomes in both trials (Table 3). In both trials, most AEs were mild or moderate in severity. The most frequently reported AEs were flushing, dyspepsia, headache and nasal congestion in the fixed-dose trial, which occurred at similar frequencies in the sildenafil 50-mg and 100-mg groups, and flushing, headache, nasal congestion and dizziness in the flexible-dose trial (Table 4).

Dosage Adjustments in Specific Situations

Mild side effects

However, for the fixed-dose sildenafil 100-mg group relative to the flexible-dose sildenafil group there was a greater improvement from baseline in SEAR scores (8–16 point difference between the groups across SEAR components) and in SEX-Q scores (3–7 point difference between the groups across SEX-Q domains), a greater least square mean±s.e. EDITS Index (78.4±2.0 and 66.5±3.3, respectively), and a larger estimated percentage of men who were satisfied with sildenafil treatment (dichotomized EDITS scores: 93 vs 69%). The SEX-Q total score, which assesses the sexual experience overall in the domains of erection, individual satisfaction and couples satisfaction, correlated positively with all other outcomes in both trials (Table 3). In both trials, most AEs were mild or moderate in severity. The most frequently reported AEs were flushing, dyspepsia, headache and nasal congestion in the fixed-dose trial, which occurred at similar frequencies in the sildenafil 50-mg and 100-mg groups, and flushing, headache, nasal congestion and dizziness in the flexible-dose trial (Table 4).