Viagra experiences & reviews 2020

How is the Viagra rating composed?

Viagra in the test – grade: good

Behind the product name Viagra is a drug that has made a name for itself in the treatment of erectile dysfunction in men. The active ingredient sildenafil, a so-called PDE-5 inhibitor, is known for its vasodilating effect and has thus found its use in the fight against erectile dysfunction.

The relevant area of ​​application is based on a coincidence, which appeared as a side effect, so to speak, during the testing of the active ingredient for the treatment of high blood pressure and angina pectoris. In this actually unforeseen function, Viagra appeared on the market by the US company Pfizer in 1998 and is now one of the best-known brands for erectile dysfunction.

What is Viagra?

Viagra is a sexual enhancer based on the active ingredient Sildenafil. Sildenafil belongs to a group of phosphodiesterase type 5 inhibitors. It is a vasodilator substance. Immediately before an erection, a cellular messenger substance known as cyclic guanosine monophosphate (cGMP) is released. cGMP causes the muscles around the blocking arteries in the erectile tissue of the penis to relax. This allows blood to flow into the erectile tissue and enables an erection.

The enzyme phosphodiesterase-5 (PDE5) splits cGMP and thus breaks it down. The result is renewed tension around the blocking arteries, which prevents the blood flow in the erectile tissue and leads to the erection waning.

The active ingredient sildenafil inhibits PDE5 and thus reduces the rate of breakdown of cGMP. The resulting, higher CGMP level in the erectile tissue leads to a longer and stronger erection. An erection does not occur automatically after taking Viagra. Sexual stimulation and arousal are a prerequisite for this.

Viagra is prescribed to treat erectile dysfunction. By this we mean the inability of men to get and maintain an erect penis for sexual activity.

The desired effect occurs after 30 minutes. Viagra develops its maximum effect about one hour after ingestion. The effect lasts for an average of four hours.

Key data on Viagra:

• Drug based on the active ingredient sildenafil for the symptomatic treatment of erectile dysfunction;
• Development of effect during sexual stimulation through a vasodilating mechanism and the breakdown of cGMP;
• available in different dosage forms and different active ingredient concentrations;

Learn more about Viagra:

Mechanism of action of Viagra

During an erection, the release of the messenger substance cGMP relaxes the muscles in the erectile tissue of the penis, making them easier to fill with blood. This is how an erection comes about.

The active ingredient sildenafil contained in Viagra is known as a PDE-5 inhibitor to delay the breakdown of precisely this cGMP. The slower this is broken down, the more stable and lasting the erection, which ultimately characterizes the mechanism of action of Viagra.

Effect of Viagra: What to watch out for?

Unlike other erectile dysfunction drugs, Viagra only works when there is actually sexual stimulation. In a non-excited state, the genital blood vessels are closed by tense muscles.

Only the cGMP, which is released during the state of excitement, with its muscle-relaxing effect, creates an opening of the blood vessels and the blood flowing in with it creates an erection. Since Viagra inhibits the breakdown of this messenger substance cGMP, which is released only when excited, there will be no development of any effect without sexual stimulation. The fear of an unpleasant permanent erection is therefore unfounded.

Effectiveness of Viagra: Clinical Studies

Studies show that Viagra has the desired effect in the fight against erectile dysfunction in 69 percent of all test subjects. In practice, too, many users speak of an effect lasting between 1 and 2.5 hours, which now contributes to a fulfilling sex life with previously restricted erectile function.

The causal relationship between ingestion and sexual stimulation for the development of effects is also mentioned as being present. Nevertheless, there are still people for whom Viagra does not achieve the desired effect: Around a third of all those treated have to switch to alternatives.

How is Viagra dosed and taken?

Viagra is available to patients in different dosage forms and also in different strengths. They are available as tablets, film-coated tablets, orodispersible tablets and chewable tablets in strengths of 25 mg, 50 mg, 75 mg and 100 mg.

In this way, different treatment and consumption needs are recognized. The attending physician decides which strengths and dosage forms are most suitable for the individual treatment.

Users of Viagra are recommended to drink plenty of water in the context of the application in order to prevent dehydration of the body during sexual intercourse. After all, this is the most common initiator of unpleasant side effects. A fatty food intake should also be rejected, as this can reduce the effectiveness of Viagra.

An overall positive mood without pressure to perform or exaggerated expectations is mandatory during sexual contact, even during treatment with Viagra. The tablet is taken approximately one hour before sexual intercourse in the usual manner for the dosage form.

Which side effects of Viagra can occur?

The active ingredient Sildenafil contained in Viagra has a vasodilating effect, which is desirable for an erection, but also extends to other parts of the body and can cause unpleasant side effects there.

Many users report headaches, which can also take on severe proportions, as well as intense reddening of the face. Palpitations and a blocked nose can also be undesirable side effects of the treatment.

Occasionally, there is also talk of a changed visual perception in the color spectrum. Although these side effects are unpleasant, they are classified as harmless. Nevertheless, everyone has to weigh up whether they want to accept them.

Interactions with other drugs

Taking Viagra and alpha blockers at the same time can lead to a sudden drop in blood pressure. Alpha-blocker active ingredients approved in Germany are:

• Alfuzosin;
• Bunazosin;
• doxazosin;
• prazosin;
• phentolamine;
• Silodosin;
• Tamsulosin;
• Terazosin;
• urapidil;
• Yohimbine;

There can be life-threatening interactions between Viagra and drugs containing nitrates. Medicines containing nitrates are used in the treatment of angina pectoris. In combination with Viagra there is the risk of a life-threatening reduction in blood flow to the coronary arteries.

Nitrate-based antihypertensive drugs categorically exclude the use of any PDE5 inhibitors (including other sexual enhancers such as Cialis, Levitra and Spedra). The following active ingredients fall under this category:

• amyl nitrite;
• glycerine trinitrate;
• isosorbide dinitrate;
• isosorbide mononitrate;
• Molsidomine;
• Nicorandil;
• Pentaerythrityl tetranitrate;

Various party drugs, which operate under the name poppers, can result in life-threatening interactions in connection with Viagra. These substances are similar in their mode of action to the drugs containing nitrates mentioned above. Well-known poppers are:

• amyl nitrite;
• Cyclohexyl nitrite;
• isopropyl nitrite;

PDE5 inhibitors should not be taken in combination with one another. In addition to Sildenafil (Viagra), there are the following other PDE5 inhibiting active ingredients (and sexual enhancers based on them):

• Avanafil (e.g. Spedra);
• Tadalafil (e.g. Cialis);
• Vardenafil (e.g. Levitra);

Viagra can reduce the effects of the following drugs:

• Antidepressants (e.g. Fluvoxamine, Nefazodone);
• HIV / AIDS drugs (e.g. atazanavir, darunavir, fosamprenavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir);

The following drugs can negatively influence the effect of Viagra or increase possible side effects:

• Antibiotics (clarithromycin, erythromycin, rifampicin);
• Antifungal drugs (antifungal agents such as fluconazole, itraconazole, ketoconazole, voriconazole);
• H2 blocker cimetidine (against stomach acid);
• Immunosuppressants tacrolimus (after transplants);

It is known that alcohol (weakening) and grapefruit juice (strengthening) can interact with Viagra and cause more severe side effects.

When should the medication not be taken?

The following health restrictions exclude the use of Viagra:

• Hypersensitivity to the ingredients;
• Taking nitrate-based antihypertensive drugs (see interactions);
• Non-arteritic anterior ischemic optic neuropathy (NAION, damage to the optic nerve due to vascular occlusion);
• Serious cardiovascular diseases (e.g. angina pectoris, heart failure, stroke within the last six months);
• Low blood pressure (systolic value below 90 mmHg);
• Severe pulmonary hypertension (class IV);
• Serious dysfunction of the liver or kidneys;

With the following health restrictions, taking Viagra may be possible, subject to a medical risk assessment:

• Circulatory disorders of the arteries;
• Blood pressure control disorder;
• Blood clotting disorder;
• Certain forms of blood cancer (e.g. leukemia, plasmacytoma);
• Sickle cell anemia;
• Cardiovascular diseases (e.g. hypertrophic cardiomyopathy);
• Narrowing of a heart valve;
• Kidney weakness;
• Liver dysfunction (e.g. cirrhosis of the liver);
• stomach ulcers;
• Penile malformations;
• Permanent painful erections;

Viagra and all other PDE5 inhibitors are not suitable for women.

What alternatives to Viagra are there?

There are a number of sexual enhancers whose active ingredients also belong to the group of PDE5 inhibitors. Their modes of action are comparable to that of Viagra.

Cialis: Cialis is based on the active ingredient Tadalafil. It relaxes the blocking arteries in the erectile tissue of the penis and works for 36 hours. The effect occurs after approx. 30 minutes.

Tadafil generics (e.g. Tadalafil Aristo, TadaHEXAL) : The patent for the active ingredient in Cialis expired at the end of 2017. A number of copycat preparations (so-called generics) have since appeared on the market. Because they are cheaper to manufacture, they cost less. However, they contain the same active ingredient and their effects (and side effects) are identical.

Spedra : Spedra contains the active ingredient avanafil. Compared to Viagra, the effect starts much faster. An erection is possible 15 to 30 minutes after application. The duration of action is about four to six hours. The agent may only be used once every 24.

Levitra : The active ingredient in Levitra is vardenafil. After ingestion, the effect sets in within 30 minutes and levels off after about four hours.

Sildenafil generics (e.g. SildeHEXAL, Sildenafil Ratiopharm): After Pfizer’s patent for the active ingredient of Viagra expired, numerous companies brought cheaper generics with the same effect onto the market.

All mentioned sexual enhancers are based on the same mechanism of action. Differences exist in the time until the onset of the effect and the duration of the effect.

What does Viagra cost?

Viagra is only available on prescription, but is usually not financed by health insurance. Although this takes over all examinations related to the prescription, the drug itself then has to be paid for and is a not insignificant cost factor.

A pack that contains an average of 4 film-coated tablets is so expensive that the price per tablet is in the double-digit range. Larger packs with 12 tablets in their contents are only marginally cheaper. This makes the drug treatment of erectile dysfunction expensive fun.

Can you buy Viagra without a prescription in Germany?

Viagra requires a prescription in Germany.

Neither Viagra nor its generic drugs or any other PDE5 inhibitor-based sexual enhancer is available in German pharmacies without a prescription.

Erectile dysfunction is often related to vascular disease. Before taking a sexual enhancer, a doctor must rule out the possibility of a serious cardiovascular disease. Patients with dangerously low blood pressure should also refrain from taking a PDE5 inhibitor.

There are a number of clinical pictures which, in connection with Viagra or a similar sexual enhancer, can have serious and sometimes life-threatening consequences. Certain medications such as nitrate-based antihypertensive drugs can interact with sexual enhancers in a life-threatening manner.

Viagra should never be taken without prior medical examination.

Numerous sexual enhancers are available over the counter on the Internet. Buyers should be aware of the risks. Many shady vendors sell counterfeit drugs. At best, there is no effect. In the worst case, serious side effects are the consequence. Potency products should always be obtained from trustworthy providers.

In Germany it is illegal to send prescription drugs without a prior prescription.

Where can I buy Viagra online?

There are two legal ways to buy Viagra online.

Order Viagra from an online pharmacy

Many pharmacies in Germany now offer the option of ordering over-the-counter and prescription drugs online.

The legal regulations for the shipping of prescription drugs are the same as for the purchase on site. The submission of a valid original recipe is mandatory. After Viagra has been placed in the virtual shopping cart of an online pharmacy (mail order pharmacy), the type of prescription must be specified.

The prescription must then be sent by post together with the order confirmation to the address given in the pharmacy. Faxes, scans or copies are not enough. After an examination, the mail-order pharmacy will send the product within a few days (see also DocMorris experiences, shop-apotheke.com experiences and Sanicare experiences).

Buy Viagra with an online prescription

Nowadays it is possible to get a medical diagnosis and a corresponding prescription without having to see a doctor personally.

Online medical practices (see also experience with 121doc, experience with ZavaMed (previously DrEd), experience with euroClinix) require patients to fill out a medical questionnaire. The sheet is analyzed by a doctor who contacts the patient if he has any questions. The doctor then suggests a possible treatment and, if necessary, issues a prescription.

The prescription can be sent to the patient or forwarded directly to a mail order pharmacy. The remote diagnostic process can vary slightly depending on the online doctor’s practice chosen. Some practices allow a patient to indicate which prescription drug is required before completing the questionnaire.

Correct online diagnoses require that the patient completes the medical questionnaire truthfully.

Conclusion

With Viagra, the US company Pfizer launched probably one of the most famous drugs for erectile dysfunction in 1998. The effect is based on the ingredient sildenafil, which was processed in different doses. The product, which is available in different dosage forms, causes horrendous costs that are not covered by health insurance. Unpleasant side effects also have to be accepted. Nonetheless, in scientific studies, Viagra was able to effectively eliminate erectile dysfunction in more than 2/3 of all test subjects and also convince practical users in many areas. As a result, Viagra was given the grade Good.