Sildenafil Tablet (Viagra): Uses, Dosage & Side Effects in Pakistan

Sildenafil (Viagra) Tablet Uses, Dosage, Side Effects & Price in Pakistan

1. Quick Info (Mukhtasir Maloomat)

2. What is Sildenafil? (Sildenafil kya hai)

Sildenafil is a PDE5 inhibitor that treats Erectile Dysfunction (mardana kamzori) and, at different doses, Pulmonary Arterial Hypertension (PAH). The brand name Viagra (Pfizer) is the most widely recognized; multiple local Pakistani generic versions are also available.

How it works: Sildenafil inhibits phosphodiesterase type 5 (PDE5), which increases cyclic GMP (cGMP) in penile smooth muscle, causing relaxation and increased blood flow — enabling an erection. It requires sexual stimulation to work — it does not cause erections on its own.

Critical safety notes: 1. ABSOLUTE CONTRAINDICATION with nitrates (heart medicines like GTN spray, Sorbitrate, isosorbide) — can cause sudden, severe, potentially fatal blood pressure drop. 2. COUNTERFEIT WARNING: Many fake Viagra/sildenafil tablets are sold in Pakistan — only buy from licensed pharmacies with a valid prescription.

3. Uses (Fayde / Kis kaam aati hai)

• Erectile Dysfunction (ED — mardana kamzori)
• Pulmonary Arterial Hypertension (PAH — specialist indication, different dosing regimen)

4. Who Should Take (Kis ko leni chahiye)

• Adult men with diagnosed Erectile Dysfunction after physician evaluation
• PAH patients under specialist/cardiologist supervision (Revatio formulation — different dosing)
• Men in whom underlying causes of ED have been evaluated (cardiovascular risk, diabetes, hormonal, psychological)

5. When NOT to Take (Kab nahi leni chahiye)

• ABSOLUTE CONTRAINDICATION: Any patient taking nitrates (GTN, isosorbide mononitrate, isosorbide dinitrate, amyl nitrate/poppers) — any form, any route
• Recent MI (heart attack), stroke, or life-threatening arrhythmia (within last 6 months) — consult cardiologist
• Severe cardiovascular disease — cardiologist clearance required
• Severe hepatic impairment — avoid
• Non-arteritic anterior ischaemic optic neuropathy (NAION) — history of — avoid
• Hypotension (low BP <90/50 mmHg) — avoid
• Concurrent use with ritonavir — extreme caution / dose reduction required
• Women and children (for ED indication — PAH pediatric dosing is strictly specialist only)

6. Dosage (Kitni leni hai)

• Typical starting dose: 50mg taken 30-60 minutes before sexual activity
• Range: 25mg-100mg (based on response and tolerability — doctor adjusts)
• Maximum: once daily — do NOT use more than once in 24 hours

• Elderly (65+): start with 25mg
• Renal/hepatic impairment: dose reduction — doctor decides
• Concurrent ritonavir: max 25mg every 48 hours

• 20mg three times daily (Revatio formulation) — strictly specialist prescribed, different from ED dosing

• ED indication: Sildenafil is taken as needed — not on a regular schedule. Use as prescribed before activity.
• PAH: If you miss a dose, take it as soon as you remember. Never take a double dose.

7. How to Take (Kaise leni hai)

• Take 30-60 minutes before sexual activity

• Fatty/heavy meals can delay the effect — taking it on an empty stomach or with a light meal is better

• Avoid or limit alcohol — alcohol is a vasodilator and can further lower BP, increasing side effects

• Remember: sildenafil does not work on its own — sexual stimulation is required

8. Best Time (Kab leni chahiye)

• 30-60 minutes before activity
• Avoid fatty food 2-3 hours before

9. Empty Stomach or After Food (Khali pait ya khane ke baad)

Taking it on an empty stomach or with a light meal gives the fastest onset. Heavy fatty meals (such as biryani, fried food) slow absorption and can delay onset (1-2 hours).

10. Warnings (Ihtiyat)

• If taking nitrates in any form, NEVER take sildenafil: GTN spray or tablet, Sorbitrate (isosorbide), Isordil, amyl nitrite (poppers), or any heart pain medication
• Combined use can drop BP so severely that unconsciousness and cardiac arrest can occur

• Recent heart attack or stroke (6 months) — consult cardiologist first
• Active cardiac disease, unstable angina — contraindicated
• Sexual activity itself is cardiovascular stress — fitness evaluation is necessary

• Sudden vision loss in one or both eyes — IMMEDIATELY stop and seek emergency care (NAION risk)
• Bluish tinge in vision is a common minor side effect — not fading vision or vision loss

• Sudden hearing loss or severe tinnitus — IMMEDIATELY stop and see a doctor

• Many fake Viagra tablets are sold in Pakistan — unknown ingredients, wrong doses
• Only buy from licensed pharmacies with a valid prescription
• NEVER buy from online or street vendors

11. Precautions (Ahm ehtiyaat)

• Store in a cool and dry place (below 30°C)
• Keep away from direct sunlight
• Keep out of the reach of children
• Keep in original packaging

• If erection lasts more than 4 hours — go to the emergency room IMMEDIATELY
• Delay can cause permanent damage

12. Side Effects (Nuksanat)

• Headache (sir dard), Flushing, Dyspepsia, Nasal congestion, Visual colour tinge (bluish hue), Dizziness

• Fatal hypotension with nitrates — EMERGENCY
• Priapism (>4 hours) — EMERGENCY
• NAION (sudden vision loss) — EMERGENCY
• Sudden hearing loss — EMERGENCY

13. Drug Interactions (Dawaon ke sath reaction)

• Nitrates (GTN, Sorbitrate, isosorbide) — ABSOLUTE CONTRAINDICATION — fatal hypotension
• Alpha-blockers (Tamsulosin, Prazosin, Terazosin) — orthostatic hypotension — take at different times, low starting dose
• Ritonavir / HIV protease inhibitors — sildenafil levels increase dramatically — max 25mg/48hrs
• Antifungals (Itraconazole, Ketoconazole) — sildenafil levels can increase — caution
• CYP3A4 inhibitors — various interactions possible
• Alcohol — enhanced vasodilation, hypotension, dizziness

Before starting any new medicine, always inform your doctor about sildenafil use.

14. When to See Doctor (Kab doctor ke paas jayein)

• Chest pain during or after use — cardiac event or nitrate interaction — EMERGENCY
• Erection lasting >4 hours (priapism) — EMERGENCY
• Sudden vision loss in one or both eyes — EMERGENCY
• Sudden hearing loss or severe tinnitus — EMERGENCY
• Severe dizziness or fainting

15. Alternatives (Sasti Dusri Dawaein)

16. Price in Pakistan (Price kitni hai)

17. FAQs (Aksar poochay jane walay sawalat)

Q: Sildenafil kis kaam aata hai?

A: Sildenafil (Viagra) is a PDE5 inhibitor used to treat Erectile Dysfunction (mardana kamzori). It works with sexual stimulation — it does not work without stimulation. Use only on a doctor's prescription.

Q: Sildenafil ke side effects kya hain?

A: Common side effects: headache, flushing (facial redness), dyspepsia (indigestion), nasal congestion, bluish colour tinge in vision, dizziness. Serious: fatal BP drop with nitrates, priapism, sudden vision loss or hearing loss.

Q: Sildenafil kaise lena hai?

A: Typically 50mg, taken 30-60 minutes before sexual activity. Maximum once daily. Food (especially fatty meals) and alcohol can delay the effect. Follow your doctor's prescribed dose exactly.

Q: Sildenafil price in Pakistan kya hai?

A: Sildenafil price in Pakistan is approximately Rs. 500-2,500 per tablet. Pfizer Viagra branded tablets are more expensive; local generics are cheaper. Only buy from a licensed pharmacy — there is a very high risk of counterfeit in Pakistan.

Q: Sildenafil safe hai?

A: Safe for healthy men under doctor's guidance. However, it is ABSOLUTELY FORBIDDEN with nitrates (heart medicine — sorbitrate, GTN spray) — a fatal blood pressure drop can occur. Patients with heart disease, recent heart attack, or stroke should consult a cardiologist first. Beware of counterfeits.

18. Medical Review (Medical jaiza)

Compiled by the PakVita Editorial Team · AI-assisted drafting with editorial review · Sourced from DRAP, WHO, BNF · Last updated: 2026-06-17

19. Disclaimer (Zaroori tanbeeh)

The information on this page is for awareness only. It is not medical advice. Always consult your doctor or pharmacist before taking any medicine. PakVita is not responsible for any harm.