Is 20 mg an Effective Dose of Sildenafil? | Ro

Sildenafil 20 mg is a dosage approved to treat a serious lung condition known as pulmonary arterial hypertension (PAH), but it’s also effectively prescribed to help with erectile dysfunction (ED). Sildenafil, the active ingredient in Viagra (with sildenafil being its generic name), is a widely recognized medication used to treat erectile dysfunction and is usually prescribed in higher doses such as 25 mg, 50 mg, or even 100 mg. However, healthcare providers sometimes opt for a sildenafil 20 mg dosage to tailor treatment specifically for those patients who may benefit more from a lower dosage option. 

Continue reading to learn if sildenafil 20 mg is the right treatment choice for you, considering both its benefits and potential drawbacks. 

Sildenafil (marketed under the brand name Revatio) is primarily used to manage a lung condition known as pulmonary arterial hypertension (PAH). The way this medication works is through the relaxation of blood vessels, which enhances blood flow significantly. Consequently, due to its mechanism of action, sildenafil is also effective in treating erectile dysfunction since improved blood flow to the penis leads to harder erections that facilitate more satisfying and fulfilling sexual experiences.

The FDA has approved sildenafil 20 mg for treating pulmonary arterial hypertension, while the other standard dosages available for erectile dysfunction treatment include 25 mg, 50 mg, and 100 mg dosages for ED specifically. Since sildenafil is fundamentally the active component in Viagra, prescriptions for the 20 mg dosage can also be considered off-label to manage ED effectively (DailyMed, 2020).

When a healthcare provider considers prescribing sildenafil for the treatment of erectile dysfunction, the traditional starting dose typically is 50 mg. However, not every patient responds to this dosage, and some patients may experience side effects when taking higher doses. A higher dose can also mean an increased risk of adverse reactions for certain individuals. Since the generic version of Viagra is only marketed in dosages of 25 mg, 50 mg, and 100 mg, healthcare providers may choose to prescribe sildenafil in 20 mg increments to provide more flexibility and precision in achieving an effective dosage for their patients. 

The cost is also an essential consideration when weighing options between Viagra and its generic version, sildenafil. Brand name Viagra can be prohibitively expensive, often costing upwards of $70 per dose. Opting for the generic sildenafil not only lowers the treatment cost, but choosing generic Revatio in 20 mg increments may present an even more economical and budget-friendly option.

So, why would one choose a 20 mg sildenafil dosage over the available 25 mg option? Here are several possible reasons to consider: 

• Your healthcare provider might initiate treatment with a 20 mg dose to monitor your response to the medication before adjusting upward.

• Some patients may encounter side effects at higher dosages of 25 mg or 50 mg but experience significantly fewer side effects, or none at all, with dosages such as 20 mg or 40 mg. 

• It’s a possibility that 50 mg might not yield the desired effect as effectively as a higher 60 mg would, and mutual agreement between you and your healthcare provider can lead to a slight upward adjustment in dosage for better outcomes.

In general, it is advisable to take the lowest effective dose of any medication to avoid unnecessary side effects. Prescribing sildenafil in 20 mg increments permits healthcare providers to identify the most suitable dosage for you—one that maximizes the treatment benefits while also minimizing potential adverse effects for a tailored approach to managing erectile dysfunction.

Sildenafil usually begins to take effect within 30 to 60 minutes, and its efficacy generally lasts for about four hours, making prior planning essential for optimal results. Keep in mind that sildenafil does not provide an instant erection; rather, it assists you in achieving and sustaining an erection when sexual arousal occurs (Smith, 2022). 

If you find that a dose of Viagra doesn’t work as anticipated, refrain from taking another dose until at least 24 hours have elapsed. Should you discover that your prescribed dosage isn’t producing effective results, it’s crucial to consult your healthcare provider to discuss the possibility of adjusting to a higher dose or exploring alternative medications.

While Viagra remains a commonly effective treatment for erectile dysfunction, there are alternative medications that may offer better results for specific individuals. Other erectile dysfunction medications include: 

• Vardenafil (brand name Levitra)

• Tadalafil (brand name Cialis)

• Avanafil (brand name Stendra)

Sildenafil and its alternatives are categorized as PDE5 inhibitors, which operate by inhibiting the action of an enzyme known as PDE5, effectively functioning as an erection's "off switch." The "on switch" is a natural chemical called cGMP, which signals the blood vessels in the penis to enlarge and fill with blood. When PDE5 is inhibited, blood vessels in the penis remain dilated, leading to longer-lasting and harder erections (Dhaliwal, 2022).

Although all PDE5 inhibitors work on the same natural chemical—PDE5—they’re not all identical in their functionality. Sildenafil may take around 30 minutes to become effective and can last anywhere from 4 to 5 hours, whereas Avanafil can be taken as little as 15 minutes before sexual activity and remains effective for a similar duration. Tadalafil, on the other hand, comes in two formulations: one taken daily and one as needed, which can be effective for an extended period of up to 36 hours.

Choosing the most suitable medication for your condition may require a bit of dialogue with your healthcare provider. If a particular medication doesn’t yield the desired results you expected, be sure to inform your provider. Finding the right medication paired with the appropriate dosage can significantly enhance your sexual experience and overall quality of life.

Erectile dysfunction (ED)—which involves the inability to obtain or sustain an erection sufficient for enjoyable sexual activity—is recognized as the most common sexual dysfunction affecting men. Current estimates suggest that around 30 to 50 million men in the United States have experienced ED at some point in their lives. While ED can potentially occur at any age, its prevalence notably increases with advancing age. By the time men reach their 40s, they have approximately a 40% probability of experiencing ED, with that likelihood escalating by about 10% for every subsequent decade of life (Sooriyamoorthy, 2022; Ferrini, 2017).

Nevertheless, it’s crucial to understand that experiencing ED is not considered a “natural” part of aging. There are numerous underlying health conditions that can contribute to the development of erectile dysfunction, and addressing these health issues can often lead to an improvement in ED symptoms. Potential contributing factors include:

• Heart disease

• Diabetes

• High blood pressure

• High cholesterol

• Low testosterone

• Nerve damage

• Depression

• Sleep apnea

Therefore, it’s vital to consult with a healthcare provider upon noticing the first signs of erectile dysfunction. They will assess your medical history, evaluate your overall health, and can identify any underlying health concerns, ensuring you receive the necessary treatment promptly.

Viagra (sildenafil) is not available over the counter, but it is possible to consult with a qualified healthcare provider, either in person or via telemedicine, to obtain a prescription. The convenience of receiving Viagra discreetly through the mail has become increasingly popular for those who prefer privacy in their healthcare decisions. 

When purchasing sildenafil online, be cautious of counterfeit sources. Many may have encountered a barrage of suspicious advertisements promoting Viagra at drastically reduced prices which often lead to illegitimate online sellers. These counterfeit products can pose serious health risks to consumers.

In fact, Pfizer, the manufacturer behind Viagra, conducted an investigation in 2011 regarding counterfeit pills purchased online. The results were alarming; some of the pills contained dangerous substances including blue printer ink, amphetamines, a common antibiotic called metronidazole, incorrect dosages of sildenafil, or even harmful substances like drywall (Pfizer, n.d.). 

Possible side effects associated with sildenafil and other ED medications include headache, facial flushing, nasal congestion, stomach upset, backache, and, in rare instances, temporary vision changes, including impaired color perception. Should you notice any significant vision changes, experience chest pain, or have an occurrence of priapism (defined as an erection lasting longer than four hours), it is essential to seek immediate medical attention. 

Furthermore, sildenafil and other PDE5 inhibitors must never be taken in conjunction with nitrates or nitrites. These substances include various prescription medications used to manage chest pain, alongside recreational drugs known as poppers. The combination of sildenafil with nitrates can lead to a dangerous drop in blood pressure that could potentially be life-threatening.

If you are contemplating taking sildenafil to treat erectile dysfunction, scheduling an appointment with your healthcare provider is recommended. They will assist you in selecting a medication and dosage that best aligns with your health needs and goals.