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Peak concentration in the blood is reached after two hours for tadalafil and about one hour for sildenafil. As such, we always suggest taking medication about an hour or two before sexual activity. The time it takes for the drug to function will vary between patients, so use prior experience as a guide.

Sildenafil and other PDE5 inhibitors should never be taken with nitrates. In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. Sildenafil is a potent and selective inhibitor of cGMP-specific phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.

Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events have been chosen for inclusion either due to their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors. In placebo-controlled clinical studies, the discontinuation rate due to adverse reactions for VIAGRA (2.5%) was not significantly different from placebo (2.3%).

ED is when you can't get or keep an erection long enough to have satisfying sex. That includes erections that aren't as firm or don't last as long as you'd like. Some people with ED have trouble getting morning erections as well. Please note that all PharmacyChecker-accredited online pharmacies (tier 1 and non-tier 1) meet the same high standards as identified in the PharmacyChecker Verification Program. Such countries are known to have equally advanced pharmaceutical and pharmacy regulatory systems.

Avanafil is the active ingredient in Spedra tablets which tackles ED. It is a PDE-5 inhibitor — a drug that increases the blood flow to your penis once you have become aroused. This blood flow will only occur during sexual stimulation