Sildenafil, which is also called sildenafil citrate, comes as an oral tablet.

Author information

Ejaculatory abnormalities in mice lacking the gene for endothelial nitric oxide synthase (eNOS-/-). Abdel-Hamid IA ENE, El Gilani A-H. Assessment of as needed use of pharmacotherapy and the pausesqueeze technique in premature ejaculation. Efficacy of sildenafil citrate in treatment of erectile dysfunction: Impact of associated premature ejaculation and low desire. Goldmeier D, Lamba H.

Conservative Non-surgical Options for Erectile Dysfunction

Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation by Abdel-Hamid et al. Intracavernous medication for treatment of premature ejaculation. Chen J, Mabjeesh NJ, Matzkin H, Greenstein A. Efficacy of sildenafil as adjuvant therapy to selective serotonin reuptake inhibitor in alleviating premature ejaculation. A new combination treatment for premature ejaculation: A sex therapist’s perspective. The drug also comes as an oral liquid suspension and IV infusion.

Product	Dosage	Quantity + Bonus	Price
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Kamagra Polo	100mg	12 Pills	60.21€ 57.34€
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Viagra Generic	50mg	120 + 6 Pills	129.64€ 123.47€
Kamagra Soft Tabs	100mg	20 Pills	79.79€ 75.99€
Kamagra Polo	100mg	60 + 4 Pills	189.39€ 180.37€
Kamagra Oral Jelly	100mg	30 + 5 Sachets	136.20€ 129.71€
Viagra Generic	25mg	20 Pills	37.74€ 35.94€
Viagra Generic	25mg	60 + 4 Pills	71.99€ 68.56€
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However, this article does not cover these forms. It only covers the side effects of sildenafil oral tablets.

Effect	Description	Onset Time	Duration	Notes
Vasodilation	Dilates blood vessels to improve blood flow	30-60 min	4-6 hours	Main mechanism for erectile support
Neural modulation	May influence neural pathways involved in ejaculation	N/A	N/A	Not fully understood
Side effects	Headache, flushing, dizziness	Within hours	Varies	Common with higher doses

If you’d like to learn more about these forms, talk with your doctor. As with other drugs, sildenafil can cause side effects (adverse effects). It’s typically taken as a long-term treatment.

Tip	Explanation	Best Practice
Consult a healthcare professional	To determine appropriateness and safe dosage	Essential before starting treatment
Start with low dose	To minimize side effects and assess response	Usually 25-50 mg
Monitor and report side effects	To optimize treatment and safety	Follow-up appointments
Combine with behavioral therapy	Enhances overall outcomes	Address psychological factors

Read on to learn about potential common, mild, and serious side effects. For a general overview of sildenafil, including details about its uses, refer to this article.

Surgical Intervention

Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, Abraham L, Crossland A, Morris M. Development and validation of a premature ejaculation diagnostic tool. Azam U. Late-stage clinical development in lower urogenital targets: Sexual dysfunction. Taber MT, Wright RN, Molski TF, Clarke WJ, Brassil PJ, Denhart DJ, Mattson RJ, Lodge NJ.

Early and Delayed Ejaculation: Psychological Considerations

Neurochemical, pharmacokinetic, and behavioral effects of the novel selective serotonin reuptake inhibitor BMS-505130. Pharmacol Biochem Behav 2005;80:521–8. Aloosh M, Hassani M, Nikoobakht M. Seminal plasma magnesium and premature ejaculation: A case-control study. Q. Your doctor can also tell you more about sildenafil. Sildenafil can cause certain side effects, some of which are more common than others.

Misusing sildenafil for PE can cause serious health risks.
The drug's primary purpose is erectile dysfunction.
Off-label use for PE should be supervised by a doctor.
Performance anxiety often exacerbates PE.
Proper medication adherence improves results.
Natural remedies lack strong scientific support.
Combining drugs without guidance is dangerous.
Behavioral adjustments can sometimes eliminate PE.
It is vital to address both physical and psychological aspects.
Clinical trials explore sildenafil's role in PE management.
Open communication with a healthcare professional is key.

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Sildenafil is a PDE5 inhibitor used mainly for erectile dysfunction.
Some men use sildenafil to delay ejaculation temporarily.
Sildenafil may improve confidence in sexual performance.
It does not treat underlying causes of premature ejaculation.
Sildenafil's effects can last up to 4-6 hours.
Using sildenafil for PE is off-label and not medically approved.
Combining sildenafil with other ED medications can be risky.
Timing of sildenafil intake affects its effectiveness.
Side effects include headaches, flushing, and nasal congestion.
It may interact with nitrates, causing dangerous blood pressure drops.
Always consult a doctor before using sildenafil for PE.

These are just a few of the more common side effects reported by people who took sildenafil in clinical trials:* * To learn more about the clinical trials of sildenafil, refer to the drug’s prescribing information for erectile dysfunction and pulmonary arterial hypertension.

Cited by (115)

I am in a new sexual relationship and surprised that at age 63 I have premature ejaculation. My partner is understanding, but it bothers me. Premature ejaculation is common in older men, especially when beginning a new relationship. Even men with erectile dysfunction (ED), who have difficulty getting and holding an erection, can experience premature ejaculation. It's great that your partner is so understanding, and it benefits you both to be open about the issue and discuss your options together.

A new combination treatment for premature ejaculation: A sex therapist's perspective

The official definition of premature ejaculation is uncontrolled and unwanted ejaculation within a minute or less of penetration. Personally, I think this definition is too limiting. Of course, men need to be realistic about their expectations for staying power. But if a man is consistently ejaculating before he wants to, and it causes him distress, then he should speak with his doctor. However, there are two techniques you and your partner can try right away that may help. † For more information about this side effect, see “Sildenafil: Side effect specifics” below. Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission.

Parameter	Value	Explanation
Absorption	Fast, begins within 30 min	Peak plasma concentration achieved in 1 hour
Bioavailability	~40%	Due to first-pass metabolism
Metabolism	Liver (CYP3A4 enzyme)	Adjust dose if on CYP3A4 inhibitors
Excretion	Feces (~60%), urine (~30%)	Slow process, affects timing of doses

Mild side effects can occur with sildenafil use.

Research Design

Effective daily treatment with clomipramine in men with premature ejaculation when 25 mg (as required) is ineffective. Maier U, Koinig G. Andrological findings in young patients under long-term antidepressive therapy with clomipramine. Mousavizadeh K, Ghafourifar P, Sadeghi-Nejad H. Calcium channel blocking activity of thioridazine, clomipramine and fluoxetine in isolated rat vas deferens: A relative potency measurement study.

Ejaculation Problems: Too Fast, Too Slow or Not at All

Tramadol HCL has promise in on-demand use to treat premature ejaculation. J Sex Med 2008;5:188–93. Safety and efficacy of tramadol in the treatment of premature ejaculation: A double-blind, placebo-controlled, fixed-dose, randomized study. Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to sildenafil’s prescribing information for erectile dysfunction (ED) and pulmonary arterial hypertension (PAH). Mild side effects that have been reported with sildenafil include: These side effects may be temporary, lasting a few days to weeks. Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking sildenafil and want to tell the FDA about it, visit MedWatch. * For more information about this side effect, see “Sildenafil: Side effect specifics” below. † An allergic reaction is possible after taking sildenafil. However, this side effect was rarely reported in clinical trials of sildenafil for ED and PAH. To learn more, see the “Sildenafil: Side effect specifics” section below.

Cited by (15)

A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation. FDA proposes new warnings about suicidal thinking, behavior in young adults who take antidepressant medications. Available at NEW01624.html (accessed March 24, 2008). Rosen RC, Casey R, Levine SB, Mudumbi R, Tesfaye F, Hasmonay R. Treatment of premature ejaculation (PE) with dapoxetine (DPX) is not associated with suicidality.

Corresponding author

Healy D, Whitaker C. Antidepressants and suicide: Risk-benefit conundrums. Girgis SM, El-Haggar S, El-Hermouzy S. A double-blind trial of clomipramine in premature ejaculation. Clomipramine as a treatment for rapid ejaculation: A double-blind crossover trial of fifteen couples. The list below may not include all possible serious side effects of the drug. If you develop serious side effects while taking sildenafil, call your doctor right away.

Premature ejaculation affects about 30% of men.
Psychological factors often contribute to PE.
Behavioral therapies can help manage PE.
Topical anesthetics are alternative treatments for PE.
SSRI antidepressants are commonly prescribed for PE.
Combining sildenafil with PE drugs requires care.
Lifestyle changes like exercise may improve PE.
Stress and anxiety can trigger premature ejaculation.
Delay techniques include the stop-start method.
Medical treatments should be personalized for each patient.
Education about sexual response can reduce PE.

If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number. Serious side effects that have been reported and their symptoms include: Symptoms can include:tinnitus (ringing in your ear)dizzinessdecrease in hearing Symptoms can include:trouble sildenafil tablets 125 seeing in either eyeblurry visionseeing eye floaters * To learn more about this side effect, see the “Sildenafil: Side effect specifics” section below. Sildenafil is not approved by the Food and Drug Administration (FDA) for use in children. In clinical trials, children who were given sildenafil long term to treat pulmonary arterial hypertension had an increased risk of fatality.

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Some studies suggest that paroxetine (Paxil) may be the most helpful, but any of the other SSRIs also should work, such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro). However, they need to be taken daily, since they don't work on an as-needed basis. Men who have both ED and premature ejaculation should first address their ED. That usually entails taking medication like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), or avanafil (Stendra). After this, sildenafil 45 mg chewable tablets they can add an SSRI.

Curr Opin Neurobiol

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Sildenafil (Revatio, Viagra) is a generic prescription medication used to treat erectile dysfunction and pulmonary arterial hypertension in adults. However, your child’s doctor may recommend taking sildenafil off-label in some cases. (With off-label use, a doctor prescribes an FDA-approved drug for a purpose other than what it’s approved for.) Talk with your child’s doctor to determine if sildenafil is right for your child.

Alternative medicine

They are the "stop-start" and "stop-squeeze" methods. With stop-start, you begin sexual intercourse and keep going until you are close to the point of orgasm. You stop all sexual stimulation until the feeling passes and then resume intercourse. When you approach orgasm, you pause, and you (or your partner) use the thumb and two fingers to gently apply pressure just below the head of the penis for about 20 seconds. Then release the squeeze, and resume sexual activity.

Premature Ejaculation: 2020 Update

Both techniques can be repeated as often as needed. Another option is to apply a topical numbing agent to the head of the penis. The most convenient types are sprays that contain lidocaine or a similar anesthetic product. You will need to test this out to see if your partner finds it causes irritation. (Using condoms also might help by reducing sensation.) Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), can counter premature ejaculation because delayed orgasm is a common side effect. They can help compare the risks and benefits of the drug. Sildenafil oral tablets come in different strengths: 20 milligrams (mg), 25 mg, 50 mg, and 100 mg. The dosage you’re prescribed will depend on what condition you’re taking sildenafil for. It also depends on how the dosage is working for you.