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Consult your doctor or pharmacist for more details. Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist. To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). A high-fat meal may delay how quickly the drug begins to work. When a man is sexually excited, the penis rapidly fills with more blood than usual. With this extra flow of blood, the penis then expands and hardens. After the man is done having sex, this extra blood flows out of the penis back into the body. In an opposite extreme situation, if an erection lasts for a long time (more than 6 hours), it can permanently damage your penis. 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Erectile dysfunction, defined today as the inability to attain and maintain an erect penis with sufficient rigidity for sexual intercourse, has become an increasingly common complaint that affects 140 million men worldwide. So Viagra stands out as the pioneer of drugs that treat erectile dysfunction, for twenty years. Sildenafil citrate was the first oral agent to be introduced for the treatment of erectile dysfunction, thanks to the researchers from Pfizer. Sildenafil is the active substance of Viagra, while Viagra is the commercial name. Teva’s generic Viagra has launched already in December 2017 in the United States. Risk factors for developing erectile dysfunction include age, diabetes, hypertension, obesity, lack of exercise, dyslipidemia, smoking, depression, lower urinary tract symptoms, and pelvic surgery. Sildenafil is a highly selective inhibitor of PDE type 5 and enhances NO-mediated relaxation of human corpus cavernosum. 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