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The mean absolute oral bioavailability is 41% (range 25-63%). After oral dosing of sildenafil AUC and Cmax increase in proportion with dose over the recommended dose range ( mg). No relevant adverse effects were found in reproduction studies in rats and rabbits following oral administration of sildenafil. Cimetidine (800 mg), a cytochrome P450 inhibitor and non-specific CYP3A4 inhibitor, caused a 56% increase in plasma sildenafil concentrations when co-administered with sildenafil (50 mg) to healthy volunteers. Since sildenafil clearance is reduced in patients with hepatic impairment (e.g. cirrhosis) a 25 mg dose should be considered. Based on efficacy and tolerability, the dose may be increased step-wise to 50 mg up to 100 mg as necessary.

Viagra is best taken on an empty stomach one hour before sex. Eating food directly before taking Viagra will delay its absorption. This can delay the onset of action and reduce the effectiveness of the drug. Swallow the tablet whole with a glass of water, and if you have consumed a heavy meal, wait a couple of hours. You may be disappointed that Viagra hasn’t worked the first time but try to remain patient. Give yourself time to become more comfortable and mentally adjust to the idea of taking a pill before sex.

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