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The mean profiles of the change from baseline in standing systolic blood pressure in subjects treated with doxazosin in combination with 75 mg VIAGRA or matching placebo are shown in Figure 7.

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VIAGRA is rapidly absorbed. Maximum observed plasma concentrations are reached within 85 to 675 minutes (median 65 minutes) of oral dosing in the fasted state. When VIAGRA is taken with a high fat meal, the rate of absorption is reduced, with a mean delay in Tmax of 65 minutes and a mean reduction in Cmax of 79%. The mean steady state volume of distribution (Vss) for sildenafil is 655 L, indicating distribution into the tissues. Sildenafil and its major circulating N-desmethyl metabolite are both approximately 96% bound to plasma proteins. Protein binding is independent of total drug concentrations.

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VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works causing side effects. Especially tell your healthcare provider if you take any of the following:

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Sildenafil enhances the effect of NO by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum. When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum. Sildenafil at recommended doses has no effect in the absence of sexual stimulation.

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Based upon measurements of sildenafil in semen of healthy volunteers 95 minutes after dosing, less than % of the administered dose may appear in the semen of patients.

Across all trials, VIAGRA improved the erections of 98% of radical prostatectomy patients compared to 65% on placebo.

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