What should you expect the first time you take Viagra? An erection that comes more easily when you are aroused, not one that appears on its own. Take the tablet about an hour before sex: it usually starts working in 30 to 60 minutes and its effects can last for up to 4 hours (healthdirect). A mild headache or flushing is common, and one tablet is not the final verdict: men are advised to judge it over five to six occasions (Australian Prescriber).
How much Viagra should you take the first time?
The dose your doctor prescribes, usually 50 mg. The starting dose is 50 mg, which may later be raised to a maximum of 100 mg or lowered to 25 mg depending on how well it works and on side effects (EMA), and it is one tablet a day at most (Viagra CMI). How the strengths compare is in what is the difference between 50 mg and 100 mg Viagra?
When should you take it, and how long does it take to work?
About one hour before sex, swallowed whole with a full glass of water. It "normally takes between half an hour and one hour" to start working, and it can take longer after a heavy meal (Viagra CMI). So give it the full hour the first time: "not waiting long enough for them to work" is one of the reasons Australian Prescriber gives for a poor response. More on the wait in how long to wait for Viagra to kick in.
What does it feel like when Viagra works?
Much like a normal erection, only easier to get and to keep. Viagra relaxes the blood vessels in the penis when you are sexually excited, "allowing you to get an erection in the natural way"; it "will not increase your sex drive" (Viagra CMI), and "Sexual stimulation is still needed" (healthdirect). The effects last up to 4 hours, but "the actual erection will only last for a normal period of time" (healthdirect). Why arousal matters is explained in how PDE5 inhibitors work.
Which side effects are normal the first time?
Headache, indigestion or heartburn, dizziness, back pain, muscle aches, flushed skin and a stuffy or runny nose are the most common, and "These side effects usually go away after a few hours" (healthdirect). If you feel dizzy or your vision changes, do not drive (Viagra CMI). More on heartburn and indigestion with ED tablets.
A few effects need help straight away: sudden vision problems, loss of hearing, or "an erection that persists for more than 4 hours" (Viagra CMI), for which you go to the nearest hospital emergency department (healthdirect). For chest pain during or after sex, get into a semi-sitting position, try to relax, seek medical help, and do not use nitrates to treat it (EMA package leaflet).
What if Viagra does not work the first time?
Do not take a second tablet; try again another day. Men should take it as prescribed "on five to six occasions, to assess the treatment effect", and the response can be blunted by "anxiety, alcohol, excessive expectations of how these drugs should work, and not waiting long enough for them to work" (Australian Prescriber). One tablet in 24 hours is the limit (healthdirect); see can I take Viagra twice in one day? If it keeps failing, tell your doctor: "your doctor may decide that you need a higher dose" (Viagra CMI), or a different treatment (healthdirect). Other reasons it can fail are in why Viagra may not work.
Should you eat or drink before your first dose?
Keep it light. Viagra works with or without food, but "You may find VIAGRA takes longer to work if you take it with a heavy meal", and "Drinking alcohol can temporarily impair the ability to get an erection" (Viagra CMI). Australian Prescriber's advice: "Large meals and alcohol should be avoided before a dose". More in empty stomach or after eating? and foods to avoid with Viagra.
Who should not take Viagra?
Anyone who uses nitrates, the medicines for angina, or "poppers" (amyl nitrite): the combination may cause a severe drop in blood pressure that is hard to treat. The same goes for riociguat, and the leaflet also rules Viagra out after a heart attack or stroke in the last 6 months, with severe liver problems, or with blood pressure that is unusually high or low (Viagra CMI). In Australia it is a prescription medicine for erectile dysfunction, and a doctor assesses you first (healthdirect), including whether your heart is fit enough for sex (Viagra CMI). See how to get a prescription for Viagra.
The short answer
Take your prescribed dose, usually 50 mg, about an hour before sex, and expect it to help only when you are aroused, for up to 4 hours. Headache and flushing are common and usually pass within hours. If the first tablet disappoints, do not take another that day; try again, and tell your doctor if it keeps failing. Never with nitrates. More on doses is in our dosage guide.
