How can you increase the effects of Viagra? Mostly by taking it the way the label describes: about an hour before sex, not straight after a heavy meal, with sexual arousal, without much alcohol, and at the dose that suits you, up to 100 mg. In studies of men who said Viagra had failed them, more than half had not taken it that way, and many succeeded once shown how.
How should you take Viagra to get the best effect?
About one hour before sex, swallowed whole with a full glass of water (Viagra CMI). It usually starts working in 30 to 60 minutes, and the effects can last for up to 4 hours (healthdirect), so there is no need to take it at the last minute; see how long does sildenafil take to work? Arousal is needed: sildenafil restores erections "by increasing blood flow to the penis" only with sexual stimulation (EMA product information). Chewing or crushing the tablet is not a shortcut; see does chewing or crushing Viagra make it work faster?
Do food and alcohol weaken it?
A heavy meal slows it down, and alcohol can get in the way. "You may find VIAGRA takes longer to work if you take it with a heavy meal" (Viagra CMI); with food, sildenafil peaks about an hour later and 29% lower (EMA product information). More in empty stomach or after eating? On alcohol, the leaflet says: "Drinking alcohol can temporarily impair the ability to get an erection. Do not drink large amounts of alcohol before sexual activity" (Viagra CMI); see can you drink alcohol with Viagra?
What if it has not worked the first few times?
Check how it was taken, and give it more than one or two tries. Of 100 men at a Greek clinic for whom Viagra had failed, 56 had used it wrongly: 45 had never tried the 100 mg dose, 32 had taken it on a full stomach right after a meal, 22 just before sex, and 12 did not know arousal was needed. After the dose was adjusted and the timing explained, 31 of the 100 responded (Hatzichristou et al., 2005). In a Taiwanese clinic, 60% of the men who said it had failed had tried it fewer than four times; after instruction and four 100 mg doses, 24 of 41 had successful sex (Jiann et al., 2004). In a US series of 236 men, re-education turned 41.5% into responders (Atiemo et al., 2003). None had a comparison group, but they point the same way.
Would a higher dose work better?
Up to 100 mg, it can. The usual start is 50 mg, which may be raised to 100 mg or lowered to 25 mg (EMA product information). In the fixed-dose studies, 74% of men on 50 mg and 82% on 100 mg reported better erections, against 25% on placebo; see the difference between 50 mg and 100 mg Viagra. If it is not working, tell your doctor: "your doctor may decide that you need a higher dose" (Viagra CMI). Beyond 100 mg there is nothing to gain: doses of 200 mg "did not result in increased efficacy" but brought more side effects (EMA product information), and you should not take more than one tablet in 24 hours (healthdirect); see can you take multiple Viagra pills safely?
Can exercise or losing weight make it work better?
Probably, going by a small trial. In an open-label Italian study, 60 men with erectile dysfunction took a PDE5 inhibitor, the class Viagra belongs to, alone or with at least three hours a week of aerobic exercise. After three months, erectile function was back to normal in 77.8% of the exercise group against 39.3% on the tablet alone (Maio et al., 2010). A review of six trials with 740 men found that lifestyle change and treating heart risk factors improved erectile function scores (Gupta et al., 2011). healthdirect names stopping smoking, exercise, weight loss and healthy food as ways to prevent some causes (healthdirect — Erectile dysfunction), and Healthy Male says you might get back to normal erectile function "simply by taking better care of yourself" (Healthy Male).
Can it make you last longer?
Not directly: sildenafil is licensed for erectile dysfunction, not premature ejaculation (EMA product information). The full answer is in does Viagra make you last longer in bed?, and what happens after you come in can Viagra maintain a hard-on after ejaculation?
What if it still does not work?
Go back to your doctor. ED medicines "do not work for everyone", and your doctor will first treat any condition that may be causing the problem (healthdirect — Erectile dysfunction). Other options include tadalafil, alprostadil injections, a vacuum device and counselling (healthdirect — ED medicines). Why it fails is covered in causes and solutions for Viagra not working, and whether it wears off with time in can you develop a tolerance to Viagra?
The short answer
Take Viagra about an hour before sex, not after a heavy meal, with arousal and little alcohol, and give it several tries. If it still falls short, ask your doctor about the dose: up to 100 mg, one tablet a day. More in our guide to Viagra effectiveness.
