Sildenafil (Viagra)
Libido · PDE5 inhibitor
Tier A
What this is
Generic since 2017 — dramatic price drop. Fang 2021 and others show observational Alzheimer risk reduction in PDE5i users — mechanism via cerebral blood flow and Aβ modulation plausible. Take food separation seriously — high-fat meal delays absorption >1 hour. Do not combine with any nitrate.
Mechanism
Selective phosphodiesterase-5 inhibitor; prevents cGMP breakdown → sustained smooth muscle relaxation in corpus cavernosum → erection (upon sexual stimulation, not spontaneous); also pulmonary vasodilation
Dose & route
25-100 mg PO 30-60 min before activity; take on empty stomach for faster onset
Citations
- https://pubmed.ncbi.nlm.nih.gov/34811549/
- https://pubmed.ncbi.nlm.nih.gov/9462139/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8681697/
Links go to the source. If a link is dead or you want something re-checked, let me know.
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.