Overview and indication

Cenforce contains sildenafil, a medicine used for the treatment of erectile dysfunction (ED). By improving blood flow to the penis during sexual stimulation, it helps many men achieve and maintain an erection. Conditions relevant to this page: erectile dysfunction. Although sildenafil has been discussed in sports contexts, it is not indicated to enhance athletic performance and should not be used for that purpose.

Active ingredient: Sildenafil. Common tablet strengths marketed internationally include:

  • 25 mg
  • 200 mg
  • 50 mg
  • 100 mg
  • 120 mg
  • 150 mg
  • 130 mg

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How sildenafil works

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor. During sexual arousal, nitric oxide triggers production of cGMP in penile tissue. PDE5 breaks down cGMP; sildenafil blocks PDE5 so cGMP stays around longer, relaxing smooth muscle and opening blood vessels. The result is improved blood flow, which can enable an erection when there is sexual stimulation.

Go to dosing or safety.

Dosages and how to take

Typical starting dose for most adults: 50 mg taken once, about 0.5 to 1 hour before sexual activity. Some people respond as soon as 30 minutes after taking it; others may need up to 2 hours. Do not take more than once in 24 hours.

  • Older adults or those on interacting medicines: consider 25 mg to start.
  • Maximum commonly recommended dose: 100 mg once per day. Doses above 100 mg increase side effects and are generally not advised.
  • High-fat meals can delay the effect; taking on an empty stomach may lead to a faster onset.
  • Duration of action is typically 4 to 6 hours, with some effect possible up to 8 to 12 hours.

Note: In the United States, the FDA-approved tablet strengths for sildenafil for ED are 25 mg, 50 mg, and 100 mg. Larger strengths sometimes sold internationally (for example 120 mg, 150 mg, 200 mg) are not standard in the US and should not be used without clinician guidance.

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Precautions and contraindications

Before using sildenafil, discuss your health history and all medicines with a licensed clinician. People with significant cardiovascular disease need specific medical advice about sexual activity and ED medicines.

  • Do not use if you take any nitrate drug for chest pain or heart conditions (for example nitroglycerin, isosorbide dinitrate or mononitrate). The combination can cause a dangerous drop in blood pressure.
  • Avoid if you use riociguat for pulmonary hypertension.
  • Allergy to sildenafil or any tablet component is a contraindication.
  • Not intended for women or for children.
  • Use caution in severe liver or kidney disease; a lower dose may be appropriate.
  • If you have had vision loss due to NAION, or have certain retinal disorders, discuss risks carefully with an ophthalmologist and prescriber.

See interactions and possible side effects.

Side effects to watch for

Many users tolerate sildenafil well. Mild, short-lived effects are more common than serious ones.

  • Headache
  • Facial flushing and warmth
  • Indigestion or stomach upset
  • Nasal congestion
  • Dizziness or lightheadedness
  • Diarrhea
  • Heartburn

Seek urgent care if you have chest pain, fainting, a sudden decrease or loss of vision or hearing, an erection lasting more than 4 hours (priapism), or signs of a severe allergic reaction such as swelling of face or throat, trouble breathing, or hives.

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Important interactions

Interactions can increase side effects or reduce effectiveness. Consult your prescriber or pharmacist if unsure.

  • Nitrates (any form, including emergency nitroglycerin): absolutely avoid.
  • Alpha-blockers for the prostate or blood pressure: may cause low blood pressure; dose timing and adjustments may be needed.
  • Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin, or grapefruit juice: can raise sildenafil levels; a lower dose might be warranted.
  • HIV protease inhibitors and some hepatitis C antivirals: may require dose limits.
  • Other ED drugs or recreational nitrite products known as poppers (amyl or butyl nitrite): do not combine.
  • Excess alcohol: increases dizziness and blood pressure changes and can worsen ED.

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Missed dose and overdose

Sildenafil for ED is taken only as needed. There is no routine daily schedule for on-demand use. Do not take more than one dose in a 24-hour period.

Suspected overdose requires prompt medical attention. Symptoms may include severe dizziness, fainting, chest pain, nausea, or a fast or irregular heartbeat.

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Storage

  • Store at 20 to 25 C (68 to 77 F).
  • Protect from moisture and excessive heat; keep in the original container until use.
  • Do not store in bathrooms.
  • Keep out of reach of children and pets.
  • Dispose of unused or expired tablets according to local guidance or pharmacy take-back programs.

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Similar and alternative medicines

If sildenafil is not appropriate or does not work well for you, other options exist. Speak with a clinician to match a therapy to your health status and preferences.

  • Avanafil (brand: Stendra) - PDE5 inhibitor with a faster possible onset for some users.
  • Alprostadil (Caverject, Edex injections; MUSE urethral suppository) - non-PDE5 option that can work when PDE5 inhibitors are unsuitable.
  • Tadalafil (Cialis and generics) - longer duration of action, available as daily low-dose or on-demand dosing.
  • Vardenafil (Levitra and generics) - PDE5 inhibitor similar to sildenafil with slightly different timing and side effect profile.

Non-drug approaches such as vacuum erection devices, psychotherapy for performance anxiety, and lifestyle changes (sleep, exercise, weight management, limiting alcohol) can also help and may be combined with medicines.

See price comparisons and US legal notes.

Typical prices in USD

Prices vary widely by pharmacy, dose, quantity, and discount programs. The rough ranges below are typical cash prices in the US as of recent years and may change:

  • Generic sildenafil 25 to 100 mg: about $1 to $5 per tablet with common coupons; some pharmacies offer bulk pricing near $0.50 to $1 per 100 mg tablet.
  • Brand Viagra 25 to 100 mg: often $60 to $90 per tablet.
  • Tadalafil generics 5 to 20 mg: roughly $1 to $6 per tablet; brand Cialis is significantly higher.
  • Vardenafil generics 5 to 20 mg: commonly $2 to $10 per tablet; brand Levitra higher.
  • Avanafil (Stendra) 50 to 200 mg: approximately $20 to $60 per tablet.
  • Alprostadil injections or urethral suppositories: estimates range from $30 to $100+ per dose depending on formulation and dose.

Note on Cenforce: Cenforce-branded tablets are typically manufactured for markets outside the US and are not FDA-approved. US pharmacies generally will not dispense Cenforce. US-legal options are FDA-approved sildenafil products (brand or generic) prescribed by a US-licensed clinician.

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