Generic Viagra ( Sildenafil Citrate )

Buy Generic Viagra (Sildenafil Citrate ) without prescription in Canada

In our Canadian pharmacy, you can buy Viagra (Sildenafil Citrate) without a prescription, with delivery across Canada within 5‑14 days. Discreet and anonymous packaging.

Viagra (sildenafil citrate) is the original and most widely recognised oral treatment for erectile dysfunction (ED). It belongs to the phosphodiesterase type 5 (PDE5) inhibitor class. When combined with sexual stimulation, sildenafil works by relaxing the smooth muscles and widening the blood vessels in the penis, which increases blood flow and helps to produce and maintain a firm erection sufficient for satisfactory sexual activity. The standard therapeutic strengths available in Canada are 25 mg, 50 mg, and 100 mg; higher strengths up to 200 mg may be available internationally and are supplied by our pharmacy through the international supply chain for patients who have been prescribed a specific dose.

Usual adult dose: The recommended starting dose is 50 mg taken orally as needed, approximately 30 to 60 minutes before anticipated sexual activity. Depending on effectiveness and tolerability, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day. Doses above 100 mg (such as 120 mg, 130 mg, 150 mg, or 200 mg) are not routinely recommended and are generally used only under specialist direction for patients who have demonstrated a need for a higher dose without dose‑limiting side effects. A high‑fat meal may delay the onset of action, so taking the tablet on an empty stomach or after a light meal is best.

Dosage form: Oral tablets: 25 mg, 50 mg, 100 mg, 120 mg, 130 mg, 150 mg, and 200 mg of sildenafil citrate. The 25 mg, 50 mg, and 100 mg strengths are the standard Health Canada‑approved doses. Higher strengths are sourced internationally for personal importation.

Onset of action: The medication typically begins to work within 30 to 60 minutes after ingestion. Some men may notice an effect in as little as 15 to 20 minutes if taken on an empty stomach. Sildenafil requires sexual stimulation to produce an erection.

Duration of action: The ability to achieve an erection in response to sexual stimulation is maintained for up to 4 to 6 hours after taking a dose. The elimination half‑life of sildenafil and its active metabolite is approximately 4 hours. Sildenafil does not cause a constant erection; arousal is still required.

Alcohol recommendation: Alcohol consumption should be limited or avoided while taking Viagra. Drinking alcohol can temporarily reduce the ability to get an erection and may increase the risk of side effects such as headache, dizziness, flushing, and a drop in blood pressure. Excessive alcohol consumption may also impair the overall sexual experience.

Most common side effects: Headache (16%), facial flushing (10%), dyspepsia (indigestion, 7%), nasal congestion (4%), dizziness (3%), and visual disturbances (e.g., blue‑tinged vision, increased sensitivity to light, blurred vision; 3%). These effects are usually mild to moderate and temporary. A prolonged and painful erection lasting more than 4 hours (priapism) is a rare but serious side effect requiring immediate medical attention. Sudden vision loss and sudden hearing loss have also been reported rarely.

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General Information about Viagra (Sildenafil Citrate)

• INN (International Nonproprietary Name): Sildenafil Citrate
• Brand names available in Canada: Viagra® (Pfizer Canada Inc.) is the original brand‑name product. Generic sildenafil tablets are widely available from manufacturers including APO‑Sildenafil (Apotex Inc.), TEVA‑Sildenafil (Teva Canada Limited), Sandoz Sildenafil (Sandoz Canada Inc.), PMS‑Sildenafil (Pharmascience Inc.), and many others. Our pharmacy also supplies internationally sourced generic sildenafil tablets in higher strengths under various brand names.
• ATC code: G04BE03 (urologicals, drugs used in erectile dysfunction)
• Dosage forms and strengths: Oral tablets: 25 mg, 50 mg, 100 mg (Canadian‑approved strengths); 120 mg, 130 mg, 150 mg, and 200 mg (internationally sourced generic strengths available through our pharmacy).
• Manufacturers in Canada: Pfizer Canada Inc. (Viagra), Apotex Inc., Teva Canada Limited, Sandoz Canada Inc., Pharmascience Inc., and other generic manufacturers. Higher strengths are manufactured internationally by various pharmaceutical companies and are imported for personal use.
• Registration status in Canada: Approved by Health Canada for the 25 mg, 50 mg, and 100 mg tablets (DINs: 02230918, 02230919, 02230920, etc.). The higher strengths (120 mg to 200 mg) are not approved by Health Canada but are available internationally; our pharmacy supplies them through the international supply chain for personal importation.
• OTC / Rx classification: Prescription only (Rx). Sildenafil is a Schedule I drug in Canada and requires a valid prescription from a licensed Canadian healthcare professional. Our pharmacy fulfills this prescription for both Canadian‑approved and internationally sourced products.

Mechanism of Action and Pharmacology

Sildenafil citrate is a potent and selective inhibitor of cyclic guanosine monophosphate (cGMP)‑specific phosphodiesterase type 5 (PDE5). During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum of the penis. Nitric oxide activates the enzyme guanylate cyclase, which increases the intracellular concentration of cGMP. This leads to relaxation of the smooth muscle in the penile arteries and the corpus cavernosum, allowing blood to flow in and produce an erection. PDE5 normally breaks down cGMP, terminating the erectile response. By inhibiting PDE5, sildenafil allows cGMP to accumulate and persist, significantly enhancing and prolonging the erection in the presence of sexual stimulation. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum smooth muscle without sexual stimulation.

Sildenafil is rapidly absorbed after oral administration, with peak plasma concentrations reached within 30 to 120 minutes (median 60 minutes) under fasting conditions. The absolute bioavailability of oral sildenafil is approximately 40%. Food, particularly a high‑fat meal, delays absorption and reduces peak concentration. Sildenafil is metabolized primarily by the cytochrome P450 isoenzyme CYP3A4 (major route) and CYP2C9 (minor route), to an active N‑desmethyl metabolite that possesses approximately 50% of the pharmacologic activity of the parent drug. The elimination half‑life of sildenafil and its active metabolite is approximately 4 hours. Sildenafil is excreted as metabolites predominantly in the faeces (80%) and to a lesser extent in the urine (13%). At doses above 100 mg, the incidence of adverse effects, particularly visual disturbances, headache, and hypotension, increases in a dose‑dependent manner; therefore, higher doses are used only under careful specialist monitoring.

Indications

• Treatment of erectile dysfunction (ED), which is the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance. Sildenafil is effective for ED of various aetiologies, including organic, psychogenic, and mixed causes. It is only active when there is adequate sexual stimulation.
• Sildenafil is also approved by Health Canada for the treatment of pulmonary arterial hypertension (PAH) under the brand name Revatio® (20 mg tablet and injection); the doses used for PAH are lower and the dosing schedule is different (three times daily). Our pharmacy dispenses sildenafil only for the ED indication.
• Not indicated for use in women or in children and adolescents under 18 years of age.

Important Warnings and Precautions

At‑risk groups

• Pregnancy and breastfeeding: Viagra is not indicated for use by women. There are no adequate and well‑controlled studies of sildenafil in pregnant or breastfeeding women.
• Paediatrics (< 18 years): Sildenafil is not approved for use in children or adolescents for the treatment of erectile dysfunction.
• Elderly: No dose adjustment is required based on age alone. However, elderly patients may be more sensitive to the vasodilatory effects of sildenafil, and the risk of orthostatic hypotension may be increased. A lower starting dose of 25 mg may be considered.
• Cardiovascular disease: Sexual activity carries a degree of cardiac risk for patients with pre‑existing cardiovascular disease. Sildenafil has vasodilatory properties and can cause mild and transient decreases in blood pressure. It is contraindicated in patients with severe cardiovascular disease, including unstable angina, severe heart failure, and recent myocardial infarction or stroke (within the last 6 months).
• Use with nitrates: Sildenafil potentiates the hypotensive effects of nitrates and nitric oxide donors (e.g., nitroglycerin, isosorbide mononitrate, amyl nitrate). Concomitant use is absolutely contraindicated and can lead to a life‑threatening drop in blood pressure. Patients must be counselled not to take Viagra with any form of nitrate medication. The contraindication applies to all doses, including higher doses.
• Use with guanylate cyclase stimulators: Concomitant use of sildenafil with riociguat (a stimulator of soluble guanylate cyclase) is contraindicated, as this can also cause severe hypotension.
• Priapism: Prolonged erection (longer than 4 hours) has been reported rarely with PDE5 inhibitors. This is a medical emergency that can lead to permanent penile tissue damage and impotence. Men who experience an erection lasting more than 4 hours should seek immediate medical attention. The risk may increase with higher doses.
• Vision loss: Non‑arteritic anterior ischaemic optic neuropathy (NAION), a cause of sudden vision loss, has been reported rarely in temporal association with PDE5 inhibitor use. The risk may be increased in patients with a small cup‑to‑disc ratio, those with hypertension or diabetes, and smokers. Men who experience sudden vision loss should stop taking the drug and seek immediate medical care.
• Hearing loss: Sudden decrease or loss of hearing has been reported. Patients should discontinue sildenafil and seek prompt medical attention if this occurs.
• Renal impairment: No dose adjustment is required in mild to moderate renal impairment. In patients with severe renal impairment (creatinine clearance < 30 mL/min), a starting dose of 25 mg is recommended; higher doses should be used with extreme caution.
• Hepatic impairment: The metabolism of sildenafil is reduced in patients with hepatic impairment (e.g., cirrhosis). A starting dose of 25 mg is recommended. Higher doses should be used only with careful titration and monitoring.
• Anatomical deformation of the penis: Use with caution in patients with anatomical deformation (e.g., Peyronie’s disease, angulation, cavernosal fibrosis) or conditions predisposing to priapism (e.g., sickle cell anaemia, multiple myeloma, leukaemia).
• Allergy: Do not take Viagra if you have a known hypersensitivity to sildenafil citrate or any of the tablet’s excipients.

Driving and alcohol

Sildenafil may cause dizziness, blurred vision, or altered colour perception. Patients should be aware of how they react to the medication before driving or operating heavy machinery. Alcohol consumption should be limited, as it may impair the ability to achieve an erection, lower blood pressure, and worsen the side effects of sildenafil such as headache and dizziness. At higher doses of sildenafil, the risk of these effects is increased, and patients should exercise particular caution.

Dosage Instructions

• Standard adult dosing (25 mg, 50 mg, 100 mg): The recommended starting dose for most patients is 50 mg taken as needed, approximately one hour before sexual activity. Based on efficacy and tolerability, the dose may be increased to 100 mg or decreased to 25 mg. The maximum recommended frequency is once daily.
• Higher doses (120 mg, 130 mg, 150 mg, 200 mg): These doses are prescribed only for patients who have demonstrated an inadequate response to the 100 mg dose and who have been assessed by a specialist to tolerate the medication well. These doses should be taken as a single dose, not exceeding once daily, and only under the specific instruction of a physician. The maximum dose that may be considered in exceptional circumstances is 200 mg; doses above 200 mg are not recommended.
• Patients with renal or hepatic impairment: Start with 25 mg. Higher doses should be used with extreme caution and only after careful titration.
• Patients taking potent CYP3A4 inhibitors (e.g., ritonavir, ketoconazole, itraconazole): A starting dose of 25 mg is recommended, and the maximum dose should not exceed 25 mg in a 48‑hour period when co‑administered with ritonavir. For other strong CYP3A4 inhibitors, a maximum single dose of 25 mg is recommended.
• Patients taking alpha‑blockers: The patient should be stable on alpha‑blocker therapy before initiating sildenafil, and sildenafil should be started at the lowest dose of 25 mg. Higher doses should be used only after careful assessment.
• Administration: Swallow the tablet whole with a glass of water. For the fastest onset, take on an empty stomach or after a light meal. A high‑fat meal can significantly delay absorption. Do not take more than one dose per day. Tablets are scored and can be divided if a half‑dose is prescribed, but only under the direction of a physician.
• Missed dose: Viagra is taken as needed, not on a fixed daily schedule, so a missed dose is not applicable.

Side Effects and Contraindications

• Very common side effects (≥ 10%): Headache (16%) and flushing (10%).
• Common side effects (1‑10%): Dyspepsia (7%), nasal congestion (4%), dizziness (3%), and visual disturbances (colour tinge, increased sensitivity to light, blurred vision; 3%). At doses above 100 mg, the frequency and severity of these effects increase; headache, flushing, and visual disturbances may affect a higher proportion of patients.
• Uncommon but potentially serious side effects (more frequent with higher doses): Priapism (prolonged, painful erection lasting more than 4 hours), sudden vision loss in one or both eyes (NAION), sudden decrease or loss of hearing, and serious cardiovascular events (myocardial infarction, stroke, ventricular arrhythmia) occurring in temporal association with sexual activity and sildenafil use. Hypotension and syncope have also been reported, particularly with higher doses.
• Contraindications: Concomitant use of organic nitrates in any form, or nitric oxide donors (e.g., amyl nitrite). Concomitant use of riociguat (a guanylate cyclase stimulator). Known hypersensitivity to sildenafil citrate or any component of the product. Severe cardiovascular disease or conditions in which sexual activity is inadvisable. Recent myocardial infarction (within 6 months) or stroke. Severe hepatic impairment. The contraindications apply regardless of the dose strength.

Drug Interactions

• Nitrates and nitric oxide donors — contraindicated: The co‑administration of sildenafil with any organic nitrate or nitrite (e.g., nitroglycerin, isosorbide mononitrate, isosorbide dinitrate, amyl nitrite) is absolutely contraindicated because it can cause profound hypotension that may result in fainting, shock, or even death.
• Guanylate cyclase stimulators — contraindicated: Riociguat (e.g., Adempas®) should not be co‑administered with sildenafil due to the risk of additive hypotensive effects.
• Alpha‑blockers: Concomitant use of sildenafil and alpha‑adrenergic blocking agents (e.g., doxazosin, tamsulosin, terazosin) may lead to additive vasodilation and symptomatic hypotension. Patients on alpha‑blockers should be stabilized on the lowest dose before starting sildenafil, and sildenafil should be initiated at 25 mg. Higher doses increase this risk.
• Potent CYP3A4 inhibitors: Drugs that inhibit CYP3A4, such as ritonavir, indinavir, saquinavir, ketoconazole, itraconazole, clarithromycin, and erythromycin, can increase plasma levels of sildenafil. A lower starting dose of sildenafil (25 mg) is required, and the maximum dose should be limited. For ritonavir, sildenafil should not exceed 25 mg in 48 hours. For other strong CYP3A4 inhibitors, the maximum recommended dose is 25 mg. The use of higher sildenafil doses with these inhibitors is contraindicated unless under specialist supervision.
• Antihypertensives: Sildenafil may produce additive blood‑pressure‑lowering effects when administered with antihypertensive medications. Most patients tolerate this combination without significant adverse effects; however, those with pre‑existing hypotension should be cautious, and higher sildenafil doses may increase the risk.
• Grapefruit juice: Grapefruit juice is a moderate CYP3A4 inhibitor and may modestly increase sildenafil exposure. It should be consumed in moderation, particularly with higher sildenafil doses.
• Alcohol: Alcohol may increase the risk of headache, dizziness, and hypotension. Patients taking higher sildenafil doses should be particularly cautious about alcohol consumption.

Practical Advice

• Administration: Take Viagra exactly as prescribed by your doctor. For the standard doses (25 mg, 50 mg, 100 mg), take one tablet about one hour before you plan to have sex. If you are prescribed a higher dose (120 mg to 200 mg), follow your specialist’s instructions precisely. Do not take more than one dose per day. For a faster effect, take on an empty stomach. Swallow the tablet whole with water; if a tablet is scored, you may split it only if your doctor has instructed you to do so.
• Monitoring: No routine laboratory monitoring is required. However, men with underlying cardiovascular risk factors should have a medical evaluation before starting treatment for erectile dysfunction, especially if a dose higher than 100 mg is being considered. If you experience chest pain during sexual activity, stop immediately and seek medical attention. Monitor for any visual or hearing changes and report them to your doctor promptly.
• Storage: Store at room temperature (15‑30 °C) in a dry place, protected from moisture and heat. Keep out of the reach and sight of children. Higher‑dose tablets sourced internationally should be stored according to the manufacturer’s recommendation on the packaging.
• Lifestyle: Sildenafil is a treatment for erectile dysfunction, not a cure. Addressing underlying causes—such as quitting smoking, reducing alcohol consumption, losing weight, and controlling diabetes and hypertension—can improve erectile function. Never share your medication, and do not take Viagra with other sildenafil‑containing products or any other PDE5 inhibitor (e.g., tadalafil, vardenafil).
• Emergency information: If you develop an erection that lasts longer than 4 hours (priapism) or experience sudden vision or hearing loss, stop taking Viagra and go to the nearest emergency department immediately. If you require emergency medical care for any reason, always tell the treating physician that you are taking sildenafil, and specify the dose, particularly if you are taking a dose above 100 mg.
• Disposal: Return unused or expired tablets to a pharmacy for safe disposal. Do not flush down the toilet or discard in household waste.

Alternative Medications

• Tadalafil (Cialis®): An oral PDE5 inhibitor with a longer duration of action (up to 36 hours), available as a tablet for daily or on‑demand use. In Canada, it is available as a brand name and generic. It is less affected by food intake. The maximum approved dose is 20 mg for on‑demand use and 5 mg for daily use.
• Vardenafil (Levitra®): Another PDE5 inhibitor, available as an oral tablet (10 mg) and an orally disintegrating tablet. A generic version is available. The duration is similar to sildenafil (4‑5 hours).
• Avanafil (Stendra®): A fast‑acting PDE5 inhibitor that can start working in as little as 15 minutes. It is available as a brand‑name prescription drug in Canada. The maximum dose is 200 mg.
• Alprostadil (Caverject®): An injectable or intraurethral pellet that stimulates an erection directly by relaxing penile smooth muscle. It is used when oral PDE5 inhibitors are ineffective or contraindicated, and it does not rely on PDE5 inhibition, so it can be used in patients taking nitrates.
• Non‑pharmacological options: Vacuum erection devices (VEDs), penile implants, and psychological counselling for psychogenic ED are alternatives or adjuncts to drug therapy. Treating underlying cardiovascular risk factors is also a cornerstone of long‑term ED management.

Clinical Efficacy

Sildenafil citrate has been proven effective for the treatment of erectile dysfunction in numerous double‑blind, placebo‑controlled clinical trials. At the standard doses of 25 mg, 50 mg, and 100 mg, sildenafil significantly improved the ability to achieve and maintain erections compared with placebo. In fixed‑dose studies, the 100 mg dose improved erectile function in approximately 82% of men, compared with 24% of men on placebo. The response rate is higher for those with psychogenic ED. The 50 mg dose is effective in about 74% of men, and the 25 mg dose in about 63%. Higher doses (150 mg, 200 mg) have been studied in limited clinical settings and have been shown to produce a greater pharmacodynamic effect in some men, but are associated with a significant increase in adverse events, particularly headache, flushing, dyspepsia, and visual disturbances. These doses are not part of the standard treatment algorithm and are reserved for patients who have failed to respond to the 100 mg dose after adequate trial and who have been assessed by a specialist. Generic sildenafil, including internationally sourced products, is bioequivalent to branded Viagra. A systematic review of multiple trials concluded that sildenafil is an effective and generally well‑tolerated first‑line therapy for erectile dysfunction, with a number needed to treat (NNT) of approximately 2.

Important:

Viagra (sildenafil citrate) is a prescription medication that should be used only under the supervision of a qualified healthcare professional. The most critical safety warning is that sildenafil must never be taken with any form of organic nitrate (e.g., nitroglycerin, isosorbide mononitrate, “poppers”) as this combination can cause a severe, sudden, and potentially fatal drop in blood pressure. This contraindication applies to all doses. If you experience chest pain or an erection lasting longer than 4 hours, stop using the medication and seek emergency medical attention immediately. High doses (above 100 mg) increase the risk of adverse effects and should only be used under specialist direction. Sexual activity carries a risk to the heart in patients with pre‑existing cardiovascular disease. This product is for adult men and is not intended for use by women or children. Do not take sildenafil with other PDE5 inhibitors. If you are taking alpha‑blockers or medications that inhibit CYP3A4, you must inform your doctor; the dose of sildenafil must be reduced accordingly. Avoid grapefruit juice and limit alcohol. This information is not a substitute for professional medical advice, diagnosis, or treatment.

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