Viagra Pack-90 – Patient Information and Use in Australia
Basic Product Information
| International Nonproprietary Name (INN) | Sildenafil citrate |
|---|---|
| Common Brand Names (Australia) | Viagra, Vedafil, Silvasta |
| ATC Code | G04BE03 |
| Available Forms and Strengths | Film-coated tablets: 25 mg, 50 mg, 100 mg |
| Manufacturer | Pfizer Australia, Aspen Pharmacare Australia, others |
| Prescription Status | Prescription only (S4 - Prescription Only Medicine) |
Viagra Pack-90 refers to a pack of 90 film-coated tablets containing sildenafil citrate, a medication widely used in Australia for managing erectile dysfunction (ED). It is available by prescription from your doctor or authorised Nurse Practitioner.
Mechanism of Action
Simple Terms
Sildenafil, the active ingredient in Viagra, helps men achieve and maintain an erection by increasing blood flow to the penis when sexually aroused. It does this by relaxing blood vessels and enhancing natural processes that enable penile erection.
For Specialists
Sildenafil is a selective phosphodiesterase type 5 (PDE5) inhibitor. By inhibiting PDE5 in the corpus cavernosum, sildenafil enhances the effect of nitric oxide (NO), increasing levels of cyclic guanosine monophosphate (cGMP). This results in smooth muscle relaxation, vasodilation, and enhanced penile arterial and venous blood flow during sexual stimulation.
Pharmacokinetics
- Absorption: Rapidly absorbed, with maximum plasma concentrations reached within 30–120 minutes (average ~60 minutes) after oral dose.
- Metabolism: Metabolised mainly by hepatic enzymes CYP3A4 (major route) and CYP2C9 (minor pathway).
- Elimination: The terminal half-life is about 4 hours. Metabolites are excreted in faeces (primary) and urine.
- Duration of Action: Clinical effect usually lasts 4–6 hours, but some effect can persist up to 12 hours in certain individuals.
Use in Everyday Life and Best Practices in Australia
Viagra is a first-line oral medication for men with erectile dysfunction, including those with diabetes or cardiovascular risk factors (where appropriate and under GP supervision). The most common starting dose is 50 mg, taken approximately one hour before intended sexual activity. Dosing can be adjusted (25 mg or 100 mg) based on efficacy and tolerability.
- Only take one dose per 24 hours.
- Swallow the tablet whole with a glass of water.
- Sexual stimulation is required for the drug to work; Viagra will not cause an erection without arousal.
- Store tablets below 25°C, away from direct sunlight.
- Keep out of reach of children.
In Australia, treatment should be tailored individually following a discussion about expectations, safety, and potential lifestyle factors such as alcohol consumption or underlying medical conditions.
Dosing in the Morning vs Evening
- Evening Use: Most men choose to take Viagra in the evening, as it coincides with typical times for sexual activity. This can encourage routine and prepare for planned intimacy.
- Morning Use: May be appropriate based on couples’ needs (e.g., shift workers or for spontaneous morning intercourse). No medical disadvantage, but some men may find it less convenient due to work schedules or the potential for interacting meals (e.g., breakfast).
- Tips: Take at approximately the same time before sexual activity, and note that food may delay onset.
Taking Viagra With Food or on an Empty Stomach
- On an empty stomach: Maximum absorption and fastest onset (30–60 minutes).
- With food: A high-fat meal (e.g., English breakfast, fried foods) can delay absorption by up to one hour and reduce peak plasma levels, potentially reducing efficacy in some men.
- Best Practice: Take on an empty stomach or after a light meal for optimal effect. Avoid high-fat meals close to dosing.
- Australian Context: Foods such as large portions of eggs, bacon, sausages, and fried foods typical in some Australian diets may slow onset of action – plan accordingly.
Interaction Warnings
| Substance/Class | Interaction | Advice |
|---|---|---|
| Nitrates (e.g., glyceryl trinitrate for angina) | Severe drop in blood pressure; potentially life-threatening | CONTRAINDICATED – Never use with Viagra |
| Alpha-blockers (e.g., doxazosin) | Risk of hypotension (fainting, dizziness) | Monitor closely; separate dosing times if possible |
| Other ED medicines (e.g., tadalafil, vardenafil) | Risk of additive side effects | Do not use together |
| Strong CYP3A4 inhibitors (e.g., erythromycin, ketoconazole) | Increases sildenafil levels, higher risk of side effects | May require dose adjustment |
| Alcohol | Can increase risk of side effects (flushing, dizziness); may worsen erectile dysfunction | Limit to one or two standard drinks |
| Grapefruit juice | May increase blood levels of sildenafil | Avoid large amounts of grapefruit/grapefruit juice |
Indications
| Indication | Status (Australia) | Comment |
|---|---|---|
| Erectile Dysfunction (ED) | Approved | First-line oral therapy; PBS subsidised in specific cases (e.g., diabetes, spinal cord injury) |
| Pulmonary Arterial Hypertension | Off-label (Viagra strength/form) | Specialist supervision required; alternative brands/doses (e.g., Revatio) preferred |
| Raynaud’s Phenomenon, Female Sexual Dysfunction | Experimental/off-label | Not routinely prescribed in Australia |
Dosing According to Clinical Indications
| Population | Typical Starting Dose | Maximum Dose | Comments |
|---|---|---|---|
| Adult males (18–65) | 50 mg once, as needed, 1 hour prior to sexual activity | 100 mg once per 24h | May reduce to 25 mg if adverse effects occur |
| Elderly males (>65) | 25 mg once, as needed | 100 mg once per 24h | Start low; titrate only if well tolerated |
| Pediatric (Under 18) | Not recommended | — | Viagra not for use in this group for ED |
| Liver or severe kidney impairment | 25 mg once, as needed | Maximum as advised by doctor | Dose adjustment required; consult your specialist |
Safety Profile / Side Effects
- Very Common: Headache, flushing, nasal congestion, indigestion
- Common: Dizziness, visual disturbances (e.g., blue tinge, blurred vision), muscle pain, nausea, hot flushes
- Uncommon: Rash, nosebleed, increased heart rate, high or low blood pressure
- Rare / Serious: Priapism (prolonged erection >4 hours), sudden vision loss, allergic reaction, chest pain (seek urgent help)
- Contraindicated in: Use with nitrates or guanylate cyclase stimulators for angina, severe cardiovascular disease, recent stroke/heart attack, known hypersensitivity to sildenafil
- Warnings: Use only under supervision if you have anatomical penile deformities, severe liver, or kidney impairment
Guidelines for Proper Use (Australian Conditions)
- Consult your doctor or accredited pharmacist before starting or adjusting your dose.
- Keep all follow-up appointments for review of efficacy and side effects.
- Never take Viagra with street drugs, non-approved supplements, or alcohol in excess.
- Use protection if you are at risk of sexually transmitted infections (Viagra does not prevent STIs).
- If you develop chest pain, sudden loss of vision, or a painful erection lasting >4 hours—seek medical help immediately (dial 000).
- Inform your prescriber if you have recently undergone surgery, take other regular medicines, or have had cardiovascular conditions.
Alternative Treatment Options
- Tadalafil (Cialis, generic) – Longer duration (up to 36 hours), can be taken daily at low dose; PBS subsidised for certain medical conditions. Slower onset than sildenafil.
- Vardenafil (Levitra) – Similar onset and duration as sildenafil; may be preferred in some men with diabetes.
- Avanafil (not widely available) – Fastest onset, but limited PBS subsidy.
- Non-drug options: Vacuum erection devices, penile implants, psychosexual therapy (support available via Medicare mental health plans).
Pros and cons should be discussed with your prescribing GP or urologist. All PBS-subsidised options are listed on the Pharmaceutical Benefits Scheme (PBS) website.
Legal, Registration, and Reimbursement Status in Australia
- Therapeutic Goods Administration (TGA): Registered as a prescription medicine for erectile dysfunction.
- Prescription-Only (S4): Must be prescribed by a doctor, prescriber nurse, or authorized healthcare provider.
- PBS Reimbursement: Available for certain conditions (e.g., men with diabetes, spinal cord injury, or post-prostatectomy). Restrictions and specialist requirements may apply.
- Community Pharmacy: Not available over the counter; must be dispensed by a registered pharmacist on valid prescription.
Latest Research and Clinical Guidance (2022–2025)
- The Urology Society of Australia and New Zealand (USANZ) 2023 guideline recommends PDE5 inhibitors—like Viagra—as first-line therapy for most men with erectile dysfunction, except those with contraindications (USANZ, 2023).
- Recent research (Lancet 2024) underscores ongoing cardiovascular monitoring for men on sildenafil, especially those over 60.
- The Australian Men’s Health Forum (2024) stresses importance of integrated sexual and psychological health support, with medication as part of a holistic management strategy.
- Consensus supports regular medication review, moderate alcohol intake, and avoidance of illicit drugs to optimise safety.
References: USANZ Clinical Guideline 2023; The Lancet 2024; PBS Updates 2024.
Availability and Delivery
| Pack Size | Approx. Price (AUD) | Typical Delivery Time (working days) |
|---|---|---|
| 4 tablets | $28–$45 | 1–3 (Sydney, Melbourne, Brisbane) |
| 12 tablets | $84–$120 | 1–3 (Sydney, Melbourne, Brisbane) |
| 30 tablets | $210–$320 | 1–4 (Adelaide, Perth, Gold Coast) |
| 90 tablets (Pack-90) | $600–$900 | 2–6 (Nationwide incl. regional/rural) |
Viagra Pack-90 is typically offered by selected online and community pharmacies. Delivery times may vary, with faster times in metro regions and longer times for rural or remote areas. Secure, discreet packaging is standard.
Frequently Asked Questions (FAQ)
- Can I drink alcohol while taking Viagra?
You may have a small amount of alcohol (1–2 standard drinks), but excessive drinking can increase the risk of side effects and reduce the effectiveness of Viagra. Avoid binge drinking before using this medicine. - How quickly does Viagra work, and how long will the effects last?
Viagra usually takes effect within 30–60 minutes (faster on an empty stomach) and lasts for around 4–6 hours. - Do I need to take Viagra every day?
No, Viagra is taken only as needed before sexual activity, not on a daily schedule, unless directed otherwise by your doctor. - Can I take Viagra with other medicines?
Some medicines (especially nitrates, some blood pressure tablets, and certain antibiotics or antifungals) can interact with Viagra. Always inform your GP and pharmacist of all current medicines before starting Viagra. - Is Viagra safe for older men?
Many older men use Viagra safely with medical supervision. Lower starting doses are often recommended. Always discuss your full medical history with your GP before use.
This information is intended as a general guide and does not replace individual medical advice. Speak to your doctor or pharmacist for advice specific to your health and circumstances.
