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If you order before our daily cut off time, you can receive your order the next day. If you are experiencing side effects which are bothering you, you should reduce the dose to 25mg. Dr. Kinnari Kennedy, MD is a urology specialist in Dulles, VA. She is affiliated with medical facilities Reston Hospital Center and Stonesprings Hospital Center.

Sildenafil and other PDE5 inhibitors should never be taken with nitrates. In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. Sildenafil is a potent and selective inhibitor of cGMP-specific phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.

The usual recommended dose is 50&nbsp