Sildenafil is a medication introduced to the United States a little more than a decade ago. It is the active ingredient in Viagra, the oral medication prescribed to men experiencing erectile dysfunction. Since then, Sildenafil has become a globally available medication with a growing number of uses. It is typically prescribed to treat pulmonary arterial hypertension, chronic kidney disease, liver disorders, and benign prostate hypertrophy. It also appears to offer neuroprotection in the face of neurological disorders like Alzheimer’s disease and Parkinson’s disease. But does Sildenafil work like Viagra? How does it compare to the drug that pioneered the ED pill market? Let’s take a closer look.
How Does Sildenafil Work?
Sildenafil works by inhibiting the enzyme phosphodiesterase 5 (PDE5), which breaks down cGMP in the body. Decreased levels of cGMP lead to increased levels of the vasoconstrictive chemical Nitric oxide (NO) in the blood. This, in turn, causes vasodilation — an increase in blood vessel dilation — throughout the body, resulting in increased blood flow to virtually any organ or tissue.
The mechanism of action of Sildenafil is similar to that of Viagra, which means that the two medications are functionally interchangeable. The only real difference is in the pharmacological properties of Sildenafil. Inhibiting PDE5 prevents the drug from being metabolized by the liver, resulting in significantly increased bioavailability. This unique property allows Sildenafil to be more effective in elevating cGMP and, subsequently, eliciting its vasodilatory effects.
Is Sildenafil a One-Size-Fits-All Solution?
Unlike Viagra, which is tailored for the treatment of erectile dysfunction, Sildenafil is a generalized medication that can be used to treat a variety of disorders. Its main action is not specifically on the cardiovascular system, but on the entire body. Sildenafil has been shown to improve exercise capacity and pulmonary hemodynamics (blood pressure) in patients with pulmonary arterial hypertension. This, in turn, may translate into improvements in clinical outcomes like exercise capacity and survival rates. Researchers are currently investigating whether or not Sildenafil can prevent and/or delay the onset of chronic kidney disease and even reverse it when administered early in the condition’s progression.
Because Sildenafil has such a wide range of effects, it is sometimes difficult to determine which disorders it will effectively treat. This is why doctors may prescribe the medication for several different conditions, only to find out later that it was most effective in treating one of them. Unfortunately, this is not the case with Sildenafil. The medication is known to be safe and effective when used for the intended purposes — as long as doctors and patients know how to correctly utilize it. The lack of specificity in Sildenafil’s mechanism of action hinders its effectiveness as a rescue medication in case of adverse effects from other medications. This could lead to dangerous complications if used in combination with other drugs.
Which Patients Should Avoid Sildenafil?
As we mentioned above, Sildenafil is typically used to treat a variety of disorders, but not all patients will benefit from the medication. In fact, it could be extremely dangerous for some individuals. Due to its somewhat indiscriminant mechanism of action, Sildenafil could end up treating conditions for which it was not originally designed. While this may not be a problem in the majority of cases, it could lead to adverse effects that are more serious than anticipated. Certain patients should avoid Sildenafil due to risk of toxicity or serious adverse effects. These include individuals with impaired liver or kidney function and older adults with decreased mental capacity.
For patients with any of these conditions, other treatments may be the better option. For example, patients with liver impairment should avoid Sildenafil because it is not recommended for this group. Drugs like sildenafil work by specifically interacting with the molecular target in the body (in this case, PDE5) and, as a result, have more specific effects. Because it is more effective when used for its intended purposes and has fewer side effects, sildenafil is the treatment of choice for erectile dysfunction and, in some cases, pulmonary arterial hypertension. Due to its unique properties, Sildenafil is also the drug of choice for patients with the aforementioned disorders. Despite its effectiveness and safety, Sildenafil is not without its risks. Common side effects include headache, flushing, dyspepsia, and rhinitis. Some patients may experience visual effects and/or a metallic taste in the mouth. Less frequently, Sildenafil has been associated with rare but serious side effects like liver toxicity, gastrointestinal perforation, and priapism. These side effects can be life-threatening and, as a result, make Sildenafil a medication that should be used with caution.
Similarities And Differences Between Sildenafil And Viagra
In general, Sildenafil and Viagra are quite similar, but there are a few key differences. First, Sildenafil has fewer side effects than Viagra. This is mainly because it is not metabolized by the liver and, therefore, is not associated with the significant metabolism-related effects that sometimes occur with Viagra. The second major difference between Sildenafil and Viagra is that the former is a more potent medication. This means that a smaller dose is typically required to produce the same effects. The third key difference is that Sildenafil is more cost-effective. It is a generic medication, which is cheaper to produce than Viagra. Due to its fewer side effects and greater efficacy, Sildenafil is preferred for the treatment of erectile dysfunction, although it can be used to treat other conditions as mentioned above.
How Effective Is Sildenafil?
The effectiveness of Sildenafil is, in many cases, comparable to that of Viagra. This is because the drug effectively treats erectile dysfunction and pulmonary hypertension, which are the two major diseases for which it was primarily designed. Sildenafil also appears to prevent and even reverse chronic kidney disease in some patients. This disease is caused by high blood pressure and results in damage to the blood vessels throughout the body. The end-stage disease is generally treated with dialysis or a kidney transplant. Sildenafil not only prevents and delays the onset of chronic kidney disease, but also improves the condition in patients with established disease.
The exact mechanisms by which Sildenafil prevents and treats chronic kidney disease are not fully known. It is thought to act on vasodilatory pathways like nitric oxide and prostaglandins and, in the case of those with the disease, inhibit the production of vasoconstrictive substances like endothelin-1 and angiotensin II. These substances have been shown to play a role in the progression of chronic kidney disease and have even been implicated in the disease’s etiology. By inhibiting these substances, Sildenafil may slow the progression of chronic kidney disease and, in some cases, even reverse it.
Chronic kidney disease is quite prevalent in the United States and around the world. This year, there will be 12 million new cases diagnosed and more than 400,000 patients will die from the condition. Even if you don’t have kidney disease, but you feel like you’re constantly struggling with erectile dysfunction, you may benefit from Sildenafil. If you’re looking to prevent and/or treat erectile dysfunction and/or chronic kidney disease, this is a medication worth considering.