Sildenafil is commonly used to treat erectile dysfunction (ED) by increasing blood flow to the penis during sexual stimulation. Its effects generally last for several hours, although the exact duration varies from person to person. A 200 mg dose is higher than the usual recommended maximum dose of 100 mg, so it should not be taken unless specifically prescribed by a healthcare professional.
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Sildenafil typically begins working within 30 to 60 minutes after taking it. Sexual stimulation is still necessary for an erection to occur. The medicine does not continuously produce an erection; instead, it helps the body respond more effectively to sexual stimulation during its active period.
For many people, sildenafil can remain effective for approximately 4 hours, with the strongest effect often occurring earlier in that period. This does not mean an erection should last for four hours. Rather, a person may find it easier to achieve or maintain an erection when sexually stimulated during this timeframe.
Several factors can influence how long sildenafil works. Age, metabolism, overall health, other medicines, and the presence of certain medical conditions may affect its duration. A large or high-fat meal can also delay how quickly sildenafil starts working.
Taking a higher dose does not necessarily make sildenafil last longer. Instead, higher doses can increase the likelihood or severity of side effects such as headache, flushing, indigestion, dizziness, nasal congestion, and visual disturbances.
Because 200 mg exceeds the usual recommended maximum single dose, taking this amount without medical supervision is not advisable. Never take additional sildenafil simply because the first dose does not seem to be working. Doing so can increase the risk of adverse effects.
Sildenafil should also not be taken with nitrates, such as certain medicines used for chest pain, because the combination can cause a dangerous drop in blood pressure. Certain other medicines can also interact with sildenafil.
If an erection lasts more than four hours, seek emergency medical attention immediately. Prolonged erections can damage penile tissue if they are not treated promptly.