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Here at Manual, all of our medication comes from the officially accredited Manual Pharmacy. Before you buy, you will receive a consultation from one of our clinicians, who are all registered with the UK’s General Pharmaceutical Council.

Our pharmacist will prescribe you the correct dose of Sildenafil to best treat your ED. The normal dosage of Sildenafil is 50mg, and this has the desired effect for the vast majority of men who use it. It can also be taken in 25mg and 100mg forms.

When you take Sildenafil for the first time, the most important thing is to relax and enjoy some sexual stimulation. This will give the drug the best chance to kick in and help you get the firm erection you’re looking for. Learn more about first-time use of Sildenafil on our blog.

Sildenafil is the world’s most counterfeited drug – and there are many online vendors trying to pull a fast one. So if it looks like too much of a good deal, it most likely is.

Sildenafil was first brought to the UK market by global pharmaceutical giants, Pfizer, and it was only available under their brand name, Viagra. This exclusivity meant the price tag was high and many men couldn’t afford this type of legitimate ED medication.

In 2013, however, Pfizer’s patent expired, and it became legal to manufacture the drug under its generic name, Sildenafil.

Here at Manual, we provide a digital consulting service. The recommended retail price for branded Viagra Connect is equivalent to about £5 per pill. At Manual, the same Sildenafil is available for as little as £2 per tablet.

Firstly, it’s important to know that side effects are rare. However, when they do occur, the most common side effects of Sildenafil are: headaches, facial flushing, indigestion, nasal congestion, dizziness, nausea, hot flushes, vision changes (such as having a blue colour tinge, or blurred vision).

Serious side effects can become more common when Sildenafil is misused, mixed with excessive alcohol, or due to drug interactions with other medications. Although rare, Priapism (an erection that lasts for 4 hours or more) is a serious side effect that requires immediate medical attention.

Please read the patient information leaflet carefully for a full list of side effects and advice. As with any drug, if you notice any adverse effects, stop taking it and seek medical advice.

Women should never take Sildenafil, and nobody under the age of 18 – male or female. And, of course, if you don’t have erectile dysfunction, you shouldn’t use Sildenafil.

If you’ve been told by the doctor not to have sex – perhaps due to lack of fitness or a recent acute myocardial infarction (AMI) or stroke, you should also avoid Sildenafil. And generally, men who have had other heart problems needing care. These include: low blood pressure or uncontrolled high blood pressure (pulmonary arterial hypertension); unstable angina (chest pain), irregular heartbeat or palpitations (arrhythmia); valvular heart disease; cardiomyopathy; problems causing blood flow issues.

Other conditions may prohibit the use of Sildenafil, such as anatomical deformation of the penis (e.g. Peyronie's disease); loss of vision in one eye due to non-arteritic anterior ischaemic optic neuropathy (NAION) or hereditary degenerative retinal disorders like retinitis pigmentosa; severe renal impairment; any of the following: sickle cell anaemia, multiple myeloma or leukaemia, or active stomach ulcers.

And you should also confirm with your GP if you’re taking nitrates (nicorandil or other nitric oxide donors e.g. isosorbide mononitrate, isosorbide dinitrate); ‘poppers’ (e.g. amyl nitrite), or recreational stimulant drugs (e.g. cocaine, MDMA); riociguat or other guanylate cyclase stimulators; ritonavir; CYP3A4 inhibitors, e.g. saquinavir; cimetidine; itraconazole or ketoconazole; erythromycin or rifampicin; diltiazem; alpha-blockers; doxazosin or tamsulosin.

Before using Sildenafil, please read the Patient Information Leaflet supplied with your medication. This provides important information.

The Sildenafil in Viagra is one of a number of PDE5 enzyme inhibitors. Alternatives include Tadalafil (Cialis), Vardenafil (Levitra) and Avanafil (Spedra) – for which you do still need a prescription.

• Get started by selecting your desired strength, frequency, and the number of pills. If you’re unsure, get in touch with us.
• Confirm in our questionnaire that you’re over 18, you need the medicine, and you’ll be the one using it.
• Declare that you don't have a history of heart disease, Peyronie's disease, high blood pressure, stomach ulcers, or other relevant medical conditions. If you do have any of these conditions, we’ll be unable to sell you Sildenafil. Please get in touch with us about your options.
• Confirm that you’re not using medicines including nitrates, alpha-blockers, Riociguat, or poppers. 
• Enter your address and check out. You'll receive Sildenafil in a discreet package straight to your door.

We get that you might want a glass of wine or two to get in the mood. And a small amount probably won't hurt. But side effects can be serious and, at the very least, they can spoil the fun.

If Sildenafil does not work, try taking it at least a couple of hours after a meal. Fatty foods can slow down the onset of the drug, meaning you might miss optimal timings.

Remember, it's best if you take Sildenafil about an hour before sex to ensure that it’s fully absorbed.

We recommend that you try treatment eight different times before trying another ED treatment. This does not apply if you experience serious side effects, in which case you should stop immediately. 

If Sildenafil stops working, it may mean a couple of things: 

Your Sildenafil has expired. If Sildenafil passes its shelf life, it may not work as effectively.
Your body has changed. This can happen if you take Sildenafil for many years. If this is the case, try a different ED medication, like Tadalafil.
The causes of your erectile dysfunction have worsened. In some cases, the artery supplying your penis may be blocked completely.
If Sildenafil stops working, talk to a Manual clinician. We can help.