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Der Wirkstoff Sildenafil gehört zur Gruppe der PDE-5-Hemmer, die zur Behandlung einer Erektilen Dysfunktion geeignet sind. Er blockiert das Enzym Phosphodiesterase-5 und verzögert so den Abbau von zyklischem Guanin-Monophospat (cGMP). Dieser Botenstoff sorgt dafür, dass Blut in die Schwellkörper des Penis strömt und eine Erektion zustande kommt. Durch die Einnahme von Sildenafil bleibt mehr cGMP im Umlauf, die Muskelentspannung verstärkt sich und die Erektion wird verbessert. Wie alle PDE-5-Hemmer führt auch Sildenafil nicht "automatisch" zu einer Erektion, sondern ermöglicht, dass der Körper bei Erregung mit einer Erektion reagieren kann.
Die Wirkung von Sildenafil setzt etwa eine Stunde nach der Einnahme ein und hält bis zu fünf Stunden an. Innerhalb dieser Zeitspanne wird die Erektionsfähigkeit verbessert. Fettreiche Speisen können die Wirkung von Sildenafil verzögern.
Zu den häufigsten Nebenwirkungen von Sildenafil zählen nach Angaben des Herstellers Kopfschmerzen. Gelegentlich können auch Hautrötung mit Hitzegefühl (Flush), Verdauungsstörungen, Nasenverstopfung, Sehstörungen und Schwindel und auftreten.
Wie alle PDE-5-Hemmer darf auch Sildenafil von Männern mit schweren Herz-Kreislauf-Erkrankungen und Patienten, die Nitrate einnehmen, nicht angewendet werden. Zudem dürfen Menschen, die aufgrund einer Erkrankung des Sehnervs (anteriore ischämische Optikusneuropathie/ NAION) die Sehfähigkeit auf einem Auge verloren haben, keine PDE-5-Hemmer nehmen. Dasselbe gilt für Menschen, die eine erblich bedingte Erkrankung der Netzhaut aufweisen.
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