Sexual HealthEstablishedHuman trials

Sildenafil

Sildenafil Citrate

Overview

Sildenafil (Viagra/Revatio) is a phosphodiesterase type 5 (PDE5) inhibitor FDA-approved for erectile dysfunction and pulmonary arterial hypertension. It is one of the best-selling pharmaceuticals in history with one of the largest clinical evidence bases of any drug — thousands of controlled trials across ED pulmonary hypertension altitude sickness and various investigational applications. While technically a small molecule rather than a peptide sildenafil is fundamental to the sexual health pharmacology landscape and serves as the benchmark against which newer sexual health peptides are compared.

Mechanism of Action

Sildenafil inhibits PDE5 — the enzyme that breaks down cyclic GMP (cGMP) in vascular smooth muscle. In the penis sexual stimulation triggers nitric oxide release from cavernous nerves which activates guanylate cyclase producing cGMP. cGMP causes smooth muscle relaxation in the corpora cavernosa increasing blood flow and producing erection. By inhibiting PDE5 sildenafil prevents cGMP breakdown prolonging and enhancing the natural erectile response to sexual stimulation. The critical distinction from bremelanotide is mechanism dependency — sildenafil requires sexual stimulation to work because it amplifies the natural NO/cGMP pathway rather than generating desire de novo. In pulmonary hypertension the same mechanism reduces pulmonary vascular resistance through PDE5 inhibition in pulmonary arterial smooth muscle.

Dosage Information

Typical Dose

25-100 mg as needed for ED. 20 mg three times daily for pulmonary hypertension.

Frequency

As needed for ED (30-60 minutes before sexual activity). TID dosing for PAH.

Administration

Oral tablet

Notes

Requires sexual stimulation to produce erection — does not cause spontaneous erections. Avoid with nitrates (absolute contraindication — dangerous hypotension). Food slows absorption. Grapefruit juice increases drug levels.

Where does Sildenafil sit?

See how this peptide compares across all 111 peptides in our database.

Evidence Score

0.73

Clinical trials
1.0035%
Literature
0.8430%
Community
0.0020%
Completeness
0.8815%
6 RCTs3 clinical trials4 reviews

Compound Data

Sildenafil structure

Molecular Formula

C22H30N6O4S

Molecular Weight

474.60 g/mol

IUPAC Name

5-[2-ethoxy-5-(4-methylpiperazin-1-yl)sulfonylphenyl]-1-methyl-3-propyl-6H-pyrazolo[4,5-d]pyrimidin-7-one

PubChem CID

135398744

Potential Side Effects

Headache (common)Facial flushing (common)Dyspepsia (common)Visual disturbances — blue tinge (uncommon)Hypotension especially with nitrates (serious — avoid combination)Priapism (rare but requires urgent treatment)

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Quick Facts

Administration
Oral tablet
Typical Dose
25-100 mg as needed for ED. 20 mg three times daily for pulmonary hypertension.
Frequency
As needed for ED (30-60 minutes before sexual activity). TID dosing for PAH.
References
0 curated + 47 from PubMed
Clinical Trials
50 registered
Evidence Score
0.7 / 100