Sildenafil (Viagra) Treatment

Our sildenafil is the same active ingredient as Viagra — the PDE5 inhibitor sildenafil citrate. The difference is in the formulation and delivery. We offer custom-compounded sublingual troches that dissolve under the tongue, bypassing the digestive system for faster onset (often 15-20 minutes versus 30-60 minutes for oral tablets). We can also combine sildenafil with complementary ingredients like oxytocin, testosterone, or sermorelin in a single troche — something a standard pharmacy cannot do.

Sildenafil typically lasts 4 to 6 hours after administration. The peak plasma concentration occurs within 30 to 120 minutes depending on the delivery method (sublingual troches tend toward the faster end). During this window, the medication enhances your ability to achieve and maintain an erection in response to sexual stimulation. Sildenafil does not cause a continuous erection — arousal is still required.

Sildenafil is typically prescribed as an on-demand medication rather than for daily use, due to its shorter duration of action (4-6 hours). If you prefer daily readiness without planning around a dose, tadalafil is usually the better option — it is FDA-approved for daily low-dose use and provides a 36-hour window. However, some patients do use sildenafil regularly, and we will design a dosing strategy that fits your lifestyle and sexual activity patterns.

The most common side effects are headache, facial flushing, nasal congestion, and mild indigestion — all caused by the vasodilating effects of the medication. Sildenafil can also cause a temporary blue-green tint to vision in some patients. These effects are typically mild and temporary. Sildenafil is contraindicated with nitrate medications (nitroglycerin, isosorbide) due to the risk of dangerous blood pressure drops. Always inform your provider of all medications you take.

Both are PDE5 inhibitors that work through the same mechanism — blocking the enzyme that breaks down cGMP to allow blood flow into the erectile chambers. The key differences are duration and timing. Sildenafil works within 30-60 minutes and lasts 4-6 hours, making it ideal for planned, on-demand use. Tadalafil works within 30 minutes to 2 hours but lasts up to 36 hours, earning it the nickname 'the weekend pill.' Tadalafil is also available as a daily low-dose option. Read our detailed comparison in our blog.

Yes. Sildenafil is a prescription medication that requires a medical evaluation. At Rewind Anti-Aging, our providers assess your symptoms, cardiovascular health, current medications, and underlying causes of ED before prescribing. This ensures the medication is safe for you and that we are not masking a treatable underlying condition. All of our custom compounds are prepared by licensed compounding pharmacies meeting USP quality standards.