However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work. Those with a history of blood pressure or heart issues, hormonal imbalances, mental health issues, and diabetes should consult their doctor before trying PDE5 inhibitors. Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient. People with heart conditions should never take ED medications without consulting a doctor. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. You can see an in-person provider or speak with a doctor virtually. Often they are combined with various automatisms – repetitive movements that can be a continuation of actions begun before an attack or occur de novo.Oral medicines for ED usually work well and cause few side effects. The four main medicines taken by mouth for erectile dysfunction are: Avanafil (Stendra). . Branded Viagra: $90 per 25 mg, 50 mg, or mg pill; Generic Cialis (tadalafil): $11 per 5 mg pill, Without a membership, each consultation costs between $50 and $60 (on average). $ per month + prescription cost after that: Yes: Sildenafil, tadalafil. The dose can be increased to mg or decreased to 25mg depending on its effect. Take sildenafil up to 4 hours before you want to have sex. For sildenafil to work properly, you’ll need to be sexually excited. Dosage and strength for pulmonary hypertension. Sildenafil tablets for pulmonary hypertension come in 10mg and 20mg strengths.