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Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis. Viagra inhibits an enzyme called phosphodiesterase-5 (PDE5) which destroys the cGMP. Thus, Viagra prevents the destruction of cGMP and allows cGMP to accumulate and persist longer.

" Neurology 59 (2002): 293-4. Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies. " Urology 53 (1999): 1011-8. Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED "Side-effect profile of sildenafil citrate (Viagra) in clinical practice.

This list is not complete. Other drugs may interact with sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. More about Viagra (sildenafil) Consumer resources.]