Finding the Right Viagra Dose for a 70-Year-Old Male: Dosage Info

January 13, 2023

4 mins

Erectile dysfunction (E.D.) happens to men of all ages, but risk is closely related to age. The older you get, the greater your likelihood of E.D. happening. Some estimates are that E.D. prevalence increases by 10% points for every ten years of life: 70% of men in their 70's may be affected.

Viagra® (sildenafil) is one of the most popular and effective treatments for erectile dysfunction today, but finding the right starting dose is a common question, especially for men in their 70s and up.

Despite initial questions, Viagra® is a great starting point for men new to the E.D. medication landscape, and it’s often your doctor’s first suggestion before considering other pharmaceutical options. Most men in their 70's will begin Viagra treatment at 25 or 50 mg, the lowest and middle dose available. 

Here’s what else guys in their 70’s should know about starting on Viagra.

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What is Viagra?

Viagra is a prescription medication that treats the symptoms of erectile dysfunction, helping to provide an erection firm enough for sexual intercourse. 

Researchers from the pharmaceutical company Pfizer stumbled on this drug by accident in the late 1980s. Sildenafil citrate (the active ingredient in Viagra) was being studied as a potential treatment for high blood pressure and chronic chest pain. While sildenafil wasn’t especially effective for treating these conditions, researchers noticed that participants were able to achieve and sustain erections with ease. The research focus shifted to whether or not sildenafil could be used as a treatment for erectile dysfunction. 

After years of clinical trials, Viagra® was approved by the Food and Drug Administration (FDA) as the world’s first oral treatment for erectile dysfunction. Viagra hit the market in 1998 and quickly changed the world, becoming one of the most popular and top-selling drugs of all time. 

Since then, Viagra’s patent protection and FDA exclusivity have expired, and today several pharmaceutical companies manufacture their own generic versions of sildenafil. These drugs are just as effective as the name-brand Viagra and are much cheaper.       

How Does Viagra Work?

The active ingredient in Viagra is sildenafil, which is a phosphodiesterase type 5 (PDE5) inhibitor. Cialis® (tadalafil) and Levitra® (vardenafil) are also PDE5 inhibitors. 

Erections are a result of increased blood flow into the penis, and PDE5 inhibitors all work to accelerate and increase blood flow and blood volume into the penis. 

PDE5 inhibitors work by stopping the PDE5 enzyme, a naturally-occurring molecule that usually helps to reduce blood flow. By stopping this normal function, Viagra essentially removes the braking mechanism on blood flow, allowing the penis to increase in size and become firm. During an erection, your penis holds about 7 times its usual amount of blood!

Most men will be able to get an erection in the 1-4 hours following taking the medication.

What are the Side Effects of Viagra?

Viagra is considered safe for most healthy men, but just like with any medication, side effects are possible. Taking this drug can have a significant impact on blood flow and cause unexpected side effects. A doctor can help you determine if Viagra is right for you.

Some of the most common side effects include:

• Headache

• Indigestion

• Stuffy or runny nose

• Vision changes including blurring or blue tint

• Abdominal cramps

• Back pain

It’s important to remember that the higher the dose being taken, the higher the possibility of side effects. 

Viagra can also interact with prescription drugs in a dangerous manner, particularly those used to treat high blood pressure. If you take nitrates or any other blood thinners, you shouldn’t take PDE5 inhibitors. 

What are the Different Doses of Viagra?

There are three doses of Viagra® and generic sildenafil available for men with E.D. Finding the right dose might take some time and require trial and error, but a doctor can help.

When trying to find the proper dose for a man 70 years of age or older, your doctor will likely recommend starting small and working upwards if necessary. 

25 mg Viagra dose

Older men often begin Viagra® treatment on the smallest dose of 25mg due to an increased risk of adverse effects. 

25mg is also the most common dose to begin when mild-to-moderate drug interactions are suspected, such as those with CYP3A4 inhibitors like ritonavir, saquinavir, ketoconazole, itraconazole, and erythromycin, which can increase plasma levels of Viagra. 

50 mg Viagra dose

Most healthcare providers will begin Viagra treatment with a 50mg dose, the midpoint of the Viagra dose options. If results with this dose are not satisfactory, the dose may be increased. If side effects are experienced, the dose may be lowered. 

100 mg Viagra dose

This highest dose of Viagra is often reserved for more severe cases of erectile dysfunction. It’s never advised to take more than 100mg total within 24 hours — taking more than this dose will not result in greater efficacy, even in younger men. 

In the event that a 100 mg dose isn’t enough to provide a satisfactory erection, alternative options may need to be considered.  

Alternative Options to Viagra

Although Viagra is effective for most cases of erectile dysfunction, it will not work for everyone. 

Additionally, PDE5 inhibitors can have drug interactions with medications commonly prescribed to older populations, such as medications to treat high blood pressure. 

Side effects are common for older men, especially those with liver cirrhosis, severe kidney impairment, and cardiovascular conditions like heart failure, a history of heart attack (myocardial infarction), or stroke. 

Fortunately, there are other ways to effectively treat the symptoms of erectile dysfunction.  

Vacuum pumps for E.D.

Unlike Viagra, using a vacuum pump doesn’t typically result in side effects other than mild bruising or pain when used improperly. Vacuum pumps require a bit more work than swallowing a tablet, but the process isn’t particularly complicated, and these are effective for many men.

Vacuum pumps work by mechanically drawing blood into the penis. A plastic cylinder is placed over the length of the penis, where the bottom of the cylinder creates a seal at the base of the penis. 

Air is drawn out of the cylinder with a hand pump or battery-powered pump, creating a vacuum in the cylinder.

Blood rushes into the penis as a result, and the penis becomes engorged like during a normal erection. With the penis full and erect, the cylinder is removed, and a band may be placed at the base to help keep blood in the penis during intercourse. 

The effects of a vacuum pump can last for 10-30 minutes, and it can be a fun non-pharmaceutical way to get strong erections.

Most of the issues and side effects associated with vacuum pumps are the result of problems with the constriction band. Be sure to use a size that is tight enough to maintain an erection, but not too tight that it cuts off circulation completely. You should also never wear a constriction band for longer than 30 minutes. Any longer than that can result in permanent nerve damage.

Injection Therapy for E.D.

Most of the time, injections for E.D.  will involve using a combination of the drugs alprostadil, pavarene, and phentolamine. Whatever mixture your doctor recommends, it will work similarly to the way that Viagra works: by relaxing and dilating the blood vessels to increase blood flow to the penis. 

The key difference is that these medications need to be injected directly into the penis in order to work. 

Outside of bruising and potential scarring at the site of injection, there aren’t many side effects associated with injection therapy. It might take some time to learn the proper techniques for self-injections, but with enough practice, the pain and discomfort should be minimal. 

Similar to treatment with Viagra, injection therapy can result in priapism, or a prolonged erection. Any erection lasting longer than four hours could result in permanent damage. In the event that you have an erection lasting longer than two hours after orgasm, you should seek medical attention and have it treated.   

Penile implants for E.D.

This treatment option is especially popular in older men once Viagra or alternative options have failed. 

There are a few options available, but the decision will come down to one of two choices:

• Semi-rigid implant. This procedure will involve the insertion of two silicone rods into the penis, creating a semi-permanent erection. Although the less invasive and less expensive of the two, this surgery can alter the cosmetic appearance of the penis and change some of its functions.

• Inflatable implant. For this surgery there will be several implants made in the penis and scrotum. Two cylinder bladders will be installed in the penis, a manual pump will be inserted into the scrotum, and a fluid reservoir will be placed at the base of the penis. By squeezing the pump, the fluid reservoir will empty into the two bladders and inflate the penis. This is often the more preferred surgery of the two due to its more natural appearance and function, but it is more expensive and mechanical failures could mean multiple operations may be needed.   

How Rex MD Can Help

When it comes to treating erectile dysfunction, it can get more challenging the older you get. 

At the age of 70, Viagra can be an effective treatment for E.D., and your doctor will likely start you at a 25 mg or 50 mg dose.

In the event that Viagra doesn’t work or isn’t recommended due to interactions with other medications you’re taking, plenty of other options are available.