Cobra (sildenafil) is a PDE5 inhibitor used to temporarily alleviate erectile dysfunction. The medication is a vasodilator, which improves blood flow to the penis. Improving blood flow is an effective treatment for the majority of ED, though it may not work when a physical obstruction or physical damage is causing the condition.

In simpler terms, Cobra---also known as King Cobra in some parts of the world---is essentially Viagra by a different name. It contains the same active ingredient as Viagra, though dosage strength differs to some extent; while Viagra comes in 25, 50, or 100 mg tablets, Cobra comes in 120 mg tablets. Cobra tablets can be split to form two smaller, 60 mg doses. Cobra tablets are also considerably less costly than their brand-name counterpart.

Like Viagra tablets, a Cobra tablet should be taken about 30 minutes prior to intimacy. Effects last 4 to 6 hours, depending on individual patient response. A handful of men find effects last 8 or 12 hours, though this is unusual.

Also like Viagra---and all PDE5 inhibitors---Cobra will lower blood pressure to some extent, which can be a concern for men taking antihypertension medications, who already have low blood pressure, or who take certain medications---notably nitrates, often prescribed for angina. If these are a concern, speak with a doctor before taking Cobra or any PDE5 inhibitor.

Women and young men under 18 years old should avoid this product. While PDE5 inhibitors do occasionally see use in these populations, it is nearly always at much lower doses than found in Cobra.

Taking Cobra

As mentioned above, Cobra comes in tablets of 120 mg strength. A 120 mg tablet can be split along its score line to form two 60 mg doses. Tablets or half-tablets should not be chewed; they should be swallowed whole.

Food is optional. Heavy or fatty meals are best avoided as they can interfere with absorption, slowing the onset of effects and reducing overall effects. A light snack may help reduce gastrointestinal effects, however. Alcohol is best avoided, as it can cause a dangerous drop in blood pressure.

To take Cobra:

• Take one tablet 30 minutes prior to intimacy.
• Do not exceed 120 mg in 24 hours.

Some stimulation is required to form an erection; Cobra will not produce an erection or increase desire on its own.

Men taking sildenafil for the first time, particularly elderly men or those with major medical conditions, are advised to start with a 60 mg half-tablet rather than the full 120 mg dose. Some men find 60 mg works fine, but more importantly lower doses allow patients to see if side effects develop with decreased risk of side effects being dangerously severe. If alarming side effects occur at 60 mg doses the medication should be discontinued entirely. If 60 mg does not produce a firm erection and no side effects develop, dosage may be increased to 120 mg.

The fact is some men simply don't tolerate sildenafil, or PDE5 inhibitors at all, very well. There are other options available, some of which are listed at the bottom of this page.

Potential Complications

Men with a history of the following should be sure to discuss risks and warning signs with a doctor before taking Cobra at any strength:

• Significantly low or high blood pressure
• Heart, liver or kidney problems
• Any blood cell or bleeding disorders
• Any vision or hearing disorders
• Penile implants or physical abnormalities

Men with the above may be started on very low doses of 25-30 mg, or may be told to avoid sildenafil altogether.

Similarly, if taking certain other medications, the initial dosage may be lower or the medication may need to be avoided entirely:

• Other ED treatments
• Nitrites or nitrates
• Protease inhibitors
• Alpha-blockers
• High blood pressure treatments
• Antibiotics
• Antifungal medications
• Guanylate cyclase stimulators

The above medications are concerning, but are not the only medications that can interact with Cobra. Always double-check with a doctor or pharmacist before mixing treatments.

Otherwise healthy men rarely experience side effects, and when they do occur they're typically mild. Most commonly reported are:

• Headache
• Mild muscle aches
• Mild stomach upset
• Cold-like symptoms

Though rare, sildenafil products are associated with vision impairment, including blurry vision, seeing a blue halo or tint, and light sensitivity. These symptoms typically reverse when the medication wears off. Even more rarely vision loss or hearing loss occurs; this may or may not be reversible. Stop taking sildenafil and consult a doctor if any vision or hearing symptoms develop.

Alternative Options

There are many ED treatments available on the market, all with their pros and cons. Some of the more popular options include:

• Viagra Oral Jelly, which contains sildenafil but comes in a fast-acting jelly formula. Effects are felt in about 15 minutes and last 3 or 4 hours.
• Tadalafil, better known as Cialis, is also a PDE5 inhibitor available in tablets, which work in about 30 minutes, or a jelly, which works in about 15 minutes. Effects last an impressive 24 to 36 hours.
• Vardenafil, better known as Levitra, is still another PDE5 inhibitor. Available in tablets, it starts working in about 30 minutes and effects last 4 or 5 hours.
• Alprostadil, better known as Vitaros, is a prostaglandin E1 (PGE1), so not a PDE5 inhibitor. It can be applied to the penis as a cream, a penile suppository, or by injection. It begins working in about 5 minutes and effects last 1 or 2 hours.

There are numerous other ED treatments available, many of which are sold at Kiwi Drug. Men are welcome to contact us for help finding a suitable product.