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Sexual health · Varna

Sildenafil in Varna, online

An EU-licensed doctor reviews your case and, if eligible, issues an electronic prescription you can collect at a pharmacy in Varna.

€35once

Consultation price. The medicine is paid at your pharmacy.

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  • Collect at any EU pharmacy
  • Full refund if not approved
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Sildenafil

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Valid across the EU

E-prescription accepted at EU pharmacies.

Local facts

Sildenafil consultations in Varna

Available toResidents of Bulgaria
LanguagesSpanish and English
Doctor replyUnder 2 hours on average
Collected atPharmacies in Bulgaria · e-prescription (PDF)
About the medicine

What it is and how it works

Sildenafil is a phosphodiesterase-5 (PDE5) inhibitor. It relaxes smooth muscle in the penile blood vessels, facilitating an erection in response to sexual stimulation. It does not cause spontaneous erections or change desire.

It's taken on demand, 30 to 60 minutes before sexual activity; high-fat meals can delay onset. The doctor prescribes the appropriate dose after reviewing your cardiovascular health, current medication and contraindications.

Who it is for

  • Adult men with erectile dysfunction; sexual stimulation is still required
  • One tablet about an hour before sex, never more than one dose in 24 hours

Safety summary

Nitrates and poppers are contraindicated: blood pressure can fall dangerously

Read the safety summary
Pricing

One consultation, one clear price

You pay for the doctor's consultation. If a prescription is issued, the medicine is paid at your own pharmacy.

  • Consultation reviewed by an EU-licensed doctor
  • Private follow-up in the in-app chat
  • Full refund if the doctor does not approve
One-off

Sexual health

One-offNo subscription€35once
  • Consultation reviewed by an EU-licensed doctor
  • Electronic prescription if approved
  • Private follow-up chat
Start consultation

Full refund if a review is not approved

FAQs

Your questions answered

Sildenafil16 questions
How does sildenafil work in erectile dysfunction?
It is a phosphodiesterase-5 (PDE5) inhibitor. It relaxes smooth muscle in the penile vessels, facilitating an erection in response to sexual stimulation. It does not cause spontaneous erections.
30 to 60 minutes before sexual activity. High-fat meals can delay onset. The doctor prescribes the appropriate dose (25, 50 or 100 mg) depending on your case and other treatments.
More questions
It must not be combined with nitrates (e.g. for angina) or with alpha-blockers without supervision. The doctor reviews your cardiovascular health, current medication and contraindications before prescribing.
Sildenafil acts fast but lasts 4–6 h; tadalafil is slower and lasts up to 36 h. The choice depends on frequency and desired spontaneity. The doctor discusses this with you.
Most men feel the effect within about half an hour. In a study that measured erections directly, the median time to an erection firm enough for sex was 25 minutes, with a range of 12 to 37 minutes. A separate study showed sildenafil could still produce an erection in response to sexual stimulation four to five hours after the dose. The blood level peaks between 30 and 120 minutes, and the medicine has a half-life of three to five hours. Sexual stimulation is needed throughout.
A heavy meal will not stop sildenafil working, but it slows it down. Taken with food, the peak blood level arrives about 60 minutes later and is roughly 29 percent lower, so the tablet takes longer to act. An empty stomach gives the fastest onset. On alcohol, sildenafil 50 mg did not add to alcohol's blood-pressure-lowering effect in healthy volunteers at blood alcohol levels around 80 mg per decilitre, but the NHS still advises against drinking too much. Avoid grapefruit juice, which can raise sildenafil levels.
In most European countries sildenafil is prescription-only, and the EU marketing authorisation for the original brand states it can only be obtained with a prescription. There are exceptions. The UK regulator reclassified a 50 mg sildenafil product from prescription-only to pharmacy medicine in November 2017, so a pharmacist can supply it after a consultation. Ireland and Poland have equivalent pharmacy products. Men with severe cardiovascular disease, liver failure, severe kidney failure or interacting medicines are excluded from that route and stay under a doctor's care.
Write to your doctor in the private chat in your account: describe what you notice and when it started. The doctor can adjust the plan, pause it or suggest another option. If you have severe symptoms such as difficulty breathing, swelling of the face or chest pain, call 112 or go to an emergency department straight away.
It depends on what you take. List every medicine, supplement and herbal product in the questionnaire, including ones you use only occasionally. The doctor checks for interactions before prescribing, and your pharmacist checks again when you collect Sildenafil.
Depending on your case, the doctor can consider a different medicine or dosing pattern, or recommend an in-person urologist, a sexual health clinic or psychosexual therapy. If a heart condition or another health issue needs checking first, the doctor tells you before prescribing anything.
If the medicine does not work as expected or causes side effects, write to your doctor in the private chat. The doctor can review the dose or the option chosen. Tell the doctor about any new health condition or new medicine before you use it again.
Yes. Hi-Doctor runs 100 % online across the EU, so if you live in Varna you can fill in the questionnaire and receive the medical review without travelling. The electronic prescription issued by the licensed doctor is valid in any EU pharmacy under Directive 2011/24/EU; outside Spain, the pharmacist dispenses the locally marketed equivalent of the same active ingredient.
Yes. All communication happens in the private chat of your account, GDPR-compliant. The doctor treats discretion as a core of the service and there is no history visible outside your consultation.
The private electronic prescription (Receta Médica Privada Electrónica) is issued by a licensed doctor in Spain. It is a PDF carrying every field required by EU Directive 2011/24/EU (patient, prescriber with country of registration, active ingredient, dose), which makes it legally recognised across all 27 EU member states. In Spanish pharmacies it is dispensed from the QR; outside Spain, the pharmacist dispenses the locally marketed equivalent of the same active ingredient.
1) Fill in an online medical questionnaire in about 4 minutes. 2) The plan is €25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth; sexual health is €35 per consultation and a skin consultation is €40. 3) An EU-licensed doctor reviews your case and, if appropriate, issues an electronic prescription. 4) Collect it at any EU pharmacy. If the review is not approved, the applicable fee is refunded in full.
The plan is €25/month for weight loss or €15/month (billed €45 every 90 days) for hair growth; a one-off sexual-health consultation is €35 and a skin consultation covering acne, rosacea, melasma and ageing skin is €40. Each includes a licensed doctor's review and an electronic prescription if approved. If the review is not approved, the applicable fee is refunded in full. Medication is paid for separately at the pharmacy at the price it sets.
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A licensed doctor reads your full questionnaire.

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Medicine information and safety

How does Sildenafil work?

Arousal releases nitric oxide. During sexual stimulation, nerves and blood vessel linings in the penis release a gas called nitric oxide. Nitric oxide switches on an enzyme, guanylate cyclase, which makes a messenger chemical called cyclic GMP inside the erectile tissue.

Cyclic GMP lets blood in. Cyclic GMP relaxes the smooth muscle in the corpus cavernosum, the two spongy columns that run the length of the penis. As that muscle relaxes, blood flows in faster than it drains away, and the penis becomes firm.

Sildenafil blocks the PDE5 enzyme. Sildenafil is a selective blocker of phosphodiesterase type 5, the enzyme that breaks cyclic GMP down. With that enzyme blocked, cyclic GMP lasts longer and the natural response to arousal is stronger. Sildenafil does nothing on its own, so sexual stimulation is still required.

How to use Sildenafil

Take it before sex. Swallow one tablet whole with a drink of water about one hour before sexual activity. The tablet does not cause an erection by itself, so you still need to feel sexually aroused for it to work.

Keep to one dose daily. Never take more than one dose in 24 hours. The usual dose is 50 mg and the maximum licensed dose is 100 mg. In volunteer studies 200 mg did not improve results but did increase side effects.

Expect it within the hour. In a study using a penile measuring device, the median time to an erection firm enough for sex was 25 minutes, with a range of 12 to 37 minutes. Effects can persist four to five hours.

Watch heavy meals. A meal slows absorption. With food, peak blood levels arrive about 60 minutes later and are roughly 29 percent lower, so the tablet may take longer to work. An empty stomach gives the fastest onset.

Go easy on alcohol. In healthy volunteers, sildenafil 50 mg did not add to the blood-pressure-lowering effect of alcohol at blood alcohol levels of about 80 mg per decilitre. The NHS still advises not drinking too much while taking it.

Skip the grapefruit juice. Swallow the tablet with water or juice, but not grapefruit juice. Grapefruit juice weakly blocks the same liver enzyme that clears sildenafil, so it can modestly raise the amount of the medicine in your blood.

Give it more than one try. Some men need to take sildenafil on several separate occasions before they get an erection good enough for sex. If several attempts do not help, or things get worse, tell the doctor rather than raising the dose yourself.

Book a medical review. Erection problems often sit alongside high blood pressure, diabetes, high cholesterol or heart disease. The product information advises every man with erectile dysfunction to see a doctor within six months to check for those underlying causes.

Common side effects

Stop and get urgent medical help if (seek medical help immediately): An erection that will not go down, especially past four hours, needs emergency treatment, Sudden loss or blurring of vision in either eye: stop and get seen, Sudden loss of hearing, with or without ringing: stop and seek help, Chest pain during or after sex: call emergency services, and take no nitrates, A seizure or fit: call emergency services, Swelling of the lips, mouth, throat or tongue, or difficulty breathing: allergic reaction, Peeling, blistering or widespread rash: possible severe skin reaction

Very common (very common (≥1/10)): Headache

Common (common (≥1/100 to <1/10)): Dizziness, A blue or otherwise altered tinge to colours you see, Blurred vision or other changes to how you see, Flushing of the face and neck, Hot flushes, A blocked or stuffy nose, Feeling sick (nausea), Indigestion

Uncommon (uncommon (≥1/1,000 to <1/100)): Runny nose, nosebleeds or sinus congestion, Feeling sleepy, or reduced sensation in the skin, Sore, red or watery eyes, or sensitivity to light, Ringing in the ears (tinnitus) or a spinning feeling (vertigo), A fast or pounding heartbeat, Raised or lowered blood pressure, Vomiting, reflux, upper tummy pain or a dry mouth, Skin rash, muscle aches, pain in an arm or leg, or tiredness

Rare (rare (≥1/10,000 to <1/1,000)): Non-arteritic anterior ischaemic optic neuropathy (NAION), a sudden loss of vision, Blockage or bleeding in the blood vessels of the retina, glaucoma or double vision, Sudden deafness, Priapism, an erection that will not go down, or bleeding from the penis, Stroke, mini-stroke (TIA), fainting or a seizure, Heart attack, unstable angina, irregular heartbeat or sudden cardiac death, Severe skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis, Throat tightness, swelling inside the nose or nasal dryness

Do not use Sildenafil if

  • You take nitrates for chest pain, or any nitric oxide donor such as nicorandil or amyl nitrite ("poppers"), in any form
  • You take riociguat or another guanylate cyclase stimulator for pulmonary hypertension
  • You are already taking another PDE5 inhibitor or another erectile dysfunction treatment, because of the risk of severe low blood pressure and priapism
  • You have ever had an allergic reaction to sildenafil or to any ingredient in the tablet
  • A doctor has advised you against sexual activity, for example because of unstable angina or severe heart failure
  • You have had a stroke or a heart attack recently
  • Your blood pressure is low, below 90/50 mmHg
  • You have severe liver problems
  • You have an inherited degenerative eye disease such as retinitis pigmentosa
  • You have lost the sight in one eye because of non-arteritic anterior ischaemic optic neuropathy (NAION)

Medicines and substances that interact

  • Nitrates and nitric oxide donors (GTN spray, isosorbide, nicorandil, amyl nitrite "poppers"): Sildenafil strongly amplifies their blood-pressure-lowering effect, which can cause collapse. Contraindicated. The prescriber will not issue sildenafil while these are being used.
  • Riociguat and other guanylate cyclase stimulators: Adds to the blood-pressure fall, with no proven benefit from the combination. Contraindicated. The prescriber selects a different treatment for erection problems.
  • Alpha-blockers (doxazosin, tamsulosin, alfuzosin): Can cause dizziness or light-headedness on standing, usually within four hours of the dose. Stabilise on the alpha-blocker first, then consider starting sildenafil at 25 mg.
  • Ritonavir: Raised sildenafil blood exposure about eleven-fold in a study of healthy volunteers. Co-administration is not advised; if used at all, never above 25 mg in 48 hours.
  • Other CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin, cimetidine, saquinavir): Slow sildenafil clearance; erythromycin raised exposure by 182 percent, cimetidine by 56 percent. The prescriber considers a 25 mg starting dose.
  • Strong CYP3A4 inducers (rifampicin, bosentan): Lower sildenafil levels; bosentan cut exposure by about 63 percent in volunteers. The prescriber may adjust the dose or reconsider the choice of medicine.
  • Sacubitril/valsartan: Blood pressure fell significantly more than with sacubitril/valsartan alone in patients with hypertension. Caution when starting sildenafil; the prescriber checks blood pressure.
  • Grapefruit juice: A weak inhibitor of gut-wall CYP3A4 that can modestly raise sildenafil blood levels. Take the tablet with water rather than grapefruit juice.

References

  1. Viagra 50 mg film-coated tablets: Summary of Product Characteristics electronic medicines compendium (emc), 2026
  2. Viagra: EPAR product information (Annex I, Summary of Product Characteristics) European Medicines Agency, 2026
  3. Viagra: European public assessment report overview European Medicines Agency, 2026
  4. Goldstein I, et al. Oral sildenafil in the treatment of erectile dysfunction (Sildenafil Study Group) New England Journal of Medicine, 1998
  5. EAU Guidelines on Sexual and Reproductive Health, 2025 edition (PDE5 inhibitors first-line for erectile dysfunction, strong rating) European Association of Urology, 2025
  6. Sildenafil (Viagra): NHS medicines A to Z NHS, 2022
  7. Viagra Connect 50 mg film-coated tablets: Summary of Product Characteristics electronic medicines compendium (emc), 2026
  8. MHRA reclassifies Viagra Connect tablets to a Pharmacy medicine Medicines and Healthcare products Regulatory Agency (GOV.UK), 2017
  9. Cialis 20 mg film-coated tablets (tadalafil): Summary of Product Characteristics electronic medicines compendium (emc), 2026
  10. Vardenafil 20 mg film-coated tablets: Summary of Product Characteristics electronic medicines compendium (emc), 2025
  11. Spedra 100 mg tablets (avanafil): Summary of Product Characteristics electronic medicines compendium (emc), 2024
  12. CIMA: sildenafil records, prescription condition "Medicamento sujeto a prescripción médica" Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), 2026
  13. Sozialgesetzbuch V, §34: medicines excluded from statutory provision, naming erectile dysfunction treatment Bundesministerium der Justiz (gesetze-im-internet.de), 2026
  14. VIAGRA 50 mg, comprimé pelliculé: liste I, "Prix libre, médicament non remboursable" Base de données publique des médicaments (ANSM / Ministère de la Santé), 2026
  15. Bollettino d'Informazione sui Farmaci: sildenafil (Viagra) non-repeatable prescription, all packs in fascia C Agenzia Italiana del Farmaco (AIFA), 2000
  16. Medicijnkosten: sildenafil 50 mg tablets listed as "niet vergoed" Zorginstituut Nederland, 2026
  17. Relatório de avaliação do pedido de comparticipação: Sildenafil Sandoz, indeferimento 19/07/2010 INFARMED, I.P., 2010
  18. Viagra Connect 50 mg film-coated tablet: authorised medicine record and pharmacy supply materials Health Products Regulatory Authority (HPRA), Ireland, 2026
  19. Rejestr Produktów Leczniczych: sildenafil products including Maxigra Go 25 mg and Viagra Connect Max 50 mg Centrum e-Zdrowia, Poland, 2026
  20. Die Grenzen des Krankenbehandlungsanspruchs am Beispiel der erektilen Dysfunktion (potency medicines on the negative list since April 2004) Dachverband der österreichischen Sozialversicherungsträger, 2026
  21. Gecommentarieerd Geneesmiddelenrepertorium: sildenafil oral, PDE5 inhibitors for erectile dysfunction Belgisch Centrum voor Farmacotherapeutische Informatie (BCFI/CBIP), 2026

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All content on this page has been medically reviewed by: Dr. Alejandro Infante, General medicine, on 27 July 2026. Registration: 080869277 View profile

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