cGMP relaxes smooth muscle in the corpus cavernosum.
Relaxed muscle allows penile arteries to widen.
Blood flows in and fills the erectile chambers.
Expanding tissue compresses the veins, trapping blood inside.
This produces and sustains a firm erection.
An enzyme called PDE-5 breaks cGMP down.
Rapid breakdown makes the erection fade too early.
Sildenafil blocks PDE-5, so cGMP stays elevated longer.
Blood flow is therefore maintained during sexual activity.
Why 120 mg does not work better:
PDE-5 enzymes in the penis become largely saturated at around 100 mg. Extra drug cannot block much more enzyme there. The additional Erex 150 mg only raises drug levels elsewhere in the body. That increases side effects without improving the erection.
Why visual side effects occur:
PDE-6 is a related enzyme found in the retina. Sildenafil affects PDE-6 alongside PDE-5. Blue-tinged and blurred vision are therefore more likely at higher doses.
Key point:
Without sexual stimulation, no nitric oxide is released. The medicine then has nothing to act on.
Take one dose 30 to 60 minutes before sexual activity.
Duration:
The effect can last up to 4 to 5 hours.
Nitrate interval:
Allow at least 24 hours after a dose before any nitrate.
Food:
A high-fat meal can delay onset by about one hour.
Lower doses:
Use a Erex Soft 100, 25 mg, 50 mg, or 100 mg product if prescribed.
Do not split:
Film-coated tablets should not be halved unless scored.
Missed dose:
Not applicable. This medicine is used only as needed.
How to Take It
Take the tablet exactly as your doctor prescribed.
Confirm with your doctor why 120 mg rather than 100 mg.
Swallow the tablet whole with a glass of water.
Do not chew, crush, or split the tablet.
Take it 30 to 60 minutes before planned sexual activity.
Take it on an empty stomach for the fastest onset.
Avoid heavy or high-fat meals before dosing.
A fatty meal can delay onset by about one hour.
Sexual stimulation is required for the medicine to work.
The effect lasts around 4 to 5 hours.
Take no more than one tablet in 24 hours.
Do not combine it with any other ED medicine.
Do not take a second tablet if the first seems weak.
Wait a full 24 hours before considering another dose.
Expect side effects to be more likely at this strength.
Tell your doctor if side effects trouble you.
Ask about reducing to 100 mg or 50 mg if they do.
Do not share your tablets with anyone else.
Precautions
Absolute Contraindications – Do Not Use If You
Take any nitrate medicine in any form.
Nitrates include glyceryl trinitrate and isosorbide mononitrate or dinitrate.
This covers nitrate sprays, patches, and sublingual tablets.
Take nicorandil, a nitrate-like anti-anginal medicine.
Use amyl nitrite or butyl nitrite recreationally (“poppers”).
Take riociguat or another guanylate cyclase stimulator.
Already take sildenafil for pulmonary arterial hypertension.
Are allergic to sildenafil or any tablet excipient.
Have had a heart attack or stroke within 6 months.
Have unstable angina or angina during sexual intercourse.
Have severe heart failure classified as NYHA class IV.
Have severe low blood pressure below 90/50 mmHg.
Have severe uncontrolled high blood pressure.
Have severe liver disease, such as decompensated cirrhosis.
Have retinitis pigmentosa or another inherited retinal disease.
Have previously lost vision from non-arteritic anterior ischaemic optic neuropathy (NAION).
Have been advised to avoid sexual activity for cardiac reasons.
Are a woman, a child, or an adolescent under 18.
Critical:
Nitrates plus sildenafil can cause a fatal drop in blood pressure. The risk is greater at higher doses. Never combine them. Allow at least 24 hours between a dose and any nitrate.
Conditions to Disclose to Your Doctor
Tell your doctor before use if you have or had:
Any heart disease, arrhythmia, or heart valve problem.
A previous heart attack, stroke, or bypass surgery.
Angina, or any prescription for nitrates in the past.
High blood pressure or low blood pressure.
Liver disease or hepatitis of any type.
Kidney disease or reduced kidney function.
Any eye disease or sudden vision loss previously.
Any visual disturbance on a previous sildenafil dose.
Hearing loss, tinnitus, or other ear disorders.
Sickle cell anaemia, leukaemia, or multiple myeloma.
Any bleeding disorder or clotting problem.
An active or recent stomach ulcer.
A penile deformity such as Peyronie’s disease or angulation.
Cavernosal fibrosis or a previous prolonged erection.
An enlarged prostate, or treatment for it.
Diabetes, especially if poorly controlled.
Low testosterone or any hormonal disorder.
Any previous failure of sildenafil at 100 mg.
Any recreational drug use, including nitrites.
Recent or planned surgery, including dental procedures.
Also disclose every medicine, supplement, and herbal product you take.
Food and Drink Precautions
Item
Effect
Recommendation
High-fat meals
Delay absorption and onset
Take on an empty stomach or after a light meal
Grapefruit and grapefruit juice
Raise sildenafil blood levels further
Avoid entirely on dosing days
Alcohol
Impairs erection and lowers blood pressure
Limit strictly; avoid binge drinking
Excess caffeine
May worsen palpitations and headache
Reduce intake around dosing
Water
No interaction
Use a full glass to swallow the tablet
Grapefruit-containing supplements
Same risk as the fruit
Check labels and avoid
Seville oranges and pomelo
May affect the same enzyme pathway
Best avoided on dosing days
Note on grapefruit:
This matters more at 120 mg. Blood levels are already above the approved maximum.
Before-Use Safety Checklist
Confirm every point below before each dose:
A doctor has specifically prescribed 120 mg for me.
I have discussed why 120 mg rather than 100 mg.
I have taken no nitrate medicine in the past 24 hours.
I have not used poppers or amyl nitrite.
I have taken no other ED medicine today.
I have not taken a dose in the last 24 hours.
I take no interacting antifungal or antibiotic.
My doctor knows all my current medicines.
My heart is fit enough for sexual activity.
I have not eaten a heavy or fatty meal.
I have avoided grapefruit juice today.
I have limited or avoided alcohol.
The blister is sealed and undamaged.
The strength on the pack matches my prescription.
The expiry date has not passed.
I know the emergency warning signs listed below.
Side Effects
Side effects are dose-related. Expect them to be more frequent at 120 mg than at 100 mg.
Side Effect
Frequency
What To Do
Headache
Common
More likely at this dose; rest and hydrate
Facial flushing or warmth
Common
Settles as the drug wears off
Indigestion or heartburn
Common
Avoid heavy or spicy meals
Blocked or runny nose
Common
Temporary; no treatment usually needed
Dizziness
Common
Sit or lie down; do not drive
Blurred or blue-tinged vision
Common
More likely at this dose; avoid driving
Light sensitivity
Common
Avoid bright screens and sunlight
Nausea
Common
Take with a light snack next time
Back pain or muscle ache
Common
Usually resolves within 24 hours
Rapid or pounding heartbeat
Less common
Rest; seek advice if it persists
Nosebleed
Less common
Apply pressure; report if repeated
Dry mouth or altered taste
Less common
Sip water regularly
Skin rash or itching
Less common
Stop use and contact your doctor
Low blood pressure symptoms
Less common
Stop use; seek medical advice
Ringing in the ears
Less common
Report to your doctor
Fainting or near-fainting
Rare
Stop use; seek medical care
Chest pain
Rare
Emergency; see section 8
Priapism (erection over 4 hours)
Rare
Emergency; see section 8
Sudden vision loss (NAION)
Rare
Emergency; stop use permanently
Sudden hearing loss or tinnitus
Rare
Emergency; stop use immediately
Seizure
Very rare
Emergency; call for help
Severe skin reaction with blistering
Very rare
Emergency; stop use immediately
If side effects trouble you at 120 mg, a lower dose is likely to work just as well. The erectile benefit does not increase above 100 mg.
Drug Interactions – Avoid With
Never combine (dangerous):
All nitrates: glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate.
Nicorandil, a nitrate-like anti-anginal medicine.
Amyl nitrite and butyl nitrite (“poppers”).
Riociguat and other soluble guanylate cyclase stimulators.
Other PDE-5 inhibitors: tadalafil, vardenafil, avanafil, udenafil.
Any other sildenafil product, including jellies and chewables.
Sildenafil brands prescribed for pulmonary hypertension.
Alprostadil or any other erectile dysfunction treatment.
Use only with medical supervision and dose adjustment:
HIV protease inhibitors: ritonavir, saquinavir, cobicistat-boosted regimens.
Cimetidine, an acid-reducing medicine.
Bosentan, used in pulmonary hypertension.
Blood pressure medicines, including amlodipine and diuretics.
Any medicine for an enlarged prostate.
These drugs raise sildenafil blood levels. Combining them with 120 mg is especially risky.
May reduce effectiveness:
Rifampicin, an antibiotic used for tuberculosis.
Carbamazepine, phenytoin, and phenobarbital.
St John’s Wort, a herbal antidepressant.
Always show your doctor a full list of your medicines.
Emergency Warning Signs
Stop the medicine and seek emergency care immediately if you experience:
An erection lasting longer than 4 hours (priapism).
A painful erection that will not subside.
Chest pain, pressure, or tightness during or after sex.
Pain spreading to the jaw, neck, or left arm.
Sudden loss of vision in one or both eyes.
Sudden decrease or loss of hearing.
Ringing in the ears with dizziness.
Fainting, collapse, or severe persistent dizziness.
Severe shortness of breath.
Swelling of the face, lips, tongue, or throat.
Widespread rash with blistering or peeling skin.
A seizure or convulsion.
Signs of stroke: sudden weakness, slurred speech, facial droop.
Tell emergency staff you have taken sildenafil. State the dose as 120 mg, which is above the standard maximum. They must not give you nitrate medicines. Untreated priapism can cause permanent erectile damage within hours.
Why Choose Erex 120 mg
This section is deliberately honest. Read all of it.
What this product offers:
Contains sildenafil citrate, the most established ED molecule.
Sildenafil has been in clinical use since 1998.
No other ED drug has a longer safety record.
Its interaction profile is the best characterised in the class.
Most doctors worldwide recognise the active ingredient.
Provides an effect window of 4 to 5 hours.
Taken only when needed, not on a daily schedule.
What this product does not offer:
It does not work better than 100 mg for most men.
It does not produce a firmer erection than 100 mg.
It does not last longer than 100 mg.
It does not act faster than lower strengths.
It does not treat premature ejaculation.
It does not enhance performance in men without ED.
What the extra 20 mg does bring:
A higher chance of headache and flushing.
A higher chance of blue-tinged or blurred vision.
Higher blood levels with no matching benefit.
Who should use a lower strength instead:
Anyone using sildenafil for the first time.
Men aged 65 and over.
Men with liver or kidney impairment.
Men taking alpha-blockers or CYP3A4 inhibitors.
Men who experienced side effects at 100 mg.
Men with existing eye disease or previous visual effects.
Bottom line:
Choose the lowest dose that works for you. For most men that is 50 mg or 100 mg. If 100 mg has failed, ask your doctor to find the reason rather than raising the dose.
Storage Instructions
Store below 30°C in a cool, dry place.
Protect tablets from direct sunlight and heat.
Keep tablets sealed in the original blister until use.
Do not store in the bathroom or near a sink.
Moisture and humidity can degrade the tablets.
Do not transfer tablets into unlabelled containers.
Keep the original pack for the drug name and strength.
Never mix tablets of different strengths in one container.
Do not freeze or refrigerate this product.
Keep it out of the sight and reach of children.
Accidental ingestion by a child is a medical emergency.
Check the expiry date printed on the pack.
Never use tablets after the expiry date.
Discard damaged, cracked, or discoloured tablets.
Dispose of unused medicine through a pharmacy take-back scheme.
Do not flush tablets or throw them in household waste.
Medical Disclaimer
This content is for information only. It is not medical advice. Erex 120 mg is a prescription-only medicine. The 120 mg strength exceeds the approved sildenafil maximum of 100 mg and is not licensed in the US, UK, or EU. Clinical evidence shows no additional erectile benefit above 100 mg, while adverse effects increase with dose. Nitrate medicines must be avoided for at least 24 hours after a dose. Use only under a qualified doctor’s supervision and direction. Always read the manufacturer’s package insert before use. Consult your doctor or pharmacist about your specific condition and dose.
Licensed pharmacist (B.Pharm) with 12+ years in clinical pharmacy and patient care. Reviews every article for evidence-based accuracy before it is published on ACTIZA Store.
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