What clock sends you in?
Longer than 4 hours. That is the patient-counseling line. Do not ice-and-wait through dawn because a review said it usually settles. Emergency departments would rather see you early.
Tell them the drug name, the milligram, the swallow time, and any second agent that can prolong erection.
What happens if you wait?
Penile tissue damage and permanent loss of potency can follow. That sentence is why the board does not treat a 5-hour erection as an inconvenience.
A late peak after a fatty plate does not change the 4-hour door. Food delay lives on the food scan.
Is a 4-hour erection a reason to drop the rung at home?
It is a reason to seek care, not a home titration note. After the event is treated, the prescriber decides whether any sildenafil rung remains. The dose ladder is not the next click during a prolonged erection.
Safety stop stays on the sildenafil panel 25-100 mg card.
What does the label call priapism?
A painful erection greater than 6 hours in duration. Prolonged erection greater than 4 hours and priapism have both been reported infrequently. The 4-hour door is when to seek help. The 6-hour line is the priapism definition on that file.
This is not the Eardley 4-hour responder clock. Duration efficacy sits on the 4-hour scan. This room is the safety stop.
What if another erection-prolonging drug is on the chart?
Adding an agent that can prolong erection raises the stakes. Name both drugs in the emergency department. Do not assume 25 mg is too small to matter next to that mix.
Trazodone and similar stories belong in the history. This scan will not write a second INN's dose. It will say bring both names.
Who is already on the caution list?
Anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease. Conditions that predispose to priapism: sickle cell anemia, multiple myeloma, or leukemia. There are no controlled clinical data on safety or efficacy in sickle cell or related anemias.
Those men need a prescriber who already knows the anatomy and the blood file before anyone trials 50 mg.