What does the mechanism paragraph actually say?
Nitric oxide is released in the corpus cavernosum during sexual stimulation. Guanylate cyclase then raises cGMP. Sildenafil blocks PDE5 so that cGMP lasts longer. It does not replace the nitric oxide step.
A quiet hour on the couch with no cue is not a failed 50 mg tablet. It is a missing first step.
Does a fasted peak replace stimulation?
No. A fasted Tmax near 60 minutes only places the plasma peak. The nitric oxide step still has to happen. Food delay numbers sit on the food scan.
Cue rule sits beside the sildenafil panel 25-100 mg card.
Does a daily habit change the cue rule?
A morning-and-night sildenafil habit is not this label. As-needed 25-100 mg still needs stimulation on the night it is used. This scan will not write another INN's daily course into the room.
Yuki Tanaka tags 'it should just happen' as a mechanism miss, not as a 100 mg indication.
Did the hardness studies skip stimulation?
No. Eight double-blind crossover studies used sexual stimulation and RigiScan hardness. Most reads sat about 60 minutes after the dose. The tablet was never tested as a spontaneous switch.
Eardley's onset and duration programs used visual sexual stimulation on a clock. Those rooms live on the hour scan and the 4-hour scan.
Does 100 mg skip the need for a cue?
No. Recommended doses have no effect in the absence of sexual stimulation. 100 mg is not a spontaneous-erection rung. Climbing to outrun a missing cue is a sloppy rating.
Step-up after a clean, cued 50 mg trial lives on the dose ladder.
Can first-night anxiety look like a dead tablet?
Yes. A new ritual plus performance pressure can look like pharmacological failure. The next home attempt with a cue and a lighter plate is the fair retest.
Do not add a second swallow the same night because the first hour was quiet. Once per day still holds. See the once-a-day scan.