I had a fellow in my office last week, let's call him Mike. Mike's in his late forties, dealing with the early onset of some erectile difficulties – enough to cause him distress and affect his confidence, but not a complete shutdown. We’d had a good chat, done the necessary workup to rule out glaring underlying issues like uncontrolled diabetes or severe vascular disease, and I’d written him a prescription for generic sildenafil, 50mg, to be taken as needed. Standard, sensible stuff.
He comes back for his follow-up a month or so later, and he’s got this slightly mischievous glint in his eye. "Doc," he says, "that sildenafil worked pretty well. But then I was online, and I saw this stuff called Fildena. Comes in all sorts of colours and strengths. What's the deal with that? Is it better?" He even had a picture on his phone of a vibrant purple triangular pill – Fildena 100mg, if memory serves.
Ah, Fildena. Another prominent player in the online sildenafil marketplace, manufactured by Fortune Healthcare in India. Like its many counterparts (Kamagra, Cenforce, etc.), Fildena is essentially a branded generic of sildenafil citrate. It's marketed heavily on the internet, often with flashy packaging and the promise of potent effects, and yes, it comes in a veritable rainbow of colours and even different formulations like chewable tablets or gel caps. You can find Fildena in doses ranging from 25mg all the way up to "Fildena Super Active" or "Fildena XXX" (yes, really) at 100mg or even higher purported strengths, often playing on the "more is better" fallacy.
"Mike," I started, "the sildenafil I prescribed for you and the sildenafil that's supposed to be in Fildena is, chemically, the same active ingredient. The difference lies in a few key things: regulation, quality control, and the journey that pill takes to get to you."
I explained that the generic sildenafil he gets from his local pharmacy is subject to stringent regulatory oversight. We know the dose is accurate, the purity is high, and it's manufactured in facilities that meet specific standards. With Fildena, bought from an online vendor who likely sources it from overseas without local regulatory checks, those guarantees go out the window. You're trusting that the pill contains what it says it contains, in the amount it says it contains, and nothing else harmful. That’s a big leap of faith when it comes to your health.
"But it looks so… professional," Mike countered, gesturing at the slick marketing he'd seen for Fildena.
"Looking professional and being medicinally sound are two different things," I replied. "The manufacturers of these products are very good at marketing. They use appealing colours – the 'purple Viagra' or 'blue pill' association is strong. They offer high doses like Fildena 100mg or even 150mg, which might make some men think they're getting more bang for their buck, when in reality, such high doses might just increase the risk of side effects like headaches, flushing, visual disturbances, or nasal congestion, without necessarily providing a better erection than an appropriately dosed, regulated product."
We discussed why I'd started him on 50mg of sildenafil. It's a common starting dose, often effective, and allows us to see how he responds and tolerates it. If needed, we can titrate up to 100mg, but jumping straight to a high dose like that found in many Fildena products, especially from an unverified source, isn't good medical practice.
The other point with products like Fildena is the "why." Why are men seeking them out? Sometimes it's cost – though generic sildenafil through legitimate channels is now very affordable in most places. Sometimes it's the lure of not needing a prescription, bypassing a conversation with a doctor that they might find embarrassing. And sometimes, it's genuinely just curiosity, fueled by aggressive online marketing.
I reiterated to Mike that if the 50mg of prescribed sildenafil was working, there was no clinical reason to seek out something like Fildena. If it wasn't working optimally, the answer wasn't to self-medicate with a potentially dodgy online purchase, but to come back and talk to me. We could then discuss adjusting his dose of the regulated generic, or even consider if a different PDE5 inhibitor (like tadalafil or vardenafil) might suit him better.
He seemed to take it on board. The allure of the flashy Fildena had dimmed a bit once we shone a light on the regulatory realities. It’s a constant educational battle, this. Helping patients understand that when it comes to medication, "boring and regulated" is almost always better than "exciting and unregulated." Even if it doesn't come in quite as many pretty colours.
And if you want more detailed and professional information, here’s the link: https://www.imedix.com/drugs/fildena/