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The overall time for onset of effect ranges from 12 to 70 minutes, with 27 minutes being the median time needed to get an erection. Within the general population, vascular insufficiency, usually caused by atherosclerosis, is by far the single biggest cause of ED. Nitric oxide dilates blood vessels, optimizing the flow of oxygen-rich blood to all the organs they supply. Combining Viagra and alcohol is ill-advised, thus, it is better to completely forgo the use of alcohol while being treated using sildenafil as well as any other PDE5 inhibitors.

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