Silvitra 120
✅ Dual action formula
✅ Treats erectile dysfunction
✅ Enhances sexual performance
✅ Increases stamina
✅ Improves satisfaction
Silvitra contains Sildenafil & Vardenafil.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Silvitra 120?
Silvitra 120 contains sildenafil 100 mg + vardenafil 20 mg and is used for erectile dysfunction (for men unresponsive to single-agent PDE5 inhibitors). Available in sildenafil 100 mg + vardenafil 20 mg. Clinical effect lasts around 4–5 hours. Manufactured by RSM Enterprises.
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Silvitra 120 is an unusual dual-PDE5 tablet combining sildenafil 100 mg and vardenafil 20 mg. Both are PDE5 inhibitors — and clinically, PDE5 inhibitors are not normally combined. The rationale for this product is to target men who have been inadequately responsive to monotherapy with either drug alone, by pooling the distinct receptor-binding profiles of the two molecules.
Manufactured by RSM Enterprises, Silvitra 120 should be used only under medical supervision because of the amplified cardiovascular and side-effect load of combining two PDE5 inhibitors.
What Is Silvitra 120?
Silvitra 120 contains:
- Sildenafil 100 mg — the classic short-acting PDE5 inhibitor; ~4-hour half-life
- Vardenafil 20 mg — a potent PDE5 inhibitor with faster onset and robust diabetic-ED data
The two drugs bind PDE5 with slightly different kinetics, and combining them may rescue response in men who are incomplete responders to either drug alone. This is not a first-line option — it is a salvage approach for hard-to-treat ED.
How Does Silvitra 120 Work?
Both components act via the same cGMP pathway:
- Sexual stimulation releases nitric oxide in penile tissue
- Nitric oxide activates guanylate cyclase, raising cyclic GMP
- cGMP relaxes smooth muscle, increasing arterial inflow
- Both sildenafil and vardenafil block PDE5, prolonging cGMP action
The combination provides additive PDE5 blockade — plus each molecule’s independent receptor-binding quirks. Onset is 25–60 minutes, clinical window 4–5 hours.
Warning: because two PDE5 inhibitors are stacked, side-effect risk is amplified — headache, flushing, blood-pressure drop, and priapism risk all rise. Use only with close medical oversight.
Uses and Indications
- Erectile dysfunction unresponsive to single-agent PDE5 therapy — the primary and intended use
- Not recommended as first-line treatment
Silvitra 120 Dosage and Administration
| Scenario | Recommended Approach | Notes |
|---|---|---|
| Standard dose | 1 tablet (sildenafil 100 + vardenafil 20) on-demand | 30–60 min before activity; max 1 tablet per 24 h |
| First-time use | Consider halving the tablet if scored | Due to dual-drug side-effect risk |
| Elderly (65+) | Not recommended | Amplified side-effect risk |
| Hepatic or renal impairment | Not recommended | Use single-agent lower-dose alternative |
| Maximum | 1 tablet per 24 hours | Do not combine with any other PDE5 |
How to Take Silvitra 120 Properly
- Swallow whole with water, ideally on an empty stomach (fatty meals slow absorption of both components)
- Allow 30–60 min before intended activity
- Do not exceed one tablet per 24 hours
- Do not combine with any other PDE5 inhibitor
- Limit alcohol strictly — combined vasodilation risk
Side Effects of Silvitra 120
Side effects are the sum of both components — and often more intense.
| Severity | Side Effect |
|---|---|
| Common | Headache (often more intense than monotherapy), flushing, nasal congestion, dyspepsia, back pain |
| Uncommon | Visual disturbance, dizziness, orthostatic hypotension, palpitations |
| Rare | Priapism (elevated risk with dual PDE5), sudden vision loss (NAION), sudden hearing loss |
Priapism warning: dual PDE5 blockade carries a meaningfully higher priapism risk than monotherapy. An erection lasting more than 4 hours is a medical emergency — seek urgent care.
Warnings and Precautions
- Cardiovascular fitness for sex — sexual activity places cardiac demand on the heart. Men with active angina, recent MI (within 90 days), uncontrolled arrhythmia, or severe heart failure should have a cardiac assessment before starting a PDE5 inhibitor
- Blood pressure — PDE5 inhibitors cause mild, transient reductions in BP; use with caution if taking multiple antihypertensives
- Priapism — higher risk in men with sickle-cell disease, multiple myeloma, or leukaemia; seek urgent care if an erection lasts more than 4 hours
- Vision — discontinue and seek review if sudden visual changes occur; rare cases of non-arteritic anterior ischaemic optic neuropathy (NAION) have been reported
- Hearing — rare reports of sudden sensorineural hearing loss — stop and consult a doctor if affected
- Alcohol — significant alcohol intake combined with any PDE5 inhibitor can compound dizziness, headache, and low blood pressure
- Grapefruit juice — inhibits CYP3A4 and can raise blood levels
Contraindications — Who Should NOT Take This Medication
- Concurrent use of any nitrate — GTN, isosorbide mono/dinitrate, nicorandil, amyl nitrite (“poppers”)
- Concurrent use of guanylate cyclase stimulators such as riociguat
- Recent heart attack (within 90 days), unstable angina, or angina during intercourse
- NYHA Class II or greater heart failure within the last 6 months
- Uncontrolled arrhythmia, hypotension (BP <90/50) or uncontrolled hypertension (BP >170/100)
- Stroke within the last 6 months
- Known non-arteritic anterior ischaemic optic neuropathy (NAION) in one or both eyes
- Severe hepatic impairment (Child-Pugh C)
- Hypersensitivity to the active ingredient or any excipient
Drug Interactions
| Drug / Class | Interaction |
|---|---|
| Nitrates (GTN, ISMN, ISDN, amyl nitrite/”poppers”) | Absolute contraindication — severe, potentially fatal hypotension |
| Alpha-blockers (doxazosin, tamsulosin, alfuzosin) | Additive blood-pressure lowering — stabilise alpha-blocker dose first, start at lowest PDE5 dose |
| CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, clarithromycin) | Raise PDE5 plasma levels — reduce dose or avoid combination |
| CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John’s wort) | Lower PDE5 plasma levels — efficacy may be reduced |
| Riociguat and other sGC stimulators | Contraindicated — severe hypotension risk |
| Other PDE5 inhibitors | Do not combine — additive side effects without extra efficacy |
| Antihypertensives | Small additive BP reduction — usually clinically insignificant |
| Grapefruit juice | Inhibits CYP3A4 — avoid large or regular intake |
Always share a full list of your current medications, including over-the-counter products, recreational drugs, and herbal supplements, with your prescriber before starting this medication.
What to Do in Case of Overdose
Symptoms of a PDE5 overdose include severe headache, marked hypotension, dizziness, back or muscle pain, and prolonged erection. Management is supportive, with fluid resuscitation and cardiac monitoring. Contact your local poisons service or emergency department immediately if an overdose is suspected.
Storage Instructions
- Store below 30 °C in a dry place, away from direct sunlight
- Keep in the original blister packaging until use
- Keep out of reach of children and pets
- Do not use after the expiry date printed on the pack
- Dispose of unused tablets via a pharmacy take-back scheme where available
Related Alternatives on MedsBase
Looking for related ED or sexual-health treatment options?
- Modula — tadalafil 5 mg, ideal for once-daily low-dose therapy
- Vidalista — Centurion Labs tadalafil, 2.5 to 80 mg
- Tadacip — Cipla tadalafil 20 mg
- Megalis — Macleods tadalafil 10 mg / 20 mg
- Suhagra — Cipla sildenafil 25/50/100 mg
- Browse all Erectile Dysfunction treatments →
Frequently Asked Questions
Why would anyone combine two PDE5 inhibitors?
Dual PDE5 therapy is a salvage approach for men who have been incomplete responders to single-agent treatment. The two molecules have slightly different receptor-binding profiles, and combining them can rescue response. It is not a first-line option.
Is Silvitra 120 safe?
Only under medical supervision. Stacking two PDE5 inhibitors amplifies cardiovascular, visual, and priapism risks. Do not use this product if you have not already trialled single-agent PDE5 therapy with guidance.
How long does Silvitra 120 last?
About 4–5 hours — limited by vardenafil’s half-life. Sildenafil contributes a similar window.
Who should NOT take Silvitra 120?
First-line ED patients who haven’t tried monotherapy. Men over 65. Anyone with heart disease, hepatic or renal impairment, or on nitrates. Anyone taking another PDE5 inhibitor or CYP3A4-inhibiting drug.
What if Silvitra 120 causes a bad headache?
Headache is much more common with dual PDE5 than monotherapy. If it persists or is severe, switch to single-agent therapy — either sildenafil (Suhagra, Malegra) or vardenafil (Zhewitra) at a standard dose.
Is there a simpler alternative?
For most men: yes. Try tadalafil or avanafil as single-agent options before resorting to dual PDE5. These work in many sildenafil or vardenafil non-responders.
Can I drink alcohol with Silvitra 120?
Strictly limit alcohol. Dual PDE5 amplifies vasodilation; alcohol compounds the risk of dizziness, fainting, and severe headache.
Does Silvitra 120 work for diabetic ED?
Possibly — the vardenafil component has strong diabetic-ED data. However, a single-agent vardenafil trial should precede combination therapy.
Can I take Silvitra 120 daily?
No — on-demand only, max once per 24 hours. For daily dosing, tadalafil 5 mg (Modula) is the only licensed option.
What if Silvitra 120 doesn’t work?
If dual PDE5 fails, specialist urology referral is the next step. Options beyond oral therapy include intracavernosal injections (alprostadil), vacuum erection devices, or penile implants.
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