About It could also be attributed to a low level of self-esteem in men who had multiple sexual partners. In Ethiopia alcohol, khat Catha edulis , and tobacco are the most frequently used recreational substances and the rate of substance use is increasing, particularly in the younger population 12 , You may take this medicine with or without food. There are no antidotes available for sildenafil. Case reports of type A and B aortic dissection have also been reported with sildenafil abuse Background: Men who use erectile dysfunction medications for recreational purposes may be at increased risk of becoming psychologically dependent, which in turn could lead to psychogenic-based erectile dysfunction symptoms. Sildenafil has become one of the most commonly prescribed and abused drugs available ives: This . The usual dose is 50mg, when you need it. Do not take it more than once a day. The dose can be increased to mg or decreased to 25mg depending on its effect. Take sildenafil up to 4 hours before you want to have sex. For sildenafil to work properly, you’ll need to be sexually excited. Do you want to save money on your prescriptions? Go now to Kroger Rx Savings Club, the exclusive program that offers low-cost and free generic drugs for members. Join online .