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    Το φάρμακο αποκαθιστά την κανονική αντίδραση στη σεξουαλική διέγερση. Ο φυσιολογικός μηχανισμός, που εξασφαλίζει στύση, είναι αδύνατος χωρίς απομόνωση του μονοξειδίου του αζώτου στα σηραγγωδή σώματα κατά τη διάρκεια της σεξουαλικής διέγερσης. Το ΝΟ ενεργοποιεί ένα ειδικό ένζυμο που ονομάζεται γουανυλική κυκλάση, με αποτέλεσμα την αύξηση του επιπέδου της c GMP (κυκλικής μονοφωσφορικής γουανοσίνης), χαλάρωση των μυών του σηραγγώδους σώματος και αύξηση της ροής αίματος στα γεννητικά όργανα. Το βιάγκρα περιέχει την δραστική ουσία Σιλδεναφίλη – ένας ισχυρός εκλεκτικός αναστολέας της PDE5 (φωσφοδιεστεράσης τύπου 5), η οποία είναι υπεύθυνη για την διάσπαση της c GMP στα σηραγγώδη σώμα. Το φάρμακο δρα στα αγγεία του πέους, προκαλώντας την στύση. Στα αξιοσημείωτα, ότι η σιλδεναφίλη δεν χαλαρώνει τα σηραγγώδη σώματα άμεσα, αλλά χρησιμοποιεί την χαλαρωτική λειτουργία του οξειδίου του αζώτου. Είναι γνωστό ότι για μια χρήσιμη φαρμακολογική δράση του φαρμάκου είναι απαραίτητη η σεξουαλική διέγερση. De voorbereiding herstelt de normale reactie op seksuele opwinding. Een fysiologisch mechanisme dat zorgt voor een erectie is niet mogelijk zonder het uitstoten van stikstofmonoxide in holle lichaam tijdens seksuele stimulatie. NIET activeert een speciale enzym guanylaat cyclase, genoemd als een resultaat van het niveau van de cyclus calciumguanosine monofosfaat (c GMP) wordt verhoogd, spieren van het holle lichaam ontspannen en de doorbloeding wordt verhoogd in een penis. Sildenafil, het werkzame bestanddeel van VIAGRA, is selectieve remmer van PDE5 (fosfodiesterase type 5) die zorgt voor de ineenstorting van c GMP in het holle lichaam. De drug wordt gekenmerkt door een perifere effect op penile erectie. Het is opmerkelijk dat sildenafil ontspant de holle lichaam niet rechtstreeks, maar door middel van ontspannende functie van stikstofmonoxide. Het is bekend dat de seksuele stimulatie nodig is voor een nuttige farmacologische werking.

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