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Some older ED medications, such as sildenafil, are slower to work if taken with food. Although sildenafil is used as a first line treatment for erectile dysfunction, there are some people that need to take caution when using it. Sildenafil treatment significantly decreases the number of TL cells at 10 but not 05 mg kg. Because alcohol can make it more difficult to achieve or maintain an erection, it s a good idea to avoid using it alongside sildenafil as it might defeat the object of the drug. There was no impairment of fertility in rats given sildenafil up to 60 mg kg day for 36 days to females and 102 days to males, a dose producing an AUC value of more than 25 times the human male AUC.