Doctor Maria Hernandez , who has an intensive research work behind her on Viagra, strongly recommends Sildenafil 200 mg pills for severe cases of erectile dysfunction. But she also cautions that this is the highest dose of the Viagra and takes it only with medical guidance. Never use the highest dose without medical guidance.To ensure safety and best results, Dr Maria says that let your doctor come to the right conclusion on this Viagra dose. Let him examine the tolerability of your body. It is a FDA approved dose for erectile dysfunction, but it is reserved for extreme cases of erectile dysfunction.