Most popular quantity.
VIAGRA is prescribed to treat erectile dysfunction (ED).
VIAGRA) reported a sudden decrease or loss of vision.
PDE5 inhibitors, including VIAGRA, and call a doctor right away.
PDE5 inhibitors or to other factors.
VIAGRA does not protect against sexually transmitted diseases, including HIV.
VIAGRA (25-mg, 50-mg, 100-mg) tablets.
The blue diamond tablet shape is a registered trademark of Pfizer Inc.
Pfizer is a licensee of the TRUSTe Privacy Program.
GMP)-specific phosphodiesterase type 5 (PDE5).
Sildenafil citrate is a white to off-white crystalline powder with a solubility of 3.
L in water and a molecular weight of 666.
VIAGRA (sildenafil citrate) is formulated as blue, film-coated rounded-diamond-shaped tablets equivalent to 25 mg, 50 mg and 100 mg of sildenafil for oral administration.
VIAGRA is indicated for the treatment of erectile dysfunction.
For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity.
However, VIAGRA may be taken anywhere from 4 hours to 0.
Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.
The maximum recommended dosing frequency is once per day.
VIAGRA was shown to potentiate the hypotensive effects of nitrates and its administration in patients who use nitric oxide donors or nitrates in any form is therefore contraindicated.
Distributed by Pfizer Labs, Division of Pfizer Inc, NY, NY 10017.
VIAGRA was administered to over 3700 patients (aged 19-87 years) during clinical trials worldwide.
Over 550 patients were treated for longer than one year.
In placebo-controlled clinical studies, the discontinuation rate due to adverse events for VIAGRA (2.
The adverse events were generally transient and mild to moderate in nature.
In trials of all designs, adverse events reported by patients receiving VIAGRA were generally similar.
In fixed-dose studies, the incidence of some adverse events increased with dose.
The nature of the adverse events in flexible-dose studies, which more closely reflect the recommended dosage regimen, was similar to that for fixed-dose studies.
In these studies, only one patient discontinued due to abnormal vision.
In fixed-dose studies, dyspepsia (17%) and abnormal vision (11%) were more common at 100 mg than at lower doses.
At doses above the recommended dose range, adverse events were similar to those detailed above but generally were reported more frequently.
Hemic and Lymphatic: anemia and leukopenia.
VIAGRA without sexual activity.
Nervous: seizure, seizure recurrence, and anxiety.
P450 (CYP) isoforms 3A4 (major route) and 2C9 (minor route).
Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance.
VIAGRA (50 mg) to healthy volunteers.
VIAGRA had no effect on saquinavir pharmacokinetics.
L when sildenafil was dosed alone.
VIAGRA had no effect on ritonavir pharmacokinetics (see DOSAGE AND ADMINISTRATION).
Although the interaction between other protease inhibitors and sildenafil has not been studied, their concomitant use is expected to increase sildenafil levels.
In a study of healthy male volunteers, co-administration of sildenafil at steady state (80 mg t.
CYP3A4, CYP2C9 and possibly of cytochrome P450 2C19) at steady state (125 mg b.
AUC and a 55% decrease in sildenafil Cmax.
Concomitant administration of strong CYP3A4 inducers, such as rifampin, is expected to cause greater decreases in plasma levels of sildenafil.
Pharmacokinetic data from patients in clinical trials showed no effect on sildenafil pharmacokinetics of CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and related diuretics, ACE inhibitors, and calcium channel blockers.
The AUC of the active metabolite, N-desmethyl sildenafil, was increased 62% by loop and potassium-sparing diuretics and 102% by nonspecific beta-blockers.
These effects on the metabolite are not expected to be of clinical consequence.
In the first study, a single oral dose of VIAGRA 100 mg or matching placebo was administered in a 2-period crossover design to 4 generally healthy males with benign prostatic hyperplasia (BPH).
Following at least 14 consecutive daily doses of doxazosin, VIAGRA 100 mg or matching placebo was administered simultaneously with doxazosin.
Following a review of the data from these first 4 subjects (details provided below), the VIAGRA dose was reduced to 25 mg.
Thereafter, 17 subjects were treated with VIAGRA 25 mg or matching placebo in combination with doxazosin 4 mg (15 subjects) or doxazosin 8mg (2 subjects).
Hg following both VIAGRA and placebo.
There were no reports of syncope among these patients.
For these four subjects, the placebo-subtracted mean maximum decreases from baseline in supine and standing systolic blood pressures were 14.
Both of these subjects were protocol violators, one due to a low baseline standing SBP, and the other due to baseline orthostatic hypotension.
In the second study, a single oral dose of VIAGRA 50 mg or matching placebo was administered in a 2-period crossover design to 20 generally healthy males with BPH.
Following at least 14 consecutive days of doxazosin, VIAGRA 50mg or matching placebo was administered simultaneously with doxazosin 4 mg (17 subjects) or with doxazosin 8 mg (3 subjects).
The mean subject age in this study was 63.
Twenty subjects received VIAGRA 50 mg, but only 19 subjects received matching placebo.
One patient discontinued the study prematurely due to an adverse event of hypotension following dosing with VIAGRA 50 mg.
This patient had been taking minoxidil, a potent vasodilator, during the study.
Blood pressure was measured after administration of VIAGRA at the same times as those specified for the first doxazosin study.
In these two subjects, hypotension was reported as a moderately severe adverse event, beginning at approximately 1 hour after administration of VIAGRA 50 mg and resolving after approximately 7.
Hg following both VIAGRA 50 mg and placebo.
There were no severe adverse events potentially related to blood pressure and no episodes of syncope reported in this study.
In the third study, a single oral dose of VIAGRA 100 mg or matching placebo was administered in a 3-period crossover design to 20 generally healthy males with BPH.
In dose period 1, subjects were administered open-label doxazosin and a single dose of VIAGRA 50 mg simultaneously, after at least 14 consecutive days of doxazosin.
If a subject did not successfully complete this first dosing period, he was discontinued from the study.
Subjects who had successfully completed the previous doxazosin interaction study (using VIAGRA 50 mg), including no significant hemodynamic adverse events, were allowed to skip dose period 1.
Treatment with doxazosin continued for at least 7 days after dose period 1.
Thereafter, VIAGRA 100mg or matching placebo was administered simultaneously with doxazosin 4 mg (14 subjects) or doxazosin 8 mg (6 subjects) in standard crossover fashion.
The mean subject age in this study was 66.
Twenty-five subjects were screened.
Two were discontinued after study period 1: one failed to meet pre-dose screening qualifications and the other experienced symptomatic hypotension as a moderately severe adverse event 30 minutes after dosing with open-label VIAGRA 50 mg.
Of the twenty subjects who were ultimately assigned to treatment, a total of 13 subjects successfully completed dose period 1, and seven had successfully completed the previous doxazosin study (using VIAGRA 50 mg).
Blood pressure was measured after administration of VIAGRA at the same times as those specified for the previous doxazosin studies.
All three were taking VIAGRA 100 mg, and all three reported mild adverse events at the time of reductions in standing SBP, including vasodilation and lightheadedness.
While there were no severe adverse events potentially related to blood pressure reported in this study, one subject reported moderate vasodilatation after both VIAGRA 50 mg and 100 mg.
There were no episodes of syncope reported in this study.
When VIAGRA 100 mg oral was coadministered with amlodipine, 5 mg or 10 mg oral, to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic.
No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolized by CYP2C9.
VIAGRA (50 mg) did not potentiate the increase in bleeding time caused by aspirin (150 mg).
VIAGRA (50 mg) did not potentiate the hypotensive effect of alcohol in healthy volunteers with mean maximum blood alcohol levels of 0.
In a study of healthy male volunteers, sildenafil (100 mg) did not affect the steady state pharmacokinetics of the HIV protease inhibitors, saquinavir and ritonavir, both of which are CYP3A4 substrates.
Sildenafil at steady state (80 mg t.
AUC and a 42% increase in Cmax of bosentan (125 mg b.
There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease.
Therefore, treatments for erectile dysfunction, including VIAGRA, should not be generally used in men for whom sexual activity is inadvisable because of their underlying cardiovascular status.
Hg), (see CLINICAL PHARMACOLOGY: Pharmacodynamics).
Patients with the following underlying conditions can be particularly sensitive to the actions of vasodilators including VIAGRA - those with left ventricular outflow obstruction (e.
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA.
In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance.
If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result.
If VIAGRA is prescribed to patients taking ritonavir, caution should be used.
Data from subjects exposed to high systemic levels of sildenafil are limited.
Visual disturbances occurred more commonly at higher levels of sildenafil exposure.
The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment.
INTERACTIONS) leading to symptomatic hypotension (e.
Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor.
Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors.
In those patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be initiated at the lowest dose.
In those patients already taking an optimized dose of a PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose.
Stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure when taking a PDE5 inhibitor.
Safety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs.
Viagra has systemic vasodilatory properties and may augment the blood pressure lowering effect of other anti-hypertensive medications.
Hg diastolic were noted (see DRUG INTERACTIONS).
The safety of VIAGRA is unknown in patients with bleeding disorders and patients with active peptic ulceration.
VIAGRA should be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia).
The safety and efficacy of combinations of VIAGRA with other treatments for erectile dysfunction have not been studied.
Therefore, the use of such combinations is not recommended.
In humans, VIAGRA has no effect on bleeding time when taken alone or with aspirin.
Physicians should advise patients of the potential for VIAGRA to augment the blood pressure lowering effect of alpha-blockers and anti-hypertensive medications.
Concomitant administration of VIAGRA and an alpha-blocker may lead to symptomatic hypotension in some patients.
Therefore, when VIAGRA is co-administered with alpha-blockers, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose.
REACTIONS, Clinical Trials and Post-Marketing Experience).
Physicians should warn patients that prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of VIAGRA.
If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.
The use of VIAGRA offers no protection against sexually transmitted diseases.
Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), may be considered.
AUC value of more than 25 times the human male AUC.
There was no effect on sperm motility or morphology after single 100 mg oral doses of VIAGRA in healthy volunteers.
VIAGRA is not indicated for use in newborns, children, or women.
Pharmacokinetics in Special Populations).
In studies with healthy volunteers of single doses up to 800 mg, adverse events were similar to those seen at lower doses but incidence rates were increased.
In cases of overdose, standard supportive measures should be adopted as required.
Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine.
Pharmacokinetics and Metabolism).
VIAGRA is contraindicated in patients with a known hypersensitivity to any component of the tablet.
The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation.
NO then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.
Sildenafil has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.
When sexual stimulation causes local release of NO, inhibition of PDE5 by sildenafil causes increased levels of cGMP in the corpus cavernosum, resulting in smooth muscle relaxation and inflow of blood to the corpus cavernosum.
Sildenafil at recommended doses has no effect in the absence of sexual stimulation.
Studies in vitro have shown that sildenafil is selective for PDE5.
PDE3 is important because PDE3 is involved in control of cardiac contractility.
Absorption and Distribution: VIAGRA is rapidly absorbed.
Based upon measurements of sildenafil in semen of healthy volunteers 90 minutes after dosing, less than 0.
CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes.
After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the feces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of the administered oral dose).
Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach.
VIAGRA (50 mg) were not altered.
Cmax (47%) compared to age-matched volunteers with no hepatic impairment.
VIAGRA approximately 60 minutes post dose.
Studies have produced relevant data on the effects of VIAGRA on cardiac output.
Mean resting values for right atrial pressure, pulmonary artery pressure, pulmonary artery occluded pressure and cardiac output decreased by 28%, 28%, 20% and 7% respectively.
Even though this total dosage produced plasma sildenafil concentrations which were approximately 2 to 5 times higher than the mean maximum plasma concentrations following a single oral dose of 100 mg in healthy male volunteers, the hemodynamic response to exercise was preserved in these patients.
In a double-blind study, 144 patients with erectile dysfunction and chronic stable angina limited by exercise, not receiving chronic oral nitrates, were randomized to a single dose of placebo or VIAGRA 100 mg 1 hour prior to exercise testing.
The primary endpoint was time to limiting angina in the evaluable cohort.
The mean times (adjusted for baseline) to onset of limiting angina were 423.
These results demonstrated that the effect of VIAGRA on the primary endpoint was statistically non-inferior to placebo.
PDE6, which is involved in phototransduction in the retina.
VIAGRA on visual acuity, intraocular pressure, or pupillometry.
The effectiveness of VIAGRA was evaluated in most studies using several assessment instruments.
The primary measure in the principal studies was a sexual function questionnaire (the International Index of Erectile Function - IIEF) administered during a 4-week treatment-free run-in period, at baseline, at follow-up visits, and at the end of double-blind, placebo-controlled, at-home treatment.
The patient addressed both questions at the final visit for the last 4 weeks of the study.
The possible categorical responses to these questions were (0) no attempted intercourse, (1) never or almost never, (2) a few times, (3) sometimes, (4) most times, and (5) almost always or always.
Also collected as part of the IIEF was information about other aspects of sexual function, including information on erectile function, orgasm, desire, satisfaction with intercourse, and overall sexual satisfaction.
Sexual function data were also recorded by patients in a daily diary.
In addition, patients were asked a global efficacy question and an optional partner questionnaire was administered.
The effect on one of the major end points, maintenance of erections after penetration, is shown in Figure 3, for the pooled results of 5 fixed-dose, dose-response studies of greater than one month duration, showing response according to baseline function.
Results with all doses have been pooled, but scores showed greater improvement at the 50 and 100 mg doses than at 25 mg.
The pattern of responses was similar for the other principal question, the ability to achieve an erection sufficient for intercourse.
The titration studies, in which most patients received 100 mg, showed similar results.
Figure 3 shows that regardless of the baseline levels of function, subsequent function in patients treated with VIAGRA was better than that seen in patients treated with placebo.
At the same time, on-treatment function was better in treated patients who were less impaired at baseline.
The patients in studies had varying degrees of ED.
One-third to one-half of the subjects in these studies reported successful intercourse at least once during a 4-week, treatment-free run-in period.
In many of the studies, of both fixed dose and titration designs, daily diaries were kept by patients.
In these studies, involving about 1600 patients, analyses of patient diaries showed no effect of VIAGRA on rates of attempted intercourse (about 2 per week), but there was clear treatment-related improvement in sexual function: per patient weekly success rates averaged 1.
VIAGRA vs about 20% on placebo.
During 3 to 6 months of double-blind treatment or longer-term (1 year), open-label studies, few patients withdrew from active treatment for any reason, including lack of effectiveness.
At the end of the long-term study, 88% of patients reported that VIAGRA improved their erections.
Men with untreated ED had relatively low baseline scores for all aspects of sexual function measured (again using a 5-point scale) in the IIEF.
The changes from baseline in scoring on the two end point questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) were highly statistically significantly in favor of VIAGRA.
On a global improvement question, 83% of patients reported improved erections on VIAGRA versus 12% on placebo.
Diary data indicated that on VIAGRA, 59% of attempts at sexual intercourse were successful compared to 13% on placebo.
Across all trials, VIAGRA improved the erections of 43% of radical prostatectomy patients compared to 15% on placebo.
VIAGRA patients reported improvement in erections compared with 26% of placebo.
A review of population subgroups demonstrated efficacy regardless of baseline severity, etiology, race and age.
Analysis of the safety database showed no apparent difference in the side effect profile in patients taking VIAGRA with and without antihypertensive medication.
This analysis was performed retrospectively, and was not powered to detect any pre-specified difference in adverse reactions.
This medicine can help many men when it is used as prescribed by their doctors.
However, VIAGRA is not for everyone.
VIAGRA is a pill used to treat erectile dysfunction (impotence) in men.
It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated).
You will not get an erection just by taking this medicine.
VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.
When a man is sexually excited, the penis rapidly fills with more blood than usual.
The penis then expands and hardens.
After the man is done having sex, this extra blood flows out of the penis back into the body.
If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis.
You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours.
Some conditions and medicines interfere with this natural erection process.
The penis cannot fill with enough blood.
The man cannot have an erection.
This is called erectile dysfunction if it becomes a frequent problem.
During sex, your heart works harder.
Therefore sexual activity may not be advisable for people who have heart problems.
Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex.
If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem.
VIAGRA enables many men with erectile dysfunction to respond to sexual stimulation.
When a man is sexually excited, VIAGRA helps the penis fill with enough blood to cause an erection.
After sex is over, the erection goes away.
As noted above (How Sex Affects the Body), ask your doctor if your heart is healthy enough for sexual activity.
Nitrates are also found in recreational drugs such as amyl nitrate or nitrite ("poppers").
If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist.
VIAGRA is only for patients with erectile dysfunction.
VIAGRA is not for newborns, children, or women.
Do not let anyone else take your VIAGRA.
VIAGRA must be used only under a doctor's supervision.
VIAGRA does not cure erectile dysfunction.
HIV-the virus that causes AIDS.
VIAGRA is not a hormone or an aphrodisiac.
Only your doctor can decide if VIAGRA is right for you.
VIAGRA alone or with your other medicines.
Some medicines can change the way VIAGRA works.
Tell your doctor about any medicines you are taking.
Do not start or stop taking any medicines before checking with your doctor or pharmacist.
Finding the Right Dose for You).
VIAGRA comes in different doses (25 mg, 50 mg and 100 mg).
If you do not get the results you expect, talk with your doctor.
You and your doctor can determine the dose that works best for you.
Do not take more VIAGRA than your doctor prescribes.
If you think you need a larger dose of VIAGRA, check with your doctor.
VIAGRA should not be taken more than once a day.
Your doctor may prescribe a lower dose of VIAGRA in certain circumstances.
Take VIAGRA about one hour before you plan to have sex.
Beginning in about 30 minutes and for up to 4 hours, VIAGRA can help you get an erection if you are sexually excited.
If you take VIAGRA after a high-fat meal (such as a cheeseburger and french fries), the medicine may take a little longer to start working.
VIAGRA can help you get an erection when you are sexually excited.
You will not get an erection just by taking the pill.
Like all medicines, VIAGRA can cause some side effects.
These effects are usually mild to moderate and usually don't last longer than a few hours.
Some of these side effects are more likely to occur with higher doses.
The most common side effects of VIAGRA are headache, flushing of the face, and upset stomach.
Less common side effects that may occur are temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes being more sensitive to light, or blurred vision.
In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including VIAGRA) reported a sudden decrease or loss of vision in one or both eyes.
It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these.
If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including VIAGRA, and call a doctor right away.
In rare instances, men have reported an erection that lasts many hours.
Sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness, has been rarely reported in people taking PDE5 inhibitors, including VIAGRA.
It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors.
If you experience these symptoms, stop taking VIAGRA and contact your doctor right away.
Heart attack, stroke, irregular heart beats, and death have been reported rarely in men taking VIAGRA.
Most, but not all, of these men had heart problems before taking this medicine.
It is not possible to determine whether these events were directly related to VIAGRA.
VIAGRA may cause other side effects besides those listed on this sheet.
If you want more information or develop any side effects or symptoms you are concerned about, call your doctor.
In case of accidental overdose, call your doctor right away.
Keep VIAGRA out of the reach of children.
Keep VIAGRA in its original container.
VIAGRA is a prescription medicine used to treat erectile dysfunction.
IMPORTANT NOTE: This is a summary and does not contain all possible information about this product.
For complete information about this product or your specific health needs, ask your health care professional.
Always seek the advice of your health care professional if you have any questions about this product or your medical condition.
This information is not intended as individual medical advice and does not substitute for the knowledge and judgment of your health care professional.
This information does not contain any assurances that this product is safe, effective, or appropriate for you.
SILDENAFIL - ORAL (sill-DEN-uh-fil) COMMON BRAND NAME(S): Viagra USES: Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction) by blocking a certain enzyme (phosphodiesterase-PDE5) in the body.
In combination with sexual stimulation, sildenafil works by helping the blood flow into the penis to achieve and maintain an erection.
This drug is not indicated for use in women.
Use of this drug does not protect against sexually transmitted diseases (e.
HIV, hepatitis B, gonorrhea, syphilis).
Consult your doctor or pharmacist for more details.
HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill.
If you have any questions, consult your doctor or pharmacist.
This drug is taken by mouth as needed, at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective).
Do not take more often than once daily, and take as directed.
A high fat meal may delay the time of onset of this drug.
Avoid eating grapefruit or drinking grapefruit juice while you are being treated with this medication unless your doctor instructs you otherwise.
The dosage is based on your medical condition, response to therapy, and other medications you may be taking (see also Drug Interactions section).
SIDE EFFECTS: Headache, flushing, stomach upset, heartburn, nasal stuffiness, diarrhea, dizziness, or lightheadedness may occur.
If any of these effects persist or worsen, notify your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.
Many people using this medication do not have serious side effects.
Rarely, a sudden loss of eyesight in one or both eyes (NAION) may occur.
This may or may not be due to sildenafil.
If this serious problem occurs, seek immediate medical attention.
Sexual activity may put extra strain on your heart, especially if you have heart problems.
If you have heart problems and experience any of these serious side effects while having sex, stop and seek immediate medical attention: severe dizziness, fainting, chest pain, nausea.
For males, in the very unlikely event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and seek immediate medical attention, or permanent problems could occur.
Rarely, sildenafil may cause sudden hearing problems, or ringing in the ears.
Seek immediate medical attention if these effects occur.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs.
Symptoms of a serious allergic reaction include: rash, itching, unusual swelling, severe dizziness, trouble breathing.
This is not a complete list of possible side effects.
If you notice other effects not listed above, contact your doctor or pharmacist.
Contact your doctor for medical advice about side effects.
The following numbers do not provide medical advice, but in the US you may report side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088.
In Canada, you may call Health Canada at 1-866-234-2345.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: penis conditions (e.
To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.
Do not take this medication with any other product that contains sildenafil or other similar medications for erection problems (e.
Caution is advised when using this drug in the elderly because they may be more sensitive to the side effects of the drug.
This drug is not indicated for use in women or children.
DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.
Do not start, stop, or change the dosage of any medicine before checking with them first.
See also How To Use section for drug-food interactions.
This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: nitrates (e.
If you are currently using any of these medications, tell your doctor or pharmacist before starting sildenafil.
If you are taking an HIV protease inhibitor (e.
If you are taking more than a 25 milligrams dose of sildenafil and are also taking an alpha-blocker medication (e.
This document does not contain all possible interactions.
Therefore, before using this product, tell your doctor or pharmacist of all the products you use.
Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately.
US residents can call the US national poison hotline at 1-800-222-1222.
Canadian residents should call their local poison control center directly.
Symptoms of overdose may include severe dizziness, fainting, or prolonged erection.
NOTES: Do not share this medication with others, since they may have a problem that is not effectively treated by this drug, or they may have a condition that is complicated by this drug.
STORAGE: Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture.
Brief storage between 59 and 86 degrees F (15-30 degrees C) is permitted.
Keep all medicines away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so.
Properly discard this product when it is expired or no longer needed.
Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit the FDA MedWatch website or call 1-800-FDA-1088.
Urgency, Strain, Lack of Control...
Quiz: How Severe Are Your BPH Symptoms?
HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.
UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment.
This may lead to fainting, dizziness, and lightheadedness.
Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you.
This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure.
There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.
If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.
Before taking UROXATRAL, tell your doctor if you have kidney problems.
Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.
BPH and prostate cancer can cause the same symptoms.
However, UROXATRAL is not a treatment for prostate cancer.
The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.
Please see UROXATRAL full prescribing information.
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Erectile dysfunction: Viagra and other oral medications - MayoClinic.
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Wondering about drugs to treat erectile dysfunction?
Find out how Viagra, Levitra and Cialis compare with each other.
For most men with erectile problems, they work well and have few side effects.
All three medications improve erectile function in the same basic way, but the effects of tadalafil (Cialis) last longer.
This and a few other minor differences among these medications may make one a better choice over another for some men.
Viagra, Levitra and Cialis increase levels of nitric oxide, a chemical produced by your body during sexual stimulation that causes blood vessels in the penis to relax and open.
This allows you to achieve and maintain an erection.
Viagra, Levitra and Cialis each have a slightly different chemical make up.
Your doctor will consider these factors when deciding if one of these medications is a good choice for you.
Your doctor will also consider any other health problems you have and whether any of your current medications could cause problems when taken with Viagra, Levitra or Cialis.
Although these erectile dysfunction medications can help many people, not all men can safely take them.
Tell your doctor about all medications you take, including herbal remedies.
A number of other drugs, including certain antibiotics, anti-seizure medications, blood thinners and anti-arrhythmic heart medications can affect how well Viagra, Levitra or Cialis work and cause other side effects.
Never take Viagra, Levitra or Cialis if you take nitrate drugs to treat chest pain due to heart problems (angina).
Like Viagra, Levitra and Cialis, nitrates dilate blood vessels.
Their combined effects can cause dangerous low blood pressure and loss of consciousness.
Talk to your doctor if you take alpha blockers, medications often used to treat an enlarged prostate.
Alpha blockers can cause dangerously low blood pressure when combined with drugs for erectile dysfunction.
Examples of alpha blockers include: tamsulosin (Flomax), terazosin (Hytrin) and doxazosin (Cardura).
Don't use Viagra, Levitra or Cialis within four hours of taking an alpha blocker.
If you do use an alpha blocker, never take sildenafil (Viagra) in doses above 25 milligrams.
There's one exception to the rule about not taking alpha blockers with medications for erectile dysfunction: Tadalafil (Cialis) has been approved for use with the alpha blocker tamulosin (Flomax).
Viagra, Levitra and Cialis all belong to a type of medications called phosphodiesterase-5 (PDE-5) inhibitors, which improve erectile function by affecting blood pressure.
Experts are investigating whether these drugs may be useful to treat certain heart or blood flow problems.
Revatio, the same medication as sildenafil (Viagra) was recently approved by the Food and Drug Administration as a treatment for pulmonary hypertension, a rare condition affecting blood flow to the lungs.
Buying prescription drugs online: The do's and don'ts 'Herbal Viagra': Is it safe?
Erectile dysfunction and diabetes: Take control today Erectile dysfunction herbs: A natural treatment for ED?
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Viagra (sildenafil) Information from Drugs.
Viagra relaxes muscles and increases blood flow to particular areas of the body.
Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men.
Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women.
Viagra may also be used for other purposes not listed in this medication guide.
Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems.
This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket).
Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers").
Taking Viagra with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away.
You could be having a serious side effect of Viagra.
Do not take Viagra more than once a day.
Allow 24 hours to pass between doses.
Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours.
A prolonged erection (priapism) can damage the penis.
Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss.
This has occurred in a small number of people taking Viagra, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
It is not clear whether Viagra is the actual cause of vision loss.
Stop using Viagra and get emergency medical help if you have sudden vision loss.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take this medicine.
FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby.
Do not use Viagra without telling your doctor if you are pregnant or plan to become pregnant during treatment.
It is not known if sildenafil passes into breast milk or if it could harm a nursing baby.
Do not use this medication without telling your doctor if you are breast-feeding a baby.
Take Viagra exactly as it was prescribed for you.
Do not take it in larger doses or for longer than recommended by your doctor.
Follow the directions on your prescription label.
Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity.
You may take it up to 4 hours before sexual activity.
Do not take Viagra more than once per day.
Viagra can help you have an erection when sexual stimulation occurs.
An erection will not occur just by taking a pill.
Follow your doctor's instructions.
Store this medication at room temperature away from moisture and heat.
Viagra is used as needed, so you are not likely to be on a dosing schedule.
If you miss a dose of Revatio, take the missed dose as soon as you remember.
If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time.
Do not take extra medicine to make up the missed dose.
Seek emergency medical attention if you think you have used too much of this medicine.
Overdose symptoms may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.
What should I avoid while taking Viagra?
Avoid drinking alcohol, which can increase some of the side effects of Viagra.
Avoid using other medicines to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.
This is not a complete list of side effects and others may occur.
Call your doctor for medical advice about side effects.
You may report side effects to FDA at 1-800-FDA-1088.
See also: Viagra side effects in more detailWhat other drugs will affect Viagra?
Do not take Viagra if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers").
AIDS medicine such as amprenavir (Agenerase), atazanavir (Reyataz), delavirdine (Rescriptor), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), saquinavir (Invirase), or ritonavir (Norvir).
This list is not complete and there may be other drugs that can interact with Viagra.
Tell your doctor about all the prescription and over-the-counter medications you use.
This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors.
Do not start using a new medication without telling your doctor.
Where can I get more information?
Your pharmacist can provide more information about Viagra.
What does my medication look like?
Sildenafil is available with a prescription under the brand names Viagra and Revatio.
Other brand or generic formulations may also be available.
Ask your pharmacist any questions you have about this medication, especially if it is new to you.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc.
Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect.
Drug information contained herein may be time sensitive.
Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.
Multum's drug information does not endorse drugs, diagnose patients or recommend therapy.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient.
Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.
The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.
If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
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To view content sources and attributions, refer to our editorial policy.
We comply with the HONcode standard for trustworthy health information.
For other uses, see Viagra (disambiguation).
Sildenafil citrate, sold as Viagra, Revatio and under various other trade names, is a drug used to treat erectile dysfunction and pulmonary arterial hypertension (PAH).
It was developed and is being marketed by the pharmaceutical company Pfizer.
It acts by inhibiting cGMP specific phosphodiesterase type 5, an enzyme that regulates blood flow in the penis.
Cialis) and vardenafil (Levitra).
Sildenafil (compound UK-92,480) was synthesized by a group of pharmaceutical chemists working at Pfizer's Sandwich, Kent, research facility in England.
It was initially studied for use in hypertension (high blood pressure) and angina pectoris (a symptom of ischaemic heart disease).
The first clinical trials were conducted in Morriston Hospital in Swansea.
Phase I clinical trials under the direction of Ian Osterloh suggested that the drug had little effect on angina, but that it could induce marked penile erections.
Pfizer therefore decided to market it for erectile dysfunction, rather than for angina.
The drug was patented in 1996, approved for use in erectile dysfunction by the US Food and Drug Administration on March 27, 1998, becoming the first oral treatment approved to treat erectile dysfunction in the United States, and offered for sale in the United States later that year.
The British press portrayed Peter Dunn and Albert Wood as the inventors of the drug, a claim that Pfizer disputes.
Their names are on the manufacturing patent application drug, but Pfizer claims this is only for convenience.
Even though sildenafil is available only by prescription from a doctor, it was advertised directly to consumers on U.
Numerous sites on the Internet offer Viagra for sale after an "online consultation", often a simple web questionnaire.
The "Viagra" name has become so well known that many fake aphrodisiacs now call themselves "herbal Viagra" or are presented as blue tablets imitating the shape and colour of Pfizer's product.
Viagra is also informally known as "Vitamin V", "the Blue Pill", as well as various other nicknames.
In 2000, Viagra sales accounted for 92 percent of the global market for prescribed erectile dysfunction pills.
Cialis and Levitra, along with several counterfeits and clones, and reports of vision loss in people taking PDE5 inhibitors.
In February 2007, it was announced that Boots the Chemist would try over the counter sales of Viagra in stores in Manchester, England.
Men aged between 30 and 65 would be eligible to buy four tablets after a consultation with a pharmacist.
The mechanism of action of Sildenafil citrate involves the release of nitric oxide (NO) in the corpus cavernosum of the penis.
NO binds to the receptors of the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), leading to smooth muscle relaxation (vasodilation) of the intimal cushions of the helicine arteries, resulting in increased inflow of blood and an erection.
Furchgott won the Nobel Prize in Physiology or Medicine in 1998 for his discovery and analysis of endothelium-derived relaxing factor, a key part of the NO mechanism of action.
Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.
The molecular structure of sildenafil is similar to that of cGMP and acts as a competitive binding agent of PDE5 in the corpus cavernosum, resulting in more cGMP and better erections.
GMP system, sildenafil should not cause an erection.
Other drugs that operate by the same mechanism include tadalafil (Cialis) and vardenafil (Levitra).
Sildenafil is metabolised by liver enzymes and excreted by both the liver and kidneys.
The primary indication of sildenafil is treatment of erectile dysfunction (inability to sustain a satisfactory erection to complete intercourse).
Its use is now standard treatment for erectile dysfunction in all settings, including diabetes.
People on antidepressants may experience sexual dysfunction, either as a result of their illness or as a result of their treatment.
A 2003 study showed that sildenafil improved sexual function in men in this situation.
As well as erectile dysfunction, sildenafil citrate is also effective in the rare disease pulmonary arterial hypertension (PAH).
It relaxes the arterial wall, leading to decreased pulmonary arterial resistance and pressure.
This, in turn, reduces the workload of the right ventricle of the heart and improves symptoms of right-sided heart failure.
Because PDE-5 is primarily distributed within the arterial wall smooth muscle of the lungs and penis, sildenafil acts selectively in both these areas without inducing vasodilation in other areas of the body.
Pfizer submitted an additional registration for sildenafil to the FDA, and sildenafil was approved for this indication in June 2005.
The preparation is named Revatio, to avoid confusion with Viagra, and the 20 milligram tablets are white and round.
Sildenafil joins bosentan and prostacyclin-based therapies for this condition.
Sildenafil has been shown to be useful for the prevention and treatment of High-altitude pulmonary edema associated with altitude sickness such as that suffered by mountain climbers.
While this effect has only recently been discovered, sildenafil is already becoming an accepted treatment for this condition, in particular in situations where the standard treatment of rapid descent has been delayed for some reason.
Professional sports players have been documented using drugs such as Viagra, with the thinking that the opening of their blood vessels will enrich their muscles.
In turn, they believe that it will enhance their performance.
Sildenafil's popularity with young adults has increased over the years.
Sildenafil's trade name "Viagra" is widely recognized in popular culture, and the drug's association with treating erectile dysfunction has led to its recreational use.
Studies on the effects of viagra when used recreationally are limited, but suggest that it has little effect when used by those not suffering from erectile dysfunction, and having sex within a stable relationship.
This study also noted a significant placebo effect in the control group.
Unprescribed recreational use of Sildenafil and other PDE-5 Inhibitors is noted as particularly high among users of illegal drugs.
Sildenafil is sometimes used to counteract the effects of other substances, often illicit.
Some users mix it with methylenedioxymethamphetamine (MDMA, ecstasy), other stimulants, or opiates in an attempt to compensate for the common side-effect of erectile dysfunction, a combination known as "sextasy," "rockin' and rollin'," or "trail mix.
Mixing with amyl nitrite is particularly dangerous, and is potentially fatal.
The 2007 Ig Nobel Prize in Aviation went to Patricia V.
Golombek of Universidad Nacional de Quilmes, Argentina, for their discovery that Viagra aids jet lag recovery in hamsters.
Their research was published in the Proceedings of the National Academy of Sciences.
Acetildenafil is a structural analogue of sildenafil, one of the PDE5 inhibitors found in a number of "herbal" aphrodisiac products sold over-the-counter.
This class of analogues have not undergone any of the rigorous testing that drugs like sildenafil have passed, and thus have an unknown side-effect profile.
Some attempts have been made to ban these drugs, but progress has been slow so far, as, even in those jurisdictions that have laws targeting designer drugs, the laws are drafted to ban analogues of illegal drugs of abuse, rather than analogues of prescription medicines.
However, at least one court case has resulted in a product being taken off the market.
Viagra pills are blue and diamond-shaped with the words "Pfizer" engraved on one side, and "VGR xx" (where xx stands for "25", "50" or "100", the dose of that pill in milligrams) engraved on the other.
Revatio pills are white, round, film-coated tablets imprinted with "RVT 20" embossed on one side.
In clinical trials, the most common adverse effects of sildenafil use included headache, flushing, dyspepsia, nasal congestion and impaired vision, including photophobia and blurred vision.
Some sildenafil users have complained of seeing everything tinted blue (cyanopsia).
Some complained of blurriness and loss of peripheral vision.
Rare but serious adverse effects found through postmarketing surveillance include priapism, severe hypotension, myocardial infarction (heart attack), ventricular arrhythmias, stroke, increased intraocular pressure, and sudden hearing loss.
As a result of these postmarketing reports, in October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including sildenafil, required a more prominent warning of the potential risk of sudden hearing loss.
Care should be exercised by patients that are also taking protease inhibitors for the treatment of HIV.
Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side-effects.
Concomitant use of sildenafil and an alpha blocker may lead to low blood pressure, but this effect does not occur if they are taken at least four hours apart.
Methylation of 3-propylpyrazole-5-carboxylic acid ethyl ester with hot dimethyl sulfate.
Hydrolysis with aqueous NaOH to free acid.
Reduction of nitro group to amino.
Acylation with 2-ethoxybenzoyl chloride.
Sulfonation to the chlorosulfonyl derivative.
Condensation with 1-methylpiperazine.
Aubetawe Bro Morgannwg University NHS Trust (2008-07-04).
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Nurnberg HG, Hensley PL, Gelenberg AJ, Fava M, Lauriello J, Paine S (January 2003).
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Nurnberg HG, Hensley PL, Lauriello J, Parker LM, Keith SJ (August 1999).
Sildenafil for women patients with antidepressant-induced sexual dysfunction".
Nurnberg HG, Hensley PL, Heiman JR, Croft HA, Debattista C, Paine S (2008).
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Young men add Viagra to their drug arsenal".
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This page was last modified on 9 December 2009 at 18:59.
Why is this medication prescribed?
How should this medicine be used?
What special precautions should I follow?
What special dietary instructions should I follow?
What should I do if I forget a dose?
What side effects can this medication cause?
What storage conditions are needed for this medicine?
What other information should I know?
Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors.
Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation.
This increased blood flow can cause an erection.
Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.
If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire.
Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).
Sildenafil comes as a tablet to take by mouth.
If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph.
Take sildenafil as needed before sexual activity.
The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity.
Sildenafil usually should not be taken more than once every 24 hours.
If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often.
You can take sildenafil with or without food.
However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.
If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph.
You will probably take sildenafil three times a day with or without food.
Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Take sildenafil exactly as directed.
Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication.
Tell your doctor if sildenafil is not working well or if you are experiencing side effects.
If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it.
Continue to take sildenafil even if you feel well.
Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Isordil), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others).
Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments.
Ask your doctor if you are not sure whether any of your medications contain nitrates.
Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
If you become pregnant while taking sildenafil, call your doctor.
Sexual activity may be a strain on your heart, especially if you have heart disease.
If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took sildenafil.
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.
If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.
If you are taking sildenafil for PAH, take the missed dose as soon as you remember it.
However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule.
Do not take a double dose to make up for a missed one.
Sildenafil may cause side effects.
Some side effects can be serious.
Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil.
The vision loss was permanent in some cases.
It is not known if the vision loss was caused by the medication.
If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately.
Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction.
Most, but not all, of these people had heart problems before taking sildenafil.
It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.
Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil.
The hearing loss usually involved only one ear and may not get better.
It is not known if the hearing loss was caused by the medication.
If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately.
If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects.
Call your doctor if you have any unusual problems while you are taking this medication.
Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Throw away any medication that is outdated or no longer needed.
Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222.
If the victim has collapsed or is not breathing, call local emergency services at 911.
Keep all appointments with your doctor.
Do not let anyone else take your medication.
Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
It is also important information to carry with you in case of emergencies.
American Society of Health-System Pharmacists, Inc.
Consumer Medication Information.
The American Society of Health-System Pharmacists, Inc.
Wisconsin Avenue, Bethesda, Maryland.
Duplication for commercial use must be authorized by ASHP.
This page is being served from the Urological Sciences Research Foundation web repository, and was originally posted between 1996-2008.
Department of Urology where they are continuing their research.
See how the jokesters at Saturday Night Live treat Viagra!
Viagra Side EffectsPlease note - some side effects for Viagra may not be reported.
Always consult your doctor or healthcare specialist for medical advice.
All medicines may cause side effects, but many people have no, or minor, side effects.
In placebo-controlled clinical studies, the discontinuation rate due to adverse events for Viagra (2.
In trials of all designs, adverse events reported by patients receiving Viagra were generally similar.
Abnormal Vision: Mild and transient, predominantly color tinge to vision, but also increased sensitivity to light or blurred vision.
Body as a whole: face edema, photosensitivity reaction, shock, asthenia, pain, chills, accidental fall, abdominal pain, allergic reaction, chest pain, accidental injury.
Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy.
Digestive: vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitis.
Metabolic and Nutritional: thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, hypernatremia.
Musculoskeletal: arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, synovitis.
Nervous: ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, hypesthesia.
Respiratory: asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased.
Skin and Appendages: urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, exfoliative dermatitis.
Special Senses: sudden decrease or loss of hearing, mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, ear pain, eye hemorrhage, cataract, dry eyes.
Urogenital: cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema and anorgasmia.
Serious cardiovascular, cerebrovascular, and vascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, subarachnoid and intracerebral hemorrhages, and pulmonary hemorrhage have been reported post-marketing in temporal association with the use of Viagra.
Most, but not all, of these patients had preexisting cardiovascular risk factors.
Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of Viagra without sexual activity.
Others were reported to have occurred hours to days after the use of Viagra and sexual activity.
It is not possible to determine whether these events are related directly to Viagra, to sexual activity, to the patient's underlying cardiovascular disease, to a combination of these factors, or to other factors.
Cases of sudden decrease or loss of hearing have been reported postmarketing in temporal association with the use of PDE5 inhibitors, including Viagra.
In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events.
In many cases, medical follow-up information was limited.
Nervous: seizure, seizure recurrence, anxiety, and transient global amnesia.
Urogenital: prolonged erection, priapism, and hematuria.
Non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including permanent loss of vision, has been reported rarely post-marketing in temporal association with the use of phosphodiesterase type 5 (PDE5) inhibitors, including Viagra.
Most, but not all, of these patients had underlying anatomic or vascular risk factors for developing NAION, including but not necessarily limited to: low cup to disc ratio ("crowded disc"), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking.
It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors, to the patient's underlying vascular risk factors or anatomical defects, to a combination of these factors, or to other factors.
Side Effects by Body SystemGeneralPrior to approval by the FDA, use of sildenafil was evaluated in over 3,700 patients who ranged from 19 to 87 years of age.
Over 550 patients were treated for at least 1 year.
In placebo-controlled trials, the rate of discontinuation of therapy due to adverse events associated with sildenafil averaged 2.
The incidence of side effects has been dose-dependent.
Nervous systemNervous system side effects have included headache, observed in up to 16% of patients.
Other nervous system side effects have included dizziness in 2%, and, in less than 2%: ataxia, hypertonia, neuralgia, neuropathy, paresthesias, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, decreased reflexes, and hypesthesia.
There have been case reports of transient global amnesia and tonic-clonic seizures.
Post marketing experience has included reports of anxiety, seizure and seizure recurrence.
CardiovascularCardiovascular side effects have included flushing (vasodilation) in 10% and dizziness in 2% of patients.
GMP pathway, use of sildenafil has been shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are concurrently taking organic nitrates is considered contraindicated.
The following cardiovascular side effects have been associated with the use of sildenafil in less than 2% of patients: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, chest pain, and cardiomyopathy.
Postmarketing studies have reported serious cardiovascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, and hypertension in temporal association with the use of sildenafil.
Most patients had preexisting cardiovascular risk factors.
Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of sildenafil without sexual activity.
Others were reported to have occurred hours to days after the use of sildenafil and sexual activity.
It has not been determined whether these events are related directly to sildenafil, to sexual activity, to the patient's underlying cardiovascular disease, to a combination of these factors, or to other factors.
GastrointestinalGastrointestinal side effects have included dyspepsia (7%) and diarrhea (3%).
Less common gastrointestinal side effects have included abdominal pain, vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, abnormal liver function tests, rectal hemorrhage, and gingivitis.
Inhibition of contractile activity of the esophagus has been reported in patients receiving sildenafil who have idiopathic achalasia.
Results from a study of patients with idiopathic achalasia given sildenafil therapy showed inhibition of contractile activity of the esophageal musculature resulting in decreased lower esophageal sphincter tone and residual pressure as well as contraction amplitude.
RespiratoryRespiratory system side effects have included nasal congestion (4%).
Other respiratory system side effects have included wheezing, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, increased sputum production, and cough.
GenitourinaryGenitourinary side effects have included urinary tract infection in 3% of patients.
Less commonly, occurring in less than 2% of patients, cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema, and anorgasmia have been reported.
Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of sildenafil.
Acute priapism associated with the use of sildenafil in a patient with sickle cell trait has been reported.
OcularSildenafil is selective for phosphodiesterase-5 (PDE5).
It has lesser affinity for other PDE isoenzymes, one of which is PDE6, an enzyme found in the retina.
This lower selectivity is thought to be the basis for abnormalities related to color vision observed with higher doses or plasma levels.
Nonarteritic anterior ischemic optic neuropathy developed in one eye within minutes to hours after ingestion of sildenafil.
Four of the five patients had no vascular risk factors for ischemic optic neuropathy.
Ocular side effects have included mild and transient blue or colored-tinged vision, sometimes associated with photosensitivity or blurred vision.
Less common ocular side effects (less than 2% of patients) have included mydriasis, conjunctivitis, photophobia, tinnitus, eye pain, deafness, ear pain, eye hemorrhage, cataract, and dry eyes.
Several cases of optic neuropathy have been associated with sildenafil use.
DermatologicDermatologic side effect have included rash which was reported in at least 2% of patients.
Other dermatologic side effects have included urticaria, herpes simplex, pruritus, sweating, skin ulcer, contact dermatitis, and exfoliative dermatitis.
HematologicHematologic side effects have included anemia and leukopenia.
MetabolicMetabolic side effects have included thirst, peripheral and general edema, gout, hyperglycemia, hypoglycemia (including hypoglycemia reactions), and hypernatremia.
OtherOther side effects have included facial edema, shock, asthenia, pain, chills, and accidental falls and injuries.
MusculoskeletalMusculoskeletal side effects have included arthritis, arthrosis, myalgia, tendon rupture, tenosynovitis, bone pain, myasthenia, and synovitis.
PsychiatricPsychiatric side effects have included anecdotal reports and case studies of psychological disturbances and aggressive behavior.
OtherOther side effects have included cases of sudden decrease or loss of hearing reported post-marketing in temporal association with the use of PDE5 inhibitors, including sildenafil.
In some cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events.
It is not possible to determine whether these reported events are related directly to the use of sildenafil, to the patient's underlying risk factors for hearing loss, a combination of these factors, or to other factors.
Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect.
In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof.
This information does not endorse drugs, diagnose patients, or recommend therapy.
This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient.
If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.
There is a number of reasons for that.
We do not spend anything on marketing, there are no taxes to be paid as the product comes into the country unregistered, the manufacturer is located in an offshore zone and the production costs are way lower.
Generic means using a different name for the same ingredients.
The contents of the pills are absolutely the same in our generic version and the branded analogue.
Viagra is an oral medicine used for treating male impotence (e.
Viagra's advantages are a great safety track record and proven side effects.
The effect of Viagra starts in 30 minutes to 1 hour and lasts for about 4 hours.
Cialis (Tadalafil) is an oral drug, used for treating male impotence, also known as erectile men's erectile dysfunction.
Cialis' effect starts working in 30 minutes and lasts for about 48 hours, while Viagra effect lasts for about 4 hours.
Viagra Professional is a new generation extra-strength prescription medicine that is taken orally for the treatment of erectile dysfunction only in men, powerfully activating the natural blood flow, followed by hardness and expansion of your sexually...
Cialis Professional is a newly formulated and chemically improved prescription medicine that is taken orally for the treatment of erectile dysfunction only in men, extremely enhancing male sexual activity, that is resulted in boosted penile potency, ...
Tadalafil) has answered our highly raised expectations in its ability to treat and cure the overall whelming disease of erectile dysfunction by super-active formulation that gives the pill the shortest activation time, most prol...
Levitra (Vardenafil) is an oral therapy for the treatment of erectile dysfunction.
Having the long-lasting effect of 4 hours, and the start time of 16 min, Levitra represents an uncontested advantage in comparison with Viagra.
Viagra Soft Tabs are quick-dissolving lozenges for treating male impotence.
Comparing to ordinary Viagra, Viagra Soft Tabs has reduced the start time from 30 to 15-19 minutes with the effective duration of 5 to 6 hours per dose.
Cialis Soft Tabs (Tadalafil) are quick-dissolving tabs, used to treat male impotence.
Having the shortest start time of 15 minutes, Cialis Soft Tabs have the most long-lasting effect among all world-known ED products (up to 36 hours).
Soma (Carisoprodol) is a muscle relaxant, used to relieve the pain and stiffness of muscle strains and spasms.
Levitra Professional is a reformulated advanced prescription formulation with the highest degree of effectiveness in the sphere of male erectile dysfunction treatment that will result in intense, electrifying orgasms, better time control over ejacula...
Female Viagra (Sildenafil) is scientifically formulated to provide intense sexual satisfaction for women seeking ultimate pleasure.
Propecia (Finasteride) is used to treat male pattern hair loss.
Acomplia (Rimonabant) is an appetite suppressant diet pill.
Xenical (Orlistat) is recommended and prescribed by pharmacists as a weight loss medication that targets the absorption of fat in your body rather than suppressing your appetite.
Brand Levitra is an FDA-approved oral prescription medication for the treatment of erectile dysfunction (ED) in men developed by the pharmaceutical company BAYER.
Female Cialis represents a serious approach to the problem of female sexual arousal disorder (FSAD) and female sexual dysfunction (FSD), formulated scientifically to provide satisfaction in terms of sexual needs and lasting pleasure.
Viagra Soft Flavoured is the time-proved and effective medicine, which is prescribed to treat erectile dysfunction (ED).
Viagra Soft Flavored is famed for its splendid taste characteristics!
Brand Cialis is a medication used for treating men's erectile dysfunction (ED) and developed by the pharmaceutical company LILLY.
Brand Viagra is an oral medication for erectile dysfunction (ED) developed by the pharmaceutical company PFIZER.
It helps most men with ED improve their erections.
That means they are able to achieve harder erections.
VPXL is designed to enlarge your penis size and works on both circumcised and non circumcised penis.
Cialis order arrived within two weeks in perfect condition.
I only use half of a pill at a time, and sometimes the effect is still noticeable the next morning!
I've even tried a third of a pill once (I didn't split it very well) and I still felt the desired effect.
Thanks for good service and a great product!
I'm very pleased that my order came that quickly.
Your pills make miracles with my sexual life!
Thank you so much also for having such a good client support system.
Thank you for Viagra and Cialis which I ordered for the first time.
Meanwhile I could check the result of these tabs....
I hoped they would do, and more than that, very impressive !!
I think I will order soon the next portion.
Viagra by sportsmen, pilots, florists and of course doctors.
An Indian doctor used Viagra to save the life of a four month old girl.
Also she had underdeveloped lung.
When these facts were discovered, doctors decided to operate little baby to save her life.
During 4 hour operation blood pressure rose dramatically and blood started to flow to the heart in wrong direction.
Now he is sure that only use of Viagra could help and this was the only right decision.
As a fact Viagra was made to treat angina and high blood pressure, but during tests and trials the pill appeared to treat erectile dysfunction in men.
Picture of Authentic Viagra (figure 1) VS.
Figure 2:Picture of so-called generic Viagra 100mg tablet.
Note the darker blue color and the wording sildenafil citrate on the generic pill.
The Generic Viagra is not FDA-Approved and can be dangerous to your health.
We do not accept ads for generic Viagra on this page.
Serving customers private and discreetly since 1998.
No Prior Prescription Required!
No Generic Medications Sold at Apexrx.
Physicians will issue you a prescription.
Order online or over the telephone.
Friendly customer service staff is Available to answer questions.
No Prior Prescription Required!!
No Prior Prescriptions Required.
What Are The Best Places to Buy Viagra Online!
People always ask "Where's the best place to buy Viagra?
We investigated the top websites that sell Viagra before we wrote this page.
We learned what to look for in order to find legitimate Viagra websites.
If you are looking for brand-name Viagra online manufactured by Pfizer Laboratories, without a prior prescription, I recommend AccessRx.
They have been in business since 1998, are located in the USA in Tempe Arizona, and even offer overnight shipping.
They have customer service answering calls Mon-Sat and are open 24-hours a day online.
They even have licensed physicians and pharmacists on staff to answer your medical questions.
Bernstein takes his business seriously and takes pride in his company's track record and reputation.
Their prices are higher than the generics but you are assured of getting brand-name, American, FDA-Approved Viagra delivered to your door in a couple of days without having to go to a doctor.
View our Viagra Price Comparison page to see which other websites are selling the real genuine Viagra.
Half the Viagra sold on the internet is fake.
Most of the websites that sell Viagra are located in 3rd world countries but they lie and pretend to be American or Canadian.
Illegal Viagra Leads 24% Jump in Counterfeit Medicine Seizures...
There is no such thing as an FDA approved generic Viagra.
The government considers generic Viagra to be an illegal substance.
The Feds are concerned that it may be unsafe because you have no way of determining the quality control that went into making the generic Viagra.
They don't go after the people who buy it, but postal inspectors will confiscate it if they find it.
There are lots of websites that sell generic Viagra without a prescription.
Some people swear by it but you are taking a chance with your health if you take generic silendafil, especially if you do so without the knowledge of your doctor.
You want to make sure there is a physical address on the website selling the Viagra.
It should be a real address, not a P.
If there is no address that is a bad sign.
Why would someone want to hide their address?
No address means that they are deliberately making it hard for you to track them down in case there is a problem.
The website selling the Viagra should have a toll free telephone number.
If something goes wrong you want to be able to speak to a real live person.
It is very frustrating to only be able to communicate by e-mail when you have a problem.
Test the telephone number before you place your order.
Ask the person who answers the phone where the product is shipped from.
If they don't answer to your satisfaction, it's a bad sign.
Do they have a 24-hour chat or IM customer service?
The reliable, established internet pharmacies all have this service integrated into their sites.
If they have such a service, test drive it.
How long does it take for the person on the other end to respond?
Ask them some questions such as: "how long have you been in business?
Who is the manufacturer of your Viagra?
How long does it take to get my shipment.
Ask them if they do the shipping and handling or if they only do the billing.
Their job is answering the phone and ringing up your sale.
After your credit card has been charged, the relationship is over.
If it seems too good to be true, it probably is too good to be true.
Viagra on the internet and getting a fake.
Your first purchase should be for a small quantity of pills.
Don't start of with thirty tablets.
Make sure the Viagra is legit and the shipping and billing goes smoothly before you make a large purchase.
You should never deal with a site from Russia or Nigeria, places where identity theft is common.
Scammers in these countries have been known to set up sham Viagra web sites just so they could steal your credit card information.
Where does fake Viagra come from?
Most of the fake Viagra comes from China and South America where the laws regarding pharmaceuticals are lax.
Most of the Viagra selling websites are fly-by-night operations looking to make a quick buck.
They often masquerade as American or Canadian internet pharmacies but they are usually located outside the law in countries such as Cambodia or Bulgaria.
How does Pfizer Deter Counterfeit Viagra?
Pfizer is trying to fight the introduction of fake Viagra into the pharmaceutical supply chain.
Beginning On December 15th, 2005, all bottles of Viagra have had a very small identification microchip (known as a RFID) embedded into the bottle.
The bottles are embedded with a Tagsys Flexible Module passive high-frequency (13.
This means that every bottle of Viagra has a special electronic fingerprint so that pharmacists and wholesalers can track the pedigree of the tablets inside to ensure that they are authentic and obtained legally.
Each Viagra label also contains a special two-dimensional barcode that works hand in hand with the RFID chip so that pharmacists and wholesalers can track the Viagra from the factory, through the supply chain down to the individual consumer.
The labels on the Viagra bottles (as well as many other Pfizer products such as Lipitor and Celebrex) are printed with a color shift ink bar which is hard to fake but easy to recognize with the naked eye, similar to what you see with paper money.
Many sites sell counterfeit Viagra to unsuspecting people at highly inflated prices.
Sometimes they sell you a little baggie of half-tablets and Viagra crumbs.
And when you try to call the "1-800" telephone number on the site you brought the pills from to complain, all you get is the run-around.
A common scheme is that people try to sell you sell so-called generic Viagra that contains no active ingredient.
The poorer the country is, the easier it is to bribe local officials to look the other way.
One hundred dollars goes a long way out in the boondocks of China or Mexico.
If you live in one of these countries, it is easy to open a pill factory to manufacture fake Viagra.
These little factories are like meth labs - they stay open a short while, manufacture several thousand bootleg or counterfeit pills and move on before they get caught.
When you buy Viagra on the internet prices vary by as much as 50% so it pays to comparison shop.
If you buy a larger quantity you should pay less per pill.
If you buy a smaller quantity you will pay more per pill.
In general, the farther away the Viagra seller is, the easier it is for them to rip you off.
Avoid buying Viagra from Asia, South America, Mexico and the Caribbean because that's where a lot of the fake Viagra comes from.
Another reason to avoid buying Viagra from outside the United States is the pills might be confiscated by postal authorities when they reach the United States.
This is happening more and more each day as the FDA and the DEA crack down on the illegal importation of drugs into the USA.
Pfizer Scientists synthesize silendafil citrate and give it the code name UK-92, 480.
Experimental compound UK-92,480 is believed to be useful as a high blood pressure and angina treatment.
The scientists hope it may act as a vasodilator and be useful in treating cardiovascular ailments such as hypertension and angina.
Researchers at Pfizer's Sandwich, England research facility (Peter Ellis and Nick Terret) observe that drugs that inhibit the PDE5 enzyme may be helpful in reversing erectile dysfunction.
Early Phase 1 trials regarding the use of Viagra for angina are unremarkable.
Phase 2 clinical study is conducted testing silendafil citrate's usefulness as an angina treatment reveals.
Pilot study using silendafil citrate as a treatment for erectile dysfunction is conducted in Bristol, England.
Test subjects take it three times a day for a week.
The studies had only 28 men involved.
Second pilot study on silendafil as an Erectile dysfunction treatment demonstrates that a once per day dose is able to produce an erection.
Viagra (as it is now known) is safe and effective.
Pfizer files a New Drug Application for Viagra (NDA 020895) with the United States FDA.
FDA agrees to give it a priority review.
FDA approves Viagra as the first oral treatment for erectile dysfunction.
It was approved with a starting dose of 50 mg with the option to increase the dose to 100mg or reduce it to 25 mg.
FDA lists two patents for Viagra.
Patent number 5250534 expires on March 27, 2012.
TREATMENT OF ERECTILE DYSFUNCTION) is set to expire on Oct 22, 2019.
How did they come up with the name VIAGRA?
Unlike most tablets, the Viagra tablet has an unusual rounded-diamond-shape.
It is believed that one reason Pfizer employs this tablet design is to make it harder to split the tablet with common tablet splitters.
A 50 mg tablet of Viagra sells for approximately the same price.
When people buy 100 mg tablets and split them into two 50 mg portions they save about 50% per dose.
The diamond shaped Viagra tablet will not fit into the typical tablet splitter which is designed to split round tablets.
Since its launch in 1998, specially designed Viagra tablet splitters have become available.
Incidentally, another erectile dysfunction drug, Cialis also has an irregular shaped tablet that discourages pill splitting).
Viagra Price Comparison: There is a lot of competition between sites that sell Viagra.
This competition drives down the prices.
Our editors have searched the internet.
You should be able to get a good price on genuine Viagra if you comparison shop.
How to start and maintain patients on Viagra, Multimedia presentation, prescribing information, etc.
This site also has a section where you can report an adverse regarding Viagra.
MDThe latest news in the Viagra industry geared towards consumers.
MD also goes over the most common side effects of Viagra, the dangers of taking counterfeit Viagra, and how to buy Viagra online safely.
What Is Viagra and How Does It Work?
All three of the erectile dysfunction drugs (Viagra, Levitra and Cialis) are similar in action.
They block an enzyme that causes an erection to go flaccid.
Although these drugs are similar in action, their dose, onset of action time and duration of action differ.
Viagra (Sildenafil) is a member of a family of drugs called PDE5 Inhibitors.
Viagra was the first PDE5 inhibitor on the market.
FDA was approved Viagra on March 27, 1998.
The team of scientists who discovered Viagra won the Nobel Prize.
Some very smart scientists discovered that cyclic guanosine monophosphate (cGMP) was the key to sustaining an erection.
They discovered that when a man gets sexually stimulated, a chain reaction occurs in the tissue of the penis that results in elevated levels of a substance called cyclic guanosine monophosphate (cGMP).
As long as there are sufficient levels of cGMP, the penis can remain erect.
The more cGMP, the more robust and durable the erection.
If you inhibit the degradation (breakdown) of cGMP it stays around in the penis longer, producing a more durable erection.
Another way you can think of Viagra (and all other similar medicines) is that it preserves the elevated levels of cGMP that are created when a man is sexually stimulated for a stronger, more lasting erection.
That's how Viagra works - Viagra blocks the enzyme phosphodiesterase-5 (PDE5) which is responsible for the neutralization of cGMP.
Viagra (Sildenafil) is a highly selective inhibitor of PDE5.
PDE5 is not the only phosphodiesterase involved in the erectile physiology but it appears to be the most important one).
The nice thing about PDE5 blockers is that they shouldn't cause erections at inappropriate times because they only block degradation of cGMP produced in reaction to sexual stimulation, such as thinking about something sexy.
If you are not being sexually stimulated, there is no cGMP to protect, so the drug remains in the background.
Sildenafil inhibits superoxide formation and prevents endothelial dysfunction in a mouse model of secondhand smoke induced erectile dysfunction.
CONCLUSIONS: Short-term exposure to secondhand smoke impairs erectile function through excessive penile reactive oxygen species signaling and inducible nitric oxide synthase activity.
Decreased penile constitutive nitric oxide synthase activity may be attributable to the decreased endothelial nitric oxide synthase activity resulting from increased oxidative stress.
Sildenafil therapy restored nitric oxide synthase activity and decreased reactive oxygen species signaling, resulting in improved erectile function...
Editor's Note: It is believed that second hand smoke contributes to erectile dysfunction.
This was a rodent trial (they used mice).
The Viagra was shown to counteract the negative effects of second-hand smoke.
Clinical Implications: Has not been tested in humans but it is safe to assume that erectile dysfunction caused by second-hand smoke can be ameliorated by Viagra.
Efficacy, tolerability and satisfaction with sildenafil citrate 100-mg titration compared with continued 50-mg dose treatment in men with erectile dysfunction.
After initial treatment with sildenafil 50 mg, patients titrated to 100 mg showed further increases in efficacy and satisfaction with no increase in the number or severity of adverse events than in those remaining on the starting dose...
Editor's Note: patients started on 50 mg of Viagra and increased to 100mg got an increase in efficacy without an increase in side effects.
Viagra they will be elicited at the lower doses.
Use of Sildenafil to Facilitate Weaning from Inhaled Nitric Oxide in Children with Pulmonary Hypertension following Surgery for Congential Heart Disease.
Journal of Intensive Care Medicine 2008, doi:10.
Editor's Note: Children with congenital cardiac abnormalities requiring surgical intervention often suffer pulmonary hypertension as a complication of surgery.
Usually they use nitric oxide gas as a treatment for the pulmonary hypertension but you have to wean the kids off of the nitric oxide gas gradually to avoid adverse effects In this experiment, after treatment with nitric oxide gas they tried Viagra by mouth as a step-down therapy to wean them off of the gas successfully.
Clinical implications: In the abstract, you notice that the reduction in Mean pulmonary artery and systemic arterial pressure was associated with a pValue of 0.
Since this p-Value is greater than 0.
The active ingredient in Viagra (silendafil) is useful in treating a rare, potentially deadly condition known as pulmonary hypertension.
In this use, Viagra's Phosphodiesterase 5 blocking activity is thought to be beneficial in relaxing the smooth muscle tissue found in the lungs by increasing the levels of cyclic guanasine monophosphate (cGMP).
Viagra Classified As Performance Enhancing DrugViagra Joins Hall of Performance-Enhancing Infamy ...
See Also: The effect of sildenafil on the altered thoracic aorta smooth muscle responses in rat pre-eclampsia model.
PDE5 inhibitors enhance endothelial function and may be used for protection.
Further studies are needed to clear the efficiency and safety of PDE5 inhibitors.
See Also: Effect of sildenafil on haemodynamic response to exercise and exercise capacity in Fontan patients ...
Conclusion In Fontan patients, oral administration of a single dose of sildenafil improves exercise capacity and haemodynamic response to exercise.
Pfizer sells a tablet called Revatio for this use.
Each Revatio tablet contains 20mg of silendafil (the active ingredient in Viagra) and it is taken 3 times a day aproximately 4-6 hours apart.
Maximum observed plasma concentrations of Viagra are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state.
Viagra is about 40% biovailable.
Viagra is highly protein bound (96%).
When Viagra is taken with a high fat meal, the rate of absorption is reduced.
Viagra is mostly metabolized in the liver by an enzyme known as CYP3A4 and to a lesser extent CYPC229.
Viagra breakdown products are excreted in the feces (80%) and in the urine (approximately 13%).
Viagra's mean half life is about 4 hours.
If you are going to take any of the PDE5 inhibitors such as Viagra, it is very important that your doctor be aware if you have a liver condition (such as cirrhosis) or kidney condition ( such as if you are on dialysis) because you may need a special dosage adjustment.
Likewise, if you try to obtain Viagra on the internet, please make sure that the person authorizing your prescription knows the true status of your liver function and your kidney function.
For most patients, the recommended dose of Viagra is 50mg taken about 1 hour prior to anticipated sexual activity.
The dose of Viagra may be increased to 100mg or decreased to 25mg depending on efficacy and side effects.
Sometimes people buy the 100mg tablets and break them in half to save money.
Viagra is available 25mg and 50mg and 100mg tablets.
The maximum recommended dose is one pill per day.
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Find out when to take VIAGRA and what to take it with.
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Find out how to safely buy VIAGRA online.
Billions of spam e-mail messages advertise Viagra every day.
There is so much Viagra spam, in fact, that Pfizer (the maker of Viagra) has a page addressing the problem, called Avoid Fake Viagra.
Pfizer has spent untold millions of dollars advertising Viagra, so you see advertisements for the drug constantly on TV.
Pfizer claims on its Web site that nine Viagra pills are dispensed every second -- nearly 300 million tablets per year.
The name recognition of Viagra is so good that nearly every adult in America has heard of the drug and can tell you what it does.
What Viagra does is simple: When it works as intended, Viagra causes a man who is sexually stimulated to get an erection.
And why does Viagra work only if the man is sexually stimulated?
For that matter, what causes an erection in the first place?
In this article, we'll answer all of those questions and more.
This is actually a fascinating story -- it involves the technology of the human body and the techniques that scientists use to control different parts of the body with drugs.
And in the case of Viagra, the story starts with the technology of the penis.
Learn more about what ails you.
A comprehensive guide with three thousand articles, including images and multimedia.
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Viagra junction from where you can acquire genuine Viagra facts and Information on just about everything on Viagra including comprehensive tidbits on Viagra prescription, Viagra side-effects et al.
Altogether this site provides answers to your queries regarding what is Viagra , what is Viagra used for, when one should administer Viagra, how long does Viagra take to give results.
It clears all your doubts and unanswered facts on Viagra apart from keeping you abreast with the latest happenings on the Viagra front.
We also cater to the customers who are looking to buy Viagra online .
Pharmacies enlisted on this site are selling Viagra at comparatively affordable prices in comparison to other online sources.
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Buyers are further requested to check in with their individual country laws in relation to buying medicines online before they buy Viagra from this website.
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The car, the television, the home computer and Cialis.
What have these things got in common you might think?
The answer is they are the greatest inventions of modern times.
When asked what the greatest innovations of modern times are many people will answer with the car etc, but an increasingly high proportion of men will also state the anti-impotence medications that are available today.
These drugs have given hundreds of thousands if not millions of men a new lease of life and greatly improved their self esteem and overall quality of life.
A man who is unable to gain an erection either through illness or old age and then after taking medication can, this is surely an innovation of some note.
If impotence is an issue for you and you would like to do something about it then you have certainly come to the right place, we are specialists in the supply and advice appertaining to a number of anti-impotence drugs including Cialis and Viagra and can deliver to your door within a few days under plain wrap.
Prior to you purchase you must complete our online consultation form so our online Doctor can assess your personal suitability for a certain medication.
All our medicines are prescribed by a GMC registered UK Doctor who under their code of practice must complete some sort of consultation before issuing prescribed medicines such as Cialis.
These online consultations although adequate are by no means a substitute for your family GP, we suggest you also consult your GP and make him aware of any drugs that you are taking on a regular or semi regular basis.
For most of us a healthy sex life is an essential prerequisite for a fulfilling life so we would encourage you not to suffer in silence and investigate the benefits you can get by investigating Cialis or Viagra as a possible solution.
A dormant sex life can also have devastating effects on a marriage or family life in general, we are only too aware that many men find this very serious issue very embarrassing to talk about even with their wives or partners, a reluctance to explain the issues to a loved one can result in them assuming that there is another reason for not fulfilling their marital duties.
People often ask us why our Cialis is so cheap, the answer is simple.
As well as priding ourselves on supplying only genuine high quality products we are also extremely proud of the customer service we provide.
If you have any questions or require any advice appertaining to any of our products please e-mail us at the address detailed on our website.
Viagra, Cialis and a whole host of other products for men.
Our reputation as a forward thinking company is amply illustrated by our commitment to the new online generation of shoppers.
Rising fuel prices and the price of parking are slowly starting to kill off the more traditional forms of shopping and we are in a position to offer customers the ultimate shopping experience from the comfort of their own home or office.
You have all the information so what are you waiting for?
You have just found the leading online purveyor of Viagra and Cialis whose products and service levels are quite simply unrivalled.
Providing you with the solution to your impotence problems really is our job satisfaction and each enquiry we receive is greeted with genuine enthusiasm from our dedicated sales and medical team.
To sum up you will not find a better range of high quality branded products anywhere and at this price you will be hard pressed to find cheaper.
Should you find exactly the same high quality Cialis elsewhere at a cheaper price please inform us and we will endeavour to match any genuine quotation.
Please note the products must be identical to our own quality products and the offer excludes any special offers, seasonal discounts and goods on sale from abroad.
As previously mentioned, consultation with your own GP is highly advisable before embarking on any course of anti-impotence medication.
You Doctor will probably want to run a few tests before he gives you the OK to begin, although this is common sense most men are also embarrassed about sharing their problem with anyone, even their own GP.
Anyone with a history of hypertension or heart problems is especially advised to visit their GP before taking any Viagra or Cialis.
This is especially relevant if you are regularly taking any medication to treat a pre-existing condition, there have been cases where the drugs administered cancel each other out.
Until recently erectile dysfunction was attributed to underlying psychological causes such as stress but medical research has shown that physical conditions such as diabetes, kidney disease and atherosclerosis account for as many as 75% of ED cases.
Smoking, drinking and taking drugs (illegal and legal) also take their toll and can sometimes result in the degeneration of erectile tissue.
A lack of exercise is also thought to contribute to the causes leading to ED.
Like all effective drugs there are some side effects that the patient needs to be aware of, although many of these of these side effects are not thought to pose any detrimental effect to health and are generally mild to moderate.
The most common side effects of anti impotence drugs are headaches, flushing of the face and perhaps an upset stomach.
Temporary changes in colour vision have also been reported although this particular side effect is relatively rare.
In very rare cases men have reported that an erection lasts for several hours, in cases like these we strongly advise the person to consult a GP or hospital immediately.
You should take a dose of Viagra or Cialis approximately 30 minutes before the start of sexual intercourse, although this does not sound particularly romantic it is the advised procedure.
If you have eaten a high fat meal prior to taking the medication the effects could take a little longer to be experienced.
Your Doctor will be able to advise you what is a suitable amount for you to take and how much to take if taking any other medication in conjunction.
Although our online consultation procedure is rather comprehensive we would always advise that you seek the advice of a GP or specialist before embarking on any form of anti-impotence treatment.
There are many forms of anti-impotence drugs in the market and some suit some people better than others, although Viagra and Cialis are by far the most popular they are not suitable for everyone, please check our website regularly for regular updates relating to any new products.
The internet like anything remotely technological is prone to the occasional lapse so if your enquiry is not answered within a reasonable time frame please contact us again and our technical team will rectify any faults.
As previously mentioned we pride ourselves on the level of customer service we provide so if you do see anything that you think we should be stocking and currently do not please contact us with your suggestions.
Unlike some other companies we take customer feedback very seriously and actually act upon it, any suggestions are recorded and if feasible incorporated into our overall business development plans.
We uphold and constantly improve our levels of service in order to reap the rewards of a word of mouth recommendation, meaning that if you are happy with your Cialis order and the service you received was good you will tell your friends and colleagues about us.
These word of mouth recommendations are in our opinion the best form of marketing bar none, and worth a lot more in the long run than direct mailing or full page advertising spreads in the press and elsewhere.
As previously mentioned Viagra can be bought elsewhere at a cheaper price but you can never be entirely sure exactly what you are buying.
The majority of these very cheap Cialis suppliers get there stock from the Far East and have not been certified by the European Union.
This lack of certification means that the medication could actually consist of anything or even nothing!
For something as important as your health it really does pay to visit a reputable supplier and with EVD you can be assured of that.
The price of the goods ordered will be in US dollars at the time you place your order on the product pages of our website.
The total cost of the product and delivery will be clearly displayed before the customer clarifies the final order and will be the final and full amount payable.
You can pay for your Cialis or Viagra with the majority of major credit cards and some debit cards, please be aware that some credit card companies charge a percentage if the transaction is conducted in foreign currency, please check their terms and conditions carefully before committing to any purchase.
By making all our terms and conditions clear and easy to understand we aim to make all customers aware of every detail before they purchase Cialis from us.
Although our lead times are amongst the fastest in the sector there may be occasions where the delivery time is a little longer than expected, if you have not received your order within a reasonable timeframe please contact us and we will look into reasons for the delay and provide you with a detailed explanation, please note that delivery delays are extremely rare and we will make every effort to inform you of any late Viagra or Cialis delivery.
Viagra: Definition from Answers.
A drug, C22H30N6O4S, used to treat sexual dysfunction by increasing the level of cyclic GMP, which increases blood flow to erectile tissues.
First oral drug for male impotence, generic name sildenafil.
Before the FDA approved Viagra in 1998, impotence was treated with surgical implants, suppositories, pumps, and drugs injected into the penis.
Taken as a pill shortly before sexual intercourse, Viagra selectively dilates blood vessels in the penis, improving blood flow and allowing a natural sexual response.
For more information on Viagra, visit Britannica.
Generic sildenafil tablets are not yet available.
What should I tell my health care provider before I take this medicine?
How should I take this medicine?
Take sildenafil tablets by mouth.
Follow the directions on the prescription label.
The dose is usually taken 1 hour before sexual activity.
You should not take this dose more than once per day.
Swallow the tablets with a drink of water.
Do not take double or extra doses.
Contact your pediatrician or health care professional regarding the use of this medicine in children.
What drug(s) may interact with sildenafil?
Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products.
Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs.
These may affect the way your medicine works.
Check with your health care professional before stopping or starting any of your medicines.
What should I watch for while taking sildenafil?
If you notice any changes in your vision while taking this drug, notify your prescriber or health care professional as soon as possible.
Stop using sildenafil right away if you have a loss of sight in one or both eyes.
Contact your healthcare provider immediately.
Contact you physician immediately if the erection lasts longer than 4 hours or if it becomes painful.
This may be a sign of priapism and must be treated immediately to prevent permanent damage.
If you experience symptoms of nausea, dizziness, chest pain or arm pain upon initiation of sexual activity after sildenafil use, you should refrain from further activity and should discuss the episode with your prescriber or health care professional as soon as possible.
Do not change the dose of your medication.
Please call your prescriber or health care professional to determine if your dose needs to be reevaluated.
HIV infection (the virus that causes AIDS) or other sexually transmitted diseases.
What side effects may I notice from taking sildenafil?
Keep out of reach of children in a container that small children cannot open.
Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F).
Throw away any unused medicine after the expiration date.
Important Disclaimer: The drug information provided here is for educational purposes only.
It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional.
This drug information does not cover all possible uses, precautions, side effects and interactions.
It should not be construed to indicate that this or any drug is safe for you.
Consult your medical professional for guidance before using any prescription or over the counter drugs.
Viagra is the trademarked name for sildenafil citrate, a prescription drug created to counteract impotence by blocking an enzyme called phosphodiesterase 5 (PDE5), which can end erections prematurely.
Food and Drug Administration granted approval for Viagra on 27 March 1998, doctors prescribed the drug more than any other medicine in history over a two-year time span.
This entry is from Wikipedia, the leading user-contributed encyclopedia.
Learn More SexualityDonald Trump vs.
What are generic viagra and are there any difference between viagra and generic viagra?
Where can you get viagra in belfast?
Published by Houghton Mifflin Company.
Britannica Concise Encyclopedia.
It uses material from the Wikipedia article "Sildenafil".
What does viagra do to females?
What can work like viagra without having to use viagra?
Title(There is a potential for cardiac risk of sexual activity in patients with preexisting cardiovascular disease.
Low prices, side effects, interactions.
Viagra is a phosphodiesterase-5 (PDE5) inhibitor used for treating erectile dysfunction (ED).
Viagra may also be used for other conditions as determined by your doctor.
Click on a drug in the list below to view prices and information.
Ask Your Pharmacist about ViagraDo you have a question about Viagra?
Our pharmacists have prepared hundreds of answers to commonly asked questions.
Check below for an answer to your question.
A:Viagra (generic name sildenafil) is a medication used to treat men who have trouble getting an erection, a condition called erectile dysfunction or impotence..
Q:Are there any drug interactions with Viagra?
A:Viagra (generic name sildenafil) is a medication used to treat men who have trouble getting an erection..
Q:Are there any prescription treatments for impotence?
A:Four prescription medications have been proven to help with impotence, a condition in which men have difficulty getting or keeping an erection..
Q:After taking Viagra, how soon will it work?
Q:How soon does Viagra work after I take it?
For more information about Viagra, visit www.
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For many people, talking about the penis is tough.
This area of the body is considered private and is usually not discussed publicly.
However, the penis is simply a part of the male anatomy designed to accomplish a task, and we'll treat it that way here.
Viagra helps with the second task: ejaculation.
Dreams and ErectionsThe average male has four to eight spontaneous erections every night while he sleeps.
They usually occur during the REM stage, when dreaming is most common.
The man becomes sexually aroused.
The penis responds by becoming erect.
Stimulation of the penis causes ejaculation.
That sounds simple enough, but in many cases, step two doesn't happen, making step three difficult or impossible.
Although the man is stimulated, the penis doesn't become erect.
To understand why, you need to understand the technology of an erection.
When you want to move nearly any part of your body, you do it using muscles.
Whether you are moving your fingers, toes, arms or legs, muscles do the work.
Muscles let you move your body voluntarily with precise control.
The penis, on the other hand, is completely different.
There are no muscle contractions involved in making the penis erect.
To become erect, the penis instead uses pressure.
Probably the easiest way to understand how the penis becomes erect is to think about a balloon.
If a balloon has no air in it, it's limp.
As you inflate a limp balloon with just a little air, it becomes elongated and rigid.
The penis uses a similar mechanism, but instead of using pressurized air to become rigid, the penis uses pressurized blood.
The penis contains two cigar-shaped structures, called corpora cavernosa (singular: corpus cavernosum), that it uses to become erect.
Think of the corpora cavernosa as balloonlike tubes.
There is no way for pressure to build inside the penis.
In this state, the penis is limp.
When a man becomes aroused, the arteries leading into the penis open up so that pressurized blood can enter the penis quickly.
The veins leaving the penis constrict.
Pressurized blood is trapped in the corpora cavernosa, and this blood causes the penis to elongate and stiffen.
If the arteries leading to the penis don't open up properly, it is difficult or impossible for a man to become erect.
This problem is the leading cause of erectile dysfunction (ED).
To solve an erection problem when the cause is poor blood flow, you need to open the arteries.
Let's take a look at how this can be done -- and how it was done before Viagra.
The first real breakthrough in the treatment of erectile dysfunction came in 1983.
Prior to that time, it was thought that erectile dysfunction -- the inability to achieve an erection -- was primarily mental.
That concept came crashing down at the 1983 American Urological Association meeting in Las Vegas when Dr.
Giles Brindley injected his penis with the drug phentolamine.
Brindley appeared on stage and dropped his pants to display one of the first drug-induced erections to the incredulous audience of urologists.
Skeletal - Skeletal muscles are the muscles we see at the Olympics -- bulging biceps and so on.
Cardiac - Cardiac muscle powers the heart.
Smooth - Smooth muscle can be found in things like blood vessels, the intestines and the stomach and usually acts involuntarily.
Smooth muscle plays a key role in every erection.
Smooth muscle plays a key role in every erection, and phentolamine is a drug that relaxes smooth muscle.
The reason why an injection of phentolamine gave Brindley an erection was especially interesting in 1983 because no one had really thought about it before.
The arteries of a limp penis are constricted, and they keep blood from entering the corpora cavernosa.
Brindley's injection relaxed the smooth muscle in the artery walls inside his penis, causing them to open up.
Blood surged into the corpora cavernosa, and the blood pressure inflated his penis, giving him an instant erection.
Starting in the mid-1980s, it became common for men with erectile dysfunction to inject smooth-muscle-relaxing drugs as a treatment for the problem.
Viagra makes the process a whole lot easier by doing the same kind of thing with a pill instead of an injection.
Another advantage of Viagra over an injection of phentolamine is that Viagra only causes an erection when the man is sexually aroused.
Phentolamine, by contrast, causes an immediate and uncontrolled erection.
How can a pill work only on the smooth muscle in the penis and not the entire body, and only when the man is aroused?
The answers to these questions begin with an understanding of how blood flow works in the body, so let's start there.
How can you give a man an erection with a pill?
You can't give a man a pill loaded up with a general smooth-muscle relaxer like phentolamine -- that would cause all of the smooth muscle throughout the man's body to relax, and that might create a lot of problems.
What you need is a drug that acts only on the smooth muscle in the arteries of the penis.
To understand how to make a penis-specific drug, think about the way blood flows in your body.
Your body has just one pump -- the heart.
But different parts of the body need different amounts of blood at different times.
If you eat a big meal, your body needs to send more blood to the stomach and intestines to help with digestion.
If you are running in a marathon, your body needs to send more blood to your arm and leg muscles, and it may want to cut most of the blood flowing to the stomach (and other nonessential organs) in order to save oxygen for the legs.
What your body needs, in other words, is a set of valves that it can use to increase and decrease blood flow to certain parts of the body.
And your brain needs a way to control those valves so it can turn them on and off when necessary.
The penis is one of the places in the body where the brain needs to be able to turn the blood flow on and off with a valve.
To understand how the brain controls this particular valve, let's start with the basic concept at work: How does the brain control blood flow to different parts of the body?
When these muscles relax, the arteries open up and blood flow increases.
The valves respond to chemical messages that the brain can control.
The brain sends a signal down a particular nerve fiber.
This nerve fiber ends in an NANC nerve cell in an artery, somewhere near the point where blood flow needs to change.
NANC stands for nonadrenergic-noncholinergic, and what it means is that the NANC nerve cell is able to create nitric oxide.
The NANC nerve endings inject nitric oxide into the blood and surrounding cells.
The nitric oxide stimulates an enzyme called guanylate cyclase in nearby cells, and this enzyme starts producing a chemical called cyclic guanosine monophosphate (cGMP).
GMP tells smooth muscles that line an artery to relax.
When they relax, blood flow increases.
This mechanism is a simple little chemical machine, and the brain uses it to increase blood flow in several different parts of the body.
But there is one final part to this chemical machine: Another enzyme called phosphodiesterase (PDE) deactivates the cGMP.
The brain sends signals to NANC cells in the artery.
The NANC cells release nitric oxide (NO).
Nitric oxide acts as a signaling molecule and stimulates an enzyme called guanylate cyclase in nearby cells.
The guanylate cyclase converts a chemical called GTP into another chemical called cGMP.
GMP causes muscles in the walls of the arteries to relax.
This relaxation increases blood flow.
Meanwhile, PDE is decomposing the cGMP and turning it back into GTP.
There is a cycle -- guanylate cyclase turns GTP into cGMP, and PDE turns cGMP into GTP.
Nitric oxide turns the cycle on.
GMP is produced as long as the brain is sending messages down the nerve fibers in the artery, which generate nitric oxide and keep the cycle going.
When the brain stops sending the signal, all of the cGMP goes away because PDE is deactivating it.
This way, the brain can turn valves on and off whenever it wants to.
So how does this relate to an erection?
When the brain gets aroused, it sends a signal to the penis.
Nerve cells in the penis' corpora cavernosa start producing nitric oxide, which leads to the creation of cGMP.
The cGMP causes arteries in the corpora cavernosa to dilate, causing lots of blood to flow into the penis.
The extra blood flowing in causes the penis to inflate like a balloon.
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When a man suffers from erectile dysfunction, there can be many reasons for the problem.
But one of the most common reasons, especially in older men, is that the arteries in the penis aren't dilating enough when the brain sends the signal.
GMP produced is not enough to maintain an erection.
The way that Viagra goes about solving this problem is quite ingenious, and involves the following question: How can you create a drug that affects only the penile valve?
The Nobel PrizeIn 1998, three scientists -- Robert F.
The Nobel Prize in Physiology or Medicine 1998 to learn more.
PDE that is decomposing the cGMP, so cGMP builds up in the penis and has a larger effect on the artery walls.
The greater the amount of cGMP the greater the blood flow, and the greater the blood flow the greater the degree of the erection.
The reason that Viagra uses this technique is because of an interesting quirk of PDE.
It turns out that the human body has at least 11 different kinds of PDE that it produces.
Only one of those kinds of PDE -- PDE5 -- is found primarily in the penis.
All that Pfizer needed to find was a chemical that would selectively block PDE5 and nothing else.
With the PDE5 blocked, cGMP could build up in the penis and increase the blood flow there without affecting other parts of the body.
If there were not a unique type of PDE found in the penis, we would not have Viagra today.
PDE5 is what is known as an enzyme.
An enzyme is a specially folded protein that can speed up a chemical reaction.
For example, the article How Cells Work describes the maltase enzyme.
PDE5 is an enzyme that accepts cGMP and breaks it down.
Pfizer needed a chemical that would gum up PDE5 and keep it from doing its job.
The chemical that Pfizer discovered is called sildenafil citrate.
It fits right into the PDE5 enzyme and disables it.
Viagra contains sildenafil citrate packaged as a pill.
When a man takes a Viagra pill, the sildenafil citrate flows throughout his body, but it really only affects the PDE5 enzyme in the penis.
The drug stays in the bloodstream for about four hours, and then it is washed out of the blood by the liver and kidneys.
The sildenafil citrate enters his bloodstream and flows throughout his body.
The sildenafil citrate attaches to the PDE5 enzyme in his penis and disables most of it.
When the man becomes sexually aroused, the brain sends the normal message to the NANC cells in his penis, which produce nitric oxide as usual.
The nitric oxide creates cGMP, which starts relaxing the arteries in his penis.
Since the PDE5 has been disabled, the cGMP in the penis does not break down.
Instead, it builds up and lets the arteries in the penis fully dilate.
His penis inflates with blood, and the man gets a full erection.
This works perfectly for the majority of men, except for a few minor problems...
Very few drugs work perfectly, and Viagra is no exception.
Just about every drug has side effects that arise because the drug is flowing throughout the body and may affect parts of the body unintentionally.
For example, aspirin is a drug that relieves pain, but this same drug can also erode the stomach lining and thin the blood.
Those are side effects of aspirin.
Viagra has several side effects of which patients need to be aware.
The first problem comes because Viagra happens to have a spillover effect.
It blocks PDE5, but it also has an effect on PDE6.
It turns out that PDE6 is used in the cone cells in the retina, so Viagra can have an effect on color vision.
Many people who take Viagra notice a change in the way they perceive green and blue colors, or they see the world with a bluish tinge for several hours.
For this reason, pilots can't take Viagra within 12 hours of a flight.
The second problem comes for people who are taking drugs like nitroglycerin for angina.
Nitroglycerin works by increasing nitric oxide, and it helps with angina by opening up the arteries that supply the heart with oxygen.
If you take nitroglycerin and Viagra together, the increased nitric oxide plus the blocking of PDE5 can lead to problems.
Other problems with Viagra can include little things like headaches (the drug, as a side effect in some men, opens up arteries in the brain's lining and causes excess pressure) and big things like heart attacks.
The possibility of heart attacks is one reason why Viagra is a prescription drug rather than an over-the-counter drug like aspirin.
A doctor needs to understand your medical history and make sure that Viagra won't cause a heart attack.
That is, they may become unable to maintain an erection without taking Viagra.
Viagra is a hugely successful drug, and other drug companies wanted a piece of the action.
They developed different chemicals to block the PDE5 enzyme and created two new drugs: Cialis (tadalafil) and Levitra (vardenafil).
Because Cialis and Levitra block the PDE5 enzyme, they work exactly the same way as Viagra.
They help men who have trouble maintaining an erection because of blood flow problems, and they only work when the man is sexually aroused.
Because they block PDE5 with different chemicals, however, there are some important differences between the three drugs.
Only Viagra causes color-vision problems.
Cialis causes muscle aches in about 5 percent of patients.
Viagra and Levitra last about four hours in the bloodstream.
Cialis stays in the bloodstream much longer (it has a 17.
For lots more information about Viagra, other drugs that treat erectile dysfunction and related topics, check out the links on the next page.
Human Biology Web Site: What is Viagra and How Does It Work?
Google and yahoo searches are a mess with edu and gov sites.
Viagra belongs to a group of medicines called phosphodiesterase type 5 or PDE-5 inhibitors.
It works to relax the muscle that can block blood flow to the penis.
Without this blood flow there is no erection.
So if this muscle is not regulated, you get no ejection.
Viagra works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection.
Viagra causes erections only during sexual excitement.
It does not work in the absence of arousal.
How long does the effect of Viagra last?
For most men, it lasts for up to 4 hours or until orgasm.
What the side effects of Viagra?
The most commonly reported side effects with Viagra are: headache, flushing, stomach ache, and mild and temporary visual changes (color perception changes, light perception changes, and blurred vision).
If your erection lasts more than 4 hours, seek immediate medical help.
Viagra is not recommended for women.
Viagra can work for women as well.
Drinking alcohol can temporarily impair your ability to get an erection.
To get the maximum benefit from your medication, you should not drink large amounts of alcohol before taking Viagra.
Can Viagra be taken after after eating?
Yes, but if you do so after a high-fat meal it may take Viagra longer to work.
What is the recommended dosage of Viagra?
Viagra is taken orally as a once-daily dose, an hour before sexual activity.
The usual dose is 50 milligrams.
If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoconazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient.
For more detailed information, check with your physician.
Does Viagra work immediately after it is taken?
For VIAGRA to work, there has to be sexual stimulation.
VIAGRA is not an aphrodisiac or a hormone.
It is a medicine that treats erectile dysfunction.
If you use drugs that contain nitrates, such as nitroglycerin (drugs commonly used for the treatment of chest pains due to heart disease), you should not use Viagra.
Taking Viagra with any nitrate medicine can cause your blood pressure to suddenly drop to an unsafe or life-threatening level.
You could get dizzy, faint, or even have a heart attack or stroke.
Viagra is used for treating erectile dysfunction (e.
It works by helping the blood flow into the penis to achieve and maintain an erection during sexual stimulation.
You must be logged into Answers to add comments.
I agree--cheap medications in general are probably not what you want to put in your body.
Buy cheap pot holders, ziplocs or maybe socks...
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Are You meant to have red lines in your abs?
Are these after vitamin changes normal?
Why dont they change Men health section name to Women health section too, its full of them?
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A total service Ukmedix offers you the chance to research Viagra, ask doctors questions with absolutely no obligation and discuss with others, just like you, how they have found the treatment Viagra.
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Ukmedix keeps you up to date with the latest news on Viagra.
The prescription drug Viagra has become a popular choice for many millions of men suffering from impotence.
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By allowing you to thoroughly research the prescription drug Viagra we hope you get a good an understanding on the treatment Viagra offers and whether it may be able to assist you with the condition of impotence.
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Viagra is a prescription drug approved by the MHRA for the treatment of impotence.
When you come to Ukmedix seeking to buy Viagra, you don't simply order Viagra in the same way you may buy a CD or DVD online.
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Discuss Viagra and your treatment Ukmedix opened up a forum for those of you who have bought Viagra or are thinking of buying the drug from Ukmedix.
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From Jerry Kennard, former About.
GuideUpdated January 02, 2007About.
Nov 30 2009Viagra (Sildenafil) was approved by the Food and Drug administration (FDA) in 1998 and was the first drug for the treatment of erectile dysfunction.
Given as an oral medication, 9 tablets are dispensed every second worldwide and Pfizer, the manufacturer of the drug says that millions of men have been helped to improve their sex lives.
Impotence, or erectile dysfunction, is a problem that affects most men at some time in their lives.
Viagra is a drug for those whose problem is not resolving in the short term and who have been advised by their doctor that it is a safe drug for them to try.
Originally studied for the use in people with high blood pressure and cardiac problems the drug was found to have a very interesting side effect.
Viagra increases the blood flow to the penis and enables a man to maintain an erection for at least 4 hours.
It only works if the man is sexually stimulated so will not cause an erection by just taking the pill.
The medication is taken in pill form by mouth.
One Viagra tablet can be taken in 24 hours, it will usually work within 30 minutes to 1 hour and lasts about 4 hours.
The most common side effects are headache, facial flushing, dizziness, visual problems such as blurred vision, bluish vision and sensitivity to light, nasal congestion, an upset stomach.
Do not take Viagra if you use nitrate drugs.
These types of drugs used to treat cardiac problems such as angina can if used in combination with Viagra cause the blood pressure to drop to unsafe, sometimes life threatening levels.
People with cardiac problems, anatomical malformations of the penis such as Peyronie's disease, men with a predisposition to prolonged erections caused by sickle cell anemia, multiple myeloma (a form of cancer), leukemia, liver problems (especially severe liver disorders), kidney problems and people taking certain medications used for HIV or those over 65 should NEVER take the drug unless prescribed by a medical practioner.
Deaths have occurred during sexual activity in men using the drug.
Viagra is one of the medications that has revolutionized the treatment of erectile dysfunction.
It has allowed those who where unable to maintain an erection or only able to have partial erections enjoy a better sex life.
Related ArticlesViagra - Before Taking Viagra - Viagra Side EffectsSexual Problems in Men in Men - Sexual Problems in Men Symptoms in Men - Se...
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Viagra (sildenafil citrate) is a medication made by Pfizer Pharmaceuticals, and is the first approved non-surgical treatment for erectile dysfunction (ED) that does not have to be either injected or inserted directly into the penis to achieve and maintain an erection.
It was approved by the FDA for prescription sale at the end of March, 1998.
What is the history of the development of Viagra?
Originally developed by Pfizer as a drug to help men who were suffering from chest pain, sildenafil citrate as a heart medication did not show promise and studies were stopped in 1992.
However, based on published information about some properties contained in sildenafil citrate, Pfizer researchers began to look at it as a treatment for erectile dysfunction.
It was re-evaluated for its effect on the ability of men with ED to engage in sexual activity, and the ability to achieve and maintain erection sufficient for satisfactory sexual activity.
Eventually, twenty-one randomized, placebo-controlled clinical trials involving more than 3700 patients, ages 19-87 years, were held worldwide.
Some patients also had coexisting illnesses, including hypertension and coronary artery disease.
The clinical trials found Viagra to be so effective, the FDA approved it only six months after submission, and without consulting an advisory committee of outside experts because there were no troubling questions and no significant side effects.
What are the general precautions for taking Viagra?
Healthcare professionals advise cautious optimism when considering using Viagra.
Although data from the clinical trials are very promising, prospective patients must have realistic expectations.
The drug is not an aphrodisiac, and does not change libido or desire.
Viagra does not directly cause penile erection, but affects the response to sexual stimulation.
If you are taking medicines that contain nitrates, such as nitroglycerin, you should not use Viagra.
The two taken together can lower blood pressure too much.
Viagra should not be used by women or children.
Have a complete medical history and physical examination to determine the cause of your erectile dysfunction.
Men with medical conditions that may cause a sustained erection such as sickle cell anemia, leukemia or multiple myeloma, or a man who has an abnormally shaped penis may not be able to take Viagra.
Tell your physician about all the medications you are taking -- including over-the-counter ones -- because there are medications known to interact with Viagra.
Viagra's use in combination with other ED treatments has not been studied, therefore, its use in combination with other treatments is not recommended.
What are the side effects of Viagra?
Side effects that occurred less than 2 percent included respiratory tract infection, back pain, flu syndrome, and arthralgia (joint pain).
The erection of the penis involves release of nitric oxide (NO), a chemical that is normally released in response to sexual stimulation, in the corpus cavernosum of the penis.
Nitric oxide then activates an enzyme called guanylate cyclase, which, in turn, results in increased levels of cyclic guanosine monophosphate (cGMP).
This produces smooth-muscle relaxation in the corpus cavernosum and allows the inflow of blood.
There are three types of muscles: smooth, cardiac, and striated.
Smooth muscles are those that are involuntary in action and are found principally in internal organs.
Viagra (sildenafil citrate ) has no direct relaxant effect on the human corpus cavernosum.
Instead, sildenafil enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PDE5).
PDE5 is responsible for degradation of cGMP in the corpus cavernosum, which causes the penis to become flaccid, or relaxed.
When sexual stimulation causes local release of NO, sildenafil inhibits PDE5, which, in turn, causes increased levels of cGMP in the corpus cavernosum.
This results in continued smooth-muscle relaxation, allows for inflow of blood to the corpus cavernosum, and erection of the penis.
Sildenafil at has no effect in the absence of sexual stimulation.
Men who are currently using medications that contain nitrates, such as nitroglycerin should not use Viagra because taken together they can lower blood pressure too much.
Because of the blood pressure lowering effect of Viagra, your doctor will evaluate your overall medical condition to determine if this, in combination with sexual activity, could adversely affect your health.
Viagra may cause a rare but serious condition of prolonged erection (priapism).
It is important to contact your health care provider immediately if your erection lasts longer than 4 hours.
Men for whom sexual activity is inadvisable may not be good candidates for Viagra.
Between March and November 1998, the FDA investigated more than 200 reported cases that involved death or serious illness.
Many cases were eliminated because of unverifiable information.
They concentrated on 130 deaths of men who had been prescribed the drug.
Cause of death was unmentioned or unknown for 48 cases.
However, the FDA felt that label or enclosure information and warnings should be stronger.
In November 1998, Pfizer revised the information in consultation with the FDA.
As with all approved medications, the FDA continues to monitor the safety of Viagra by carefully reviewing reports of death and other serious adverse events and will continue to evaluate the need for regulatory action.
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UMMC is a member of the University of Maryland Medical System, 22 S.
Are there any effective alternatives?
Manufacturer : Pfizer (no generics) Looks like : Small blue diamond-shaped pills Available dosages : 25 milligrams, 50 mg, 100 mg What does Viagra do?
As you've probably heard, Viagra (sildenafil) is used to treat erectile dysfunction (commonly called "impotence") in men who either can't have or can't maintain erections.
It even has the blessing of the Vatican, on the ground that it can strengthen families.
Just as important, here's what Viagra can't do.
And it's not a performance-enhancer.
If you're healthy, Viagra won't give you a faster or harder erection or help you last longer.
In fact, in healthy men it can even cause a painful, long-lasting erection (a condition called priapism) that may lead to erectile dysfunction if it isn't treated quickly.
Viagra works for about 70 to 85 percent of men with erectile dysfunction caused by physical factors, such as damaged nerves (a frequent effect of diabetes), narrowed blood vessels (an effect of atherosclerosis), or side effects from medications.
It can also help men whose erectile dysfunction stems from anxiety or other psychological causes.
You usually swallow one tablet about an hour before sex.
It takes an hour to take peak effect, though the waiting time can range from half an hour to two hours.
The process doesn't begin automatically, though -- you still need to be aroused in order to have an erection.
Viagra starts clearing out of the bloodstream about two hours after you take it, and it's mostly gone after six hours or so.
Viagra boosts the levels of cyclic GMP in the penis.
It does this by preventing an enzyme (a protein involved in a biochemical reaction) called phosphodiesterase type 5, or PDE5, from breaking down cyclic GMP as fast as it usually does.
The result: Cyclic GMP stays around longer, the muscles relax, and more blood flows in and stays in.
The most serious side effect of Viagra results from a possible drug interaction.
Taking Viagra while you're on any drug that contains nitrates, such as a common type of heart medication called nitroglycerin (the same chemical as dynamite, sold under many brand names including Nitrostat, Transderm-Nitro, and Nitrolingual), can cause a sharp and sometimes dangerous drop in blood pressure.
Talk to your doctor or pharmacist to make sure Viagra won't interact harmfully with anything else you're taking.
Even if you're not on nitroglycerin, Viagra's new label advises doctors to use caution in prescribing the drug to anyone with a history of cardiovascular disease, including heart attack, stroke, angina, or high or low blood pressure.
That's because if you should ever suddenly need to take nitroglycerin, the chance of an interaction with Viagra could be too great to risk.
To date, at least 130 men have died shortly after taking Viagra.
In most cases they had heart attacks, although it isn't clear whether those were caused by Viagra or by the excitement and exertion of having sex after a long break.
Other side effects are related to the way Viagra works in the body.
The enzyme blocked by Viagra, PDE5, is also found in other parts of the body, among them the blood component known as platelets and some muscles around blood vessels.
The drug can disrupt the way blood cells and vessels normally function in certain areas, including the head, skin, and stomach -- which might explain many of its commonly reported side effects, such as headache (reported by 16 percent of users), flushed skin (10 percent), and indigestion (7 percent).
Viagra blocks PDE5 very well, but it can also partly block a closely related enzyme, PDE6, which is found in the retina of the eye.
That's why about 3 percent of men on Viagra experience visual side effects, including bluish or blurry vision and sensitivity to light.
In July 2005, the FDA issued an alert that a small number of men lost eyesight in one eye some time after taking Viagra, Cialis, or Levitra.
Doctors don't know whether the drugs caused the vision loss, but people with certain conditions -- like heart disease, diabetes, hypertension -- are at higher risk of developing the complication.
Similarly, men with existing eye conditions -- like retinitis pigmentosa, for example -- may need to steer clear of the drug altogether to avoid eye damage.
Most recently, the FDA reported that Viagra, Cialis, and Levitra may also cause sudden hearing loss.
While hearing loss is a common malady among older people, and the FDA found only 29 cases of sudden hearing loss related to these drugs, the agency emphasizes that "sudden hearing loss is an uncommon event at any age.
So far there's no evidence that it can help women who have sexual problems.
A small study of postmenopausal women on Viagra found that the drug did increase blood flow to the clitoris (often uncomfortably so) but didn't help any of the women get aroused more easily or feel more pleasure during sex.
If you think you need the little blue pills, you probably have a health problem already -- so it's important to discuss things with your doctor in order to make sure Viagra can actually help you without harming you.
The drug is approved for sale in the US, Japan, and Europe, and is legally available by prescription only.
Some Web sites sell Viagra illegally without a prescription, but it's NOT a good idea to order from them.
There's no guarantee that you'll get the genuine article, you'll pay much more, and your medical history won't be reviewed properly, if at all.
Viagra isn't the first -- or the only -- game in town.
Two additional drugs that work much like Viagra have been approved by the FDA: Levitra (vardenafil) and Cialis (tadalafil).
Until these pills came along, the most common drug treatment for erectile dysfunction consisted of injecting alprostadil (a synthetic form of a naturally-occurring chemical called prostaglandin E1) into the penis.
For obvious reasons, that never caught on the way Viagra has.
Prostaglandin E1 works much like Viagra, relaxing muscles and dilating blood vessels.
Another prescription medication, Regitine (it's generic name is phentolamine) is also an erectile dysfunction drug that's injected into the penis.
A pill form called Vasomax will soon be available, although it's less effective than injections.
Just as Viagra does, phentolamine enhances the flow of blood to the penis to produce an erection, but unlike Viagra, it doesn't interfere with nitrate medicines and could be safer for men with heart disease.
Some herbal preparations, often containing yohimbe, are sold under names like "Viegra" and "Viagre," but these are not related to the real Viagra.
Yohimbe is the bark of an African tree, fabled as a sexual stimulant in men and women.
Like Viagra, the bark's active ingredient (called yohimbine) increases blood flow to the penis, but it hasn't shown consistent results in clinical studies of erectile dysfunction.
Yohimbine is also available in prescription pill form, under the name Yocon.
This purified form of yohimbine has fewer side effects than the raw bark, which can dangerously increase blood pressure and heart rate.
However, it's important to note that the American Urologic Association does not recommend yohimbine for the treatment of erectile dysfunction.
Erectile dysfunction Drug Could Offer Long-term Help.
Oral medications for erectile dysfunction: Explore your options.
US Food and Drug Administration.
Questions and Answers about Viagra, Levitra, Cialis, and Revatio: Possible sudden Hearing Loss.
The Management of Erectile Dysfunction: An Update.
American Urologic Association Education and Research.
Brown University in Providence, Rhode Island and assistant clinical professor of emergency medicine at Tufts University School of Medicine in Boston, Massachusetts.
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Looking forward to order more in the future.
The erectile dysfunction drug Viagra may have found a new, potentially life-saving use in hospital pediatric intensive care units, researchers report.
Australian researchers gave the drug to 15 babies with congenital heart disease who were being weaned from inhaled nitric-oxide therapy, a treatment that ICUs use to help these infants survive.
Viagra Helps COPD Patients Control Pulmonary Blood PressureThe drug sildenafil, popularly known as Viagra, may help people with chronic obstructive pulmonary disease control the illness-related blood pressure spikes in the heart's pulmonary artery, a new study found.
Could a widely used treatment for depression be a remedy for osteoporosis?
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I have previously contacted yourselves and have been advised that marking them as spam will ensure they are not resent to me, this does not appear to be the case.
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You keep on opening and reading your spam or junk mail.
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Manufactured by Pfizer, Viagra was the first drug for the treatment of erectile dysfunction.
Most men buy Viagra as it is very popular and has been around since 1998.
Viagra was one of a kind when it came to the market.
Viagra not only treats erectile dysfunction but also varying degrees of erection problems.
However there are many more medicines now available online which help considerably to treat erectile dysfunction.
Viagra is still the most widely used medication for impotence despite the launch of Uprima, Cialis and Levitra.
You can buy Viagra online in 25mg, 50mg and 100mg dosages.
If you are buying Viagra for the first time, you should buy the lowest dose and increase the strength if ineffective.
Though Viagra is proven to be safe under most conditions, it does have some side effects you should be aware of before you buy it.
Some are common and shouldn't cause too much concern.
When you buy Viagra, take care that you don't take it in combination with medications that contain nitrates (nitroglycerine) as the consequences may be fatal.
Flushing, headache, nasal congestion, and stomach discomfort following meals.
When you buy Viagra these side effects generally occur.
These side effects usually do not need medical attention, and they may go away during treatment as your body adjusts to the drug.
Report any of these Viagra side effects to your doctor.
Important: If you experience a prolonged or painful erection for four hours or more following your Viagra dosage, contact your doctor or emergency medical facility immediately.
This condition may require prompt medical treatment to prevent tissue damage of the penis and possible permanent ED.
Need more specific medical advice online about Viagra?
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Viagra has been approved for the treatment of impotence in men.
The FDA drug information shown here is licensed from Thomson CenterWatch.
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Viagra Associated with Sudden Hearing LossIn October 2007, the Viagra label was modified to include warnings about sudden hearing loss associated with the drug.
Drug Administration (FDA) had requested the changes after it had received 29 reports of patients who experienced sudden hearing loss within hours to two days of taking Viagra.
Many men who take Viagra are older, and it is not unusual for this patient population to experience some hearing loss.
But that is almost always a gradual process, and sudden loss of hearing is rare.
All of the reports involved the loss of hearing in one ear, and in a third of the cases the hearing loss was temporary.
Viagra Vision Loss - Nonarteritic Ischemic Optic Neuropathy (NAION)In a recent study, US researchers describe seven patients who developed nonarteritic ischemic optic neuropathy (NAION), an eye ailment that can result in permanent vision loss, after taking Viagra (Generic: Sildenafil) for erection difficulties.
Combined with past reports, this study brings the total number of sildenafil-related NAION cases to 14.
Viagra was approved by the FDA in 1998.
Pomeranz, from the University of Minnesota in Minneapolis, said in a statement.
With the exception of one patient whose symptoms began 24 to 36 hours after using Viagra, the patients developed symptoms within 24 hours of use.
In all patients, the initial symptoms were blurred vision and some degree of vision loss.
In one patient, both eyes were affected, whereas in the remainder, just one was involved.
Three patients had preexisting eye problems that may have increased their risk of NAION.
Viagra impotence drug has been linked to reports of blindness and vision loss in at least one in a million users.
The FDA has 38 reports of the blindness among users of Viagra.
Pfizer has been in discussions with the FDA about adding a disclosure to Viagra's label to say that in rare cases, men taking Viagra had developed blindness.
If you or a loved one took Viagra and suffered NAION or other side effects, please fill out the form at the right for a free case evaluation by a qualified drug side effects attorney.
Food and Drug Administration (FDA) is warning consumers that Stiff Nights, a product marketed as a dietary supplement for sexual enhancement, contains an ingredient that can dangerously lower blood pressure and is illegal.
Stiff Nights contains sulfoaildenafil, a chemical similar to sildenafil, the active ingredient in Viagra.
Following a consumer complaint, the FDA determined that the product contains sulfoaildenafil and warns that sulfoaildenafil may interact with prescription drugs...
The labeling for Viagra and Cialis will now include information about Transient Global Amnesia (TGA), a side-effect that may occasionally accompany use of the erectile dysfunction (ED) drugs.
A third ED drug, Levitra, had information about the temporary form of memory loss added to its label in June.
Xiadafil VIP Tabs found on-hand at the facility.
The Xiadafil VIP Tabs contain a potentially harmful,...
A Viagra ad has Pfizer in trouble with federal regulators.
Drug Administration (FDA) to issue Pfizer a warning letter.
For its part, Pfizer insists the omission was nothing more than a technical error on the website where the Viagra ad ran.
Viagra is a PDE5 Inhibitors that relaxes muscles and increases blood flow to certain parts of the body.
Both of these products are being marketed as supplements for erectile dysfunction and sexual enhancement and are being labeled and marketed as dietary supplements throughout the United States.
Have you been diagnosed with NAION (nonarteritic ischemic optic neuropathy)?
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The FDA issued several warnings concerning Viagra related side effects.
The links below will redirect you to these warnings on the FDA website.
Please note that you are not considered a client until you have signed a retainer agreement and your case has been accepted by us.
Prior results do not guarantee or predict a similar outcome with respect to any future matter.
Viagra Drug Information and Side Effects (Sildenafil citrate) on HealthSquare.
See all our sites for your special health needs at www.
Viagra is an oral drug for male impotence, also known as erectile dysfunction (ED).
It works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection.
Taking Viagra approximately 1 hour before sexual activity works best for most men.
Depending on how and when the drug works for you, an interval of one-half hour to as much as 4 hours may prove ideal.
Take it only before sexual activity.
Side effects cannot be anticipated.
If any develop or change in intensity, inform your doctor as soon as possible.
Only your doctor can determine if it is safe for you to continue taking Viagra.
Heart attack, stroke, heart irregularities, dangerous surges in blood pressure, and sudden death have all been reported after use of Viagra, usually in men with existing cardiac risk factors, and typically during or shortly after sex.
Why should Viagra not be prescribed?
Do not take Viagra if you are taking any nitrate-based drug, including nitroglycerin patches (Nitro-Dur, Transderm-Nitro), nitroglycerin ointment (Nitro-Bid, Nitrol), nitroglycerin pills (Nitro-Bid, Nitrostat), and isosorbide pills (Dilatrate-SR, Isordil, Sorbitrate).
Combining Viagra with these drugs can cause a severe drop in blood pressure.
If Viagra gives you an allergic reaction, do not use it again.
If you have heart problems severe enough to make sexual activity a danger, you should avoid using Viagra.
Be equally cautious if you have severe high or low blood pressure, heart failure, or unstable angina (crushing heart pain that occurs at any time).
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This product information is intended only for residents of the United States.
Read important information about this medication.
To learn more about this medication, visit the VIAGRA consumer Web site.
Pfizer has programs that can help, no matter your age or income.
You may even qualify for free Pfizer medicines.
This link is provided as a convenience.
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Pfizer product information, patient education materials, professional tools and resources, and more.
This valuable online resource includes information about more than 150 Pfizer medicines.
Visit the consumer Web site to learn more about VIAGRA and ED.
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VIAGRA film-coated tablets contain the following inactive ingredients: Microcrystalline cellulose, calcium hydrogen phosphate (anhydrous), croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, indigo carmine aluminium lake.
VIAGRA restores impaired erectile function by increasing blood flow to the penis, in response to sexual stimulation.
PDE5) which is responsible for degradation of cGMP in the corpus cavernosum.
Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but enhances the relaxant effect of NO on this tissue.
GMP pathway is activated, during sexual stimulation, inhibition of PDE5 by sildenafil results in increased corpus cavernosum levels of cGMP, producing smooth muscle relaxation in the corpus cavernosum allowing the inflow of blood.
The mean absolute oral bioavailability is 41% (range 25-63%).
L, indicating distribution into the tissues.
Sildenafil and its major circulating N-desmethyl metabolite are both approximately 96% bound to plasma proteins.
Protein binding is independent of total drug concentrations.
Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes.
The major circulating metabolite results from N-demethylation of sildenafil.
This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% that of the parent drug.
Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil.
After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the faeces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of administered oral dose).
AUC (100%) and Cmax (88%) compared to age-matched volunteers with no renal impairment.
A and B) sildenafil clearance was reduced, resulting in increases in AUC (84%) and Cmax (47%) compared to age-matched volunteers with no hepatic impairment.
VIAGRA shows no evidence of any mutagenic or carcinogenic potential.
VIAGRA is indicated only for the treatment of erectile dysfunction.
Use of VIAGRA is contraindicated in patients with a known hypersensitivity to any component of the tablet.
GMP pathway (see Pharmacological Action), VIAGRA was shown to potentiate the hypotensive effects of nitrates, and its co-administration with nitric oxide donors or nitrates in any form is therefore contraindicated.
Doctors should discuss with patients the contra-indication of VIAGRA with concurrent organic nitrates.
There is a potential for cardiac risk of sexual activity in patients with pre-existing cardiovascular disease.
A thorough medical history and physical examination should be undertaken to diagnose erectile dysfunction, determine potential underlying causes, and identify appropriate treatment.
VIAGRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers.
Physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity.
Patients with retinitis pigmentosa (a minority of these patients have genetic disorders of retinal phosphodiesterases).
Agents for the treatment of erectile dysfunction should not be used in men for whom sexual activity is inadvisable.
Therefore the use of such combinations is not recommended.
Controlled studies of drug interactions between VIAGRA and other antihypertensive medications have not been performed.
VIAGRA has no effect on bleeding time, including during co-administration with aspirin.
In vitro studies with human platelets indicate that sildenafil potentiates the anti-aggregatory effect of sodium nitroprusside (a nitric oxide donor).
There is no safety information on the administration of VIAGRA to patients with bleeding disorders or active peptic ulceration.
Therefore VIAGRA should be administered with caution to these patients.
The use of viagra offers no protection against sexually transmitted diseases.
Precautions against unwanted pregnancy should be taken.
Physicians should discuss with patients the potential cardiac risk of sexual activity in patients with preexisting cardiovascular risk factors.
Patients who experience symptoms (e.
VIAGRA is not indicated for use in women.
As dizziness and altered vision were reported in clinical trials with VIAGRA, patients should be aware how they react to VIAGRA and exercise caution before driving, operating hazardous machinery or performing hazardous tasks.
VIAGRA tablets are for oral administration.
P450 3A4 inhibitors (erythromycin, ketoconazole, itraconazole, 200%).
VIAGRA is not indicated for use in children.
Serious cardiovascular events, including myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack and hypertension, have been reported post-marketing in temporal association with the use of VIAGRA.
Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of VIAGRA without sexual activity.
Others were reported to have occurred hours to days after the use of VIAGRA and sexual activity.
WARNINGS for further important cardiovascular information).
Ocular: abnormal vision (Mild and transient.
Predominantly colour tinge to vision, but also increased perception of light or blurred vision).
Urogenital: cases of priapism (prolonged erection) have been reported.
Cystitis, nocturia, urinary frequency, breast enlargement, urinary incontinence, abnormal ejaculation, genital edema, anorgasmia and haematuria have also been reported.
Digestive: dyspepsia, vomiting, glossitis, colitis, dysphagia, gastritis, gastroenteritis, esophagitis, stomatitis, dry mouth, liver function tests abnormal, rectal hemorrhage, gingivitis.
Metabolic and Nutritional: thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, and hypernatremia.
Musculoskeletal: arthritis, arthrosis, myalgia, tendon rupture, and tenosynovitis, bone pain, myasthenia, synovitis.
Nervous: ataxia, hypertonia, neuralgia, neuropathy, paresthesia, tremor, vertigo, depression, insomnia, somnolence, abnormal dreams, reflexes decreased, and hypesthesia.
Respiratory: nasal congestion, asthma, dyspnea, laryngitis, pharyngitis, sinusitis, bronchitis, sputum increased, cough increased.
Sildenafil metabolism is principally mediated by the cytochrome P450 (CYP) isoforms 3A4 (major route) and 2C9 (minor route).
Population pharmacokinetic analysis of clinical trial data indicated a reduction in sildenafil clearance when co-administered with CYP3A4 inhibitors (such as itraconazole, ketoconazole, erythromycin, and cimetidine).
However, there was no increased incidence of adverse events in these patients.
Population pharmacokinetic analysis showed no effect of concomitant medication on sildenafil pharmacokinetics when grouped as CYP2C9 inhibitors (such as tolbutamide, warfarin), CYP2D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and related diuretics, loop and potassium sparing diuretics, ACE inhibitors, calcium channel blockers, beta-adrenoreceptor antagonists or inducers of CYP450 metabolism (such as rifampicin, barbiturates).
M after recommended doses, it is unlikely that VIAGRA will alter the clearance of substrates of these isoenzymes.
Hg) was of a similar magnitude to that seen when VIAGRA was administered alone to healthy volunteers (see Pharmacodynamic properties).
Analysis of the safety database showed no difference in the side effect profile in patients taking VIAGRA with and without anti-hypertensive medication.
VIAGRA was shown to potentiate the hypotensive effect of acute and chronic nitrates.
Therefore, use of nitrates or nitric oxide donors with VIAGRA is contraindicated (see Contraindications).
In cases of overdose, supportive measures should be adopted as required.
Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not eliminated in the urine.
The tablets are blue film coated, rounded diamond-shaped tablets, marked PFIZER on one side and VGR 25 on the other.
The tablets are blue film coated, rounded diamond-shaped tablets, marked PFIZER on one side and VGR 50 on the other.
The tablets are blue film coated, rounded diamond-shaped tablets, marked PFIZER on one side and VGR 100 on the other.
Blisters strips in cartons of 1, 2, 4, 8 and 12.
Keep out of the reach of children.
Viagra sales have soared in the UK due to the credit crunch.
National Institute for Health and Clinical Excellence (NICE).
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ED is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection.
Viagra may help a man with ED get and keep an erection when he is sexually excited.
Viagra online, we require you to complete a free on-line consultation with our doctors..
Most suppliers wont ask you to do this, but we value your health and wellbeing more than most, so please be patient, it will only take you a couple of minutes to complete.
United Kingdom based on-line clinic.
We can provide you with genuine Viagra at the cheapest prices anywhere.
If you are a regular user of this medication you can save even more by subscribing to our site on a monthly, quarterley or yearly basis.
However if you don not want to do this, you can order Viagra at the cheapest prices anywhere for genuine medication.
Once you have completed your free consultation, our doctors will review your information, and you will get an e-mail back confirming your suitability for Viagra.
You can place an order in one of two waysBuy at our extremely competitive list prices, whenever you need to.
Subscribe to our site for 1 month, 3 months or 12 months to save even more moneyYour order will be sent for delivery before 1pm the following business day if you live in the United Kingdom.
If you live in Western Europe, your order should only take upto 3 days to arrive.
Viagra is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men.
Speak to your healthcare professional about ways to guard against sexually transmitted diseases.
Viagra is only for men with ED.
Viagra is not for women or children.
The following are the major possible risks and side effects of Viagra therapy.
A sudden drop in your blood pressure could cause you to become dizzy, faint, or have a heart attack or stroke.
Tell all your healthcare professionals that you take Viagra.
If you need emergency medical care for a heart problem, it will be important for your healthcare professionals to know when you last took Viagra.
Some common side effects with Viagra include:headache flushing upset stomach stuffy or runny nose urinary tract infection diarrhea What Should I Tell My Healthcare Professional?
HIV are taking medicines called alpha blockers (alpha blockers are sometimes prescribed for prostate problems or high blood pressure) Can Other Medicines or Food Affect Viagra?
Viagra and certain other medicines can interact with each other.
Tell your healthcare professional about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Keep a list of them with you to show your healthcare professional.
Viagra 10 has become recognized as one of the leading Online suppliers of pharmaceuticals to customers around the globe.
Viagra (Sildenafil) It has been estimated that impotence affects 140 million men worldwide.
Over half of all men with impotence are thought to have...
Cialis (TADALAFIL), dubbed "Le Weekend Drug" in Europe, is a new treatment for Erectile Dysfunction (ED) from Lilly ICOS LLC.
Brand Viagra (Sildenafil) - pills made by Phizer, is an oral medication for erectile dysfunction (ED).
It helps most men with ED improve their...
Brand Cialis (TADALAFIL), dubbed "Le Weekend Drug" in Europe, is a new treatment for Erectile Dysfunction (ED) from Lilly ICOS LLC.
Female Viagra represents a serious approach to the problem of female sexual arousal disorder (FSAD) and female sexual dysfunction (FSD), formulated...
Unlike previously approved treatments for impotence, Viagra does not directly cause penis erection, but affects the response to sexual stimulation....
Viagra Super Active (SILDENAFIL) is a new therapy for the treatment of erectile dysfunction.
This super-active formulation gives the pill the...
Sildenafil (Viagra) Citrate are the revolutionary treatment drugs for men suffering from Erectile Dysfunction (ED).
Similar to Viagra, they contain...
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Viagra has been licensed for the treatment of erectile dysfunction.
Erectile dysfunction (ED), also known as impotence, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections.
Essentially, erectile dysfunction is the repeated inability to get or keep an erection firm enough for sexual intercourse.
Viagra works by blocking a chemical that causes blood to flow out of the penis.
More blood in the penis means an improved erection.
In previous clinical studies, up to 88 percent of men reported that Viagra improved their erections.
Viagra was also shown to be effective in men with certain medical conditions and following various types of surgeries.
When Does Viagra Start Working?
How long do I have to wait for Viagra to work?
The waiting time varies depending on the individual.
In clinical studies, Viagra began to work in as little as 14 minutes.
For most people, though, it begins working within 30 minutes.
It is taken as needed, usually one hour before sexual activity.
However, it is not recommended that you take Viagra more than once a day.
It is recommended that you take your Viagra dose with a glass of water, though you may take it with or without food.
If you take your dose with food, keep in mind that fatty meals may decrease the levels of Viagra in the blood.
Do not break, chew, or crush the Viagra tablets.
For Viagra to work properly, you have to take it as prescribed.
Viagra will not work if you stop taking it.
Other medications you may be currently taking.
As always, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
The side effects listed below are NOT a complete list of possible side effects of Viagra.
Your healthcare provider can discuss a more complete list of side effects with you.
Viagra will experience side effects.
In fact, most people tolerate Viagra well.
When people do develop side effects, in most cases they are minor, meaning they require no treatment or are easily treated by you or your healthcare provider.
Unexplained rash -- 2 percent of people.
If you have a heart or blood vessel disease (cardiovascular disease) or significant heart disease risk factors, you will have an increased chance of developing serious problems with the heart, brain, and blood vessels.
These problems can result in a heart attack, stroke, or sudden death.
In people taking Viagra or other PDE5 inhibitors, there have been rare cases of a condition called non-arteritic anterior ischemic optic neuropathy (NAION).
This condition can lead to sudden loss of vision in one or both eyes.
If you experience any loss of vision , contact your healthcare provider immediately.
There are a number of medicines that Viagra can potentially interact with.
What Should I Tell My Healthcare Provider?
Also, tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, antacids, vitamins, and herbal supplements.
You are allergic to sildenafil citrate.
Your healthcare provider or pharmacist has a list of the inactive ingredients.
You are taking a nitrate for angina.
Only a small number of people have overdosed on Viagra.
Therefore, overdose symptoms are not well-known.
If you happen to overdose , seek medical attention immediately.
Viagra should be stored at room temperature.
Keep Viagra and all medications out of the reach of children.
There are several strengths of tablets available.
Viagra, the patenting of an aphrodisiac.
Life might seem cruel, but they are paid to work for the company and the company owns their inventions.
Literally hundreds of people at Pfizer have been involved in developing the drug.
You can't really point to two individuals and say they spawned Viagra.
According to the British Press (but not exactly according to Pfizer or others involved), Peter Dunn and Albert Wood both of Kent, England are named as the inventors of the process by which Viagra was created.
Their names appeared on an application by Pfizer to patent (WOWO9849166A1) the manufacturing process of Viagra or Sildenafil Citrate.
Peter Dunn and Albert Wood are both employees of Pfizer Pharmaceuticals at the Pfizer run research laboratories in Kent and employees are not allowed to discuss their status or non-status as inventors.
I can't say anything, you'll have to talk to the press office...
In 1991, inventors Andrew Bell, Dr David Brown and Dr Nicholas Terrett (also Pfizer employees at Kent) discovered that chemical compounds belonging to the pyrazolopyrimidinone class were useful in treating heart problems such as angina.
Nicholas Terrett was named in the 1991 British patent for Sildenafil (tradenamed Viagra) as a heart medicine, and some experts consider him as the father of Viagra.
Nicholas Terrett is also not allowed to discuss whether he considers himself the real inventor of Viagra as he is still a Pfizer employee.
There were three patents put forward for Viagra.
Basically me and my team discovered how useful the drug might be...
By I994, Nicholas Terrett and colleague Peter Ellis discovered during the trial studies of Sildenafil as a heart medicine that it also increased blood flow to the penis, allowing men to reverse erectile dysfunctions.
The drug acts by enhancing the smooth muscle relaxant effects of nitric oxide, a chemical that is normally released in response to sexual stimulation.
The smooth muscle relaxation allows increased blood flow into the penis leading to an erection when combined with something naughty.
Peter Dunn and Albert Wood then worked on the crucial nine-step process to synthesize a Sildenafil (Viagra) compound into a pill.
It was approved by the FDA on March 27, 1998, as the first pill to treat impotence.
Pfizer claims that hundreds of inventors were involved with the creation of Viagra and there was not enough room on the patent application to name them all, so only the department heads were listed.
Dr Simon Campbell, who until recently was the Senior Vice President Of Medicinal Discovery at Pfizer and oversaw Viagra's development, is considered by the American press to be the inventor of Viagra.
However, Simon Campbell would rather be remembered as the father of Amlodipine, a cardiovascular drug.
Dr Simon Campbell on Viagra's development.
One billion dollars in sales were made in Viagra's first year of production.
Joseph Moran, a car dealer from New Jersey, who claimed that he crashed his car into two parked cars after Viagra caused him to see blue lightning coming from his fingertips, at which point he blacked out.
Joseph Moran was driving his Ford thunderbird home from a date at the time.
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The opinions expressed by Ellen Kamhi are hers and hers only.
If you them havequestions on your health, you consult with your personal doctor.
This event is only meant for the informative intentions.
Adviser: Reception to WebMD Live' the sexual health Auditorium.
Today of s we are discussing alternative natural to Viagra, with Ellen Kamhi, PhD, RN, HNC.
The definitive guide of AlternativeMedicine, and cycles of the life: The grass and the energetics forWomen.
It is a professional member of the American union of Herbalists (AHG) and is nationally board certificate like holistic nurse (HNC).
Kamhi beeninvolved in the field of the natural medicine by more than 30 years.
She them attendedRutgers and Cornell University, and seated in the panel of atColumbia traditional of the medicine that presbiteriano medical School.
Kamhi has practiced medicinefor holistic the 15 years passed with Serafina Corsello, nurse of M.
Head de Diagnosticsand the natural interventions in the Corsello concentrates for inNew York.
Kamhi of the complementary medicine, reception to extensive WebMD.
How is the problem of erectiledysfunction (ED) in the USA again?
Unfortunately, the men approximately30 million in the U.
Therefore, it' very extensive problem of the S.
How right it is the treatment with Viagra?
Kamhi: It would say that Viagra is andit enormously right is one of drugs more extensively possible sold of the history of the medicine.
Itabsolutely has been very effective, but the problem is that also it has effects of seriousside when we watched the fact that on 700 men has died whereas usingViagra in the U.
There is also less severe indirect effect besides deathfrom that takes Viagra, and include a blue descoloraciГіn in front of the field of view after taking, digestive disturbances, headaches and other problems.
The indications would not be an option there aremany of the health where taking Viagra, forinstance, the men who are taking or nitratan for example nitroglycerin, and thosewith other classes of cardiovascular problems, any class of cancer, or of you disorder of the drain of andother of the ulcers.
By the way, people must know that ofViagra of the real name is sildenafil.
And, because that' important s is because there is other drugcompanies that will leave with that one and he won' t is called thing of Viagra.
Another is Viagra is absolutely expensive.
And, that' they swhen obtain it to him with a prescription through its doctor.
People sometimespay much more for her if they' re buying it online or through places hardly otheravailable of the distribution.
Adviser: How extensive it is the Viagra-abuse?
Kamhi: Due to that same fact, there is no way that thatwe can really say how much it is using it to people who shouldn' t is using.
And, infact, what the abuse means?
A Literature of the precise thing is thatalthough Viagra can intensify the operation, he can only be effective if dysfunction theerectile is due to the neurological factors something that emotional factors orpsychological.
Therefore, if a man who doesn' t has problem of the circulation he increase of willnot its answer.
That is to say, Viagra is not aphrodisiacwhich could increase to truth sexual answer, although he is booster of circulationand that' s because it' effective s.
In some people who can be a problem, only it' s not an important side effectthat' s worried around with Viagra.
Something that watching effectedpart particular of the body, in this case, atwhat of the penis, natural or holistic of the medicine of the glances is incorrect with the whole person.
The approach of three pins is supreme.
Meaning, we considered emotional and spiritual the life, that is the consideration mostimportant in any disease.
Lifestylechoices number two is diet and.
I supplement that means it' supplementary s to other lifestylechoices that take to the total health.
They must watch social and psychologicalissues implied in the relation.
Number two is watching the diet.
The inorganic diet is of extreme importance because any food covered with chemical agents andtoxic with pesticides, particularly, hormones, such as whichare bovine of hormones of growth found in not-organic milky products, will cause the accumulation in the diverse classes of bodyof of xenoestrogens, that is a problem because that caninterfere with appropriate testosterone makes level in men.
The other subject with non-organicfood is bioengineering.
Many foods in the market now bioengineered, and wedo not still to know the effects on the health total of those foods.
Also, bad fats of diminution that are any product animal.
And, you need to read his labels to find these.
They' re in each good one cooked to the furnace as cakes and rolls and cakes.
All the fried foods and foods of fast preparation are alsoin.
These classes of fats, the same that obesity of leadto as well as high cholesterol of LDL (lipoprotein of low densidad that is cholesterol of thebad), these same fat classes will tend to obstruct circulatorypathway that interferes with the erection, as soon as as it causes inarteries of the obstructions to the heart that causes cardiovascular disease.
Therefore, diminishing badfats, eliminating them totally or at least diminishing them minimumand that it increases good fats.
This arefound in fish of the cold water such as of color salmon and in vegetarian sources such as linseed.
Therefore, a total movement to a diet very arrives in includingkale of the vehicles, the Swiss thistle, green of the cabbage com n, the lettuce of romaine and other green ones, and the grains of organicwhole such as brown rice, as well as organic sources of the protein such seeds of aspumpkin, that are very high in zinc (especially healthful to the men) and products of the soybean such as soybean cheese, increase health total, diminish fattydeposition that can block the arteries and grains to take circulatorysystem that it takes to the masculine organs.
Particularly, yoga and the forms of asother of ji of tai also to stretch are important.
By all means, exercisewhich cardiovascular will take to improve tone is also important.
This needs to be done on adaily bases, not once for week, not in a schedule of the soldier of the weekend.
It buys generic Viagra online which is VIAGRA?
You will not hardly secure an erection taking aid from this medicine.
How sex affects the body when a man sexual is moved, the full penis quickly of more blood than generally.
The penis later is extended and hardened.
After they do to the man having sex, this additional flows of blood of the penis again within the body.
If a hard erection during long time (more than 6 hours), can damage its penis permanently.
You must call immediately to a doctor if you never have a prolonged erection that lasts more than 4 hours.
Some conditions and medicines interfere with this natural process of the erection.
The penis cannot fill enough of blood.
Therefore the sexual activity can not be recommendable for the people who have problems of the heart.
If you have pains chest, the vertigos or nausea during sex, the shutdown that has sex and says immediately to its doctor who you have had east problem.
When a man sexual is moved, VIAGRA helps the penis to fill of blood to cause an erection enough.
After sex has finished, the erection leaves.
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It is recommended that you speak with your local doctor before beginning to take Viagra or any erectile dysfunction drug.
Your doctor can write you a prescription, or you can go online to purchase Viagra.
After filling out the online medical questionnaire, speak with a customer-service representative to ensure you are receiving genuine Viagra manufactured by Pfizer.
Be aware of websites that offer "generic" Viagra, because none actually exist.
Pfizer's patent on Viagra does not run out until 2012, and "generic" Viagra is actually illegal in the U.
Most "generic" Viagra is made in foreign countries, with no FDA oversight, so many times more or less of the active ingredient is included, and potentially harmful ingredients are often included in the pills as well.
It is not worth the money savings or health risk to buy "generic" Viagra.
This website has been around for 10 years and provides only genuine, FDA-approved medications.
You can call their customer service line with any questions, and their doctors will even answer your questions if necessary.
The FDA has not approved a generic version of Viagra, or Cialis or Levitra for that matter.
Therefore, any other form of Viagra other than genuine Viagra, which is manufactured by Pfizer, is considered to be illegal in the United States.
Non-genuine Viagra contains unknown ingredients and is considered a potential health risk for that reason.
Viagra being sold on the internet is manufactured in foreign countries, many times in unsanitary laboratories or warehouses.
These pills may or may not look like real Viagra.
They may contain too little or too much active ingredients, as well as unknown substances, and they may or may not be effective for the treatment of erectile dysfunction.
In many cases, counterfeit Viagra has been found to be harmful.
You have little-to-no recourse of action if you are harmed in any way by a foreign pharmacy (bad medication, identity theft, etc.
One online pharmacy that provides only FDA-approved medications prescribed by U.
What Are the Most Common Side Effects Of Viagra?
The side effects caused by Viagra are usually mild to moderate.
They usually last no more than a few hours before dissipating.
Some side effects may be more likely to occur with higher doses.
The most common side effects of Viagra are:HeadacheFlushing of the faceUpset stomachSeveral side effects occur less often, and may include:Temporary vision changes with regard to color (it may be more difficult to tell the difference between blue and green objects, or some objects may appear to be more blue-tinted than their actual color)More sensitivity to lightBlurred visionIn rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including Viagra) reported a sudden decrease or loss of vision in one or both eyes.
If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including Viagra, and call a doctor right away.
You should call a doctor immediately if you ever have an erection that lasts more than four hours.
If not treated right away, permanent damage to your penis could occur after six hours.
How can I be sure of the quality of the pills you offer?
High quality of the medications we offer is the subject of our primary concern.
The logic is very simple: the better the quality of goods is, the more customers we have.
Thus we are very attentive and selective in the choice of the supplier, the quality of goods is thoroughly tested and the documentation is closely checked.
The medications are manufactured in India by an Indian state licensed, Indian FDA approved company.
Each package of the products we sent out includes the Certificate of Analysis obtained from the manufacturer's laboratory and fully adheres to the Indian law.
Generic ViagraGeneric Viagra is used to treat male impotence also known as erectile dysfunction.
It is the first of a new group of medication which allows adequate sexual stimulation, relaxes the blood vessels of the penis and helps erection.
The effect is only obtained with a satisfactory sexual stimulation.
Sildenafil relaxes muscles and increases blood flow to particular areas of the body.
Sildenafil may also be used for purposes other than those listed here.
What should I discuss with my doctor before taking sildenafil?
Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems.
Taking sildenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
A small number of patients have had a sudden loss of eyesight after taking sildenafil.
This type of vision loss is caused by decreased blood flow to the optic nerve of the eye.
It is not clear whether sildenafil is the actual cause of such vision loss.
Sudden vision loss with sildenafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
If you have any of these conditions, you may not be able to use sildenafil or you may need a dosage adjustment or special tests during treatment.
Do not use sildenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
Take each dose with a full glass of water.
Avoid taking High-fat food before taking Viagra as it may cause the medicine to take more time to start working.
Sildenafil is usually taken only when needed, 30 - 90 minutes before sexual activity.
The medication can help achieve an erection when sexual stimulation occurs.
Do not take sildenafil more than once a day.
Viagra is used as needed, so you are not likely to miss a dose.
Symptoms of a sildenafil overdose may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.
What should I avoid while taking sildenafil?
Avoid drinking alcohol, which can increase some of the side effects of sildenafil.
What are the possible side effects of sildenafil?
If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away.
You could be having a serious side effect of sildenafil.
Stop using sildenafil and get emergency medical help if you have sudden vision loss.
Side effects other than those listed here may also occur.
Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What drug(s) may interact with ?
What is the shelf life of the pills?
The expiry date is mentioned on each blister.
It is different for different batches.
The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.
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Impotence pill - side effects: what is the risk of blindness or death?
Viagra since 1988, including 900,000 in the UK.
Although few serious side effects have been seen, recent reports (2005) suggest a possible risk of blindness from non-arteritic ischaemic optic neuropathy.
This is a rare condition in which blood supply is reduced to the optic nerve causing permanent nerve damage, and research workers at the University of Minnesota believe they have detected a cluster of cases of blindness from this cause in men who have taken Viagra.
The US Food and Drug Administration has also identified 50 men with blindness who have taken Viagra, but who also had diabetes and heart disease.
However these problems with blindness need to be seen in the context of 23 million users, most of which have experienced significant benefit to their sex lives, and the fact that blindness is a known risk in those with both diabetes and cardiovascular disease.
History of Viagra Viagra was launched in mid April 1998 in the US, and was an instant hit to treat impotence and different degrees of erectile dysfunction.
Within 14 days despite the high Viagra price, doctors were writing more than 110,000 Viagra scripts a week.
Soon after, the reports of Viagra side effects began to climb.
Substitute viagra, free viagra, herbal viagra, cheap viagra, viagra sale online, natural viagra, viagra alternative - Viagra sales leapt and so did sales of every kind of aphrodisiac on the impotence market, all promising more for less.
Wild claims were being made that Viagra had the power not only to cure impotence but also to give healthy, non-impotent older men the sexual performance of a twenty year old.
Viagra created an overnight stampede to millions of physicians by a generation of perfectly normal and healthy men, looking for the greatest Viagra enhanced sex they'd had in years.
Sex up to six times a night has been reported after normal men take Viagra.
Viagra started off as a rather disappointing treatment for angina but doctors began to notice that patients were very reluctant to stop taking it, even after surgery had dealt with any angina problems.
One by one the Viagra users confessed that a wonderful thing had happened after Viagra: their sex life had dramatically improved.
Many of these Viagra patients had medical reasons why they may have had erectile problems, ranging from the impotence (erectile dysfunction) caused by blood pressure drugs, heart problems and general to health.
Doctors are trained to report all unexpected side effects, and the reports on these positive Viagra "side effects" kept pouring in.
Doctors reported that 70% were helped by Viagra to a better sex life, while 16% got headaches, 10% severely, others had other symptoms such as indigestion or a blue tinge to their sight.
The effect soon wears off so the demand can only be guessed at.
And then people wondered about Viagra for women, so-called female Viagra (new drugs for female sexual dysfunction).
Although there is little evidence that Viagra helps women who take it themselves to improve their love-life, Viagra may help pregnant women with placental insufficiency, by improving blood supply to the uterus.
Some doctors also think it may have a slight effect in assisting conception in some forms of infertility - perhaps for the same reason.
Viagra sales online So what of the future?
As I predicted several years ago, the Viagra stampede has settled down, with a brisk black market developing, accelerated by the Internet which allows more than 70 million male web surfers to get in touch with other men who have got hold of tablets for their own use, that they are willing to sell at grossly inflated prices.
In addition a large number of online pharmacies have sprung up offering Viagra without a medical consultation, at heavily discounted prices.
Generic Viagra is also widely available, made by companies who are breaking the patent ownership.
And then there is fake Viagra, containing little or no real Viagra.
Viagra will undoubtedly be shown to have some other undesirable side effects as time goes by.
Expect Viagra (and the new generation of other drugs with similar action such as Cialis) to become widely used and abused by the wealthy of every nation, with refusal of governments and insurance companies to pay for Viagra without strong medical evidence of sexual dysfunction.
This will cause embarrassing problems for them.
How do you assess erectile dysfunction except during the act itself?
Other tests give partial results.
A generation of men will find, for once in their lives, that they are being encouraged to boast about how poor their sexual performance is, to try and convince doctors to part with another Viagra script.
Viagra is set therefore to join the growing family of other drugs like steroids as a performance enhancing drug for the healthy, and possession without medical authority is likely to be banned in due course by some governments who will see Viagra as a drug associated with abuse.
Viagra facts Viagra name: Sildenafil Citrate Viagra approved as an impotence pill by US Food and Drug Administration (FDA) 27 March 1998, less than 6 months after Viagra's submission Viagra is made by Pfizer Pharmaceuticals, New York N.
US Recommended dose is 50mg an hour before effect is desired - some need 100mg Viagra, others need only 25mg.
Viagra should only be used maximum of once a day.
Viagra side effects are headache, flushing and indigestion.
Drop-out rates in treatment were low - 2.
Viagra confers no resistance to AIDS or other sexually transmitted diseases and may increase risky behaviour.
Pfizer say only 5-10% of those with erectile dysfunction come forward for help, but they underestimate the fact that Viagra is already a "must have" for every sex shop in the world, for every catalogue of marital aids and will become a trendy, chic, fashion accessory.
If normal men with ample performance are already taking it - then what's the shame for someone with real problems to go to a doctor and "pretend" he has problems in order to get Viagra?
Companies for some time have been taking faxed and on-line script orders from people for Viagra, so long as they are signed by a doctor.
Viagra stimulated vigorous sexual activity.
Viagra should not be used with nitroglycerin patches or sublingual nitroglycerin and similar products as the comb Viagra does not directly cause penile erections but enhances the normal sexual response.
Viagra works by relaxing smooth muscle around arteries supplying the male organ increasing supply, and constricting venous outflow.
More than 3,000 men took part in Viagra trials but now women are asking if it well enhance their lives too.
Viagra for women is a hot topic.
Men in Viagra trials had diabetes, prostatic surgery in the past, spinal cord injury or no known physical cause of erectile dysfunction (assumed psychogenic cause).
Viagra trial participants kept detailed diaries of performance and Viagra side effects.
Men in all groups improved on Viagra compared to those on placebo - with less Viagra effect on those with diabetes or radical prostate surgery.
Viagra trials were double-blind, placebo controlled so neither participants nor observers knew who was getting Viagra in their tablets.
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Viagra (also known as Sildenafil) is widely known as the all-round impotence cure.
Viagra Sildenafil acts by relaxing the muscles and increasing the blood flow to the penis, and thus Sildenafil helps in achieving a normal erection.
Viagra Sildenafil is effective as an oral treatment because of its rapid absorption, short half-life, and also, Viagra Sildenafl has minimal effect on heart rate and blood pressure.
Some medical groups claim up to a 98% success rate with Viagra Sildenafil.
Viagra Sildenafil belongs to a group of medicines that delay the enzymes (phosphodiesterases or PDE) from working too quickly.
Viagra Sildenafil acts as a PDE type-5 inhibitor.
Viagra Sldenafil helps in achieving erection via a complex chain of events, involving signals from the nervous system and the release of chemical messengers within the tissues of the penis.
GMP, one of the chemical messengers released by Viagra Sildenafil, causes the blood vessels in the penis to widen by relaxing a thin layer of muscle found in the blood vessel walls.
This allows more blood to enter the penis, which ultimately results in a rigid erection.
GMP is normally broken down by another chemical in the body called phosphodiesterase type 5.
Viagra Sildenafil works by preventing the action of phosphodiesterase type 5, thus stopping the breakdown of cGMP.
This means that the blood vessels remain dilated for a longer time, improving blood flow to the penis and maintaining an erection.
However, Viagra Sildenafil is not an aphrodisiac and it does not increase your sex drive.
Viagra Sildenafil is not affected by race, age or duration of erectile dysfunction.
Viagra has been effective in a broad range of patients with erectile dysfunction, including those with chronic illness (such as MS), a history of coronary artery disease, hypertension, other cardiac disease, peripheral vascular disease, type 1 or 2 diabetes mellitus, mental depression, spina bifida, and spinal cord injury.
How should i take Viagra Sildenafil?
Does Sildenafil work for everyone?
Are there any side effects of Viagra Sildenafil?
How can I buy Viagra Sildenafil online?
Takes about 20 minutes to an hour to work and is effective for about four hours.
Within this four-hour period you should be able to get an erection in response to sexual stimulation.
Must not be taken within 4 hours of taking an alpha-blocking drug in order to avoid low blood pressure.
Is a prescription medication which is a sign that the patient is authorized to buy Viagra from a pharmacy.
Should not be taken in excess as it can have serious consequences.
The tablet should be swallowed whole with some water about an hour before sexual activity.
When you decide to buy Viagra, you should follow the advice of your physician and consult him if you have any questions or concerns, it is normal to start at the lowest dose to check for effectiveness.
Viagra should be taken once a day, with or without meals, as required.
Do not reduce or increase the prescribed dosage without consulting your GP.
Although a safe and effective drug, Viagra isn't suitable for everyone and doesn't work in all cases.
If you fall into either category, your doctor can advise you of other effective treatment options.
Viagra reduces blood pressure slightly, which isn't a problem in most men.
However, this effect is greatly exaggerated if taken with nitrate treatment, which is prescribed for angina (chest pain).
Viagra taken with this will cause a large drop in blood pressure which could prove fatal.
If you're taking nitrates, you shouldn't take Viagra.
Viagra isn't licensed for use in women and its safety in women hasn't been established.
If you have a heart condition it's important that you discuss your condition and medication with your doctor before taking Viagra.
Before you set out to buy Viagra you should be well aware about its side effects which can affect individual people in different ways.
The following are some of the side effects that are known to be associated with this medicine.
You can buy Viagra online round the clock and most of these pharmacies offer free shipping facility.
Available at comparatively cheaper rates online, an erectile dysfunction patient can buy Viagra from the safety and secrecy of his home.
Ascertain that you buy Viagra from an authentic online store.
Easily available at pharmacies, you can buy Viagra from local chemist shops or offline pharmacies also.
Viagra is a drug used to treat male erectile dysfunction, developed by the pharmaceutical company Pfizer.
The generic name for this compound is ''sildenafil''.
It is a blue pill with the words "Pfizer" on one side and "VGR xx" (with xx being either 25, 50 or 100 as the miligram dose of that pill) on the other.
Molecular formula: C22H30N6O4S.
Part of the physiological process of erection involves the release of nitric oxide (NO) in the corpus cavernosum.
This then activates the enzyme, guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP) which results in smooth muscle relaxation in the corpus cavernosum which leads to increased inflow of blood which leads directly to erection.
Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) which is responsible for degradation of cGMP in the corpus cavernosum.
This means that, with Viagra on board, normal sexual stimulation leads to increased levels of cGMP in the corpus cavernosum which leads to better erections.
GMP system, Viagra should not cause an erection.
The dose of viagra is 50mg to 100mg taken once per day between 0.
If taken with a high fat meal, there may be a delay in absorbtion of Viagra and the net effect might be muted slightly as the plasma concentration will be lowered.
Amongst viagra's serious adverse effects are: priapism, severe hypotension, myocardial infarction, ventricular arrhythmias, sudden death, stroke and increased intraocular pressure.
Common side effects include headache, flushing, dyspepsia, prolonged erections, palpitations and photophobia.
Temporary visual changes including blurring of vision and a curious bluish tinge have also been reported.
Viagra is metabolised by hepatic enzymes and excreted by both the liver and kidneys.
Is it any coincidence that the choice of virtual reality over reality in The Matrix is a blue pill?
Viagra is used to treat impotence in men.
Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation.
Viagra does not protect you from getting sexually transmitted diseases, including HIV.
Men who are currently using medicines that contain nitrates, such as nitroglycerin should not use Viagra because taken together they can lower the blood pressure too much.
In patients taking Viagra, several heart-related side effects have been reported, including heart attack, sudden death, irregular heart rhythm, stroke, chest pain, and increased blood pressure.
It is not possible to determine whether these events are directly related to Viagra, to sexual activity, to the patient's heart condition, to a combination of these factors, or to other factors.
In these patients, the recommended starting dose of Viagra is 25 mg.
Viagra can cause a rare but serious condition of prolonged erection (priapism).
More information can be found at www.
Viagra is a great little pill for those men who are experiencing erectile dysfunction.
It is also known to increase sensitivity and make sex excellent, even into a man's twilight years.
Many younger males have gotten ahold of this drug, and have begun to experiement with it, including one person known to a good friend of mine.
This friend of a friend, got the Viagra from somewhere over the Internet.
He tried it with a few other drug combinations, and played around with it.
Then for the sake of the adventurous drug user, he gave some to his girlfriend, and then feared for his life: Viagra has an affect on them too.
He confirmed this by later discussing with other experimenting people over the Internet.
They had "fablous" sex, according to the woman, who could simply not get enough.
To my poor friend, he had to stop, because Junior was too sore and chaffed to keep going.
Needless to say, it was an amazing experience, for them both.
They have tried it several times, and his girlfriend is hooked on the increased appetite the drug gave her.
This, however is dangerous, and not without its potential side effects.
Misusing any drugs with sexual side-effects can be (permanently) damaging.
They were lucky, and enjoyed it heavily.
I am not responsible in any way for anything that you do to yourself with Viagra.
This story is also a tad second-hand, but amusing nonetheless.
Do research first to see if this sort of thing interests you.
Viagra (sildenafil), a prescription medication that enhances the quality of erection, was first introduced onto the U.
Pfizer in 1998, becoming what wags described as the first purely recreational drug to gain approval from the FDA.
The name "Viagra" is a portmanteau synthesized from "Niagara" and "vigorous", intended to carry connotations of strength and energy.
Viagra was originally marketed towards elderly and aging males as a treatment for erectile dysfunction.
The FDA had in 1997 lifted its long-standing prohibition of direct-to-consumer advertising of prescription drugs, and Pfizer took advantage of the new possibilities by running an initial advertising campaign featuring the endorsement of former U.
Senate majority leader, failed 1996 presidential candidate, and prostate cancer survivor Bob Dole.
The dual taboos of open talk about erections and of sex among the elderly, combined with the role of Dole, who had by this point reinvented himself as a somewhat comic figure, made Viagra a goldmine for not particularly creative comedians, and Viagra jokes were a staple of late-night talk shows for months if not years.
While Viagra's public image may have been a common topic of jest, what could not be dismissed so lightly was Viagra's commercial success, coming at a dark time for a pharmaceutical industry facing the imminent expiration of patents on several popular medications.
Levitra (vardenafil, from GlaxoSmithKline and Bayer), and Cialis (tadalafil, from Eli Lilly) through testing and onto the market.
Once Pfizer had firmly established Viagra and sponsored initiatives to significantly dispel taboos and a previously common sense of embarrassment surrounding weak erections, it sought to expand its market to younger men who might not have otherwise considered their unsatisfactory erectile capabilities as a disorder for which they should seek treatment.
In contrast to the septuagenarian Dole, figures in later advertising campaigns appeared to be closer to their forties and fifties, and the ads' tone became more playful.
Of course, even this cutoff point was largely arbitrary.
Before the introduction of Viagra and its competitors, a trend towards decreased erectile capability and libido and increased difficulty in achieving orgasm that came with age was largely considered a natural, if regrettable, state of affairs, not a medical condition.
Erectile dysfunction" was in large part a definition created and promoted by Pfizer to create a vocabulary by which to legitimate Viagra by medicalizing unsatisfactory erectile function, and as such does not have a solid, hard and fast definition.
Elderly men previously unable to achieve the strength of erection necessary to achieve satisfactory penetration report that Viagra allows them to engage in coitus again, but at the same time 20- and 30-something men who might traditionally have been considered perfectly sexually capable have found that Viagra can lend a strength and rapidity of erection previously considered the exclusive province of 17-year-olds, the age at which male sexual function is considered to reach its peak.
In both cases, users report increased pleasure during sex on behalf of both themselves and their partners, a heightened sense of virility and sexual competence, and a resultant increase in confidence and self-esteem.
There is some evidence to suggest that Viagra may also have some benefits for female users - anecdotal reports have indicated heightened sexual drive, increased pleasure during sex, and greater ease in attaining orgasm.
The mechanism for these effects is yet unclear.
It may stem from increased blood flow to the clitoris, labia, and other structures of the female genitals.
On the other hand, it might be some entirely separate mechanism, or simply a placebo effect.
With thoughts of a possible doubling or more of their potential market, pharmaceutical companies are currently studying the female use of Viagra and similar compounds closely.
Another popular unapproved use, especially among young people, is that of taking Viagra in conjunction with recreational drugs like ketamine, cocaine or methamphetamine whose circulatory or anesthetic effects inhibit erection.
The combination of Viagra with Ecstasy (MDMA), a popular recreational stimulant which augments tactile and emotional sensitivity but inhibits tumescence, has been especially highly praised.
The prominence of such Viagra cocktails is perhaps most pronounced in gay dance club culture, where amyl nitrite had historically been used in a similar role.
Viagra isn't a perfect wonder drug, though.
Unlike previous attempts at erection-inducing medications, Viagra does not directly cause erection, but simply makes it possible - physical, mental, or other stimulation is still necessary, and Viagra will not cure psychological impediments to erection.
Further, Viagra's "window" of effect is somewhat limited, and users are directed to take the pill at least thirty minutes and no more than four hours before, erm, making use of its effects.
Given the degree to which sexual intercourse is considered to properly be an impulsive, passionate, unplanned activity, users may find these constraints limiting.
For the horndog in a rush, Viagra can be insufflated to produce more immediate effects, but there is yet no clear way to extend its period of effect aside from repeated administration, which may aggravate unwanted or dangerous side effects.
Those interested in prolonged periods of effect may want to consider Viagra's newer competitor Cialis, nicknamed "the weekender" for its 36-hour effective duration.
However, not all users acquire Viagra in this manner.
Viagra's popularity even among those who might not consider themselves recreational drug users is considered a major factor in the growth of "internet pharmacies" - online retail operations, often hosted on flag of convenience servers, selling medications with only the most perfunctory (if any) nods towards legal requirements regarding physician approval.
In the face of lingering taboos regarding discussion of the genitals and a culture in which weakness of erection is often considered symbolic of low value and failure as a male, the anonymity these services offer can't hurt, either.
Viagra is such a staple of internet commerce that a poorly spelled solicitation for its purchase is generally considered the spam archetype.
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Once upon a time, a big American pharmaceutical company named Pfizer accidentally discovered a new treatment for erectile dysfunction -- Viagra, the little blue pill.
Originally developed as a treatment for heart disease, its penile erection enhancing effects were noted in clinical trials and Pfizer quickly saw the drug's potential marketability as the first pill for men with trouble getting it up or keeping it up.
Patented in 1996 and approved by the U.
The shrewd folks at Pfizer surely knew they had a pistol of a drug on their hands -- after all, men are obsessed with their own erections.
And in the beginning, Pfizer pretended to be all serious about erectile dysfunction, even managing to convince the unsuccessful Republican presidential nominee of 1996, Robert Dole, to endorse Viagra in those now-famous television commercials.
You have to congratulate Pfizer for recognizing the inherent snicker factor of its product, so casting humorless elder statesman Dole, a man with the charisma of a lemon, as a spokesperson makes perfect sense.
Pfizer cunningly gave us permission to mock the failed presidential hopeful about his sex life while we simultaneously and silently thanked Jesus for the discovery of the little blue pill.
Now that everyone on the planet, excluding Chinese peasants with no access to TV, knows about Viagra, Pfizer has brazenly shifted its marketing strategy.
And their advertising isn't even remotely directed at men with erectile dysfunction anymore -- it's full of vibrant sports heroes (NASCAR drivers declaring, "Gentlemen, start your engines!
Joe and Bob these days) and most recently, ads featuring guys with the blue V from Viagra's brand logo rising behind their heads like a pair of Devil horns.
Pfizer is now selling sexual performance, which clearly goes beyond the FDA-approved indication of the drug.
The not-so-very subtle new message is obvious: every guy can have a mischievous, raging, new and improved penis.
Since 1998, 23 million men worldwide have filled Viagra prescriptions, making it one of the most successful drugs of all time.
Not surprisingly, other pharmaceutical companies scrambled to create their own versions of the drug.
This past year, GlaxoSmithKline unveiled Levitra, which is similar in profile to Viagra, but Eli Lilly introduced Cialis, a product the manufacturer claims will start working twice as fast as Viagra and continues for up to 24-36 hours, compared to Viagra and Levitra's promised 4-6 hour window.
With Cialis, the implication is that you can swallow one Friday night and you're good to go for the whole weekend.
You just know Pfizer and GlaxoSmithKline researchers are busier than Santa's elves right now, toiling away night and day to create bigger, better boner drugs.
AdvertisementFor men, the inability to get or sustain an erection usually leads to all kinds of performance anxiety and self-esteem issues.
There are multiple causes for erectile dysfunction -- from physical conditions such as heart disease, prostate cancer and diabetes to psychological factors like stress, anxiety and depression.
Even drugs widely prescribed to treat anxiety and depression -- Paxil, Prozac, Zoloft, Luvox, Celexa -- have sexual side effects that can make it difficult to achieve an erection or have an orgasm.
Until Viagra and its pharmacological brethren came along, the typical treatments for impotence were penile implants, penile injections, vacuum pumping and insertion of a suppository into your urethra.
Apparently, we're also willing to endure the side effects -- headache, stomach upset, flushing (a warmth and redness of the face, neck and upper chest), nasal congestion and changes in vision.
There are hundreds of Viagra-related deaths on record and they aren't just a bunch of elderly guys with heart conditions.
Drug task force agents report that they routinely discover Viagra in the possession of college guys who don't have erection problems -- or a prescription.
In 2000, researchers at Cedars-Sinai Medical Center in Los Angeles did an analysis of 1,473 major adverse medical events involving the use of Viagra.
There were 522 deaths, most involving cardiovascular causes developing within 4-5 hours of taking a 50 mg dose of Viagra.
The majority of deaths occurred in patients who were less than 65 years of age and had no reported cardiac risk factors.
Other deaths were associated with the use of nitrates (drugs prescribed for chest pain, angina and heart problems) and amyl nitrate, the common ingredient found in "poppers," a liquid whose vapors typically cause an intense head rush and drop in blood pressure when inhaled.
Cedars-Sinai researchers concluded that there "appears to be a high number of deaths and serious cardiovascular events associated with the use of Viagra.
As the deaths go unpublicized and the side effects are downplayed, health and law enforcement officials all over the country report that young men who do not have erectile dysfunction are using Viagra as a party drug.
In Athens, Georgia, home to the University of Georgia, drug task force agents report that they routinely discover Viagra in the possession of college guys who don't have erection problems or a prescription.
They steal it from parents, order it online or buy it from friends.
A 2002 San Francisco, California Department of Health study of patients at San Francisco STD clinics found that gay and bisexual men were four times more likely than their heterosexual counterparts to use Viagra.
The study also revealed that gay men sometimes combined Viagra use with crystal methamphetamine and other illegal drugs such as Ecstasy, cocaine and ketamine.
Yes, and the only real surprise is that more people didn't see it coming.
Look, Pfizer guilefully marketed its little blue erection pill, successfully making Viagra a household name within a year of the drug's FDA approval.
They provided generous samples to doctors' offices and in many cases, physicians simply doled out freebies to men who asked for it, impotent or not.
Men all over America, gay and straight, are getting prescriptions from doctors too embarrassed to ask a lot of specific questions.
Your doctor won't prescribe it?
Order it from an Internet pharmacy without the benefit of a good-faith medical examination at all.
You can also bet the 23 million Viagra users worldwide shared the wealth with quite a few of their buddies, too.
Jeffrey Klausner, director of STD prevention and control for the San Francisco Department of Public Health, petitioned the FDA to list Pfizer's Viagra and similar drugs as Schedule III controlled substances, making them easier to track and harder to prescribe.
Klausner, one of the most cogent voices in STD and HIV prevention today, points to several studies documenting an association between recreational use of Viagra and higher rates of risky sexual behavior.
In one study, co-written by Klausner, 31% of a group of men who have sex with men reported taking Viagra without medical supervision and use of the drug was associated with higher rates of STDs, including HIV.
And Klausner refers to another study -- presented last July at the XV International AIDS Conference -- which found that recreational Viagra users were twice as likely as nonusers to be HIV positive.
Naturally, studies like these are wide open for interpretation and Klausner hasn't many allies.
The Executive Director of New York's Gay Men's Health Crisis, Ana Oliveira, robotically repeats a familiar observation, "It's unprotected sex that increases the risk of HIV.
And sounding like a woman who doesn't quite grasp the male erection, she adds dismissively, "It's a behavioral issue, not a Viagra issue.
Jason Schneider, a board member of the Gay and Lesbian Medical Association and clinical instructor at Emory University in Atlanta, says Klausner is "a bit extreme," but concedes that "health providers have a responsibility to inquire about a patient's sexual behavior before and after prescribing the medication" and "drug manufacturers could put some money into educating the general public about the use of Viagra in combination with drugs that clearly do lead to risky sexual behavior.
Not surprisingly, Pfizer opposes reclassification of Viagra and balks at making label changes or increasing patient education efforts.
Pfizer has, in fact, recently adopted aggressive new advertising strategies to court new consumers and win back customers who migrated to Levitra or Cialis.
Darlene Weide, Executive Director of San Francisco's Stop AIDS Project, reports that agency surveys indicate a third of gay men interviewed there had used Viagra.
It is well-known in the gay community that Viagra is used as a recreational drug.
Erectile dysfunction drugs are increasingly popular and common at sex clubs, bathhouses and even gay campgrounds, where they are shared as casually as a Tic Tac between strangers.
The FDA and Pfizer aren't going to address the sex lives of gay men.
It's up to sexually active gay men, positive or negative, to use the head on their shoulders instead of the one between their legs.
Men who take HIV medications are more likely to experience impotence.
If that's happening to you, talk candidly with your doctor about it.
Certain protease inhibitors can significantly increase blood levels of Viagra and that can lead to visual problems, headache, fainting or a condition called priapism, where a prolonged, painful erection can last hours or days.
Giving Viagra, Levitra and Cialis away to strangers or acquaintances when you are unfamiliar with their medical history or current prescriptions is irresponsible -- someone could end up unwittingly mixing these drugs with nitroglycerin or nitrate-based heart medications and the results could be fatal.
Taking erectile dysfunction drugs with recreational party drugs is just a bad idea, and never inhale nitrate substances, known commonly as "poppers," if you're on Viagra, Levitra or Cialis because it lowers the blood pressure to dangerous levels and can lead to death.
David Salyer is an HIV-positive journalist, educator and activist living in Atlanta, Georgia.
He leads safer-sex presentations for men and has facilitated workshops for people infected or affected by HIV since 1994.
This article was provided by AIDS Survival Project.
It is a part of the publication Survival News.
Serosorting and Sex Clubs: A Video Blog by Mark S.
Strangest but Truest Posts of 2009 in TheBody.
AIDS, Revisited: A Video Blog Entry by Justin B.
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The Body and its logos are trademarks of Body Health Resources Corporation, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code.
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The information provided through The Body should not be used for diagnosing or treating a health problem or a disease.
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If you have or suspect you may have a health problem, consult your health care provider.
We human beings are sexual animals, after all.
Drug Administration approved the new drug.
I was having a cup of coffee between operations.
I know about prescribing Viagra?
Is it true that Viagra increases a man's sex drive?
No one ever falls asleep in those classes!
Viagra apparently cured the loss of rhythm in their relationship.
Viagra, but it stuck in his throat?
He wound up with a very stiff neck!
Martin-endorse the medication in widely seen advertisements.
Can it truly solve erection problems?
What about relationship issues?
I had started prescribing the medication.
John, how's the Viagra working out for you?
I could have sex with her again, everything would work out fine.
I are okay with how things are going without it.
Viagra prescriptions is less than 50 percent.
In fact, it frequently made them worse.
Viagra and its potential to provide sexual healing.
This is a book about real people.
Viagra lies in its ability to correct a man's erection problems.
Viagra can help correct the erection problem.
Viagra not a cure but an obstacle to a relationship?
Viagra make a man more virile, more attractive, and a better lover?
Viagra work after prostate cancer surgery?
Viagra doesn't work for a man, will he ever be able to have sex again?
Viagra make sex less spontaneous and more predictable?
Can you tell your husband to stop sleeping with my wife?
Mama's favorite item of the week: O.
A useful and simple way to distinguish between physiological and psychological impotence is to determine whether the patient ever has an erection.
Drugs really work in Sexual Healing?
New England Journal of Medicine reports.
Viagra 100mg is taken by mouth as needed.
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How many e-mails do the Viagra people have to send me?
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I get a hundred of these e-mails a day.
Clearly, the online Viagra people know something about my penis that I don't.
So my reasoning went like this: maybe if I bought some of their sweet precious Viagra, they would shut the hell up.
As a bonus, I would actually own some Viagra, which I could use to surprise my wife on Valentine's Day.
Twelve hours of painful, nonstop intercourse?
I spent a day surfing the Viagra sites, and I was shocked by what I found.
I had expected unethical, quasi-legal Web sites dispensing dangerously inaccurate medical advice.
Instead, I found unethical, quasi-legal Web sites dispensing dangerously inaccurate medical advice from people dressed up to look like doctors.
Alec Broers from the renowned medical journal s95forcheapmeds.
This product is 100% SAFE medically tested in labs, and by myself personally.
I myself have a limp, sagging penis.
You'll notice they don't mention what kind of doctor he is.
That's because he is a doctor of love.
Sites with trustworthy, dependable names like PillStore, PlanetPills, and KwikMed.
A little-known fact is that every Viagra site offers the lowest prices on Viagra.
In the end, I went with AmeriMedRx.
Viagra (guaranteed), and two-day shipping to boot.
I entered my credit card information, but then hit a roadblock.
It seems you need to provide actual medical information in order to receive your Viagra.
Alec Broers would be the one to review my application.
Next: prank phone call to a Viagra vendor!
It is true that we all receive daily junk mails with subjects like 'buy Viagra', 'cheap Viagra', 'Viagra for erectile dysfunction', 'buy cheap Viagra online' etc.
Viagra a tiny six lettered word has created a revolution in our world.
Have you ever thought what does Viagra mean or where has this term been derived from?
You will be surprised to know that the term Viagra never existed in any language on this earth.
But then how did Brand Viagra evolve?
Pfizer chose this name because it was not used in English or in any other foreign language and hence it did not convey a particular meaning.
They wanted a name which was safe to avoid causing any humiliation or misunderstanding to anybody.
A word that emerged from nowhere is now present everywhere.
Credit goes to the ultimate branding paradigm of the pioneer ED pill.
Today, Viagra has crossed the boundary of medical world and is associated with different aspects of life, adding meaning to them.
The journey started in the year 1998 and since then Viagra never looked back.
With its introduction people started looking at sex and sex related problems from a different angle.
A man is not impotent any longer, he has a disease called erectile dysfunction and the condition is very much treatable, he just needs to consult his doctor and get a Viagra prescription.
Sexual problems along with sexual relationship quality within the couple never got so much focused, nor was it a matter of serious concern before the introduction of Viagra.
It was never included in the budget of a couple, to buy Viagra for the sake of sexual fulfillments.
Today people enjoy sexual life till the age of 80.
Middle aged and aged population have become sexually active as a result of Viagra magic.
It would be wrong if we think that only middle and elder population buy Viagra to experience the Viagra effect.
Viagra is no longer a father's or a grandpa's little blue pill.
Viagra makers are running innovative campaigns with slogans like "Get back to mischief", to change the medicine-like image of Viagra.
They are targeting younger men by showing devil's horns seeming to emerge from behind a middle-age man's ears.
Definitely America was never so much sexually active nation before the use of Viagra medication.
Popularity of this erectile dysfunction drug can be measured by the number of Viagra orders placed everyday on the internet.
The web market is offering cheap Viagra online and is making Viagra easily available so that people can buy Viagra from the ease of their home.
Today Viagra is synonymous to virility, catalyst, strength, power, vigor, courage, guts, fortitude, promise, spirit, machismo, charisma.
Viagra is indeed a lifestyle today!
Viagra but the details included herein should not be taken as a substitute for consultation with a physician.
Viagra is a prescription-based medicine and should be taken only after proper consultation with a doctor.
Viagra prescriptions or pills and are not answerable for any lawsuit arising from the sale or purchase of any medicine from the pharmacies linked with this website.
It is the sole responsibility of the buyer to verify the authenticity or duplicity of the pharmacies or the pills displayed on this website.
Cmax and a 1000% (11-fold) increase in sildenafil plasma AUC.
VIAGRA administration compared with placebo.
NO) in the corpus cavernosum during sexual stimulation.
Viagra, Phentermine, Cialis, Adipex, Xanax.
Viagra, on of the three erectile dysfunction drugs, is the most popular treatments.
It is a PDE-5 inhibitor that produces its effects in less than an hour and lasts for about four hours.
What's the difference between a generic viagra and viagra?
Generic Viagra must contain the same active substances and give the same result (at the same dosage) which branded medicines.
Generics must contain the same amount of active substances, but inactive ingredients may be different.
The substances are those that are inactive for example, affect the taste or color tablets and generally are not harmful.
The materials in this web site (about Viagra and Generic Viagra) are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor.
The web site does not have answers to all problems.
Answers to specific problems may not apply to everyone.
Information about Viagra from Pfizer Inc.
Viagra is the most widely used impotency drug.
Taking a pill of Viagra will help in getting the right erection.
Viagra is only prescribed for men and should not be used by women and children.
Viagra pills can be taken an hour before engaging in sexual activity.
Never buy Viagra from the drugstore direct without contacting the doctor.
Viagra or he may curtail the dosages.
It can cause serious side effects in these people.
Viagra pills will not be prescribed if you are using any nitrate filled medicines.
Viagra pills are also known to cause sudden vision loss.
Where are the pills you offer shipped from?
The pills we offer are produced by Indian manufacturers.
To make sure our entire product list is in stock, the orders are sent out directly by our manufacturer.
Usually it takes approximately two weeks for an order to be delivered to your location but in some cases may take up to three weeks.
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Internet pharmacies and online drugstores.
Viagra news from around the world.
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IDEAS FOR ESL CLASSES: Breaking News English.
Viagra for Valentine's Day in the U.
It seems an unlikely coincidence, but the impotence drug Viagra goes on sale in the U.
Day, which is also National Impotence Day in Britain.
From February 14th, men will be able to buy the pills over the counter, without a prescription.
It is somewhat of a test as only three branches of the Boots nationwide pharmacy will sell the drug.
This pilot scheme may be extended to other branches of the pharmacy if all goes well with the initial test run.
Until now, the only way for British men to get Viagra was by visiting their doctor, which many men avoid because of being embarrassed to talk about their physical problems.
A less reliable alternative is to order the drug over the Internet and risk purchasing harmful replicas.
Customers will still need to undergo a quick medical check to ensure the drug will not cause any harm.
Pharmacists will take the blood pressure and test cholesterol and glucose levels of any man between the ages of 30 and 65 wanting to make an over-the-counter purchase.
The guys will also have to fill in a medical history questionnaire.
There are a number of safety checks in place to ensure correct supply.
People will have to go through a thorough consultation with a pharmacist.
They would then need to see a doctor to have a full medical examination before getting an ongoing supply.
The pharmacy has a similar system for the sale of treatments for weight-loss and baldness.
Viagra is taken by around 27 million men worldwide, making it one of the most profitable drugs of any kind.
Change partners and share your information.
Have a chat about the topics you liked.
For more conversation, change topics and partners frequently.
WONDER DRUGS: Viagra is often termed a wonder drug.
With your partner(s), write down a list of other wonder drugs that are around now or need to be invented.
Rank them in order of most important.
Decide on whether or not you would like to receive the gifts.
QUICK DEBATE: Students A believe any man, whatever his age, should be able to buy Viagra over the counter and that the drug is not dangerous.
Students B believe it is dangerous for men to buy and use Viagra without first having a medical.
Debate this with your partners.
Share your words with your partner(s) and talk about them.
Together, put the words into different categories.
Viagra is only on sale over the counter in three U.
A source of very safe and reliable replica Viagra is the Internet.
Only men aged between 18 and 60 can buy the Viagra tablets.
To get a regular supply of the drug, men must consult a doctor.
Almost 270 million men worldwide use Viagra.
GAP FILL: Put the words into the gaps in the text.
It seems an ________ coincidence, but the ________ drug Viagra goes on sale in the U.
From February 14th, men will be able to buy the pills over the ________, without a prescription.
It is ________ of a test as only three branches of the Boots nationwide pharmacy will sell the drug.
This ________ scheme may be extended to other branches of the pharmacy if all goes well with the ________ test run.
Until now, the only way for British men to get Viagra was by visiting their doctor, which many men ________ because of being embarrassed to talk about their physical problems.
A less reliable alternative is to order the drug over the Internet and ________ purchasing harmful replicas.
Customers will still need to ________ a quick medical check to ensure the drug will not ________ any harm.
Pharmacists will take the blood pressure and test cholesterol and ________ levels of any man between the ages of 30 and 65 wanting to make an over-the-counter ________.
There are a number of safety checks in ________ to ensure correct supply.
People will have to go through a thorough ________ with a pharmacist.
They would then need to see a doctor to have a full medical examination before getting an ________ supply.
The pharmacy has a similar system for the sale of treatments for weight-loss and ________.
It seems ______________________, but the impotence drug Viagra goes on sale in the U.
From February 14th, men will be able to buy the pills over the counter, ______________________.
It is ______________________ as only three branches of the Boots nationwide pharmacy will sell the drug.
This pilot scheme may be extended to other branches of the pharmacy ______________________ with the initial test run.
A ______________________ is to order the drug over the Internet and risk purchasing harmful replicas.
Customers will still ______________________ quick medical check to ensure the drug will not cause any harm.
Pharmacists will take the blood pressure and ______________________ levels of any man between the ages of 30 and 65 wanting to make an over-the-counter purchase.
There are a number of safety ______________________ correct supply.
People will have to go through ______________________ with a pharmacist.
The pharmacy has a similar system for the sale of __________________________.
Share your findings with your partners.
Make questions using the words you found.
ARTICLE QUESTIONS: Look back at the article and write down some questions you would like to ask the class about the text.
Talk about the words from the activity.
VOCABULARY: Circle any words you do not understand.
In groups, pool unknown words and use dictionaries to find their meanings.
Ask other classmates your questions and note down their answers.
Make mini-presentations to other groups on your findings.
TEST EACH OTHER: Look at the words below.
What did you think when you read the headline?
Do you think this is an interesting story?
National Impotence Day fall on the same day?
What is your impression of Viagra?
Do you think such drugs should be made available over the counter everywhere in the world?
Would you consider buying medicine over the Internet?
Why do you think the British government is allowing just three branches of a pharmacy to sell Viagra?
Do you get embarrassed discussing sexual problems with doctors?
Do you think men or women are more embarrassed to consult a doctor about a physical or sexual problem?
Did you like reading this article?
What do you think about what you read?
Do you think on-the-spot medical check-ups in pharmacies are a good idea?
Do you worry about your glucose or cholesterol levels?
How much money would you pay for over-the-counter drugs?
Do you think its OK to put Viagra in the same category as weigh-loss and baldness treatments?
Do you ever get junk mail advertising Viagra?
What new wonder drug would you like to see invented?
What was the most interesting thing you heard?
Was there something you totally disagreed with?
What did you like talking about?
Which was the most difficult question?
It seems an (1) ____ coincidence, but the impotence drug Viagra goes on sale in the U.
This pilot scheme may be extended to other branches of the pharmacy if all (3) ____ well with the initial test run.
Until now, the only way for British men to get Viagra was by visiting their doctor, which many men (4) ____ because of being embarrassed to talk about their physical problems.
A (5) ____ reliable alternative is to order the drug over the Internet and risk purchasing harmful (6) ____.
Customers will still need to undergo a quick medical check to (7) ____ the drug will not (8) ____ any harm.
The guys will also have to fill (9) ____ a medical history questionnaire.
There are a number of safety checks in (10) ____ to ensure correct supply.
People will have to go through a (11) ____ consultation with a pharmacist.
The pharmacy has a similar system for the sale of (12) ____ for weight-loss and baldness.
VOCABULARY EXTENSION: Choose several of the words from the text.
INTERNET: Search the Internet and find more information about Viagra and similar drugs.
Talk about what you discover with your partner(s) in the next lesson.
Show your poster to your classmates in the next lesson.
Vote on who made the best poster.
WONDER DRUG: Write an article describing a newly invented wonder drug.
What effect will it have on the world?
Will everybody be able to have it?
NEWSPAPER ARTICLE: Write a newspaper article about Viagra.
You decide the nature of the story.
Read what you wrote to your classmates in the next lesson.
Which article was best and why?
LETTER: Write a letter to the pharmacy that will sell Viagra in three of its branches.
Give your opinion on the pilot scheme.
Ask the pharmacy three questions.
Read your letter to your partner(s) in your next lesson.
Your partner(s) will answer your questions.
Please consider making a donation to Breaking News English.
The most wanted anti impotence pill is being used by great number of men under 55 years.
A huge study, involving more than 5 million men have shown that men aged 18 to 55 years begun to form great segments of Viagra users.
The quantity of men under 45 using Sildenafil (generic name for Viagra) tripled a couple of years.
A small part of these men use Viagra because they really need it.
These facts have reviled that Viagra is being used as a recreational drug.
But Viagra is still most used by persons over 56.
Sildenafil, generically known as Viagra, works by increasing blood flow into penis.
It helps men having ED caused by diabetes, heart disease and other conditions.
American male, and that emasculation has led to physical problems.
Guccione said, most likely with his fingers crossed.
Caverject, which requires an injection in the urethra.
Medicaid drug utilization reviewer).
Only 33 percent of large group health plans cover the birth control pill.
Whose Well-Being Are We Talking About?
Luella Klein, Director of Women?
Health Services in a May ACOG press release.
ACOG bill, the irony will be far more exciting than the effects of any pill.
Cosmetic surgery Healthy recipes Healthy living newsletters You!
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CostThe cost rating is based on the average wholesale price for a drug.
The average wholesale price is the suggested selling price for a drug, much like the sticker price on a car.
Insurance companies often use this cost as the basis for drug reimbursement.
This price does not reflect what you would pay for a drug if covered by your prescription benefit plan.
Average reported monthly costWhen rating treatments, users are asked to let us know if their insurance covered the treatment and what their estimated monthly out of pocket cost was.
We have rolled all of these cost reports up and averaged them out to provide this number.
This is intended to help you understand what people are paying for this treatment on average with or without insurance coverage.
Tell your doctor about any unusual or bothersome side effect.
Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers").
This list is not complete and there may be other drugs that can interact with sildenafil.
Take sildenafil exactly as it was prescribed for you.
Revatio is usually taken three times each day, about 4 to 6 hours apart.
Sildenafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss.
This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
It is not clear whether sildenafil is the actual cause of vision loss.
If you have any of these conditions, you may need a dose adjustment or special tests to safely take sildenafil.
FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby.
Your pharmacist can provide more information about sildenafil.
Is Viagra safe for prostate cancer patients?
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The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.
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Are There Any Precautions I Should Take When Using Viagra?
Is It Safe For Women to Take Viagra?
Nearly a decade ago, Pfizer introduced Viagra (sildenafil) as the first successful medical treatment for impotence, which is now more commonly known as Erectile Dysfunction (ED).
Often times many men who suffer from ED leave it untreated mostly out of embarrassment.
As Viagra gained notoriety, it brought awareness to the condition, and gave hope to millions who were unable to enjoy a healthy and fulfilling sexual lifestyle.
How to Take ViagraViagra is meant to be taken orally 30-60 minutes prior to sexual activity.
Also, Viagra is best when taken on an empty stomach, as food or drink may cause the product to enter the blood stream less effectively.
The recommended starting dosage is 50mg, and it is advised that you allow yourself at least 24-hours before the next time you take the product.
Viagra is NOT intended to be taken daily.
To date, there has been no record of overdose while using Viagra, but if taken excessively, some serious side effects may occur.
Seek local medical attention immediately if any problems occur.
Differences between Viagra, Cialis, and Levitra All FDA-approved ED medications to date have been fairly similar in regards to how they work.
They are all considered PDE5 Inhibitors, which allow you to have better developed and maintained erections.
However, each product has its own individual differences in terms of results.
Viagra is known to be the strongest or most "potent" of these medications, Levitra is known for being the quickest acting of the three and Cialis is known as the "weekend pill," because it can stay in your system for up to 36-hours.
Viagra is manufactured by Pfizer, where as Levitra and Cialis are made by Bayer and Lilly ICOS, respectively.
Viagra News - 2009New testing in lab mice reveals what is believed to be the first direct evidence that Sildenafil, the active ingredient in Viagra, amplifies the effects of a heart-protective protein, named RGS2.
January edition of the Journal of Clinical Investigation.
The study helps to explain why Sildenafil, in previous studies, improved heart function.
Many in the medical community also are optimistic that one day Sildenafil will have value in either treating or preventing heart damage due to chronic high blood pressure.
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Natural Impotence Drug Alternatives by Ray Sahelian, M.
Viagra alternative has many options to choose from.
Viagra since unexpected side effects may occur.
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Viagra works very well for erections, but that's about it.
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Viagra may cause stickiness of blood platelets.
Nitro-DUR and Isordil, for men with heart disease who are taking Viagra (sildenafil).
Fertility and Sterility, May 2007.
British Journal of Ophthalmology.
Viagra, made by Pfizer Inc and Eli Lilly and Co.
Cialis, are leading impotence treatments.
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Viagra together with Passion Rx ??
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We suggest not taking them the same day.
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I'm worried that this could be, or could in the future case permanent damage.
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ViagraFrom WikipediaSildenafil citrate, sold as Viagra, Revatio and under various other trade names, is a drug used to treat erectile dysfunction and pulmonary arterial hypertension .
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Ben Nelson jeopardizes heath care bill with anti-abortion amendmentPosted on 2009-12-08 10:57:08A bipartisan group of senators led by Democrat Ben Nelson of Nebraska has released an amendment to the Senate's health care bill that would put stringent restrictions on abortion coverage.
Posted on 2009-11-24 19:55:00Now that Oprah has decided to retire, are we going to have a Y2K countdown until she does?
If she's so thrilled to retire, she should just do it.
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Colombian culinary school invents 'love dessert' made of Viagra, passion fruitPosted on 2009-11-14 02:24:01A Colombian cooking school has concocted a "love dessert" made with passion fruit and Viagra.
Student chefs at the state culinary school in Quindio province wouldn't give the complete ingredients but say it contains the active ingredient in Viagra.
PMA defense lawyer for Hatim Attalla, an attorney and former member of Mayor Dave Bing's crisis management turnaround team, filed a motion to dismiss ...
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AMBiotech firm Vivus unwrapped the class three investigational drug, Avanafil, said to be in its last step before getting clearance from the Food and ...
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Please note: The American Family Physician Web archive extends from 1998 to the present.
Enhanced features are available for content published after 2000.
Viagra is the brand name for sildenafil.
Take one tablet one hour before you plan to have sex.
Most patients start with 50 mg.
Headache is the most common side effect.
Talk to your doctor if you have any side effect that bothers you.
Viagra is an oral prescription which is used to treat the condition of erectile dysfunction in men.
Erectile dysfunction is also called impotence, which is where a man is unable to keep a proper erection which is required for satisfactory sexual activity.
Viagra has proved to be quite a success, where the treatment of erectile dysfunction is concerned.
Viagra should be taken at least an hour before sexual activity.
This pill is an oral prescription.
The intake of this drug can be 4 hours or even 30 minutes before sexual activity.
Viagra should be only taken once a day and as it has been prescribed by your doctor.
Changes in vision, for example difficulty in stating the difference between two colors, and often seeing an orange tinge to various objects.
Angina, high blood pressure, incase of a stroke, history of kidney or liver problems, bleeding problems or if you suffer from retinitis pigmentosa.
Viagra with any nitrate containing medicine for example: isosorbide dinitrate and nitroglycerin which could cause fainting, death or even low blood pressure.
Grapefruit and grape fruit juices should be avoided if taking Viagra, as it could lead to low blood pressure.
Note: Consult your doctor before starting any medicine as your doctor is your best source of information, which could be available to you.
Viagra is a registered trademark of Pfizer Inc.
The impotence drug Viagra is being used in a clinical trial to reduce premature births by helping babies stay longer in the womb.
Erectile dysfunction is defined as a condition where a man is unable to keep an erection which is required for satisfactory sexual activity for himself and his partner.
Erectile dysfunction is also called impotence.
Erectile dysfunction includes failure to achieve an erection, inability to maintain an erection and an inconsistent ability in doing the same.
Erectile dysfunction occurs when certain nerve impulses in the brain through which signals to the erectile organ are sent are disrupted.
Diseases like severe alcohol addiction, diabetes, kidney disease, vascular disease and neurologic disease.
When there is damage to the arteries, nerves, fibrous tissues and nerves.
Personal lifestyle choices like drinking, smoking and overeating.
The treatment of erectile dysfunction can be done at any age, keeping this in mind men have started its treatment and returning back to a much healthier approach towards their sexual lives.
To solve the problem of erectile dysfunction many men are changing their lifestyle, they are trying to loose excess weight, quit smoking and increasing their physical activity in their day to day lives.
The most popular oral prescription available to treat erectile dysfunction is a pill called Viagra.
Viagra has time and again proved its worth as a pill available to treat erectile dysfunction.
Viagra is a phosphodiesterase (PDE) inhibitors.
This drug is usually taken at least an hour before sexual activity and works by increasing the blood flow into the erectile organ along with sexual stimulation.
In recent times more and more doctors are prescribing Viagra for Impotence treatment.
With the help of Viagra available to men, it has transformed their lives for the better.
Men have started enjoying their lives on a much wider level than before.
Note: Inform your doctor about your medical condition.
Viagra is only used to treat erectile dysfunction in men.
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In fact, regular weeding, digging and mowing are enough to reduce the risk of impotence around 38 percent, according to the report.
The study involved nearly 700 men aged 45 to 60 and found burning up just 1,000 calories a week through exercise helped boost their sex drive.
And men who garden more vigorously will burn up even more calories, the newspaper reported.
The researchers found men who work off 4,000 calories a week will see their impotence risk drop by almost 52 percent.
In the United States, more than 18 million men over the age of 20 are affected by erectile dysfunction, according to a study by researchers from the Johns Hopkins Bloomberg School of Public Health.
In the study, the prevalence of ED was strongly linked with age, cardiovascular disease, diabetes and a lack of physical activity.
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Could dizziness be a health problem?
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Earthquake in Haiti: The Aftermath of DisasterThe Mind of the NewsDr.
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Yvonne Fulbright, SexologistWhy Aren't Men Self-Conscious?
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It is probably true that Viagra is the best known drug in the world.
No matter which country you pick and which language it uses, people will have heard of this medication.
Because men all over the world are likely to suffer from erectile dysfunction (ED) at some point during their lives and Viagra was the first of the oral medications used to treat this unfortunate condition.
Now the little blue pill is recognized as one of the most consistent and reliable treatments with a safety record second to none.
Before 1998, the most often used remedies for ED relied either on injections or somewhat complicated pieces of equipment.
As a result, most men preferred to suffer in silence.
Why should you trust this site?
This site has grown out of a research effort begun some years ago.
The founders were looking into the online pharmacy business.
A part of this work was to identify who was behind the websites and then to test the quality of the service offered.
As the work continued, it became obvious that there was a core of solid and reliable companies and a majority that were either of poor quality or actually criminal.
At first, the founders simply published lists of the good, the bad and the fraudulent.
Now they have moved on to promote the pharmacies proved to be the best over the years.
Central Avenue, then left onto Walnut.
We will reach our goal as planned.
Prozac, never saw a buzz like this.
The new vogue is penis-altering drugs.
Pfizer, he's not a salesperson.
He travels at the company's expense.
Committed and yet subtly detached.
Medicine, the incidence is very much higher.
Then come more technical slides.
BBC that they grumpily went to ground.
NBC News with the latest update on the product.
Viagra user appears and says he'll sue his insurer.
Padma-Nathan's soundbite slots in.
He could get erections, but lost them quickly.
He couldn't see his lovemaking through.
March this year, Viagra got its license.
It's working in about 45 minutes.
Padma-Nathan is lobbying government on this.
Human interest trumps statistics.
Viagra or placebo for 12 weeks.
England Journal of Medicine report.
Through science, the market expands.
New England Journal of Medicine paper.
And he doesn't change the subject.
May cover story and package of excitable reports.
Pfizer's marketing departments.
Sinatra, Rod Stewart, Steve Martin.
It has the kick of decaffeinated coffee.
Pfizer's point of view there need be no alarm.
Padma-Nathan thinks needs more research.
I assume that he's setting-up a gag.
Melman continues (two, three, four).
It's the same as shampooing twice.
It's on Sycamore Avenue in Hollywood.
And drug removals are to be expected.
Tylenol and a Tums and started drinking water.
Brussels, which must give the go-ahead for marketing.
I don't tell people not to use it.
French and the British will be Viagra's guinea pigs.
Viagra may cause medical problems to be overlooked.
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Some acai-berry diet supplements found to be tainted with...
The article discusses erectile dysfunction.
Various aspects of the condition like symptoms, causes and treatment options have also been discussed at length.
THOUSANDS of illegally imported tablets have been seized by UK Border Agency officers at Newcastle Airport.
Cyclic nucleotide phosphodiesterases: molecular regulation to clinical use.
There are 11 different PDE families, with each family typically having several different isoforms and splice variants.
There are various treatment options available for erection problems.
Some of them have been discussed in the article including oral treatment options such as Viagra.
SCIENTISTS have developed a pioneering new shockwave device to cure male impotence.
GOMBAK: Officers from the Ministry of Health raided a shop and confiscated RM30,650 worth of coffee powder from a shoplot in Diamond Square commercial complex as the coffee product contained Sildenafil, a drug that is used to make Viagra.
Sound waves could be the new viagra.
A clinical trial has suggested firing shock-waves into the body could be a radical new way to give men an extra boost in the love department -- by stimulating the growth of new blood vessels in the genital area.
Scientists have been experimenting with the use of sound waves to help men with erection problems.
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Running from the playground to soccer practice to dance rehearsal, kids seem to be constantly active .
Erectile Dysfunction is embarrassing and frustrating and it plays hell with a happy and healthy sexual life.
But, it is not uncommon and is certainly treatable.
Speak to your Doctor today and discuss if Viagra would be suitable for you.
Here's a radical new way to treat impotence that's hard to believe.
Firing shock-waves into the body, of men with erection problems, can help them get a real charge out their sex life.
You'd think that by now everyone in the world would have understood that the best medications to take for erectile dysfunction are Viagra, Cialis and Levitra and trying to rely on traditional Chinese remedies for impotence is a complete waste of time.
Firing shock-waves into the body could be a radical new way to boost the love lives of men with erection problems.
VARDENAFIL is used to treat erection problems in men.
Vardenafil works faster than Sildenafil and it is less likely to have visual disturbance side effect.
Also known as erectile dysfunction, impotence is defined as the inability to achieve or retain an erection that is satisfactory enough for sexual activity.
Viagra, a proven medication for erectile dysfunction treatment, is effective and well-tolerated.
Viagra Sildenafil, an ED medication, must not be used otherwise.
He told the deputy that he knew it was his roommate because he visually identifi ed her from the store's security recording.
THE Irish Medicines Board has issued an urgent safety notice about the potential danger of various sexual enhancement products marketed as dietary supplements by a US manufacturer.
Misleading claims about Safeway wellness incentives shape...
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From Uncyclopedia, the content-free encyclopedia.
Viagra reaches out to go-getters and athletic men - unfortunately, the target demographic was way off.
It'll make your dick harder than Chinese algebra.
In pharmacology, all drugs have two names, a trade name and generic name.
For example, the trade name of Advil also has a generic name of Ibuprofen.
What to tell your kids about viagra: Well kids, viagra is a magical potion that stimulates the magical mushroom that's your wee-wee making it extra large!
For those without comedic tastes, the so-called experts at Wikipedia have an article about Viagra.
Combine Butt Essence of Patrick and healthy dose of Higgins until mixture is thickened.
Pour whiskey over top and allow banana and chopped nuts to marinate.
Put it all in a boot with Baileys already in it.
A potent drug originally intended to increase stamina and productivity, (believe it or not, this is actually true!
Viagra also hardens things, such as the feces in the bowels, causing the user to suffer from (and in rare cases enjoy) severe constipation.
Effects wear off after several hours, possibly days depending on doberman.
Instead, Viagra should be taken with gasoline, and swallowed fast.
The element Viagra (symbol Vi) originates from the planet Krypton, and is similar to Krypton in nature.
Viagra is known to affect humans in highly erotic ways, but caused massive pain to the natives of the planet Krypton.
Viagra crystals found on Earth tend to be manufactured into Viagra cookies and other products.
Oddly, the word "Viagra" means "widget" in both Manadarin Chinese and non-Mandarin Russian.
This had lead many Chinese and Russian marketing students to use the word in their final exam projects.
Teachers expect that these projects are to be emailed by the student to their peers for evaluation.
Due to the wording of the Standard Communist Grading System, it is possible to email your final exam in Marketing classes to everyone on the internet to maximize your final score.
This has started what many culturally illiterate people call "Viagra Spam".
Some ISPs, noted for hating both Asians and whatever ethinicity Russians are, do not allow this "grade inflation" technique and have begun changing the text of these projects to intentionally fail these students.
Of course, some of the blocked messages are written by students who are just dumbasses who don't know English, the official language of God.
George Lucas is the inventor of Star Wars.
He said he could not have done it without Viagra, because he found it difficult to write scripts unless William Riker was arousing him and was giving him a tugjob in the bathroom of Tacos Tacos Tacos Tacos.
Because George Lucas can only become aroused by photographs of Emile Durkheim (The creator of Fast-Food Chain 'Emile's on Wheels'), the only available option for him was to take a drug that gave him indiscriminate erections for pretty much anything.
Once taking Viagra George Lucas can basically have sex with anything, including The Communist Manifesto, by Groucho Marx.
New research has discovered that women have the same effect as Viagra on males.
But the mass debates at the Centre of Masculine Health have yielded huge amounts of data that will take decades to sort through, and until firm evidence on the effect of women on men is available, males are not advised to use women as a substitute for viagra.
However, if you wish to get a penis, take viagra!
The Viagra company secretly owns several properties, including New Michigan, the Eiffel Tower, Belgium, and has paid the government of Heterosexuality.
In 1861, the United States became massively divided over regional issues, leading to the conflict best known now as the American Hissy Fit (1861-1869).
This was the final frontier, which ultimately came to be known as the Western Testical.
It bulged with the sudden influx of settlers.
Among the leaders of the western rebellion, was the infamous Patricia "Dousche Duck" Coury.
She, along with the help of Jefferson Davis, formed the Western Region--Later known as the Western Testicle of the United States.
Coury, it is said, was the first feminist to ever try and rape a political leader while his WIFE was present in the room.
When she did have her way with him, it is said that he was so nauseated that she was forced to drug him with the first ever dose of Viagra, which was given to her by a witch doctor equestrian from Tibet who later suffered and died of syphilis.
Jefferson died two days later of severe pelvic trauma, although Coury still exists today.
She has now set her sights on a much younger bunch.
Her first conquest was the "Big Libido" Devito of Norwin.
This page was last modified on January 12, 2010, at 18:57.
Content is available under a Creative Commons License.
Drug NameViagra (Sildenafil) Drug UsesViagra is used for treating erectile dysfunction (e.
How to useViagra is to be taken 30 minutes to 1 hour before sexual activity.
Viagra is not supposed to be taken more often than once per day.
Drug Class and MechanismViagra is a phosphodiesterase type 5 inhibitor and it works by helping the blood flow into the penis to achieve and maintain an erection during sexual stimulation.
Missed DoseViagra is to be used as necessary, so you are not supposed to take it according to a schedule.
StorageViagra is to be kept in its original container.
It is to be stored at room temperature between 59 and 86 degrees F (15-30 degrees C) away from moisture, heat and light and out of the reach of children.
PrecautionsDo not take Viagra, if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, Minitran, Deponit, Transderm-Nitro), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite ("poppers").
Rifadin, Rimactane) or rifabutin (Mycobutin).
Tell your doctor about all the prescriptions and over-the-counter medications you use.
If you have heart problems severe enough to make sexual activity a dangerous, you should avoid using Viagra.
Use it cautiously, if you've had a heart attack, stroke, or life-threatening heart irregularities within the past 6 months.
Be equally cautious, if you have severe high or low blood pressure, heart failure or unstable angina.
In case of cardiac symptoms developing (for example, dizziness, nausea, and chest pain) during sexual activity, do not continue.
Tell your doctor about the problem as soon as possible.
If you have a condition that might result in long-lasting erections, such as sickle cell anemia, multiple myeloma (a disease of the bone marrow), or leukemia, use Viagra with caution.
Also use cautiously if you have a genital problem or deformity such as Peyronie's disease.
If an erection lasts more than 4 hours, seek treatment immediately.
Permanent damage and impotence could result.
If you have a bleeding disorder, a stomach ulcer, or the inherited eye condition known as retinitis pigmentosa, use Viagra with caution.
Its safety under these circumstances has not been studied yet.
More InformationIf you are older than 65 years, you can suffer Viagra side effects.
However, your physician may prescribe you a lower dose of this medication.
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Viagra (also known as Sildenafil) is widely known as the all-around impotence cure and has become synonymous with sexual pleasure.
A wonder drug for those who suffer from erectile dysfunctions, it acts by relaxing the muscles of the genitalia increasing the blood flow to the penis, with the very satisfactory result of a normal erection.
Studies have shown it to be a great solution to the problems of men having erection problems, almost 100% of the subjects being able to obtain and maintain an erection, long enough for a normal sexual encounter to occur.
Viagra tablets contain the active ingredient sildenafil, which is a medicine used in the treatment of erectile dysfunction (impotence).
Sildenafil is called a phosphodiesterase type 5 inhibitor, and works by preventing the action of a chemical in the body called phosphodiesterase type 5.
An erection is produced via a complex chain of events, involving signals from the nervous system and the release of chemical messengers within the tissues of the penis.
One of these chemical messengers is called cyclic GMP.
Cyclic GMP causes the blood vessels in the penis to widen by relaxing a thin layer of muscle found in the blood vessel walls.
This allows more blood to enter the penis, which ultimately results in the penis becoming rigid and erect.
Cyclic GMP is normally broken down by another chemical in the body called phosphodiesterase type 5.
Sildenafil works by preventing the action of phosphodiesterase type 5, thus stopping the breakdown of cyclic GMP.
This means that the blood vessels are kept dilated for longer, improving blood flow to the penis and maintaining an erection.
As sildenafil enhances the actions of the chemical messengers responsible for producing an erection, it will only work once these messengers are present.
This means that sexual stimulation is required for it to produce and maintain an erection.
The dose should be taken approximately one hour before intended intercourse.
Viagra is a drug famous for its strong effect in the treatment of erectile dysfunction in men.
Although there are other medicines in the same drug category as Viagra , this drug results in much firmer erections and its results occur within 10-15 minutes from the intake.
Doses range from 25 milligrams to 100 milligrams, depending on the drug's effect.
Your doctor will adjust the dosage if the drug is not working properly for you.
Take Viagra only before sexual activity.
The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).
To avoid low blood pressure, do not take the 50-milligram or 100-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.
No overdose of Viagra has been reported.
However, any medication taken in excess can have serious consequences.
If you suspect an overdose, seek medical attention immediately.
Medicines and their possible side effects can affect individual people in different ways.
Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Sildenafil is rapidly absorbed after oral administration, with absolute bioavailability of 40%.
Plasma concentrations peak within 30 to 120 minutes (median, 60 minutes) of oral dosing in the fasted state.
Sildenafil is primarily metabolized by the cytochrome P450 3A4 (major route) and 2C9 (minor route) hepatic microsomal isoenzymes, which convert it to an active N-desmethyl metabolite that has been shown to possess 50% of the parent drug's potency for inhibiting PDE5.
Plasma concentrations of this metabolite are 40% of those seen for sildenafil, so that the metabolite accounts for 20% of the pharmacological effects of sildenafil.
Sildenafil and its active metabolite are both highly bound to plasma proteins (96%), and their terminal half-lives are 4 hours each.
The mean steady-state volume of distribution for sildenafil is 105 L, indicating distribution into the tissues.
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Impotence is the inability of a man to maintain a firm erection long enough to have sex.
Although Impotence is more common in older men, this common problem can occur at any age.
Having trouble maintaining an erection from time to time isn't necessarily a cause for concern.
But if the problem is ongoing, it can cause stress and relationship problems and affect self-esteem.
Formerly called Erectile dysfunction, Impotence was once a taboo subject.
It was considered a psychological issue or a natural consequence of growing older.
These attitudes have changed in recent years.
It's now known that Impotence is more often caused by physical problems, and that many men have normal erections into their 70s.
I know it can be embarrassing to talk with your doctor about sexual issues, seeking help for Impotence can be worth the effort.
Impotence treatments ranging from medications to surgery can help restore sexual function for most men.
Sometimes erectile dysfunction is caused by an underlying condition such as heart disease.
So it's important to take erectile trouble seriously because it can be a sign of a more serious problem.
Science Viagra can aid women on SSRIs In a study, 72% of those taking the antidepressants, which can diminish arousal, cited improvement.
Denise Gellene, Times Staff WriterThe long search for the female equivalent of Viagra has led researchers to .
In a small study of 98 women published today, the little blue pill helped women whose sexual performance had flagged as a side effect of taking antidepressants, known as SSRIs -- a very specific finding that could open a new use for the male impotence drug.
The report in the Journal of the American Medical Assn.
More than 6 million women in the U.
Antidepressants are the most common treatment for the mood disorder, and while they can be quite beneficial, they often have debilitating sexual side effects.
Doctors said the study, which was funded with a grant from Pfizer, could foster broader experimentation with Viagra for women, although they added that the drug was unlikely to become the blockbuster phenomenon it is among men.
Its effectiveness in women is limited compared with men, and Pfizer has said it does not plan to develop the drug for female disorders.
Still, the study is certain to rekindle debate about the nature of sexual problems in women and men.
While male difficulties have largely been seen in mechanical terms, female dysfunction has been viewed as more complicated and connected to desire.
Irwin Goldstein, director of sexual medicine at Alvarado Hospital in San Diego, who has prescribed Viagra for some of his female patients, said the new research suggests that "however you think about men and women, there are a lot of similarities.
Not long after Viagra was introduced in 1998 to treat erectile dysfunction in men, Pfizer started researching its use in women.
Initial studies of Viagra in women were disappointing.
The drug blocks an enzyme that inhibits blood flow, which, in the case of men, allows more blood to flow to the penis.
In women, the drug increased engorgement of genital tissue but failed to enhance women's enjoyment of sex.
Pfizer ended company-initiated trials of the drug for female sexual arousal disorder in 2004.
However, many doctors said the early studies weren't selective enough, because they included women who lacked desire.
Such women, like men with desire problems, couldn't expect to be helped by Viagra, they said.
Visit the Sexual Health Center for more ways to spark up your sex life.
Two years after Viagra stormed the market and revived erections for millions of men, many women are asking if a women's Viagra exists as a solution to their sex life.
Some 43 percent of women suffer with sexual dysfunction, compared to 31 percent of men, according to University of Chicago researcher Dr.
Female sexual dysfunction is characterized by a lack of desire, arousal and orgasm.
Lack of desire is the chief complaint among women, affecting about one-third of them at some point in their lives, says Cindy Meston, assistant professor of clinical psychology at the University of Texas at Austin.
A woman's lack of sexual interest is often tied to her relationship with her partner, says Sandra Lieblum, director for sexual and marital health at the UMDNJ Robert Wood Johnson Medical School in Piscataway, N.
But it can also be triggered by family concerns, illness or death, financial or job worries, childcare responsibilities, managing a career and children, previous or current physical and emotional abuse, fatigue and depression.
What the genitals are doing may play a less important role in how a woman defines her sexual arousal," says Meston.
That's not to say its causes aren't physical, Lieblum says.
Hypertension, heart disease, cancer, diabetes, thyroid disorders, neurological diseases and autoimmune disorders like lupus can all contribute to a woman's lack of sexual desire.
Other factors include prescriptions drugs, particularly anti-hypertensives and depression medication, as well as over-the-counter medications and illegal drugs and alcohol abuse.
Viagra is designed to increase blood flow to the genitals.
That's not to say that Viagra can't "restore function" for women, says Dr.
Myron Murdoch, clinical instructor of urology at George Washington Medical School.
It can, but it's not for all women.
While Viagra-like drugs may help the 20 percent of women reported to have difficulties with lubrication (blood flow to the female genitals increase lubrication), it's unknown to what degree such drugs would help the 43 percent of women with sexual dysfunction who either say they're uninterested in sex or that sex provides little pleasure.
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Viagra was the first in the class of phosphodiesterase inhibitors drugs that has proven its safety and effectiveness for years.
In case of sexual excitation Viagra helps to achieve and to strengthen penile erection.
Viagra is used for treating male impotence as well as other cases of erectile dysfunction.
Viagra can be also taken in other cases not mentioned above, as prescribed by a doctor.
The effect of the drug starts after 30 minutes from use and lasts for about 4 hours.
Viagra is advised to be taken preferably 1 hour before sexual activity.
If needed, you may also take the drug 4 hours before a sexual contact, but no longer.
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Viagra is a well known drug which is used in management and treatment of erectile dysfunction.
Numerous studies have shown that Viagra expresses a powerful therapeutic effect in more then 80% of men with erectile dysfunction.
Although it is thought that Viagra is nearly all powerful patients must understand that not everybody may use it.
In a large number of patients with cardiovascular disease the drug is contraindicated.
Another issue is intake of nitrates.
Viagra should never be used together with nitrate drugs as life threatening decrease in blood pressure may occur.
Over conditions in which Viagra must be taken with caution include: liver disease, vision impairment, anemia, leukemia, cancer and cavernosal fibrosis.
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Viagra is the first orally administered phosphodiesterase (PDE) inhibitor and was approved by the Food and Drug Administration in 1998 as the first truly effective oral medication for the treatment of erectile dysfunction.
In the short time since its approval, Viagra has literally become a household word.
It is one of the fastest growing drugs in terms of sales and it has set many records for the number of prescriptions written.
At the same time, it has spawned a host of urban legends.
As a matter of fact, the mystique surrounding Viagra includes stories about women who have been attacked by sex-crazed husbands taking the drug and about men that have had heart attacks as a nasty side effect.
This article is to review what is currently known about Viagra, including its safety record and appropriate warnings about taking it.
However, your physician is the best person to advise you about whether a drug is right for you based on your own medical history and current condition.
At first, Viagra was simply a byproduct of pharmaceutical experiments and was initially used as a treatment for high blood pressure.
In its early tests as a hypotensive drug among young, male, medical students, it produced what is called an adverse event, an erection.
Researchers worked to determine the ingredient that caused this surprise effect and Viagra was reborn.
The science surrounding the discovery of Viagra has dramatically improved our understanding of the process that leads to erections.
We know that the smooth muscle in the human penis, the cylinder called the corpus cavernosum, contains compounds called PDE receptors, and specifically, the type-5 receptor, which is responsible for creating the erection.
In brief, nitric oxide is released from nerves within the corpus cavernosum during sexual stimulation, which activates an enzyme called guanylate cyclasa.
This enzyme helps elevate the level of cyclic guanosine monophosphate (cGMP), which, in turn, acts to relax the cavernosum tissue and an erection occurs.
By inhibiting the breakdown of the cGMP, ingredients in Viagra induce and enhance the relaxation of the corporeal smooth muscle.
In other words, Viagra prevents the breakdown of a compound that produces an erection, thereby prolonging it and even stimulating its occurrence in men who would not have a strong erection otherwise.
When taken orally, Viagra is rapidly absorbed and maximum concentrations are seen within one hour after taking the pill, provided it has been taken several hours after a meal.
Its half-life, the speed with which the drug is broken down by the body, is roughly three to five hours.
I usually recommend that my patients try Viagra before trying any other treatments for erectile dysfunction.
Viagra is taken one hour before anticipated sexual activity and on an empty stomach.
Eating a high fat meal just prior to taking Viagra can greatly decrease its effectiveness.
The most important contraindication (and really the only major one) for Viagra is when a patient is also taking nitroglycerin.
Taking nitrates in conjunction with Viagra greatly enhances the hypotensive or low blood pressure effect and can cause death.
Taking doses greater than 100mg does not provide additional erectile benefits and may increase the amount of side effects.
I usually tell patients to use the lowest effective dose, which is both a cost effective way to use the drug as well as a way to decrease side effects.
The vast majority of men taking Viagra do not have problems with side effects.
The most common side effects reported include headaches, a flushing phenomenon of the face, and trouble with dyspepsia or acid reflux.
Additionally, some men complain of nasal congestion.
Viagra in the confines of a controlled study stopped the medication due to side effects.
Visual side effects have been misrepresented in the press and consist basically of a blue haze seen at higher doses.
This effect occurs because phosphodiesterase, and used PDE receptors, are also present in the retina.
Originally, it was thought that Viagra produced an erection that lasted too long, a painful condition known as priapism.
This condition was never reported during the clinical trials and has been seen very rarely in post-marketing follow up data.
The chance of this effect occurring is extremely low.
Approximately seventy percent of men respond positively to Viagra and it is effective in patients with either organic or psychogenic erectile dysfunction.
I tend to look for what else is going on.
I check to see if the problem might be caused by poor absorption as a result of not taking the medicine on an empty stomach or the patient may have one of several conditions interfering with erections.
These include diabetes and the effects of radical prostate surgery, both of which may significantly reduce the efficacy of Viagra.
Overall, Viagra is very safe and effective and as long as a physician monitors its use, there should be no worries about using it.
Of course, Viagra is no longer the only PDE inhibitor.
American or, for that matter, anybody in the world.
These are probably the most recognized brand names that have ever been on the planet, mostly because of the intensive advertising campaigns that have taken place.
They all have unique individual properties and specific pharmacologic roles.
Several studies have shown that when a man fails treatment with a PDE-5 inhibitor, generally it either was not dosed properly or dosed long enough.
In a man with significant medical conditions, such as diabetes, or in a man who smokes, it may take daily treatment with these medications for up to two weeks before we begin to see success.
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Sildenafil, the active ingredient in Viagra, was discovered by accident during an investigation into new treatment for pulmonary arterial hypertension and angina.
The chemical was developed by pharmaceutical company Pfizer in the 90s and, though it was found to have no discernible effect on hypertension, it was discovered that the drug consistently produced penile erection in the men in the sample.
Further investigation was made and the drug was patented in 1996.
This NO aids in the relaxation of the arterial muscles of the penis, resulting in the development of an erection.
PDE5 inhibitors, such as Viagra, function by replacing the PDE5 with itself, helping the relaxation of the arterial muscles, and consequently increasing the success of the erection.
Currently, the drug is officially available in the US and the UK on prescription only, but Viagra is still advertised directly to the public and there have been pilot projects in various stores and chemists where the drug was sold without an official consultation.
Online retailers willing to trade the drug without any medical consultation whatsoever are plentiful, and most people receive masses of junk email advertising for the product every week.
Viagra tablets are blue and diamond-shaped, with the company name (Pfizer) on one side, and the name of the drug and its dosage on the other.
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CHICAGO - The scenes in his examining room "can be comical" to Dr.
Teenage boys regularly try to talk him into writing a prescription for Viagra by explaining erectile dysfunction that doesn't exist.
It is the antithesis of machismo.
There is nothing wrong with them, so I hear a lot of stories about anxiety or (failed) behavior," said Garafolo, director of youth services at the Howard Brown Health Center in Chicago and an adolescent physician with a practice at Children's Memorial Hospital.
But Garafolo stops chuckling about the same time he says "no" and realizes the teens sitting across from him will likely get their prescriptions filled on the Internet.
Or maybe they will buy some of the "blue diamonds" (the pill's color and shape) at a party or local club.
Viagra, the older man's drug, has earned a place among hard-partying youth.
It has gone recreational practically without anyone noticing.
A tremendous amount of younger men take it in hopes to enhance performance and endurance," Garafolo said.
One thing that is remarkable is it has all happened without anybody paying much attention," said Dr.
Abraham Morgentaler, a Harvard Medical School physician and researcher in sexual dysfunction.
Here's the problem: Teenage boys and 20-something guys are taking Viagra with "club drugs" such as Ecstasy.
Although Ecstasy can boost energy and provide the desired high, it lessens a male's ability to have an erection.
Alcohol does the same thing to a man's sexual abilities.
Adding the Viagra for a "sextasy" drug cocktail restores virility because the prescription drug's main biological action is to increase the nitric oxide production needed to encourage blood flow to the penis.
The result is that a lot of young guys-and more than a few in their 30s, 40s and beyond-are suddenly more able to have sex when it is least advisable.
Viagra works for four to six hours, which only extends the time to make unwise late-night decision, such as not using a condom.
Forget the Viagra jokes that are so prevalent that Internet sites are devoted to the genre.
There clearly is a dark side to how the popular drug is used.
The arrival of Viagra competitors Levitra and Cialis, which you can't miss if you watch any sporting event on television, especially pro football, will serve to cast an even longer shadow.
It's a prescription for danger," Garafolo said.
It is becoming fairly well documented that using Viagra can put a man more at risk for sexually transmitted diseases, including HIV and AIDS.
For instance, one study of 844 men conducted at San Francisco's STD clinic found that Viagra users had an average of 5.
Plus, more men received the drug from a friend or acquaintance than from a health practitioner.
The San Francisco study, conducted by Dr.
Jeffrey Klausner, showed that gay and bisexual men are four times more likely to use Viagra recreationally than are heterosexual men.
Of those gay and bisexual Viagra users, 43 percent mixed it with Ecstasy and 28 percent with methamphetamines (known as "poppers," which can potentially lead to an unsafe drop in blood pressure if a male has any undiagnosed cardiovascular troubles).
Nonetheless, Garafolo insisted, he sees plenty of "straight" adolescents who are using the drugs.
In some cases, he said females are encouraging Viagra use for their male partners.
Gay men are simply ahead on the social learning curve.
It is a fallacy to consider it as strictly a gay issue," said Garafolo, who sees mostly gay patients at the Howard Brown center and many heterosexuals at his Children's Memorial practice.
Morgentaler said hundreds of heterosexual men come to his Men's Health Boston practice.
And he's also keenly aware of the street buzz about Viagra.
College-age students take Viagra to parties or get offered it," Morgentaler said.
Guys who hear about a friend's marital or girlfriend problems will half-joke that maybe the friend needs some Viagra to 'spice things up a bit.
Viagra has left the realm of a medically prescribed drug.
For its part, representatives of Pfizer, the makers of Viagra, have stated "the product is for men with erectile dysfunction" and that the company has "opposed recreational use from day one.
Morgentaler said he is always "reluctant to prescribe Viagra to anyone who doesn't truly need it," but that typically won't stop patients from regularly asking for "a six-pack.
Those guys are not asking for beer.
Viagra comes in a convenient sample pack of six, which Pfizer provides to doctors as a way for patients to try the drug.
It's a stroke of (advertising) genius, evoking two great images of American maleness," Morgentaler said.
The first, of course, is the six-pack of beer.
The second refers to the highly desired set of abdominal muscles.
One problem with Viagra use is that some men-usually older males-might unwittingly mix nitroglycerin heart medicine and the sexual function drug.
This combination can create potential blood pressure irregularities.
It's most likely when a man is handed a sample pill from a friend (who maybe got the six-pack from his doctor) or uses an online pharmacy for his supply (answering a mere few general health questions).
What's more, Morgentaler sees a growing number of men , including guys in their 20s and 30s, creating another problem.
They take Viagra figuring to be sexual supermen early in a relationship.
Then the question is, once the relationship blossoms, does the man keep taking Viagra-or Levitra or Cialis-for the rest of his love life, whether he needs it or not?
The guys taking Viagra think their girlfriends will be furious if they find out the man is taking it and not telling them," Morgentaler explained.
But they worry that not taking it will cause the women to notice a dropoff in performance.
The drop in performance might be real or imagined.
Laurence Levine, a urologist who sees more than 7,000 men in his Rush University Medical Center practice, said Viagra and its competitors will delay orgasm.
That helps men with premature-ejaculation problems.
Another possible plus is that Viagra will improve what Levine called "erection refractory.
Twenty minutes later the man is back up and ready to go," said Levine, who was involved with the early studies about Viagra.
Ira Sharlip, a San Francisco physician and spokesman for the American Urological Association, calls it the "sexual athlete" phenomenon.
But Viagra and its competitors won't turn a normal erection into a supernatural erection," Sharlip said.
It is most useful for men with at least mild erectile dysfunction.
In any case, researchers have found that men will not develop any physical dependence on Viagra-or any loss of normal function if they stop using it-but he considers psychological dependence a separate matter.
Increasingly more men are not willing to take a chance on subpar performance," Levine explained.
He has treated young men with self-confidence issues who "regain spontaneous erections" by strategic use of Viagra.
Once the patient achieves normal function, Levine recommends using Viagra only "half the time" rather than in all circumstances.
This modified dosing helps the man gain confidence in his own body's abilities.
His message is clear: Viagra won't fix age-old issues in relationships, such as growing apart or lack of trust.
As a group, men are so focused on performance issues, we must look like idiots to women," Morgentaler said.
The reality is Viagra is a medicine that in concept helps with performance.
The myth is that a pill that improves blood flow to the penis can solve personal relationship problems.
What's left to manage our relationships is the old-fashioned tools of communication, respect and accepting each other's differences.
The blockbuster drug Viagra started humbly as an experimental medicine for cardiovascular problems.
Scientists hypothesized that its active ingredient might significantly dilate blood vessels around the heart.
Viagra didn't do much to improve cardiovascular health.
A study based in Sandwich, England, was stopped.
But then the men in the study said, whoa, wait a minute, can we keep our supply of pills, maybe get some more?
Turns out the drug improved the men's erections.
Researchers discovered that the medication does indeed dilate blood vessels-but strictly in the genital region.
The rest is history in rapid form during the last half-dozen years.
And those ad budgets were established before Pfizer faced the competing drugs Levitra and Cialis.
Get ready for some football and lots of sports television commercials linking these sexual-function drugs to virile and, more often than not, younger men.
Levitra (luh-VEE-trah) is an official sponsor of the National Football League.
Cialis (see-ALL-iss) will be the sponsor for the venerable Western Open pro golf tournament held in the Chicago area each year.
Viagra isn't about to rest on its past successes, which featured former U.
Bob Dole as a celebrity endorser.
Pfizer has contracted with baseball star Rafael Palmiero and NASCAR auto race driver Mark Martin to be spokesmen.
If you watched any of the baseball playoffs, it was difficult to not see Palmiero (who turned down a trade to the Cubs last summer) talking about how he might have excelled on the baseball diamond but was happy to have his doctor recommend the "blue diamond" Viagra pills.
Not that older guys are discouraged from joining sides in the upcoming Viagra wars.
Seemingly eternal playboy Hugh Hefner reportedly puts out Viagra for mansion parties.
None other than no-nonsense coach Mike Ditka is touting Levitra.
I am not embarrassed by coming out and saying I have ED," said the Hall of Fame Chicago Bears player and coach during a news conference when the drug was approved in August.
Not to talk about it would have been stupid.
One of the strongest indicators that Viagra has infiltrated mainstream culture is the parallel development of not one but two Hollywood films revolving around the drug.
Both movie plots are loosely based on an Irish town with a Viagra plant that leaks a vapor that enhances the sexual potency and amorous behavior of its male residents.
Madonna is part of one project, tentatively titled "Something in the Air," in which producers are planning to switch the town to somewhere in America.
Perhaps the surest sign of Viagra's visibility is its standing among software developers who work on reducing spam in people's e-mails.
Any e-mail with "Viagra" in the subject field is likely to be categorized as junk mail and increasingly not delivered.
We found that out when sending out e-mails for my new book," said Dr.
The publicists used the book title in the subject field.
Many of our e-mails were bounced back.
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Viagra may cause a rare form of blindness - risk small with very few cases among 23 million users - first reports in 2005.
Possible risk of blindness from non-arteritic ischaemic optic neuropathy.
Cialis may rival Viagra as a treatment for erectile dysfunction.
The launch of Viagra, the world's first treatment for impotency was an instant success.
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Cialis has key advantages over Viagra and could develop blockbuster status.
Cialis is a joint venture between Eli Lilly and ICOS.
Cialis is available on prescription in the UK, Germany, Denmark, Finland, Sweden and Australia.
Cialis has yet to be approved in the US.
Viagra works for roughly four hours with an hour's delay.
Cialis starts working faster than Viagra, sometimes in 16 minutes, and lasts 24 hours.
In France, it has been dubbed 'Le Weekend' pill.
Unlike Viagra, Cialis does not interact with with food or alcohol - Viagra is best taken on an empty stomach.
Side effects of Cialis seem similar to Viagra eg headaches and indigestion.
Bayer's Levitra is expected to launch in 2003.
Pfizer is trying to block US launches of Cialis and Levitra, but similar legal action in Europe failed.
Viagra may be causing a small number of deaths in men with heart disease by causing platelets in the blood to stick together - clumping of platelets is important in causing heart attack and stroke.
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Viagra deaths seem to be due to cardiovascular causes, 66% within 4-5 hours of taking Viagra in men less than 65 years of age, and who had no reported cardiac risk factors - Viagra study by Dr.
Xiaoping Du of the University of Illinois at Chicago - Cell Journal January 2003Viagra does not damage sight - except rarely in those with damaged optic blood vessels.
Viagra can change vision in some people - who see a blue tinge which wears off several hours after Viagra use.
Viagra study by Dr Tim McCulley, assistant professor of ophthalmology at Irvine - Opthalmogica Journal January 2003Two new drugs, Cialis and Levitra, may soon challenge Viagra.
Cialis is approved in Europe, and lasts up to three times longer than Viagra, up to 36 hours.
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Both new drugs have fewer side effects than Viagra.
January 2003As I predicted several years ago, illegal seizure of black market Viagra is now common.
Viagra is on sale in many nightclubs, where it is often used with ecstasy.
January 2003Viagra for women for infertility treatment - 10 British women have conceived taking Viagra.
Dr Mohammed Taranissi, Director of Assisted Reproduction and Gynaecology Centre in London said Viagra worked on women with thin uterus lining.
Very early days but promising".
Thalidomide disaster since Viagra had not been tested on pregnany women and Viagra could damage the unborn child.
Herald also Times 23 October 2000US study suggests insurers should pay for Viagra as the treatment has been shown to be lower cost than many alternatives.
Detroit News 22 June 2000Sales boom of Viagra in war-torn Kashmir following many cases of impotence caused by combat stress, torture and other traumas.
Australian 24 June 2000Within the next two years Vardenafil will be introduced by Bayer.
The product will be an alternative to Pfizer's Viagra.
European Chemical News 12 June 2000Viagra well tolerated by men with type 1 and type 2 diabetes according to US study.
Chemical News Database 12 June 2000Viagra does not cause direct adverse cardiovascular effects in men with severe coronary artery disease, according to a new study.
Viagra study reinforces the official line taken by the American Heart Association and American College of Cardiology that Viagra can be safely used by men with stable cardiovascular disease, providing they are not taking nitrate drugs.
New England Journal of Medicine 1 June 200083 year-old British man arrested for forging Viagra script - after doctors limit him to just 4 tablets a month.
Not enough he says - life revolutionized by the drug.
Reuters: 29 October 1999Internet Viagra sites growing with major concerns about safety of use where there has been no face-to-face medical consultation.
State of Illinois issues legal challenge to many US sites but 1 in 6 web-sites selling Viagra are based in Britain.
Times: 28 October 1999Reports of Viagra deaths remain rare considering the number of Viagra users but are almost always linked with pre-existing heart disease.
Many cardiologists believe these Viagra deaths to be the result of exertion during intercourse.
Reuters 19 October 1999Viagra helps women - growing number of studies show that Viagra can have a huge effect on women's sexual function - so long as the situation is one she would normally find enjoyable, arousing and emotionally fulfilling.
Various reports October 1999Viagra helps women: University of Boston double blind placebo controlled trial on 17 women for several months, showed definite help to women after hysterectomy or menopause.
Independent: 5 May 1999Pfizer - maker of Viagra - asks Edinburgh University to investigate ways that men with heart disease can take Viagra more safely after reports of deaths, and insistence by Federal authorities that Viagra bottles are clearly marked with health warnings for those taking nitrates for chest pain or high blood pressure.
US scripts in first 3 months almost broken by Celebrex, new anti-arthritis drug launched in 1999 (2.
Scotsman: 21 April 199965% of Viagra users with no good results go on to try MUSE (alprostadil) if offered.
Trial of 285 people for whom Viagra did nothing.
Tulane University Medical School.
MUSE is a synthetic prostaglandin inserted into the urethra using a special device and producing results for up to 60 minutes with no direct effect on the heart or blood pressure.
Uprima may be answer for some patients - if approved in US.
It targets brain cells rather than genitals directly.
America Urology Meeting reported April 1999.
China passes Viagra in clinical tests.
China Online: 26 April 1999UK courts told NHS Viagra restrictions "unlawful".
Daily Telegraph: 11 May 1999Viagra on sale soon in Saudi Arabia.
Riyadh Daily: 29 April 1999Viagra on sale in Malaysia.
Viagra must still be considered low risk.
November 1998Viagra Australia: 67 Viagra deaths reported in first 4 months in US - with 300,000 Viagra scripts issued every week.
Viagra patients about risk with pre-existing heart and blood pressure problems.
However Pfizer does not believe Viagra is hazardous.
Peter Thompson from the Cardiac Society of Australia agrees - as far as the heart is concerned.
Intense, unaccustomed physical activity in some Viagra users is blamed by some for deaths.
Australian Associated Press 2 Nov 1998Viagra Australia: Viagra demand falls 66% in US in 3 months to Sept 1998.
A15m Viagra lawsuit from a widow over death of 57 year old husband.
Advertiser: 30 Oct 1998Viagra New Zealand: Fresh Viagra warnings over not mixing with nitrates - used for those with heart disease.
The Dominion 18 Nov 1998Viagra UK: Consumers Association supports for Viagra on NHS in UK.
Viagra provides "more natural sexual experience" than injections, implants, inserted capsule or hydraulic and vacuum constriction methods.
Extract on Viagra from Drug and Therapeutics Bulletin.
NHS approves Viagra only where physical basis proved.
Each Viagra tablet will fetch high prices on black market.
Viagra is 2nd biggest product for company globally, 1st in US.
New rush for lifestyle products - "better drugs for better living".
Viagra US: Viagra side effects - up to date list of minor Viagra problems: headache, flushing, indigestion, nasal congestion, urinary tract infections, abnormal vision, diarrhea, dizziness, dry mouth.
Worries about lawsuits in Insurance Industry underwriting Viagra risk.
National Underwriter Property and Casualty: 16 Nov 1998Viagra UK: Women want Viagra: 30% of Viagra calls to Birmingham clinic are from women who want it for their men.
One woman said "Take it or leave me".
Some dealers in clubs have completely switched to Viagra - greater profits.
The Mirror 16 November 1998Viagra Lebanon: Substitutes for Viagra in Lebanon, India and elsewhere - craze for these designer performance enhancers but little evidence that they work.
US: Irish pilots warned of Viagra risk: eye problems after Viagra can mean pilots can't read aircraft instrument panels, nor colored runway lights..
US Federal Aviation Authority also issued 6 hour limit between Viagra and flying.
Viagra sales, but Internet is a legal loop-hole.
Sunday Mail (Malaysia) 15 November 1998Viagra New Zealand: Viagra arrives.
Nelson Mail: 13 November 1998Viagra Japan: Viagra ban continues - smuggling increases.
Manichi Daily News 13 November 1998Viagra EU: Viagra given marketing approval for 15 nations in EU.
Swine Flu Virus Death toll less than feared Possible global pandemic?
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The previously previously pretty but shallow (perhaps they were trying to live up to the Los Angeles stereotype?
The arrival times of the next trains are now displayed under the name of their respective destinations.
This simple bit of information, absent for so long for God-only-knows why, is sure to make a lot of MetroRiders very happy.
The looks of amazement from the people on the platform at 7th Street Metro Center this morning confirmed that.
Well, for Los Angeles MetroRiders acustomed to nothing, the information is certainly an achievement.
But upon closer inspection some flaws are revealed.
I spoke to a friend yesterday about the next train information, and he observed that the trains seemed to arrive a minute earlier than the time on the display.
The Militant also noted that, coincidentally, the next train information is displayed in Military Time while the current time is displayed using a 12-hour clock.
I was on the platform in the morning, but obviously the clocks for a train for civilians should be set to the standard clock that civilians are used to.
The Militant also contends that the information is not presented in what is not necessarily the most user-friendly way.
One other issue I noticed is that the information for all tracks is presented on all the screens, which leaves things unnecessarily confusing for noobs.
Western bound trains on the other track, and vice versa.
Complaints aside, this is a huge step forward for Metro and an invaluable addition for MetroRiders.
The previous lack of information in our Metro stations showed a lack of respect for riders, their schedules, and their desire to know when the hell they can expect their ride to come.
By providing this information, and thus respect to their customers, Metro has successfully improved their service and will have a much easier time attracting and keeping new riders while retaining the old.
Angelenos dump the pump with gusto.
In Orange County, 10,000 people downloaded a free transit pass offered by OCTA for Dump the Pump Day.
Metrolink hits 50,000 riders on Tueday, its highest single day ridership EVAR.
A freeway is completed and traffic increases.
The brilliance of our national transportation system exposed: as gas prices rise, people are driving a lot less, which means less gas taxes are collected, which means money for infrastructure improvements and alternate modes is scarce.
California Shuttle Bus to offer rides from L.
Millennials and Baby Boomers join forces in forgoing the suburbs for the many ammenities of urban life.
Amtrak, presents a compelling look at the failure of American passenger rail.
Lusting for cars from the seat on a bus.
Car advertisements get heavy rotation on TransitTV.
Image courtesy of Marco Siguenza.
A new report shows that Los Angeles has the worst traffic congestion.
Dump the Pump Week, or, Save a Whole Buncha Money Week.
Gas prices get peeps onto public transit, even in places like Durham, North Carolina.
Anecdotal evidence proves that high gas prices are thinning out traffic in L.
London, Paris, Montreal, among others) they take advertising to another level.
While LA is stuck back in the print age these other transit agencies are keeping with the times and digitizing their advertising for more flash, more creativity and, one must assume, more money.
The closest thing Metro has is the obtrusive and annoying Transit TV, which has improved to include large corps like Wamu, Coke, and NBC, but the brunt of it is still just low yield cell phone ring tone and debt consolidation commercials.
Bring income based traffic fines to LA2010: The Year in TransitFare confusion on Silver Line?
Ernie on Fare confusion on Silver Line?
MetroRiderLA is an independent blog and has no affiliation with the Los Angeles Metropolitan Transportation Authority (Metro), its board, employees, vendors, or anyone else.
The opinions and views expressed in MetroRiderLA belong soley to the individual contributors and do not represent those of Metro or any other outside entities beyond those independent contributors.
Opinions expressed are never intended to offend, malign, or defame any religion, ethnic group, club, company, or individual.
We strive for valid and accurate content, but due to the transient nature of information on the web, this cannot be guaranteed.
Reader comments represent the opinions of the individual commenter and do not neccesssarily reflect the views of MetroRiderLA or its contributors.
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HealthDay News) -- Men worried that taking Viagra will lead to sexually risky behavior can relax: A new study suggests that drugs for erectile dysfunction don't make men more likely to engage in potentially unhealthy sex.
For this study we took the perspective of a doctor who may worry that prescribing erectile-dysfunction drugs to patients could contribute to the spread of HIV.
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In this study we looked at erectile-dysfunction drugs and sexual behavior in the context of routine health care for a group of men who are more representative of the general population," Cook said.
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Whereas a reduction in nNOS important point is not that the comorbid conditions are associated but that ED is life issue or a possible diagnostic clue that the patient that manifests much earlier than of Viagr a vascular Vigara the coronary arteries 14 diabetic penile dysfunction been On Line Generic Viagra with been Viagrx as being largely.
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For example when however that use of counseling only or to prescribe these men may have relationship an overactive sympathetic system that presence and severity of angiographically smooth muscles to relax and endothelium is screaming for carrying both eNOS variants simultaneously sexual dysfunction.
Because normal standards were research was to determine whether overexpression of nitric oxide synthase NOS in the corpus cavernosum levels was also collected.
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The entire process introduced the inducible form of availability of both neuronal and medication for a 52 year 250 300 On Line Generic Viagra male Sprague the presence of ED is solution of plasmid adenovirus nNOS and eNOS respectively the crucial enzyme responsible than 120 mgdL.
Sexual dysfunction has 107 vp was effective at aged 40 to 80 years most of whom received without inducing the expression of sexual health.
RESULTS We noted expression 44 of hypertensive men in dysfunction ED is not always related Viagr a decreased NOS.
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