Archive for the ‘Viagra’ Category.

Viagra

Generic name:  Sildenafil
Brand names: Viagra

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.

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.

Before taking Viagra, tell your doctor if you are allergic to any drugs, or if you have:

  • heart disease or heart rhythm problems;
  • a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder;
  • congestive heart failure;
  • high or low blood pressure;
  • coronary artery disease;
  • liver disease;
  • kidney disease;
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie’s disease); or
  • if you have been told you should not have sexual intercourse for health reasons.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take Viagra.

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.

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.

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. Store this medication at room temperature away from moisture and heat.

Seek emergency medical attention if you think you have used too much of Viagra. Overdose symptoms may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

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.

Stop using Viagra and call your doctor at once if you have any of these serious side effects:

  • sudden vision loss;
  • ringing in your ears, or sudden hearing loss;
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • vision changes;
  • feeling light-headed, fainting; or
  • penis erection that is painful or lasts 4 hours or longer.

Less serious side effects may include:

  • warmth or redness in your face, neck, or chest;
  • stuffy nose;
  • headache;
  • upset stomach; or
  • back pain.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

You can get more information about Viagra here >>

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Viagra and Your Eyes

Earlier this year a number of reports surfaced in the scientific literature suggesting that Viagra might be associated with a very dramatic and dangerous retinal condition, known as nonarteritic anterior ischemic optic neuropathy (NAION), which could lead to permanent blindness.

In typical “sky-is-falling” style, some news items trumpeted this possible relationship to make it appear that almost everyone who took Viagra was at risk for serious damage to their eyes. The reality is quite different.

Viagra and the other PDE5 inhibitors, Levitra and Cialis, work by selectively inhibiting the action of a specific enzyme, PDE5, found in all the body’s vascular tissues (blood vessels). To some extent, these drugs also selectively inhibit another enzyme in the same family, PDE6, which tends to be located in the rod and cone receptors in the eye.

This is the reason for occasional mild to moderate vision side effects in men taking a PDE5. These effects, such as blue-tinged vision, lights that appear too bright, blurry vision, and difficulties with color discrimination, are almost always mild and usually disappear rather quickly.

Careful studies in people with and without eye disease have shown repeatedly that Viagra does not permanently affect visual acuity (sharpness), fields of vision, or sensitivity to visual contrast.

Over several years, isolated case reports in the medical literature have indicated that NAION and other serious visual conditions have been associated with PDE5 treatment. These reports represent the experiences of a handful of the more than 27 million men who’ve taken a PDE5 drug. At least some of these reported cases may be due to the fact that men who suffer from ED also tend to have multiple risk factors for the vascular problems that make a person vulnerable to NAION.

To date, there is no compelling evidence that taking Viagra places anyone at increased risk for NAION or related conditions affecting the retina or other important structures of the eye. Once again, the real story on this complex subject is not as simple as some news headlines.

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Can Adding Lipitor to Viagra Help Treat ED?

Erectile dysfunction (ED), or the inability to get an erection, is a complex condition with many possible causes. The cardiovascular system, specifically the thin layer of cells lining the blood vessels called the endothelium, is believed to play a major role in some cases of ED.

The presence of ED can often be one of the earliest signs of problems in endothelial function that may later progress to heart disease. In such cases of ED, the vascular endothelium loses its capacity to form nitric oxide, which is necessary to dilate the blood vessels in the penis that cause an erection.

If this hypothesis is correct, then a drug designed to treat this damaged vascular endothelium, such as a statin, should help men with ED who do not respond to treatment with Viagra.

One small but promising study involved men who previously failed treatment with Viagra alone. The men were given 80 mg daily of the statin Lipitor or a placebo. Both groups also received 100 mg tablets of Viagra to use for sexual purposes. After 12 weeks, the Viagra-plus-Lipitor group had statistically significant improvement in erectile function, while the placebo group showed no such improvement.

Although the number of men in the study was small, the results nonetheless are promising enough for the authors to call for larger trials to be done.

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Viagra and other oral medications

Until the late 1990s, there were no truly effective oral medications for erectile dysfunction — the inability to achieve or sustain an adequate erection for sexual activity. The useful drugs that were available had to be injected into the penis or inserted into the urethra.

Treatment of erectile dysfunction is much easier now, thanks to a class of drugs called phosphodiesterase-5 (PDE-5) inhibitors. The medications — sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) — all improve erectile function in the same basic way, but they differ in how quickly they take effect and how long their effects last.

How Viagra, Levitra and Cialis work

Viagra, Levitra and Cialis prevent the breakdown of nitric oxide, a chemical messenger that promotes relaxation and opening of the blood vessels that supply erectile tissue in the penis. Under the influence of nitric oxide, these vessels expand and stay dilated. Increased blood flow makes erectile tissue swell and compress the veins that carry blood out of the penis, resulting in a full erection.

PDE-5 inhibitors do not automatically trigger erections. Sexual stimulation also is needed to start the whole process. The medications enable a more complete response to sexual stimulation.

Many clinical trials have shown that PDE-5 inhibitors improve erectile function regardless of the underlying cause or causes. Viagra, Levitra and Cialis increase the number and quality of erections and sexual experiences in men with erectile dysfunction due to arteriosclerosis, diabetes, spinal cord injury, depression or the aftereffects of prostate cancer surgery.

Similarities and differences

The drugs have slightly different chemical compositions that affect how quickly they work and wear off. Other distinctions — for example, which drug may be best for men of different ages or with different medical conditions — aren’t known. No study has directly compared these three medications.

Viagra (sildenafil) Levitra (vardenafil) Cialis (tadalafil)
Usual dose 50 milligrams (mg) a day 10 mg a day 10 mg a day
Available as 20 mg, 25 mg, 50 mg and 100 mg tablets 2.5 mg, 5 mg, 10 mg and 20 mg tablets 5 mg, 10 mg and 20 mg tablets
When to take 30 to 60 minutes before sexual activity 30 to 60 minutes before sexual activity 30 minutes before sexual activity
How often to use Up to once a day Up to once a day Up to once a day
Warnings Do not take with nitrates (Nitro-Dur, others), or if you have certain heart valve problems. Should be used with caution or not used at all with alpha blockers. Should not be used with some antibiotic, antiviral or antifungal medications. Do not take with nitrates (Nitro-Dur, others) or alpha blockers (Hytrin, Cardura, others), or if you have certain heart valve problems. Should be used with caution or not used at all with alpha blockers. Should not be used with some antibiotic, antiviral or antifungal medications. Do not take with nitrates (Nitro-Dur, others) or alpha blockers (Hytrin, Cardura, others), or if you have certain heart valve problems. Should be used with caution or not used at all with alpha blockers. Should not be used with some antibiotic, antiviral or antifungal medications.

Several factors may affect your choice of medication, including how well your body responds to one drug over another and how long you want the effects of each dose to last. Talk to your doctor about your options and personal preferences to help decide which one of these medications might work for you.

Not safe for everyone

Although these medications can help many people, not all men can safely take them. PDE-5 inhibitors may worsen certain medical conditions and interact with a number of drugs. Erectile dysfunction medications are dangerous when used with nitrate medications, such as nitroglycerin (Nitro-Dur, others), often prescribed to prevent or treat acute angina (chest pain due to coronary artery disease). Both types of medication dilate blood vessels, and their combined effects can cause dizziness, low blood pressure and loss of consciousness.

In rare cases, men using PDE-5 inhibitors have suffered permanent, total vision loss due to nonarteritic anterior ischemic optic neuropathy (NAION). Because NAION and erectile dysfunction share many of the same risk factors, it’s unclear whether the drug or an underlying condition is responsible. If you’re considering an erectile dysfunction drug but have a retinal disorder, such as diabetic retinopathy, see your eye doctor first.

Realistic expectations

Occasional erectile dysfunction is a common problem, particularly as men age. Medication won’t make you feel like you’re 20 again, but it can help you achieve satisfying sexual relations more often. Be willing to work with your doctor to find which medication and dosage is best for you.

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