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How To Stop All The Viagra Emails in Snow Hill, Maryland is small town living at its best. Nestled on the south banks of the Pocomoke River Snow Hill is a place where people know each other. From the people who call it home to the business owners and those in city government, we have built a community where life is gentle, fun, and prosperous. Home to a quaint downtown retail area and a broad spectrum of recreational activities, How To Stop All The Viagra Emails is the perfect place to spend a relaxing weekend or a lifetime.

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Manufacturer link: Moots
We have a few of these 2015 models left at substantial savings. The difference vs. 2016? Only the head-tube diameter. 2015 models have regular inch and an eighth head-tubes, whereas the nearly identical 2016 models now come with slightly larger 44mm head-tubes. Very limited quantities available, so act fast! 2015 Vamoots-CR (Compact Road) frame MSRP: $3,325, now $2,895! 2015 Vamoots-RSL (Road Super Light) frame MSRP: $4,450, now $3,995!

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Manufacturer link: Bianchi
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Manufacturer link: Litespeed
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Manufacturer link: Litespeed
The How To Stop The Viagra Emails 2016 Litespeed T3 uses an ovalized 3/2.5 titanium top tube in place of the 6/4 titanium tube from the T1-SL, and a simplier bottom bracket design but is otherwise nearly identical to the T1-SL frame with almost 90% of the $4000 T1-SL frame’s performance but for $1100 less! New for 2016: the T3 now includes hex-bolt-attached removable head-tube cable guides (just remove them for conversion to Di2), and ovalized chain and seat stays for leaf-spring like shock absorption, as well as both disc brake and rim brake compatible design! Of course like all Litespeed titanium frames, the T3 is fully hand-crafted in the USA and comes with a lifetime warranty. How To Stop The Viagra Emails: Get $350 OFF any of our Adrenaline Bikes build kits with the purchase of the frame and for the $2,999 MSRP price, AND get a FREE $420 MSRP full carbon tapered fork with either a frame-alone or bike purchase!

Manufacturer link: Ritchey
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Read Road Bike Action magazine’s review of this bike:

See a video of Tom Ritchey interviewed about the Road Logic:

FREE: 48-contiguous US state shipping on Ritchey frames and bikes! (Regular $110.)

How To Stop The Viagra Emails

How can I fight Viagra spam in Outlook or webmail?

We’ve all been getting quite a bit of Viagra ads here on campus. Fortunately there’s an easy way to put it in its place…the trash. Here are instructions to create rules which will delete most of the current Viagra spam we are getting.

These instructions are for Outlook 2003 or 2007 users.

If you use other means to manage your MIIS email (Mac, Entourage, MIIS to Gmail), these instructions show you how to set up the rule via webmail .

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I take 50mg 15 minutes before love making, and now I can spend hours with foreplay and not worry if I’m gonna go soft or lose interest.

It takes effect in 15 minutes on the average and out love-making session goes for over an hour every time. – Age 65, Florida

I could feel my penis get erect within 15 minutes, getting harder than usual and lasting longer too – YT, Age 45, Nigeria

The effects last 3 or 4 hours, and it takes 30 to 45 minutes to kick in. – Art, Age 62, Texas

It worked faster than a 1/2 hour and I had the first complete sexual experience in over 6 YEARS! William, Age 42, Texas

It begins to work in about 15 minutes to a half an hour and lasts for 3 hours or so

I find that 25 mg two hours prior to sex is best for me, and allows sensitivity, to remain at its peak. – Phil, Age 60, California

The first time I took it, my wife and I had already made love that afternoon. Viagra worked well in producing another HARD erection for us that night. The next time I tried it was an hour before bedtime. This produced even greater results. – JimmyB, Age 45

I’ve found I need to take it at least 30 minutes before sex. Not only is my erection harder, but the quantity of my orgasm and the force of it is greatly increased by Viagra

I take it about an hour before making love (which for us is usually mid afternoon.)

The doctor told me when he prescribed it that the first time I tried some it would take a little while to work, like almost an hour, and to be patient. So I took it, and set back to wait. I was surprised to find out that I didn’t have to wait near that long. I was ready to go in fifteen minutes, and went a little longer than she wanted me to go.

But 30 mins after taking a 50mg dose of Viagra (with no side effects other than a very mild headache), then – boing. – my penis is as stiff as it used to be when I was 15! – Richard, Age 53, UK

I started with 50 mg (good to rev my engine, I think) but ultimately found that 25 mg about 90 minutes before sex is ideal for me.

I had a rock hard erection about a half hour after taking the pill. – Age 37. Utah

Erectile Dysfunction Health Center

WebMD archives content after 2 years to ensure our readers can easily find the most timely content.

To find the most current information, please enter your topic of interest into our search box.

“>WebMD Feature Archive

April 10, 2000 (Mill Valley, Calif.) — In his early 40s, Ron Hanson was too young to be having trouble getting and sustaining erections. But like many men, he was too embarrassed at first to talk about the problem. Hanson (not his real name) waited seven years to see a urologist. By the time he spoke up, erectile dysfunction had become a household word, thanks to the popularity of the drug Viagra. But the widely touted drug, Hanson soon learned, doesn’t work for everyone.

When Viagra (sildenafil) hit the market in 1998, some men thought it was the long-awaited answer to their problems. Many rushed to doctor’s offices to give it a try. According to the Grey Clinic in Indianapolis, which specializes in erectile dysfunction. 17% of men between 18 and 55 experience occasional impotence, while 6% have regular erectile difficulties. For men over 55, that number jumps to about one in three. Some common causes of impotence are diabetes. heart disease. and psychological problems. It also frequently occurs after prostate cancer surgery.

Because Viagra works in a way that’s similar to drugs that contain nitrates, however, it isn’t recommended for men who take nitrates for heart disease or those with certain other heart conditions. In some men, it causes bad headaches. In others, it just plain doesn’t work. In some instances, men may notice they have trouble telling blue and green colors apart when they start taking the drug.

During an erection, blood flows quickly into the penis. which increases its length, width, and firmness. If the “in” vessels (arteries ) are too narrow or if blood drains too quickly through the “out” vessels (veins), men may have trouble achieving or maintaining an erection, says Arnold Aigen, MD, a urologist with Camino Medical Group in Sunnyvale, Calif. Viagra, which increases inflow, may not be strong enough to work its magic if the arteries are too narrow.

Hanson tried Viagra, but he couldn’t tolerate the headaches it caused. Luckily, when Viagra fails, he discovered, there are several alternatives.

Alprostadil to the Rescue

A drug called Alprostadil. either alone or sometimes in conjunction with others such as papaverine and/or phentolamine, can be injected directly into the penis to dilate the arteries, experts say. The drug produces an erection in about 10 minutes that can last up to an hour. But there are several disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some patients are averse to using a needle, which is why many men abandon the therapy. Those who give it a try may experience pain at the injection site or priapism (a painful erection lasting too long).

How Long Does Viagra Last?

Many people wonder, "How long does Viagra last?" In most people, Viagra lasts for about four hours. Generally, it starts to lose its effectiveness after a couple of hours. There are a number of factors that can increase or decrease how long Viagra lasts. Some factors that increase the amount of time Viagra stays in the body include being over 65 years old, having severe kidney disease, and taking certain other medicines. Among the factors that can decrease how long Viagra lasts are taking it with a high-fat meal or certain other medicines, such as rifampin.

How Long Does Viagra Last?

Many people thinking of taking Viagra ® (sildenafil citrate ) wonder, "How long does Viagra last?" The answer is that it depends on a number of factors and will vary between individuals. However, in most people, Viagra will last for about four hours — although it generally starts to lose its effectiveness after a couple of hours.

The time it takes for Viagra to start working will also vary based on the individual. In clinical studies, Viagra began to work in as little as 14 minutes. For most people, though, it began working within 30 minutes.

Factors Affecting How Long Viagra Lasts

There are a number of factors that can increase or decrease how long Viagra lasts. Some factors that increase the amount of time Viagra stays in the body include:

  • Being over 65 years old
  • Having severe kidney disease or liver disease
  • Taking certain other medicines (see Viagra Drug Interactions ).

There are also factors that can decrease how long Viagra lasts. Some of these factors include:

  • Taking Viagra with a high-fat meal
  • Taking Viagra along with certain other medications, such as rifampin.

Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

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Viagra Concentration

Viagra Concentration in Snow Hill, Maryland is small town living at its best. Nestled on the south banks of the Pocomoke River Snow Hill is a place where people know each other. From the people who call it home to the business owners and those in city government, we have built a community where life is gentle, fun, and prosperous. Home to a quaint downtown retail area and a broad spectrum of recreational activities, Viagra Concentration is the perfect place to spend a relaxing weekend or a lifetime.

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The beautiful rural setting boasts rich farmland that has been the mainstay of the economy of the county seat of Worcester County for centuries. The rich heritage of this area is celebrated daily at Furnace Town Living Heritage Museum and during a summer festival every August with The Blessing of the Combines.

The town of Viagra Concentration welcomes you as you explore our small town steeped in history and tradition but alive with charm and activities.

ED Medications: Cialis, Levitra, Viagra

How do these drugs work?

Cialis, Levitra (Vardenafil) and Viagraв„ў (Sildenafil) work by selectively inhibiting an enzyme in the penis called Phosphodiesterase V (PDE V), a chemical that takes away the erection. By blocking PDE V temporarily, these medications empower the chemical, Nitric Oxide (NO) that occurs naturally with arousal to initiate, produce and maintain an erection. Patients need sexual stimulation and foreplay to release NO initiate an erection in order for these medications to be effective. They are called phosphodiesterase inhibitors.

This class of medication is a safe and effective oral treatment for men with erectile dysfunction of physical, psychological or mixed cause. However, it is important that patients should be aware of the low probability (less than 50%) that intercourse will be possible after the first dose – particularly in severe or advanced cases and especially when using Viagra or Levitra. The majority of men who stop Viagra because of apparent lack of effect will in fact respond and achieve intercourse if they continue to try again, progress from 50 mg to 100 mg, or take the pill without food on an empty stomach (3 hours after eating). Taking Viagra or Levitra on a full stomach will not only reduce their peak concentration in the body by 30 to 50% but in addition will delay their peak concentration by one hour. In other words one may have to wait after intake before initiating sexual activity. Cialis peak concentration and time before reaching maximum absorption is not affected by a full stomach. Because of this it remains my drug of choice for the treatment of ED and I always prescribe it first. In addition many of my patients experience fewer side effects with Cialis then with the other two. Finally Cialis has a long period of activity and patients are successful at intercourse up to 36 hours after taking this pill. This represents a distinct advantage from the patient’s perspective as it diminishes the need for planning. Sex can be more spontaneous and natural. Planning kills the mood. Having sex long after taking the pill makes men feel more normal! For these reasons I will first try Cialis on all my Patients and reserve Viagra and Levitra for those men who do not tolerate Cialis.

The steps illustrated in Reference #4 below will help optimize the chances of success of Levitra and Viagra 4.

Reliable safety data gathered in the 10 years since these PDE % inhibitors were launched confirm that side effects such as Priapism (prolonged erection), red eyes, painful eyes, syncope(fainting), tachycardia (rapid heart rate), and nausea do occur, but are rare. Back pain and muscle aches occur rarely with Cialis. HIV medications (protease inhibitors) have been shown to raise their blood levels. Certain patient groups are more susceptible to a decrease of their blood pressure, including those with aortic stenosis, hypertrophic obstructive cardiomyopathy, and multiple system atrophy. Finally, all PDE 5 inhibitors remain contraindicated in patients taking nitrates.

A few new safety concerns such as visual and hearing loss have emerged in the past year, however these remain extremely rare reinforcing that these medications are very safe. Indeed, we now know that many patients with cardiovascular disease (CVD) and ED benefit from it.

Erectile Dysfunction: Oral Therapy Treatment Options

Dr. J. Francois Eid discusses the oral therapy options, or “pills”, available to treat erectile dysfunction.

The following can be prescribed a PDE 5 inhibitor (Cialis, Levitra, Viagra) safely without the need for extensive Cardiovascular investigationВІ:

  • men who are a symptomatic and have fewer than three risk factors for coronary artery disease
  • those with controlled hypertension
  • those with mild stable angina
  • patients who have undergone successful coronary revascularisation (bypass or stent placement)
  • men with a history of uncomplicated heart attack that happened greater than 6-8 weeks ago
  • those with mild valvular disease of the heart
  • patients with mild left ventricular disease and congestive heart failure (NYHA Class I)

    Cialis (Tadalafil)

    Oral medications such as Cialis, Levitra and Viagra are available for the treatment of erectile dysfunction. They are in a class called PDE 5 inhibitors. They work to restore a normal system of blood flow in the penis so that an erection can occur with sexual stimulation.

    Highlights of Cialis:

    Only ED medicine clinically proven to work up to 36 hours.

    Works as fast as 30 minutes in some men.

    Gives you the freedom to choose the moment that is right for you.

    The most common side effects include headache, upset stomach, back pain and muscle aches. The side effects usually go away after a few hours. In the rare event of Priapism seek immediate medical help to avoid long term injury. Another uncommon side effect reported was a sudden decrease or loss of vision.

    Who should not take Cialis:

    Cialis is contraindicated in patients using nitrates. If you use recreational drugs called “poppers” like amyl nitrate and buty nitrite do not take Cialis. If Cialis is taken with certain Alpha Blockers, it can result in a sudden drop of blood pressure, which could lead to dizziness or faintness. It can however be used with Flomax 0.4mg.

    Tell your doctor if you take any other medications including prescription and non-prescription medicines, vitamins or any health supplements as Cialis and these may affect each other adversely.

    How to use Cialis:

    Cialis is available by prescription only. It is taken orally before sexual activity, not more than once daily. It may be taken with or without food. In some patients, the dose strength and maximum frequency of use may be adjusted.

    Levitra (Vardenafil)

    Levitra is also an FDA approved medication for the treatment of Erectile Dysfunction.

    How Levitra works:

    Levitra is an oral medicine, available by prescription only, and should be taken approximately 60 minutes prior to sexual activity. It should be taken no more than once daily. It can be taken with or without food.

    The side effects are generally mild and do not last very long. The most common side effects are headache, flushing, stuffy or runny nose. In rare cases Priapism and vision changes have been observed.

    Levitra is contraindicated in patients who take any form of medication known as nitrates or recreational drugs called “poppers” like amyl nitra or butyl nitrate. If you are taking any alpha blockers, Levitra is not the right medication for you.

    First effective FDA-approved oral medication for the treatment erectile dysfunction

    Boosts natural process of erection during arousal

    Works across broad range of Erectile Dysfunction causes

    Over 6 million patients have tried it

    Approximately 250,000 doctors have prescribed it

    Over 14 million prescriptions written

    Over 100 million tablets dispensed

    Unlike placebo-like drugs, Viagraв„ў has high refill rate

    How to Use Viagraв„ў

    If taken on an empty stomach, it takes about 85 minutes for Viagraв„ў to be absorbed into the circulation and reach the penis. Some patients (younger men) may experience benefits from the medication as early as 30 minutes after taking it. A high fat meal will delay the absorption of Viagraв„ў, and therefore it is recommended that Viagraв„ў is taken on an empty stomach or after a lowfat meal. Furthermore, once absorbed, Viagraв„ў will stay in the circulation for approximately four to six hours, which represents the window of sexual opportunity. If initially not successful, patients should try Viagraв„ў at 100mg on 3 different occasions before concluding that the medication is ineffective.

    Viagraв„ў is effective in two-thirds of men with erectile dysfunction regardless of age and the severity of Erectile Dysfunction. However, certain groups of men using the drug do better than others. For example, spinal cord injured males have better results than patients suffering from cardiovascular disease (e.g. hypertension, high serum fat levels), and patients who have undergone treatment for prostate cancer (e.g. removal of the prostate or radiation therapy) seem to benefit the least.

    Viagraв„ў Side Effects

    Most side effects are mild and well-tolerated. The following are the most common reported side effects: headache, flushing of the face, heartburn, and nasal congestion. A small percentage (3%) of people may develop visual disturbance; it may take the form of a blue haze or tinge as well as increased perception of brightness. This effect is very mild, transient, and reversible.

    Who Should Not Take Viagraв„ў

    Viagraв„ў is CONTRAINDICATED for patients who take any medications that contain nitrates. This includes patients who need nitrates (including nitroglycerine) on an intermittent basis for the treatment of angina.

    In patients used to regular exertion, sexual activity poses no special cardiovascular risk. Even in patients who have a history of myocardial infarction (MI), there is little risk of MI during intercourse for those who exercise regularly. However, there is insufficient information on the cardiovascular risk in previously sexually inactive men who become sexually active. Stress test and/or referral to a cardiologist may be appropriate, and variables such as patient’s age, medical history and existing medical conditions may be relevant.

    Stendra

    Alternative medication therapies

    Alternative oral therapies for Erectile Dysfunction (availability may vary geographically) are Uprima (apomorphine), and phentolamine. Both Uprima and phentolamine have very low or no efficacies and therefore for present purposes will not be addressed.

    Uprima is approved for the treatment of Erectile Dysfunction in Europe and initial sales have not been very impressive (less than 20% of ED market). Refill rates are dismal supporting lack of efficacy.

    Phentolamine’s application to the FDA was withdrawn and the drug is not available.

    Discussion

    Although Viagra, Levitra and Cialis differ in their biochemical potency and selectivity, and in onset and duration of action, it is important not to extrapolate those findings inappropriately to the clinical setting. For example, greater biochemical potency does not necessarily translate into enhanced clinical efficacy. The same is true of selectivity. In short, there appears to be little biochemical or clinical differences between the three agents except for the lack of food interaction and the duration of activity for Cialis. All three medications are contraindicated in patients who take nitrates.

    A recent survey looking at what patients with ED really want from their treatment found that efficacy and a favorable side-effect profile were the highest prioritiesВі Fast onset was desirable, but there were major differences in what was considered fast. Duration was important only in terms of lasting long enough to complete intercourse. Few men (or their partners) felt that multiple erections, or the ability to achieve them over time, were critical as long as one dose was enough for a successful encounter. Most complaints were about high cost or lack of insurance coverage.

    An underlying desire was reported by most couples for initiation of sex to be normal (spontaneous and natural). Few patients fully understood the duration of activity that Viagra can provide, and its advantages. Cialis may indeed fulfill the desire that couples and patients with ED have for the initiation of sex to be normal (spontaneous and natural). Although Viagra, Levitra and Cialis are safe and effective they do, like all medications, have disadvantages. They essentially enhance partial (sexual) erections, rather than initiating them. At best, the response rate among men with advanced ED (for example following radical prostatectomy) is 30%. Fewer than 505 of men with Diabetes will respond. Correct administration of Viagra and Levitra is critical, and if one does not work when taken correctly, no other oral “Viagra like drug” (PDE5 inhibitor like Levitra or Cialis) will either.

    In conclusion, the potencies of Viagra, Levitra and Cialis are broadly similar, but each has unique pharmacological properties related to its molecular structure. Viagra is an exemplary PDE-5 inhibitor that, after 10 years of widespread clinical use, is acknowledged to be effective and particularly well tolerated. Cialis and Levitra are the newer medications and are similar to Viagra in their efficacy and contraindications. The only new attributes of clinical significance are the lack of food interaction and the long duration of action of Cialis. This may translate into greater efficacy of the first dose as well as a return to more spontaneous (normal) initiation of sexual activity (broader window of opportunity).

    Question: Is it possible to identify potential non-responders to oral therapy?

    Answer: No, it is not possible to identify potential non-responders to a PDE 5 inhibitor such as Cialis, Levitra or Viagra, other than by a trial of these medications in the setting of sexual activity. Patients, who appear to be non-responders to Viagra or Levitra, need to repeat a trial on an empty stomach a few different times before giving up. Cialis absorption and onset of action is not affected by food. The 20-30% who still do not respond generally have ED related to an irreversible physical abnormality due to chronic poor blood flow (often smoking-related) or damaged penile tissue (often diabetes, high cholesterol and after prostate cancer surgery). The best option for these patients remains an inflatable penile prosthesis.

    Question: You said that the PDE5 inhibitors were comparable in efficacy. What about reports that Levitra is more effective than Viagra in treating ED among men with diabetes?

    Answer: Clinical trial reveals that all three medications have the same success regardless of patient age, underlying medical condition or severity of erectile dysfunction. There is no head-to-head evidence of that, and what literature there is may be misleading. My belief is that clinical experience will show them to be similar.

    References

    McCullough AR, et al. J Urol 2001. In press.

  • DeBusk R, et al. Am J Cardiol 2000; 86: 175-81.
  • Data from Six Degrees Survey, October 2001.
  • Optimizing Viagra and Levitra therapy:
    • men who require fast onset or better absorption should avoid fatty meals or take these pills on an empty stomach;
    • maximize sexual stimulation and arousal;
    • start foreplay later in older patients (who may need up to 2 hours to absorb the medicicne);
    • consider partner issues;
    • do not give up before making at least 3 attempts at intercourse having at the maximum dose: Viagra 100 mg, Levitra 20mg.
  • Erectile Dysfunction (ED)

    Wireless Innovation Alliance // Jun. 16

    Earlier today, Reps. Darrell Issa (R-CA) and Anna Eshoo (D-CA) sent the attached letter to FCC Chairman Tom Wheeler on the importance of establishing the technical rules necessary to allow unlicensed use of the 600 MHz band. The Wireless Innovation Alliance (WIA) released the statement below in response. More

    Wireless Innovation Alliance // Apr. 17

    The Wireless Innovation Alliance (WIA) released the statement below on today’s FCC Open Meeting where the Commission approved an order to implement a spectrum sharing framework in the 3550-3700 MHz band. More

    Wireless Internet Service Providers Association // 10:05 AM EST// Mar. 23

    The National Association of Broadcasters (NAB) wants the FCC to declare an “emergency” and shut down the databases that let small businesses and others deliver broadband over vacant spectrum near television channels. More

    Wireless Innovation Alliance // 6:06 PM EST// Feb. 10

    The Wireless Innovation Alliance (WIA) released the statement below in response to the introduction of the House and Senate Wi-Fi Innovation Act More

    Wireless Innovation Alliance // 4:44 PM EST// Jan. 28

    The Wireless Innovation Alliance applauds the FCC for telling Marriott International, Inc. – and everyone else – that it is illegal to interfere with lawful communications. More

    Wireless Innovation Alliance // 3:00 PM EST// Dec. 15

    This October, the FCC found Marriott’s Gaylord Opryland Hotel and Convention Center to be guilty of blocking guests’ personal Wi-Fi hotspots and fined Marriott International $600,000. Lend your social voice to our Thunderclap. More

    Wireless Innovation Alliance // 5:47 PM EST// Sep. 4

    FCC Chairman Tom Wheeler acknowledged the critical role unlicensed spectrum plays in growing competition in the broadband marketplace stating that the FCC’s “efforts to expand the amount of unlicensed spectrum creates alternative competitive pathways.” More

    The Hill // 9:25 AM EST// Jun. 16

    CEA released a report, Unlicensed Spectrum and the American Economy, examining the economic impact of unlicensed spectrum on the American economy. More

    The Wireless Innovation Alliance (WIA) is a broad-based group of innovators, providers, consumer groups, think tanks and education organizations that believe that more efficient use and expanded access to the nation’s spectrum resources are fundamental to the future of U.S. economic policy and global competitiveness, and that we face potential spectrum scarcities in both licensed and unlicensed bands that must be addressed in order for innovation and investment to move forward.

    Spectrum, and specifically, the most efficient and expansive use of this most valuable natural resource, is fundamental to the future of U.S. economic growth, and global competitiveness. United States spectrum policy must also be efficient and flexible as well, so that we can encourage and accommodate new and innovative ways to meet the growing demand for wireless services and applications, and the growing inability – in both licensed and unlicensed bands – to meet that demand.

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    High Blood Pressure and Erectile Dysfunction Treatments

    Even if your high blood pressure (or hypertension ) has caused erectile dysfunction (ED), you have every reason to be optimistic about the future and a healthy sex life. ED is a common problem associated with high blood pressure. but there are many proven treatments you can try.

    A doctor’s first choice for treating erection problems is usually one of the pills called PDE5 inhibitors. First there was Viagra. Now there’s also Cialis. Levitra. and Staxyn. All of these drugs work in similar ways. They don’t increase sexual desire. They make it physically possible to get an erection when you are aroused.

    No one of them has been proven to work better than the others. But the time they take to start working and the duration of their effects vary. That’s something you may want to consider based on your sexual habits. For example, does spontaneity matter to you, or do you usually plan sex ahead of time?

    Viagra starts working in about 15 to 30 minutes and its effects last about two to four hours. Levitra starts working in about 30 to 60 minutes and lasts four to five hours. Cialis starts working in about 30 to 60 minutes and lasts as long as 36 hours.

    Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets.

    Men whose blood pressure isn’t under control and those who take alpha-blockers (for high blood pressure or prostate problems ) shouldn’t take Cialis, Levitra, Staxyn, or Viagra.

    Also, you may not be able to take these drugs if you:

    When Erectile Dysfunction Pills Aren’t an Option

    If erectile dysfunction pills are out of the question, or if pills haven’t worked for you, don’t worry. There are other options.

    Alprostadil is another drug for erectile dysfunction. However, it’s not a pill. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis. allowing blood to fill the spongy tissue that makes the penis erect.

    Continued

    Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erectile dysfunction. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.

    Next, you may want to try a vacuum device, or “penis pump.” This is typically a clear plastic cylinder with a bulb or plunger and a constriction band.

    You put your penis in the cylinder and start pumping. The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It’s safe to keep the band on for up to 30 minutes.

    These devices are available without a prescription, but it’s important to buy one from a reputable manufacturer. The device must include a safety control so you can’t harm your penis with too much suction.

    Surgery for Erectile Dysfunction

    Most men would prefer to avoid surgery, but for some men with erection problems, penis implants are another option for regaining sexual function.

    There are two kinds of penis implants. One kind is a rigid but flexible rod implanted in the penis. You bend it up for sex or down for daily living. The other kind is an inflatable implant. The device stores fluid in a reservoir under the skin of your abdomen or scrotum. You press on the reservoir to pump fluid into cylinders in the penis. That creates an erection. A valve drains the fluid out of the penis when you’re done.

    There are drawbacks to implants. An erection you get with an implant may be slightly shorter than a natural erection. The device itself may malfunction, in which case it would require another surgery to remove or replace it.

    Getting a penis implant is a big decision. Once you have it, you may not be able to try other treatments. That’s because the implant replaces the chambers in the penis that fill with blood for a natural erection.

    Continued

    Alternative Treatments for Erectile Dysfunction

    Before Viagra hit the market in 1998, there was no proven treatment for erectile dysfunction that men could take in pill form. Doctors were interested in yohimbe. an herb that increases heart rate and blood pressure. Some doctors prescribed it to their patients in combination with other treatments for erectile dysfunction. Even then it was not a recommended treatment and is still not today. Studies have not proven that it works.

    Men with high blood pressure especially shouldn’t take either the prescription drug or the herb. It can dangerously raise blood pressure.

    Currently, no herb or supplements have been proven to help with erectile dysfunction. Herbs and supplements that some believe are helpful for erection problems include:

    Before trying any alternative treatment, be sure to ask your doctor about it. Herbs and supplements. whether they help with erections or not, have real effects on the body. They could cause dangerous reactions with other medicines you might be taking.

    WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on April 12, 2015

    Sources

    American Urological Association: “Erectile Dysfunction Clinical Guidelines Panel. The Treatment of Organic Erectile Dysfunction: A Patient’s Guide,” 1996; and “AUA Guideline on the Management of Erectile Dysfunction: Diagnosis and Treatment Recommendations,” 2005.

    Gaines, K. Urologic Nursing. February 2004.

    Lamm, S. The Hardness Factor. HarperCollins, 2005.

    Medscape Drug Reference from First DataBank: “Alprostadil Urethral” and “Sildenafil Oral.”

    Vivus, Inc. “Administering MUSE,” 2004.

    В© 2015 WebMD, LLC. All rights reserved.

    Viagra (sildenafil) facts

    What is Viagra?

    Viagra is the trade name for a drug called Sildenafil. Viagra is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors.

    Viagra and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated. Aside from Viagra, the other drugs in this class are Cialis (Tadalafil) and Levitra (Vardenafil).

    How does Viagra work?

    Viagra does not cause a man to be sexually aroused. Viagra is only effective if you are sexually aroused. To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO).

    The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.

    If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP.

    Is Viagra effective?

    Clinical studies have shown that when compared to placebo, Viagra and the other drugs in the same class, result in significant improvement in erectile function. Although established to be a safe and effective drug, Viagra isn’t appropriate for everyone and may not work in all cases.

    How does it affect blood pressure?

    Viagra can slightly lower blood pressure. This is not a problem for most men. But Viagra’s effect on blood pressure is exaggerated if the Viagra is taken with a nitrate drug.

    Nitrates are one of the treatments doctors prescribe for angina. If you take Viagra when you are also taking nitrates, the combined effect of the Viagra and the nitrates can lower your blood pressure to such an extent that it could prove fatal. Never take Viagra at the same time as taking nitrates.

    If I have a heart condition can I take it?

    If you have a heart condition it is important that you discuss this with the doctor before taking Viagra. Viagra may not be appropriate because of the danger of interacting with the nitrates.

    Can women take it?

    Viagra is not currently licensed for use by women.

    How quickly does it work?

    On average, Viagra becomes effective in just under an hour when you take a tablet on an empty stomach. Viagra can remain effective for between four and six hours. If you take it after a meal that has a high fat content, it may take longer than an hour to become effective.

    Why are there different doses?

    Viagra is available in three dosages: 25mg, 50mg and 100mg. Some men may respond to a lower dose of Viagra. Some men may already be taking medicines that interact with Viagra and thus need to adjust the Viagra dosage they are taking.

    What dose is right for me?

    The doctor needs to decide which dosage of Viagra is most appropriate. The doctor will take into account potential drug interactions, your age, the severity of your erectile dysfunction and any previous experience you have had with Viagra.

    What if it does not work the first time I use it?

    Viagra might not work the first time you take it. Most doctors advise taking Viagra at least eight times before trying a different medicine.

    What are the side-effects?

    Viagra’s Side effects are generally mild and brief. Viagra’s most common side-effects are headache and facial flushing. Less frequently, men taking Viagra have reported indigestion, a stuffy nose and a blue tint to the vision.

    Does it interact with other medicines?

    Viagra interacts with many drugs. The following list is not complete but it is important to inform the doctor of all prescription and non-prescription medication taken, especially:

    • nitrate medications (e.g. glyceryl trinitrate (GTN), nitroglycerin, isosorbide mononitrate or dinitrate)
    • nitroprusside
    • cimetidine
    • erythromycin
    • azole antifungals (e.g. itraconazole, ketoconazole)
    • mibefradil
    • rifamycins (e.g. rifampicin)
    • Alpha blockers, prescribed for prostate disease or high blood pressure
    • Ritonavir, Amyl, Butyl or Isopropyl nitrates (‘Poppers’)

    Who shouldn’t use it?

    Men who have any of the following conditions should also avoid taking it:

    • severe heart or liver problems
    • recent stroke or heart attack
    • low blood pressure
    • certain rare inherited eye diseases

    Does it treat the underlying causes of impotence?

    Viagra will resolve the underlying cause of erectile dysfunction although if the cause is primarily psychological, it may help to break the cycle of anxiety and failure associated with being unable to achieve a satisfactory erection.

    What kind of tests might highlight the underlying causes of male impotence?

    A blood test for diabetes should be performed along with cholesterol and triglyceride blood tests. It is becoming increasingly accepted among doctors that sex hormone levels (Testosterone) should also be checked by way of a blood test.

    What other impotence treatments are available?

    The other drugs, Levitra and Cialis work in similar ways. Viagra is generally prescribed as the first line treatment. Cialis has a much longer half-life than Viagra and Levitra and therefore its effect lasts much longer.

    This does not mean one has prolonged erections but the length of time available for further erections is increased without the need to take further doses. It also means however that the side effects if present will last longer. Levitra, like Cialis, can be taken with food whereas Viagra should be taken on an empty stomach.

    Some studies have shown Levitra to be more suitable for men suffering from diabetes. Other treatments include Caverject (‘Alprostadil’), which is a medication injected directly into the penis and MUSE (another form of ‘Alprostadil’), which is a pellet inserted into the urethra. These may be of use for men who have to take Nitrates and are therefore unable to take the PDE5 inhibitors.

    The use of vacuum pumps and other mechanical devices for producing and maintaining erections are alternatives to taking medication.

    PATIENT INFORMATION

    VIAGRA®
    (vi-AG-rah)
    (sildenafil citrate) Tablets

    What is the most important information I should know about VIAGRA?

    VIAGRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. Do not take VIAGRA if you take any other medicines called “nitrates.” Nitrates are used to treat chest pain (angina ). A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke .

    Do not take VIAGRA if you take medicines called guanylate cyclase stimulators which include:

    • Riociguat (Adempas®) a medicine that treats pulmonary arterial hypertension and chronicthromboembolic pulmonary hypertension.

    Tell all your healthcare providers that you take VIAGRA. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took VIAGRA.

    Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex.

    Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

    VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV —the virus that causes AIDS .

    VIAGRA is a prescription medicine used to treat erectile dysfunction (ED). You will not get an erection just by taking this medicine. VIAGRA helps a man with erectile dysfunction get and keep an erection only when he is sexually excited (stimulated).

    VIAGRA is not for use in women or children.

    It is not known if VIAGRA is safe and effective in women or children under 18 years of age.

    Who should not take VIAGRA?

    Do not take VIAGRA if you:

    • take medicines called nitrates (such as nitroglycerin)
    • use street drugs called “poppers” such as amyl nitrate or amyl nitrite, and butyl nitrate
    • take any medicines called guanylate cyclase stimulators such as riociguat (Adempas)
    • are allergic to sildenafil, as contained in VIAGRA and REVATIO, or any of the ingredients in VIAGRA. See the end of this leaflet for a complete list of ingredients in VIAGRA.

    What should I tell my healthcare provider before taking VIAGRA?

    Before you take VIAGRA, tell your healthcare provider if you:

    • have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve or heart failure
    • have had heart surgery within the last 6 months
    • have pulmonary hypertension
    • have had a stroke
    • have low blood pressure. or high blood pressure that is not controlled
    • have a deformed penis shape
    • have had an erection that lasted for more than 4 hours
    • have problems with your blood cells such as sickle cell anemia. multiple myeloma. or leukemia
    • have retinitis pigmentosa. a rare genetic (runs in families) eye disease
    • have ever had severe vision loss, including an eye problem called non-arteritic anterior ischemic optic neuropathy (NAION)
    • have bleeding problems
    • have or have had stomach ulcers
    • have liver problems
    • have kidney problems or are having kidney dialysis
    • have any other medical conditions

    Tell your healthcare provider about all the medicines you take*, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

    VIAGRA may affect the way other medicines work, and other medicines may affect the way VIAGRA works causing side effects. Especially tell your healthcare provider if you take any of the following:

    • medicines called nitrates (see “What is the most important information I should know about VIAGRA?” )
    • medicines called guanylate cyclase stimulators, such as riociguat (Adempas)
    • medicines called alpha blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA with alpha-blockers can lead to a drop in blood pressure or to fainting .
    • medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase) or atazanavir sulfate (Reyataz)
    • some types of oral antifungal medicines, such as ketoconazole (Nizoral), and itraconazole (Sporanox)
    • some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
    • other medicines that treat high blood pressure
    • other medicines or treatments for ED
    • VIAGRA contains sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension (PAH ). VIAGRA should not be used with REVATIO or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil]).

    Ask your healthcare provider or pharmacist for a list of these medicines, if you are not sure.

    Know the medicines you take. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

    How should I take VIAGRA?

    • Take VIAGRA exactly as your healthcare provider tells you to take it.
    • Your healthcare provider will tell you how much VIAGRA to take and when to take it.
    • Your healthcare provider may change your dose if needed.
    • Take VIAGRA about 1 hour before sexual activity. You may take VIAGRA between 30 minutes to 4 hours before sexual activity if needed.
    • VIAGRA can be taken with or without food. If you take VIAGRA after a high fat meal (such as a cheeseburger and french fries), VIAGRA may take a little longer to start working
    • Do not take VIAGRA more than 1 time a day.
    • If you accidentally take too much VIAGRA, call your doctor or go to the nearest hospital emergency room right away.

    What are the possible side effects of VIAGRA?

    VIAGRA can cause serious side effects. Rarely reported side effects include:

    • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis.
    • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking VIAGRA and call your healthcare provider right away if you have sudden vision loss in one or both eyes.
    • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus ) or dizziness. If you have these symptoms, stop taking VIAGRA and contact a doctor right away.

    The most common side effects of VIAGRA are:

    • headache
    • flushing
    • upset stomach
    • abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision
    • stuffy or runny nose
    • back pain
    • muscle pain
    • nausea
    • dizziness
    • rash

    In addition, heart attack, stroke, irregular heartbeats and death have happened rarely in men taking VIAGRA. Most, but not all, of these men had heart problems before taking VIAGRA. It is not known if VIAGRA caused these problems.

    Tell your healthcare provider if you have any side effect that bothers you or does not go away.

    These are not all the possible side effects of VIAGRA. For more information, ask your healthcare provider or pharmacist.

    Call your doctor for medical advice about side effects. You may report side effects to FDA at 1800-FDA-1088.

    How should I store VIAGRA?

    • Store VIAGRA at room temperature between 68°F to 77°F (20°C to 25°C).

    Keep VIAGRA and all medicines out of the reach of children.

    General information about the safe and effective use of VIAGRA.

    Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VIAGRA for a condition for which it was not prescribed. Do not give VIAGRA to other people, even if they have the same symptoms that you have. It may harm them.

    This Patient Information leaflet summarizes the most important information about VIAGRA. If you would like more information, talk with your healthcare provider. You can ask your healthcare provider or pharmacist for information about VIAGRA that is written for health professionals.

    For more information, go to www.viagra.com, or call 1-888-4VIAGRA

    What are the ingredients in VIAGRA?

    Active ingredient: sildenafil citrate

    Inactive ingredients: microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, and FD & C Blue #2 aluminum lake

    This Patient Information has been approved by the U.S. Food and Drug Administration.

    Last reviewed on RxList: 10/3/2015
    This monograph has been modified to include the generic and brand name in many instances.

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    Wednesday through Saturday evenings at 8:00 pm with a Thursday matinee at 2:00 pm.

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    The oldest building on the farmstead is the “woodshed” which is just south of the house. This building dates back to the 1600’s and has been used for many purposes over the years. It has been used as a slaughter house and for drying meat. It now is used for rehearsal space and prop storage.

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    Hackmatack exists because of the generosity of it’s patrons, friends and those that appreciate the theater’s contribution to local culture and community. It is committed to the advancement of dramatic arts and to providing quality family entertainment at a reasonable price.

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    IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

    USES: Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice “safe sex” such as using latex condoms. 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, ask your doctor or pharmacist. To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily. A high-fat meal may delay how quickly the drug begins to work. The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Tell your doctor if your condition does not improve.

    SIDE EFFECTS: Dizziness, headache, flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. 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. 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 get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea. Rarely, sudden decreased vision in one or both eyes (NAION) may occur. This effect may or may not be caused by sildenafil. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems (“crowded disk”), high blood pressure, if you are over 50, or if you smoke. Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur. In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), 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. In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

    PRECAUTIONS: Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION), bleeding disorders, active stomach ulcers. This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

    DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval. A product that may interact with this drug is: riociguat. Sildenafil can cause a serious drop in your blood pressure when used with nitrates, which can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl or butyl nitrite. If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure. Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), rifampin, among others. Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).

    OVERDOSE: If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.

    MISSED DOSE: Not applicable.

    STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications 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. or local waste disposal company for more details about how to safely discard your product.

    This product information is intended for United States residents only. Before prescribing, please refer to the patient information. You can view the document and also download it on your computer. You may also consider printing out a copy for yourself.

    • View US Prescribing Information – PDF Version

    To view the PDF document, you need Adobe Acrobat Reader which you can download for free here .

    How Can I Get a Viagra Prescription Online Using Telemedicine?

    If youпїЅre thinking about buying Viagra online to treat erectile dysfunction, you might want to do your homework first. This article will help you choose a reputable online pharmacy that sells authentic Viagra using telemedicine.

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    Does AccessRX prescribe generic Viagra using telemedicine?

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    Trademarks and registered marks are the properties of their respective companies. Copyright © 1998-2013 AccessRx.com. All Rights Reserved. | Privacy Policy | Site Map

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    User Reviews & Ratings – L-ARGININE

    « L-ARGININE Information

    Current Rating: 2

    Comment:
    Have only been taking the product a short period of time. Maybe over a longer period, it may be more effective. So far, I have not found it to be very effective.

    Comment:
    Have only been taking the product a short period of time. Maybe over a longer period, it may be more effective. So far, I have not found it to be very effective.
    Hide Full Comment

    4 people found this review helpful.
    Was this review helpful? Yes | No

    Reason for taking: Erectile dysfunction (ED)

    6/26/2016 5:42:02 PM

    Reviewer: Joe, 25-34 Male (Consumer)

    Current Rating: 5

    Current Rating: 5

    Current Rating: 5

    Comment:
    Im a 33 year old with medium ED for more than 4 years and i have been on Viagra until i find about this treatment 2 weeks ago,i was reading about keggels and some guy write a review about ED and was explaining about this treatment and i found it interesting and give it a go. I have been taking L arginine 1000 mg and Pine bark 60 mg for 2 days and i ha the best erections in years,this treatment is. Show Full Comment

    Comment:
    Im a 33 year old with medium ED for more than 4 years and i have been on Viagra until i find about this treatment 2 weeks ago,i was reading about keggels and some guy write a review about ED and was explaining about this treatment and i found it interesting and give it a go. I have been taking L arginine 1000 mg and Pine bark 60 mg for 2 days and i ha the best erections in years,this treatment is amazing,i never expect it to be like this,im wondering how is gonna be in 3 weeks because apparently thats when it start to make efect but at the moment im a 100% happy man,i can look forward to have good fun under the sheets with the miss hehe
    Hide Full Comment

    28 people found this review helpful.
    Was this review helpful? Yes | No

    Reason for taking: Erectile dysfunction (ED)

    6/7/2016 9:47:34 PM

    Reviewer: 25-34 on Treatment for 1 to 6 months (Consumer)

    Current Rating: 5

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    I am an endurance athlete who experienced sudden ED at age 31. Visited doctor who did blood test and everything came back in range. Found recommendation for L-Arginine online and started immediately. I've been getting consistent results with only 2-3 grams a day (I'm 163lbs / 74kg). I haven't experienced any side effects either.

    Comment:
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    Niacin and Impotence

    by KATHRYN GILHULY Last Updated: Jun 24, 2015

    Kathryn Gilhuly is a wellness coach based in San Diego. She helps doctors, nurses and other professionals implement lifestyle changes that focus on a healthy diet and exercise. Gilhuly holds a Master of Science in health, nutrition and exercise from North Dakota State University.

    Three types of medications to treat erectile dysfunction — sildenafil, vardenafil and tadalafil — may cause low blood pressure. Niacin, used to treat conditions such as high cholesterol and hardening of the arteries, can also lower your blood pressure. If you take medications to treat male impotence, ask your doctor before combining it with niacin.

    Blood Pressure

    Sildenafil, vardenafil and tadalafil increase the amount of nitric oxide in your body. Your body contains nitric oxide naturally, which is a gas that relaxes blood vessels. Medications to treat erectile dysfunction relax blood vessels in a man’s penis to help obtain and maintain an erection. Some medications that treat high blood pressure, high cholesterol and heart disease also relax your blood vessels. If you take niacin while you also take medications to treat erectile dysfunction, your blood pressure could drop drastically. You could faint or develop other health problems.

    Niacin and Cholesterol

    Niacin, prescribed for more than 50 years, has been successful in treating all three types of lipids in your bloodstream. It can reduce levels of low-density lipoprotein — LDL, or “bad,” cholesterol — and triglycerides, as well as elevate your levels of protective high-density lipoprotein — HDL, or “good,” cholesterol. But other medications, as well as diet and lifestyle changes, can restore your cholesterol to heart-healthy levels. If you currently take niacin and want to start taking medication to treat erectile dysfunction, ask your doctor about switching to a different type of cholesterol medication.

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    Niacin Side Effects

    Niacin — with or without the addition of drugs to treat impotence — poses serious health risks, including stomach ulcers and liver damage. If you have Type 2 diabetes, taking niacin could cause drastic elevations in your blood sugar levels. Less serious side effects include stomach upset and skin flushes — your face and chest turn red and your skin itches, tingles or burns. You can purchase niacin without a prescription, but some over-the-counter formulas — no-flush varieties that contain niacinamide — will unlikely help lower your cholesterol.

    Erectile Dysfunction Medications

    Minor side effects associated with erectile dysfunction medications include indigestion, runny nose and skin flushes. Sildenafil may cause temporary changes in your vision, and vardenafil may cause muscle aches and back pain. More serious side effects include hearing loss and erections that last longer than four hours. If you have cardiovascular problems, including a history of heart attacks or strokes, high or low blood pressure or vision problems such as retinitis pigmentosa, it may prove unsafe for you to take sildenafil, vardenafil or tadalafil. These medications may also interact poorly with some antibiotics, blood thinners and medications to prevent seizures and heart rhythm disorders.

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    Niacin (Vitamin B3)

    Having enough niacin. or vitamin B3. in the body is important for general good health. As a treatment, higher amounts of niacin can improve cholesterol levels and lower cardiovascular risks.

    Why do people take niacin?

    As a cholesterol treatment, niacin has strong evidence. Several studies have shown that it can boost levels of good HDL cholesterol and lower triglycerides as well or better than some prescription drugs. Niacin also modestly lowers bad LDL cholesterol. It’s often prescribed in combination with statins for cholesterol control, such as Crestor. Lescol. or Lipitor .

    However, niacin is only effective as a cholesterol treatment at fairly high doses. These doses could pose risks, such as liver damage, gastrointestinal problems, or glucose intolerance. So don’t treat yourself with over-the-counter niacin supplements. Instead, get advice from your health care provider, who can prescribe FDA-approved doses of niacin instead.

    Niacin has other benefits. There’s good evidence that it helps reduce atherosclerosis. or hardening of the arteries in some people. For people who have already had a heart attack. niacin seems to lower the risk of a second one. In addition, niacin is an FDA-approved treatment for pellagra, a rare condition that develops from niacin deficiency .

    Niacin has also been studied as a treatment for many other health problems. There’s some evidence that it might help lower the risk of Alzheimer’s disease. cataracts. osteoarthritis. and type 1 diabetes. However, more research needs to be done.

    Continued

    How much niacin should you take?

    Since niacin can be used in different ways, talk to your health care provider about the best dosage for you.

    Everyone needs a certain amount of niacin — from food or supplements — for the body to function normally. This amount is called the dietary reference intake (DRI), a term that is replacing the older and more familiar RDA (recommended daily allowance). For niacin, the DRIs vary with age and other factors.

    • Children: between 2-16 milligrams daily, depending on age
    • Men: 16 milligrams daily
    • Women: 14 milligrams daily
    • Women (pregnant ): 18 milligrams daily
    • Women (breastfeeding ): 17 milligrams daily
    • Maximum daily intake for adults of all ages: 35 milligrams daily

    However, the ideal dosage of niacin depends on how you’re using it. For instance, much higher doses — 2 to 3 grams or more — are used to treat high triglycerides .

    Since niacin can upset your stomach. you might want to take it with food. To reduce flushing, your health care provider might recommend taking niacin along with aspirin. an NSAID painkiller, or an antihistamine for a few weeks until tolerance to the niacin develops.

    Can you get niacin naturally from foods?

    Niacin occurs naturally in many foods, including greens, meat, poultry, fish, and eggs, though in a fraction of the dose shown to achieve changes in cholesterol. Many products are also fortified with niacin during manufacture.

    Continued

    What are the risks of taking niacin?

    • Side effects. Niacin can cause flushing — harmless but uncomfortable redness and warmth in the face and neck — especially when you first begin taking it. Your health care provider will probably suggest increasing the dose slowly to reduce this problem. He or she might also offer a time-release prescription formulation to control flushing. Niacin can cause upset stomach and diarrhea. However, all of these side effects tend to fade over time.
    • Risks. Niacin does have risks. It can cause liver problems, stomach ulcers, changes to glucose levels. muscle damage, low blood pressure. heart rhythm changes, and other issues. People with any health condition including liver or kidney disease. diabetes. high blood pressure. or cardiovascular problems need to talk to a doctor before using niacin supplements. Do not treat high cholesterol on your own with over-the-counter niacin supplements.
    • Interactions. If you take any medicines or supplements regularly, talk to your doctor before you start using niacin supplements. They could interact with medicines like diabetes drugs, blood thinners. anticonvulsants, blood pressure medicines, thyroid hormones, and antibiotics as well as supplements like ginkgo biloba and some antioxidants. Alcohol might increase the risk of liver problems. Though niacin is often used along with statins for high cholesterol, this combination may increase the risk for side effects. Get advice from your health care provider.

    At the low DRI doses, niacin is safe for everyone. However, at the higher amounts used to treat medical conditions, it can have risks. For that reason, children and women who are pregnant or breastfeeding should not take niacin supplements in excess of the DRI unless it’s recommended by a doctor.

    WebMD Medical Reference Reviewed by David Kiefer, MD on May 01, 2015

    Sources

    Fundukian, L. ed. The Gale Encyclopedia of Alternative Medicine. third edition, 2009.

    Natural Medicines Comprehensive Database: “Niacin.”

    Natural Standard Patient Monograph, “Niacin.”

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    Why Is Alcohol Bad With Viagra

    Why Is Alcohol Bad With Viagra in Snow Hill, Maryland is small town living at its best. Nestled on the south banks of the Pocomoke River Snow Hill is a place where people know each other. From the people who call it home to the business owners and those in city government, we have built a community where life is gentle, fun, and prosperous. Home to a quaint downtown retail area and a broad spectrum of recreational activities, Why Is Alcohol Bad With Viagra is the perfect place to spend a relaxing weekend or a lifetime.

    Whether you are interested in researching your genealogy in the Worcester Room of the Worcester County Library. renting a kayak from the Pocomoke River Canoe Company to paddle on an undeveloped natural river, or studying the architecture of historic homes and beautiful churches while taking the Historic Walking Tour, Why Is Alcohol Bad With Viagra has something for everyone. You will find recreational opportunities in Byrd Park and Sturgis Park, artifacts at the Julia A. Purnell Museum. and treasures in the shops and art galleries.

    The beautiful rural setting boasts rich farmland that has been the mainstay of the economy of the county seat of Worcester County for centuries. The rich heritage of this area is celebrated daily at Furnace Town Living Heritage Museum and during a summer festival every August with The Blessing of the Combines.

    The town of Why Is Alcohol Bad With Viagra welcomes you as you explore our small town steeped in history and tradition but alive with charm and activities.

    Viagra and Alcohol

    Although studies have shown that combining alcohol and Viagra is unlikely to cause problems, you should still be aware of potential risks. For example, because both substances cause the blood vessels to dilate, combining these two may lead to dizziness, a rapid heart rate, and low blood pressure. To avoid any problems, talk to your healthcare provider about consuming alcohol while taking this drug.

    Is It Safe to Drink Alcohol With Viagra?

    According to the manufacturer of Viagra ® (sildenafil citrate ), drinking alcohol while on this medication is not expected to cause problems. Although some similar medications may cause problems when combined with alcohol, this does not seem to be a problem with Viagra.

    Research on Viagra and Alcohol

    Both Viagra and alcohol can have similar effects on blood vessels, causing them to dilate (open wider). However, studies did not show such problems in men who combined the two to achieve a blood alcohol level of 0.08 percent (legally intoxicated).

    Although studies indicate that combining alcohol with Viagra is unlikely to cause problems, it is a good idea to be aware of problems that could theoretically occur due to overly dilated blood vessels, such as:

    Talking With Your Healthcare Provider

    You should talk with your healthcare provider about alcohol consumption and Viagra. You and your healthcare provider understand your situation best. Based on what you want and expect, as well as your current health situation, the two of you can make a shared decision about your intake of alcohol while on this medication. There may also be other medical reasons why you should not consume alcohol.

    Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

    Last reviewed by: Kristi Monson, PharmD;

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