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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.

Viagra

GENERIC NAME(S): SILDENAFIL CITRATE

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.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension ). 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).

How to use Viagra

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. including permanent blindness, in one or both eyes (NAION) may occur. 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.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

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).

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.

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. A serious drop in blood pressure 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 nitrate, amyl nitrite, 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), mifepristone, 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 right away. 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.

Notes

Do not share this medication with others.

Missed Dose

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.

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

Images

List of 56 Drugs That Should Not Be Mixed With Viagra Contains Some Surprises

Last Updated Jan 6, 2009 10:22 AM EST

Public Citizen has published a list of 56 drugs that interact badly with erectile dysfunction pills such as Pfizer ‘s Viagra. Public Citizen’s WorstPills.com site reports. In combination with ED drugs, these 56 drugs can cause dangerous falls in blood pressure that could lead to a heart attack or stroke; a potentially harmful “overdose,” even when taking the recommended amount; and decrease the effectiveness of the ED drugs themselves. The drugs include the usual suspects, such as nitrates for blood pressure. Taken in combination with Viagra, Cialis ior Levitra nitrates can lead to potentially lethal drops in blood pressure.

But the list also includes some surprises — household name drugs that shouldn’t be taken with ED pills — including Flomax. Provigil and grapefruit juice. Some drugs increase plasma concentrations of ED drugs, potentially leading to toxicity, and others reduce those concentrations, making the drugs ineffective. Some examples:

  • Potential low blood pressure triggers:
  • Flomax (Boehringer Ingelheim)
  • Potential toxicity:
  • Reyataz (Bristol-Myers Squibb)
  • Grapefruit juice
  • Diflucan (Pfizer)
  • Gleevec (Novartis)
  • Crixivan (Merck)
  • Tykerb (GlaxoSmithKline)
  • Mifeprex (Danco Labs)
  • Viracept (Pfizer)
  • Ketek (Sanofi-Aventis)
  • Potential Inhibitors:
  • Sustiva (BMS)
  • Provigil (Cephalon)
  • Viramune (Boehringer)

© 2009 CBS Interactive Inc. All Rights Reserved. Follow @Jim_Edwards

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Hackmatack Playhouse was founded in 1972 by S. Carleton Viagra Muscle Pain. He envisioned a summer stock theatre that would showcase the talents of professional and developing thespians from the regional area.

Many theatre goers have called Hackmatack one of New England’s most charming and quaint summer theatres. Some have even said that summer in Maine is not summer without a trip to Hackmatack. Much of the allure of this playhouse is its scenic location and historical presence.

Hackmatack Playhouse is located on the Viagra Muscle Pain family farmstead. The property was purchased by the first Viagra Muscle Pain (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas Viagra Muscle Pain built the first home, a log house which sat in the far left of the present day field overlooking the irrigation pond. According to family legend, this home was burnt down by Indians during one of the many raids on the Salmon Falls river region. The present day farmhouse was constructed between the years of 1716-2005 to appease the needs of an ever-changing diverse and dynamic Viagra Muscle Pain family. When it was first constructed, the house was a large cape sitting endwise to the road. It was occupied at one point by two Viagra Muscle Pain brothers. The younger brother decided that he would like to have a modern two story cape. His older brother in typical conservative fashion said “the house is plenty good enough the way it is”. The younger brother replied, “My half is coming off”. He then proceeded to saw his half off and tear it down. He built his family a two story cape on the end of the original house, parallel to the road, giving the house its shape. Minor reconstructions have taken place since then to create a more modern and functional house for the present day Viagra Muscle Pains.

Prior to the year of 1972 when the theatre was established, the Viagra Muscle Pain family farm functioned like many other farms at the time. The barn was the focal point of the farm. The current barn has an interesting story much like the original house. One of the first barns was struck by lightning and burned in July of 1934. Haying had just been completed for the season, and it is thought that the heat from the newly cut hay attracted the lightning. Almost immediately, Lewis Viagra Muscle Pain began looking for the right barn to replace what had been lost. He finally purchased a barn. It was a large old structure with pegged timbers measuring fifty four feet long and forty two feet wide. It was the perfect replacement for the old barn. However, there was one small problem, it was located across the street.

Luckily, the Viagra Muscle Pain’s have always been known for their ingenuity. It was with this cleverness that Lewis decided it would be easier to move the barn rather than disassemble it and rebuilt it. The entire barn was jacked up and rollers were placed underneath it. A cable was attached to one end of the barn that ran though a large turnstile. An old white horse was chosen for the job of slowly moving the barn. The horse was hitched to the turnstile and the horse walked in circles, stepping over the cable on every lap. The leverage was great and each time the horse made a circle, the barn moved one half inch. Progress was slow. The entire operation took about three days, a day of that was spent crossing Maine route 9. However, in 1934, Maine route 9 was much less traveled, and everyone cheerfully watched or made their own route around the barn.

After the theatre’s first decade the barn was expanded to the structure that you see today. An addition was added to the back, cement was added to form the floor, and the stage was expanded. These changes made room for the 218 seats the theatre houses today. It is rumored that back in 1972 patrons sat on hay bales to watch the show, however the original playhouse actually had seats that were salvaged from a Durham New Hampshire movie theater.

The grounds of Hackmatack Playhouse and the area surrounding the theatre host many other buildings built and used by the Viagra Muscle Pain clan over the years. The yellow family of buildings just south of the theatre (now owned by the Mills family) was originally built by Samuel Viagra Muscle Pain in the early part of last century. Known as the Forget-Me-Not, these buildings housed services for early automobile travelers, including fuel for the autos, and food for the hungry. Visitors could rent a cabin, and if they happened to be staying on a Saturday night, they were in luck. On Saturday night there were always barn dances.

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.

The “mill” is across the orchard from the “woodshed”. It now houses the theatre’s shop operations and its costume collection. However during the years of self-sufficient farming, it was one of several lumber mills built on the property by Lewis Viagra Muscle Pain in the middle part of the 1900’s. This was a complete finish lumber mill powered by an Allis Chalmers tractor. If you listen carefully through the whirr of the belts and the screech of the saws you might just be able to hear Lewis and Almon Allen, and young Carelton Viagra Muscle Pain, prepare a load of lumber for the newest construction project.

The Viagra Muscle Pain family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now Viagra Muscle Pain great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

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

TICKET PRICES

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Adults: $25
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Friday & Saturday
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Tickets can be purchased online. Please note all tickets purchased online are subject to a third party processing fee. To avoid this fee, tickets can be reserved by calling the box office.

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Hackmatack Playhouse was founded in 1972 by S. Carleton Can I Take Statins And Viagra. He envisioned a summer stock theatre that would showcase the talents of professional and developing thespians from the regional area.

Many theatre goers have called Hackmatack one of New England’s most charming and quaint summer theatres. Some have even said that summer in Maine is not summer without a trip to Hackmatack. Much of the allure of this playhouse is its scenic location and historical presence.

Hackmatack Playhouse is located on the Can I Take Statins And Viagra family farmstead. The property was purchased by the first Can I Take Statins And Viagra (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas Can I Take Statins And Viagra built the first home, a log house which sat in the far left of the present day field overlooking the irrigation pond. According to family legend, this home was burnt down by Indians during one of the many raids on the Salmon Falls river region. The present day farmhouse was constructed between the years of 1716-2005 to appease the needs of an ever-changing diverse and dynamic Can I Take Statins And Viagra family. When it was first constructed, the house was a large cape sitting endwise to the road. It was occupied at one point by two Can I Take Statins And Viagra brothers. The younger brother decided that he would like to have a modern two story cape. His older brother in typical conservative fashion said “the house is plenty good enough the way it is”. The younger brother replied, “My half is coming off”. He then proceeded to saw his half off and tear it down. He built his family a two story cape on the end of the original house, parallel to the road, giving the house its shape. Minor reconstructions have taken place since then to create a more modern and functional house for the present day Can I Take Statins And Viagras.

Prior to the year of 1972 when the theatre was established, the Can I Take Statins And Viagra family farm functioned like many other farms at the time. The barn was the focal point of the farm. The current barn has an interesting story much like the original house. One of the first barns was struck by lightning and burned in July of 1934. Haying had just been completed for the season, and it is thought that the heat from the newly cut hay attracted the lightning. Almost immediately, Lewis Can I Take Statins And Viagra began looking for the right barn to replace what had been lost. He finally purchased a barn. It was a large old structure with pegged timbers measuring fifty four feet long and forty two feet wide. It was the perfect replacement for the old barn. However, there was one small problem, it was located across the street.

Luckily, the Can I Take Statins And Viagra’s have always been known for their ingenuity. It was with this cleverness that Lewis decided it would be easier to move the barn rather than disassemble it and rebuilt it. The entire barn was jacked up and rollers were placed underneath it. A cable was attached to one end of the barn that ran though a large turnstile. An old white horse was chosen for the job of slowly moving the barn. The horse was hitched to the turnstile and the horse walked in circles, stepping over the cable on every lap. The leverage was great and each time the horse made a circle, the barn moved one half inch. Progress was slow. The entire operation took about three days, a day of that was spent crossing Maine route 9. However, in 1934, Maine route 9 was much less traveled, and everyone cheerfully watched or made their own route around the barn.

After the theatre’s first decade the barn was expanded to the structure that you see today. An addition was added to the back, cement was added to form the floor, and the stage was expanded. These changes made room for the 218 seats the theatre houses today. It is rumored that back in 1972 patrons sat on hay bales to watch the show, however the original playhouse actually had seats that were salvaged from a Durham New Hampshire movie theater.

The grounds of Hackmatack Playhouse and the area surrounding the theatre host many other buildings built and used by the Can I Take Statins And Viagra clan over the years. The yellow family of buildings just south of the theatre (now owned by the Mills family) was originally built by Samuel Can I Take Statins And Viagra in the early part of last century. Known as the Forget-Me-Not, these buildings housed services for early automobile travelers, including fuel for the autos, and food for the hungry. Visitors could rent a cabin, and if they happened to be staying on a Saturday night, they were in luck. On Saturday night there were always barn dances.

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.

The “mill” is across the orchard from the “woodshed”. It now houses the theatre’s shop operations and its costume collection. However during the years of self-sufficient farming, it was one of several lumber mills built on the property by Lewis Can I Take Statins And Viagra in the middle part of the 1900’s. This was a complete finish lumber mill powered by an Allis Chalmers tractor. If you listen carefully through the whirr of the belts and the screech of the saws you might just be able to hear Lewis and Almon Allen, and young Carelton Can I Take Statins And Viagra, prepare a load of lumber for the newest construction project.

The Can I Take Statins And Viagra family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now Can I Take Statins And Viagra great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

After the death of the founder in 1995, the S Carleton Can I Take Statins And Viagra Memorial Fund was established to preserve and improve our historical buildings. The fund also is dedicated to advancements of dramatic arts, both for the participant and the community, and to the commitment of providing quality family entertainment and drama at a reasonable price. Contributions are always welcomed. We thank you in advance for helping us secure the future of Hackmatack Playhouse for potential Hackmatackers.

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.

We ask that you would consider a donation, and thank you in advance.

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Erectile Dysfunction

Viagra

Viagra is indicated for the treatment of erectile dysfunction in men. Viagra is a phosphodiesterase type 5 (PDE5) inhibitor. It works by helping to increase blood flow into the penis during sexual stimulation. This helps you to achieve and maintain an erection.

Use Viagra as directed by your doctor.

  • Take Viagra by mouth with or without food. Viagra may not work as quickly if you take it with a high-fat meal.
  • Viagra is usually taken about 1 hour before sexual activity; however, it may be taken anywhere from 4 hours to a half hour before sexual activity. Talk with your doctor about the best way to take Viagra.
  • Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
  • Do not take more than the recommended dose or take it more often than once daily, or as directed by your doctor.
  • If you miss a dose of Viagra and you still intend to engage in sexual activity, take it as soon as you remember. Continue to take it as directed by your doctor.

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 0.5 hour before sexual activity. 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.

Ask your health care provider any questions you may have about how to use Viagra.

Store Viagra at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Viagra out of the reach of children and away from pets.

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.

Do NOT use Viagra if:

  • you are allergic to any ingredient in Viagra
  • you have been advised by your doctor to avoid sexual activity because of heart problems
  • you are taking nitrates (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, patch, ointment), or nitroprusside
  • you use certain recreational drugs called “poppers” (eg, amyl nitrate or nitrite, butyl nitrate or nitrite)
  • you take another PDE5 inhibitor (eg, tadalafil, vardenafil) or another medicine that contains sildenafil.

Contact your doctor or health care provider right away if any of these apply to you.

Some medical conditions may interact with Viagra. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a deformed penis (eg, cavernosal fibrosis, Peyronie disease), blood cell problems (eg, leukemia, multiple myeloma, sickle cell anemia), or any other condition that may increase the risk of a prolonged erection (priapism)
  • if you have a history of a prolonged (more than 4 hours) or painful erection (priapism)
  • if you have a history of certain eye problems (eg, macular degeneration, optic neuropathy, retinitis pigmentosa, sudden vision loss in one or both eyes) or hearing problems (eg, ringing in the ears, decreased hearing, hearing loss)
  • if you have a history of liver or kidney problems, lung problems (eg, pulmonary veno-occlusive disease), high or low blood pressure, ulcers, bleeding problems, heart problems (eg, angina, aortic stenosis, heart failure, irregular heartbeat), or blood vessel problems
  • if you have a history of heart attack, stroke, or life-threatening irregular heartbeat, especially within the past 6 months.

Some medicines may interact with Viagra. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Alpha-blockers (eg, doxazosin), medicines for high blood pressure, nitrates (eg, isosorbide, nitroglycerin), or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur
  • Azole antifungals (eg, itraconazole, ketoconazole), H2 antagonists (eg, cimetidine), HIV protease inhibitors (eg, ritonavir, saquinavir), macrolide antibiotics (eg, erythromycin), narcotic analgesics (eg, dihydrocodeine), or telithromycin because they may increase the risk of Viagra’s side effects
  • Bosentan or rifampin because they may decrease Viagra’s effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Viagra may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Important safety information:

  • Viagra may cause dizziness, drowsiness, fainting, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Viagra with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
  • Viagra may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Patients with heart problems who take Viagra may be at increased risk for heart-related side effects, including heart attack or stroke. Symptoms of a heart attack may include chest, shoulder, neck, or jaw pain; numbness of an arm or leg; severe dizziness, headache, nausea, stomach pain, or vomiting; fainting; or vision changes. Symptoms of a stroke may include confusion, vision or speech changes, one-sided weakness, or fainting. Contact your doctor or seek medical attention right away if you experience these symptoms.
  • Viagra may rarely cause a prolonged (eg, more than 4 hours) or painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if you have an erection that lasts more than 4 hours.
  • Viagra does not stop the spread of HIV or other sexually transmitted diseases (STDs) to others through sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection or an STD.
  • Viagra will not prevent pregnancy. If your partner may become pregnant and you wish to avoid pregnancy, be sure to use an effective form of birth control.
  • Viagra may uncommonly cause mild, temporary vision changes (eg, blurred vision, sensitivity to light, blue/green color tint to vision). Contact your doctor if vision changes persist or are severe.
  • Rarely, an eye problem called nonarteritic anterior ischemic optic neuropathy (NAION) has been reported in patients who took Viagra. This may lead to decreased vision or permanent loss of vision in some cases. If you notice a sudden decrease in vision or loss of vision in one or both eyes, contact your doctor right away.
  • Sudden decreases in hearing and loss of hearing have been reported in some patients who have taken Viagra. Sometimes they also noticed ringing in the ears or dizziness. If you notice a sudden decrease or loss of hearing, contact your doctor right away.
  • Do not use other medicines or treatments for ED while you are taking Viagra without first checking with your doctor.
  • Use Viagra with caution in the elderly; they may be more sensitive to its effects.
  • Viagra is not recommended for use in children younger 18 years.

All medicines may cause side effects, but many people have no, or minor, side effects.

Check with your doctor if any of these most common side effects persist or become bothersome:

Diarrhea; dizziness; flushing; headache; heartburn; stuffy nose; upset stomach.

Seek medical attention right away if any of these severe side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast or irregular heartbeat; memory loss; numbness of an arm or leg; one-sided weakness; painful or prolonged erection; ringing in the ears; seizure; severe or persistent dizziness; severe or persistent vision changes; sudden decrease or loss of hearing; sudden decrease or loss of vision in one or both eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

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Make an appointment with your doctor. There are online sources that will provide “Viagra” without a prescription, but this is an illegal action and, in the interests of your own safety, you should only consider purchasing Viagra from reputable and legal sources. One way to ensure it’s legal and safe to buy is that the site or seller requires a doctor’s prescription. You should make an appointment with your doctor to get a prescription before trying to buy Viagra.

  • Make sure your doctor is covered under your health insurance plan. If you have health insurance and do not want to be stuck with an unexpected bill, make sure to call your insurance company before making an appointment to confirm your doctor is covered under your plan.
  • Though it can be emotionally difficult to broach the subject of taking Viagra with your doctor, studies have shown that 80% of men feel better after discussing erectile dysfunction with their physicians. [1]

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Prepare for your doctor’s appointment. To make the most out of your doctor’s appointment, you should prepare questions and answers ahead of time. You’ll want to make sure to inquire about the potential side effects, contraindications (or conditions that make Viagra untenable for you, such as a history of heart problems, stroke, liver or kidney disease, etc.), and risks of taking Viagra. You should also ask what results should expect from using the medication. Be prepared as well to submit to a full medical history and answer the following specific questions about why you are interested in taking Viagra: [2]

  • Why do you want Viagra?
  • When did your erectile dysfunction start?
  • Is your erectile dysfunction always a problem? How often do you experience it?

Get your Viagra prescription. After discussing your erectile dysfunction and your medical history, ask your doctor for a prescription for Viagra. You may have your doctor’s office directly submit the script to your preferred pharmacy, or you can take it with you and use the script to purchase Viagra at a pharmacy or online.

  • Note that Viagra is only available in three doses: 25 mg, 50 mg, and 100 mg. You doctor will prescribe whatever he deems is best for you. [3]

Consider your insurance coverage. If you have health insurance, confirm your coverage online or with a customer service representative. Along with other basic personal information (such as your birth date and social security number), remember to have your health insurance ID number handy for when you log-in online or speak to a representative on the phone. Find out whether Viagra is covered under the prescription coverage component of your insurance plan.

  • If Viagra is not covered, you may want to check to see if similar drugs that help treat erectile dysfunction, like Cialis or Levitra, are covered by your health insurance plan. You can then ask your doctor if these might work for you.
  • If you don’t have any health insurance, consider purchasing a plan. You don’t need a health insurance plan to purchase Viagra, but prescriptions are usually cheaper with one. There are many factors to considering when shopping for health insurance including rate, coverage, HMO vs. PPO vs. EPO plans, deductibles, etc. Should you choose to buy health insurance, take your time to shop and compare before making a purchase.
  • Knowing whether or not you have insurance to cover the medication will make a difference in how you obtain it. If Viagra is covered by your insurance, the prescription co-pay is usually the same at all pharmacies, so there is no need to shop around for the best price. And having your doctor’s office directly submit the script means that your prescription will be ready faster. However, if your Viagra is not covered by insurance, taking the script with you gives you the time to shop for the best price.

Part Two of Two:
Obtaining Viagra Edit

Take your Viagra prescription to a pharmacy. This is the more traditional method of getting Viagra. Your doctor may send the script directly to your pharmacy of choice, or you can take the script into a pharmacy. After the pharmacy receives your prescription for Viagra, it may take a few minutes, or even a day for the pharmacy to fill your prescription.

  • When you pick up your prescription, be prepared to pay your co-pay if you are insured, and the entire cost of your prescription if you are not insured. If you have health insurance, make sure you bring your health insurance ID card with you and give it to the pharmacists.
  • The pharmacist may want to talk to you about usage and risks. This is standard for any new prescriptions and may be useful for you.

Purchase Viagra online. The online world does big business in selling Viagra and, unsurprisingly, online scams are quite common. If you opt to buy Viagra from an online retailer, you should take some precautions and do your research. Make sure the online pharmacy or other retailer is legitimate. The National Association of Boards of Pharmacy has a website where you can check to see if an online pharmacy is licensed and accredited as a Verified Internet Pharmacy Practice Site (VIPPS). [4]

  • Watch out for the following warning flags: the price seems much cheaper than other online sellers; there is no contact information, such as a phone number or address, provided on the website; the seller doesn’t require a prescription for Viagra in order to sell it to you; the medication comes in different forms other than the three doses (25 mg, 50 mg, and 100 mg), such as “fast-dissolving strength,” “soft-tab,” etc.
  • Be careful when ordering the medication online that you have input the right prescription and dose. Check as well when you receive the medication that it is the exact dose and type of medication that your doctor instructed you to take. [5]

Never purchase Viagra from online sources that do not require a prescription. This is illegal and dangerous. Harmful substances, such as blue printer ink, amphetamine, Metronidazole (a powerful antibiotic that can cause an allergic reaction, diarrhea or vomiting), and binding agents (such as drywall), have all been found in “fake” or “counterfeit” Viagra. [6]

  • Viagra is actually one of the most counterfeited drug in the entire world. In one study, 80% of websites selling Viagra were not selling the real drug but fakes.
  • To stay healthy and avoid these harmful substances and potential adverse consequences, only obtain Viagra at your local pharmacy or through an accredited online source.

Use your Viagra. Once your Viagra arrives at your house, you can start using it. Be sure that you follow your doctor’s explicit instructions regarding dose and frequency of Viagra use. Typically, this medication is taken on an empty stomach about one hour before sexual intercourse. Note that deviating from your doctor’s instructions can be life threatening. [7]

  • Do not use Viagra recreationally.
  • Do not combine Viagra with amyl nitrite as this combination can be fatal.
  • Very few men report any side effects, such as flushing, stuffy or runny nose, headache, changes in vision, and dizziness, from taking Viagra. You should, however, seek medical attention if you experience any loss in vision or hearing or if you experience an erection that does not go away on its own (after more than four hours). [8]

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Viagra Itu Apa 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 Itu Apa 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, Viagra Itu Apa 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.

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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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Tickets can be purchased online. Please note all tickets purchased online are subject to a third party processing fee. To avoid this fee, tickets can be reserved by calling the box office.

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Hackmatack Playhouse was founded in 1972 by S. Carleton Apa Itu Tablet Viagra. He envisioned a summer stock theatre that would showcase the talents of professional and developing thespians from the regional area.

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Prior to the year of 1972 when the theatre was established, the Apa Itu Tablet Viagra family farm functioned like many other farms at the time. The barn was the focal point of the farm. The current barn has an interesting story much like the original house. One of the first barns was struck by lightning and burned in July of 1934. Haying had just been completed for the season, and it is thought that the heat from the newly cut hay attracted the lightning. Almost immediately, Lewis Apa Itu Tablet Viagra began looking for the right barn to replace what had been lost. He finally purchased a barn. It was a large old structure with pegged timbers measuring fifty four feet long and forty two feet wide. It was the perfect replacement for the old barn. However, there was one small problem, it was located across the street.

Luckily, the Apa Itu Tablet Viagra’s have always been known for their ingenuity. It was with this cleverness that Lewis decided it would be easier to move the barn rather than disassemble it and rebuilt it. The entire barn was jacked up and rollers were placed underneath it. A cable was attached to one end of the barn that ran though a large turnstile. An old white horse was chosen for the job of slowly moving the barn. The horse was hitched to the turnstile and the horse walked in circles, stepping over the cable on every lap. The leverage was great and each time the horse made a circle, the barn moved one half inch. Progress was slow. The entire operation took about three days, a day of that was spent crossing Maine route 9. However, in 1934, Maine route 9 was much less traveled, and everyone cheerfully watched or made their own route around the barn.

After the theatre’s first decade the barn was expanded to the structure that you see today. An addition was added to the back, cement was added to form the floor, and the stage was expanded. These changes made room for the 218 seats the theatre houses today. It is rumored that back in 1972 patrons sat on hay bales to watch the show, however the original playhouse actually had seats that were salvaged from a Durham New Hampshire movie theater.

The grounds of Hackmatack Playhouse and the area surrounding the theatre host many other buildings built and used by the Apa Itu Tablet Viagra clan over the years. The yellow family of buildings just south of the theatre (now owned by the Mills family) was originally built by Samuel Apa Itu Tablet Viagra in the early part of last century. Known as the Forget-Me-Not, these buildings housed services for early automobile travelers, including fuel for the autos, and food for the hungry. Visitors could rent a cabin, and if they happened to be staying on a Saturday night, they were in luck. On Saturday night there were always barn dances.

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.

The “mill” is across the orchard from the “woodshed”. It now houses the theatre’s shop operations and its costume collection. However during the years of self-sufficient farming, it was one of several lumber mills built on the property by Lewis Apa Itu Tablet Viagra in the middle part of the 1900’s. This was a complete finish lumber mill powered by an Allis Chalmers tractor. If you listen carefully through the whirr of the belts and the screech of the saws you might just be able to hear Lewis and Almon Allen, and young Carelton Apa Itu Tablet Viagra, prepare a load of lumber for the newest construction project.

The Apa Itu Tablet Viagra family has a long tradition of entertaining locals and summer visitors in the Beaver Dam section of Berwick. Samuel’s weekly barn dances at the “Forget Me Not” were a favorite pastime during the early decades of the 1900’s. His son Lewis, a local and state Grange Master, was also a master of many musical instruments. He had a passion for starting bands and performing in Beaver Dam and across the state of Maine. His son Carleton organized several theatre groups, first at the Beaver Dam grange, and then at his barn now called Hackmatack Playhouse.

Every year thousands of people gather outside the Playhouse with tickets to the summer’s productions. Every year talented actors audition for their chance to perform at Hackmatack Playhouse, and to experience the history and excitement of being part of Hackmatack’s family. The farm and its building have many stories to tell. Perhaps 200 years from now Apa Itu Tablet Viagra great, great grandchildren will be telling this story to aspiring actors nervously waiting for their audition slot, and to friendly crowds waiting to take their seats; of how the barn became home for the Hackmatack Playhouse.

After the death of the founder in 1995, the S Carleton Apa Itu Tablet Viagra Memorial Fund was established to preserve and improve our historical buildings. The fund also is dedicated to advancements of dramatic arts, both for the participant and the community, and to the commitment of providing quality family entertainment and drama at a reasonable price. Contributions are always welcomed. We thank you in advance for helping us secure the future of Hackmatack Playhouse for potential Hackmatackers.

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.

We ask that you would consider a donation, and thank you in advance.

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Si usted sufre del hígado o de alguna falla renal no debe tomar propecia, además debe saber que propecia puede causar efectos secundarios como eyaculación en baja cantidad o erupciones temporales en la piel, pero todo esto desaparece una vez que el organismo se ha acostumbrado a tomar el medicamento.

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    Algo que no se debe subestimar es la importancia de las relaciones sexuales. Mientras somos jГіvenes, debemos pensar acerca de lo importante que es enm nuestras vidas. Pensamientos preocupantes vienen cuando uno por primera vez sufre una batalla amorosa. ViolaciГіn de la FunciГіn ErГ©ctil (ED) que es todavГ­a considerado un problema de edad psicolГіgica. Г‰sta es considerada una enfermedad con una gran tasa. Pero no hay ninguna razГіn para darse por vencido. El cuidado de la salud esta mejorando constantemente. Hoy en dГ­a, existen muchos medicamentos con el objetivo de deshacerse de Г©sta enfermedad. Las mГЎs famosas son: Viagra, Cialis y Levitra. ВЎSolo piense cuГЎl colorida serГЎ su vida cuando obtenga el control de su cuerpo con todos los placeres posibles! ВЎNo lo dude, compre Cialis ahora utilizando nuestra tienda en lГ­nea de personas mexicanas!

    Ahora, explicaremos la terminologГ­a. ВїQuГ© es un medicamento genГ©rico?

    La droga, que estГЎ protegida por la patente es un medicamento de marca y el medicamento que es una copia del medicamento de marca es equivalente en tГ©rminos de seguridad, la eficacia, la dosis y el uso se llama medicamento genГ©rico.

    El Viagra genГ©rico tiene los mismos ingredientes activos que la marca llamada droga patentada, tanto sean aprobados por la AdministraciГіn de Alimentos y Medicamentos (FDA). Los medicamentos genГ©ricos estГЎn disponibles, Гєnicamente despuГ©s de que expire la patente. Los periГіdos de patentes pueden durar hasta 20 aГ±os contra las drogas patentadas o medicamentos patentados. La misma empresa que fabrica el medicamento de marca tambiГ©n puede fabricar la versiГіn genГ©rica o una empresa diferente podrГ­a fabricar de igual manera.

    Las compaГ±Г­as farmacГ©uticas deben presentar una solicitud del nuevo fГЎrmaco abreviada (ANDA) para la aprobaciГіn de comercializaciГіn de un producto genГ©rico. Todos los medicamentos genГ©ricos, incluyendo el Viagra, Cialis y Levitra, al igual que otros productos nuevos, se desarrollan bajo la protecciГіn de patentes.

    Profesionales de la salud y los consumidores pueden estar seguros de que la FDA aprobГі medicamentos genГ©ricos que han cumplido con los mismos estГЎndares rГ­gidos como el medicamento innovador. Para obtener la aprobaciГіn de la FDA, un medicamento genГ©rico debe:

    • Contener los mismos ingredientes activos que el medicamento innovador (ingredientes inactivos puede variar)
    • Ser idГ©ntico en concentraciГіn, forma farmacГ©utica, vГ­a de administraciГіn y tener las mismas indicaciones de uso.
    • Son bioequivalentes.
    • Cumplir los mismos requisitos de lote para la identidad, potencia, pureza y calidad.
    • Ser fabricados bajo las mismas normas estrictas y regulaciones de buenas prГЎcticas de fabricaciГіn de la FDA que requieren los productos innovadores.

    ВїCГіmo puede un hombre vencer la disfunciГіn erГ©ctil?

    Hasta hace poco, los hombres con disfunciГіn erГ©ctil se encontraron en una situaciГіn desesperada. A finales del siglo pasado saliГі a la venta el Viagra para los hombres. Su invenciГіn fue de logros revolucionarios en la medicina, debido a lo cual muchos hombres que sufren de impotencia tuvieron la oportunidad de vivir una vida sexual normal.

    El Viagra durante dГ©cadas ganГі popularidad en todo el mundo y ayudГі a muchos hombres a disfrutar de su vida una vez mГЎs.

    El Viagra para los hombres es la primera y mГЎs popular fГЎrmaco para el tratamiento de la impotencia, conocido por todo el mundo. Se le conoce como una panacea que ayuda a miles de hombres para deshacerse de numerosos problemas sexuales.

    El Viagra genГ©rico es un clon quГ­mico exacta de un medicamento de marca. Por lo tanto, se caracteriza por la misma estructura y la acciГіn que el original. Pero su precio es varias veces menor que el costo de la marca Viagra papentado. El ingrediente activo es la droga – sildenafil. El Sildenafil aumenta el flujo de sangre al pene que resulta en la relajaciГіn de los mГєsculos de la pelvis. Cuando la relajaciГіn del mГєsculo aumenta la capacidad de los vasos, y estГЎn llenos de sangre, causan una erecciГіn.

    Las pastillas de viagra inician en 40-60 minutos despuГ©s de la ingestiГіn y el efecto se mantiene durante 4-5 horas. Debido a esto el hombre con la droga crearГЎ una erecciГіn firme, y es capaz de realizar contacto Г­ntimo largo.

    Se recomienda comprar Viagra cuando el hombre sufre de disfunciГіn erГ©ctil y trastornos de potencia. Se toma en la completa ausencia de erecciГіn o dГ©bil desarrollo.

    La Cialis actГєa como el Viagra, pero excede considerablemente la duraciГіn. La Cialis se absorbe rГЎpidamente y afecta el mГєsculo liso del cuerpo cavernoso, lo que ayuda a relajar el flujo de sangre al pene, causando una erecciГіn que puede ocurrir durante las 36 horas. Y eso hace que la Cialis sea el campeГіn de la duraciГіn.

    Gracias a la Cialis, la erecciГіn necesaria para el acto sexual se alcanza, un hombre se divierte y satisface a una mujer. ВЎadquiere confianza en sus habilidades, lo que aumenta el estado de ГЎnimo y mejorar la salud mental!

    Levitra – Una droga popular y prometedora para combatir la impotencia y competir con Г©xito con sus anГЎlogos. Fue desarrollado en Alemania. La eficacia de Levitra significativamente mayor en comparaciГіn con otros medicamentos similares. La seguridad de Levitra es probada por los mГєltiples ensayos clГ­nicos.

    El ingrediente activo de Levitra es la Vardenafil. Se caracteriza por una rГЎpida absorciГіn y penetraciГіn en la sangre, por lo que la acciГіn de la droga se encuentra dentro de 30-45 minutos despuГ©s de la ingestiГіn. Bajo el efecto de Vardenafil los mГєsculos de los cuerpos cavernosos se relajan provocando la relajaciГіn y la expansiГіn de las arterias del pene y el aumento de su capacidad.

    El Efecto de Levitra se manifiesta plenamente con la primera ingesta. TГ­picamente, con el uso adicional, se recomienda reducir la dosis, pero la eficacia se mantiene sin cambios.

    Al comprar Viagra o Levitra genГ©rico es necesario recordar que no es afrodisГ­aco o una preparaciГіn hormonal por lo que no tienen un efecto estimulante: la excitaciГіn se produce de forma natural sГіlo bajo la influencia de la estimulaciГіn sexual. Por lo tanto, tomar un medicamento no debe preocupar de que la erecciГіn se produzca en el lugar equivocado o en mal tiempo.

    La compra de Viagra o Levitra genГ©rico en Internet, ahora es posible sin ningГєn problema, pero la ventaja de nuestra tienda que esta basada en MГ©xico, se realiza la entrega muy rГЎpida de mercancГ­as, ВЎpara los clientes habituales hay un descuento del 10% y del sistema de primas flexibles! Para comprar Cialis, no es necesario proporcionar la receta. SГіlo necesitarГЎ marcar el nГєmero especificado o usar un formulario de pedido especial en nuestra pГЎgina web pueblos de MГ©xico. Estas pГ­ldoras – Viagra, Cialis, Priligy – ayudarГЎn a recuperar la virilidad, obtener nuevas experiencias, deshacerse de las preocupaciones y la elevaciГіn del autoestima.

    SГіlo los mejores productos aprobados y se presentan en nuestro servicio de compras en lГ­nea. Sus riesgos son mГ­nimos, honramos su informaciГіn personal y la voluntad de secreto. Todas las compras son estrictamente confidenciales. DespuГ©s de ordenar y comprar Viagra, Cialis, Levitra, bienes genГ©ricos de farmacia serГЎ entregado directamente a su casa en el paquete sin ninguna insignia. Los residentes de MГ©xico pueden comprar Cialis o Levitra sin salir de casa. Al Comprar Levitra genГ©rico usted se convierte en un paso mГЎs cerca de ganar su vida y poner fin a un mal entendido como la disfunciГіn erГ©ctil de una vez por todas.

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    Marathon, cyclisme, football. le Viagra amГ©liore t-il la performance des athlГЁtes ?

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    Metz – Nantes, le 10 septembre 2010 (E.POL/SIPA).

    Tous les athlètes du monde entier essaient constamment d’améliorer leur performance. Plus personne n’est donc choqué aujourd’hui d’apprendre parfois qu’un groupe d’entraîneurs et de chimistes associés à des athlètes d’élite ont pu utiliser certains médicaments pour prendre l’avantage sur leurs concurrents.

    Mais, en revanche, le public pourrait être surpris d’apprendre de quelles substances précises il s’agit.

    Le Viagra facilite la circulation du sang et l’oxygénation

    L’Agence mondiale contre le dopage (AMA). qui a des liens étroits avec des chercheurs dans le monde entier, surveille de près toute substance qui pourrait être utilisée comme une aide ergogène.

    Une petite pilule dont on parle peu mais qui n’en est pas moins suivie de près par cette agence depuis quelques années est le Viagra. Le Viagra fera t-il bientôt partie des substances interdites par l’AMA. C’est une question qui fait couler beaucoup d’encre dans les milieux médicaux.

    Le citrate de sildénafil, plus connu sous le nom de Viagra, est fabriqué par le géant pharmaceutique Pfizer. À l’origine, il avait été conçu pour soigner l’angine de poitrine. mais si les chercheurs ont rapidement découvert qu’il était très efficace sur les tissus pulmonaires et sexuels.

    Le médicament fonctionne en augmentant les effets de l’oxyde nitrique, un composé chimique qui élargit les vaisseaux sanguins, facilitant donc la circulation sanguine dans le pénis des hommes impotents. Le Viagra est prescrit dans le monde entier aux hommes souffrant de dysfonction érectile.

    Ces dernières années, de nombreux athlètes d’endurance se sont mis à en prendre, pensant qu’il leur procurerait un avantage. Mais cet avantage ne serait liés qu’aux compétitions qui ont lieu à haute altitude et se limiteraient à des sports qui sollicitent énormément le système cardio-vasculaire, comme les sports d’endurance (marathon, course, triathlons, ski de fond, course cycliste, etc).

    Le Viagra, puisqu’il élargit les vaisseaux sanguins, facilite la circulation du sang et de l’oxygène vers les poumons, ce qui a pour effet d’augmenter oxygénation des tissus dans tout le corps, y compris les muscles squelettiques.

    Des effets sur les sports d’endurance. et le football ?

    Kevin Jacobs. un physiologiste du sport réputé du département de kinésiologie et de sciences sportives à l’Université de Miami, m’a confié qu’à haute altitude, le sildénafil peut atténuer les pertes d’hypoxie provoquée par l’altitude.

    À haute altitude, la teneur en oxygène du sang diminue parce que l’environnement contient moins d’oxygène. À des altitudes encore plus élevées, les vaisseaux sanguins des poumons commencent à se resserrer ce qui réduit encore la teneur en oxygène. C’est à ces hautes altitudes que le Viagra peut être le plus efficace pour limiter ou éliminer ces problèmes grâce à son pouvoir de vasodilatation.

    “En simulant des altitudes de 3.900 mètres et moins, nous avons découvert que le sildénafil n’avait aucun effet notable sur la performance sportive de cyclistes masculins ou féminins entraînés, a déclaré Kevin Jacobs. Alors qu’à des altitudes entre 4.350 et 5.800 mètres, la plupart mais pas tous les athlètes bénéficient de la prise de ce médicament”.

    Il est également très probable que le Viagra ait un effet positif sur les sports à haute intensité intermittente, comme le football, lorsqu’il est disputé à des hautes altitudes, car la capacité à récupérer rapidement pendant un match et de faire de nombreux efforts intenses mais courts dépendent d’une capacité aérobique solide.

    Un produit efficace pour les compétitions à de très hautes altitudes

    J’ai fait remarquer au Dr. Jacobs que de nombreuses équipes brésiliennes éprouvent des difficultés quand elles se déplacent pour jouer des matchs dans des villes situées à des hautes altitudes comme La Paz (Bolivie) ou Quito (Équateur).

    “Si certains joueurs éprouvent de plus grandes difficultés que d’autres lors de matchs à des altitudes élevées, l’entraîneur peut leur conseiller de consulter le médecin de l’équipe qui pourrait leur prescrire du sildénafil”, a dit le Dr. Jacobs.

    “Bien s’acclimater à l’altitude est toujours la meilleure stratégie pour un athlète qui participe à une compétition à une altitude élevée mais le sildénafil pourrait avoir des effets physiologiques positifs à des altitudes de 4.350 mètres et au delà, même pour ceux qui y sont acclimatés”.

    De plus, certains athlètes souffrent de conditions médicales qui ne peuvent être soignées qu’avec des médicaments. Le Viagra est par exemple souvent utilisé chez les athlètes paralympiques parce les personnes atteintes de lésions de la moelle épinière souffrent davantage de dysfonction érectile que le reste de la population.

    La décision d’interdire l’usage de tout médicament ou drogue est ainsi compliquée dans la mesure où l’usage clinique de toute substance doit être pris en compte.

    Claudio Perret. un physiologiste du sport qui fait de nombreuses recherches avec des athlètes paralympiques, affirme que la qualité de vie de ces sportifs se détériorerait si le Viagra était interdit. “On pourrait même argumenter qu’il s’agit qu’une question d’éthique”, a ajouté le Dr. Perret. Pour l’instant, aucune décision n’a été prise.

    Le Dr. Arne Ljungqvist. président de la commission médicale du Comité internationale olympique (CIO) et vice-président de l’agence mondiale contre le dopage (AMA), m’a dit que “le Viagra ne devrait pas être interdit car il a des usages médicaux et sociaux qui sont plus importants que tout effet ergogène qu’il pourrait procurer à des athlètes avec une capacité pulmonaire réduite lors de compétitions à altitudes élevées”.

    “Je ne pense pas que pour l’instant le Viagra puisse être ajouté à la liste des substances interdites pour 2013. Il n’y a aucune raison à cela”, a ajouté le Dr. Ljungqvist. “Cependant, il est important de faire remarquer que la liste est mise à jour chaque année et que les choses peuvent toujours changer”.

    Pour l’instant, les athlètes peuvent toujours prendre du Viagra, comme cela a sans doute été le cas lors des derniers Jeux olympiques. Mais il est difficile de savoir combien et pour quelles raisons véritables.

    Mais si certains espéraient améliorer leur performance lors des compétitions pourtant disputées au niveau de la mer, cela était vain. Ils devront attendre que des Jeux olympiques se tiennent à des altitudes plus élevées. Ou mieux encore, profiter des vertus de ce produit uniquement dans l’intimité, pour le moment.

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    Can Viagra Cause Heartburn?

    By PDE5Guy on May 31, 2012 12:17 AM

    There’s a likelihood that it’s related. Dyspepsia, indigestion, heartburn – these can all be side effects of Viagra. And if you already get heartburn, using Viagra can aggravate it.

    What’s happening? While the drug causes the smooth muscles in the penis to relax, allowing increased blood flow that causes erection, it also causes other smooth muscles in the body to relax, including the sphincter that closes off your stomach from your esophagus. That permits the flow of stomach acid going the wrong way – up. The situation isn’t helped any by the fact that you’re probably in a horizontal position for some, if not all of the time the Viagra is in effect, making it easier for the acid to move into the esophagus.

    What can you do? You can take an antacid before or with the Viagra as a preventative. Some people say drinking a large glass of water with the Viagra reduces or eliminates the heartburn for them. Also, limit your alcohol intake when using Viagra. Alcohol relaxes the esophageal sphincter as well, exacerbating the problem (and alcohol can worsen post-Viagra headaches if you’re prone to hangovers). Having sex standing up is optional.

    Categories :

    Search

    About this Entry

    This page contains a single entry by PDE5Guy published on May 31, 2012 12:17 AM .

    This is the blog for the Viagra Stories website, aka magicbluepill.com where real people share their experiences taking Viagra.

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    Viagra Stomach Acid

    Viagra Stomach Acid 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 Stomach Acid 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 Stomach Acid welcomes you as you explore our small town steeped in history and tradition but alive with charm and activities.

    Side Effects

    List Viagra side effects by likelihood and severity.

    The following side effects are associated with Viagra:

    Common side effects of Viagra:

    • Backache Less Severe
    • Dizzy Less Severe
    • Feel Like Throwing Up Less Severe
    • Head Pain Less Severe
    • Indigestion Less Severe
    • Nosebleed Less Severe
    • Stuffy Nose Less Severe
    • Temporary Redness of Face and Neck Less Severe
    • Visible Water Retention Less Severe

    Infrequent side effects of Viagra:

    • Acute Infection of the Nose, Throat or Sinus Severe
    • Problems with Eyesight Severe
    • Chronic Trouble Sleeping Less Severe
    • Diarrhea Less Severe
    • Fever Less Severe
    • Flu-Like Symptoms Less Severe
    • Inflammation of the Nose Less Severe
    • Joint Pain Less Severe
    • Rash Less Severe
    • Redness of Skin Less Severe
    • Sinus Irritation and Congestion Less Severe
    • Trouble Breathing Less Severe
    • Urinary Tract Infection Less Severe

    Rare side effects of Viagra:

    • Abnormal Heart Rhythm Severe
    • Abnormal Increase in Muscle Tone Severe
    • Abnormal Liver Function Tests Severe
    • Abnormally Low Blood Pressure Severe
    • Anemia Severe
    • Angina Severe
    • Atrioventricular Heart Block Severe
    • Bleeding from the Lungs Severe
    • Blood Clot in the Brain Severe
    • Blood coming from Anus Severe
    • Blood Pressure Drop Upon Standing Severe
    • Cataracts Severe
    • Chest Pain Severe
    • Chronic Heart Failure Severe
    • Complete Stoppage of the Heart Severe
    • Continued Painful Erection Severe
    • Decreased White Blood Cells Severe
    • Depression Severe
    • Diabetes that is Not Under Control Severe
    • Disease of Inadequate Blood Flow to the Heart Muscle Severe
    • Disease of the Muscle of the Heart with Enlargement Severe
    • Disease of the Nerves Severe
    • Eye Disease Caused by Blood Flow Problems Severe
    • Eye Hemorrhage Severe
    • Fast Heartbeat Severe
    • Feeling Faint Severe
    • Fluid Retention in the Legs, Feet, Arms or Hands Severe
    • Hearing Loss Severe
    • Heart Attack Severe
    • Heart Throbbing or Pounding Severe
    • Hemorrhage in the Brain Severe
    • High Amount of Sodium in the Blood Severe
    • High Amount of Uric Acid in the Blood Severe
    • High Blood Pressure Severe
    • High Blood Sugar Severe
    • Increased Pressure in the Eye Severe
    • Inflammation of the Bladder Severe
    • Inflammation of the Esophagus Severe
    • Low Blood Sugar Severe
    • Pain Severe
    • Poor Vision Severe
    • Problems with Bladder Control Severe
    • Retinal Edema Severe
    • Retinal Hemorrhage Severe
    • Rupture of a Tendon Severe
    • Seizures Severe
    • Separation of the Vitreous from the Retina in the Eye Severe
    • Shock Severe
    • Skin Rash with Sloughing Severe
    • Stroke caused by Bleeding in the Brain Severe
    • Transient Ischemic Attack Severe
    • Uncoordinated Severe
    • Abnormal Dreams Less Severe
    • Abnormal Heart Electrical Signals Less Severe
    • Accumulation of Fluid or Edema in the Male Genitals Less Severe
    • Anxious Less Severe
    • Arthritis Less Severe
    • Asthma Less Severe
    • Bloody Urine Less Severe
    • Bone Pain Less Severe
    • Bronchitis Less Severe
    • Burning Stomach Less Severe
    • Chills Less Severe
    • Contact Dermatitis Less Severe
    • Cough Less Severe
    • Difficulty Swallowing Less Severe
    • Dilated Pupil Less Severe
    • Drowsiness Less Severe
    • Dry Eye Less Severe
    • Dry Mouth Less Severe
    • Earache Less Severe
    • Enlarged Breasts Less Severe
    • Episode of Short-term Memory Loss Less Severe
    • Excessive Sweating Less Severe
    • Excessive Thirst Less Severe
    • Feeling Weak Less Severe
    • Frequent Urination Less Severe
    • Gout Less Severe
    • Herpes Simplex Infection Less Severe
    • Hives Less Severe
    • Increase in the Amount of Phlegm Less Severe
    • Inflammation of the Covering of the Tendon Less Severe
    • Inflammation of the Gums Less Severe
    • Inflammation of the Large Intestine Less Severe
    • Inflammation of the Lining of a Joint Less Severe
    • Inflammation of the Lining of the Stomach and Intestines Less Severe
    • Inflammation of the Voice Box Less Severe
    • Involuntary Quivering Less Severe
    • Itching Less Severe
    • Migraine Headache Less Severe
    • Muscle Pain Less Severe
    • Muscle Weakness Less Severe
    • Nerve Pain Less Severe
    • Numbness Less Severe
    • Numbness and Tingling Less Severe
    • Orgasm Problems Less Severe
    • Pain in the Eye Less Severe
    • Painful, Red or Swollen Mouth Less Severe
    • Painful, Red or Swollen Tongue Less Severe
    • Pink Eye Less Severe
    • Problem with Ejaculation Less Severe
    • Puffy Face from Water Retention Less Severe
    • Ringing in the Ears Less Severe
    • Sensation of Spinning or Whirling Less Severe
    • Sensitive to Light Less Severe
    • Sexual Problems Less Severe
    • Skin Ulcer Less Severe
    • Stomach Cramps Less Severe
    • Sun-Sensitive Skin Less Severe
    • Swelling of the Testicles Less Severe
    • Throat Irritation Less Severe
    • Throwing Up Less Severe
    • Urination During the Night Less Severe
    • Weak Reflexes Less Severe

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    Viagra

    GENERIC NAME(S): SILDENAFIL CITRATE

    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.

    OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

    Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension ). 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).

    How to use Viagra

    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. including permanent blindness, in one or both eyes (NAION) may occur. 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.

    Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

    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).

    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.

    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. A serious drop in blood pressure 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 nitrate, amyl nitrite, 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), mifepristone, 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 right away. 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.

    Notes

    Do not share this medication with others.

    Missed Dose

    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.

    Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

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    It sounds great in theory, but there is no miracle cure for impotence and as far as the scientists are able to tell so far, there is not going to one in the near future. Workout Regularly: Workout regularly is the best way to prevent yourself from the erectile dysfunction. Regular exercise increases the blood circulation in the body. It also improves the blood supply to the penis. The word Erectile Dysfunction regards to a range of common disorders affecting the sexual health of men. It includes prolonged erection during intercourse, unsatisfactory erection, inappropriate curvature of the penis and premature ejaculation. Overall it refers to the inability to obtain a perfect erection for satisfactory sexual activity. Just like with any other business, some merchants are honest and will offer good value for your money and some have only one thing in mind: make money as fast as possible, no matter what. If you need help with impotence, small erections, erection control etc or if you simply believe that penis exercises can enhance your sexual experiences and make you feel more confident, and then you should start by researching offers available on the internet.

    Holistic exercises such as yoga, Pranayama and meditation are said to be very beneficial as male impotency treatment. Drug or alcohol abuse, smoking, obese body, surgery, hormonal imbalance are also factors leading to male saxual dysfunction. Ageing remains a natural cause for mostly all the disorders and diseases and it is no exception in the case of erectile dysfunction as well. These include depression, apprehensions about a good saxual performance, excessive tiredness, problematic relationships etc. Many impotent men in the United States seek medical advice to treat their condition. Doctors will perform thorough diagnostic test to determine the cause and extent of the condition, and eventually prescribe the appropriate therapy for it. Many of these doctor and experts of reproductive health may offer different kinds of therapies that include psychotherapy if the cause of the erectile dysfunction is psychogenic, drug therapy if the dysfunction resulted from imbalances in biochemical components of the body or trauma, and surgery if the cause is severe that damaged the nerves and blood vessels in the penile area, which are responsible to process erection.

    Secondary Premature Ejaculation is due to physical causes, usually involving the penile arteries or veins or both. Lifestyle Factors and Erectile Dysfunction The controllable risk factors for arteriosclerosis like: Being overweight Lack of exercise High cholesterol Cigarette smoking High blood pressure will often produce erectile failure before progressing to affect the heart. Unless there is a change in lifestyle, coronary artery disease may follow impotence within a few years. Traditionally, people use the power of nature to alleviate any pain. Herbal products are an excellent solution to be released from masculine impotence. Herbs are very safe for health because they do not result in any side-effect. You must try to get at least 7-8 hours of sleep every night. d) Reducing stress is also extremely important. Increasing Testosterone Production A lot of men suffer with a drop in their testosterone levels as they advance towards middle age.

    Stressed men are never able to get the hard and strong erections and usually fail to satisfy their partners as they lose the erection in between the sex. Stress reduces the sexual stamina as a result of which men fail to perform during the sexual activity. Sometimes the due to the stress men even refrain from any sexual activity. So why using risky techniques or products when one can opt for natural herbs that have identical results? Traditionally, people use the power of nature to alleviate any pain. Herbal products are an excellent solution to be released from masculine impotence. Men are now more willing to admit to needing a boost and taking action to get it. Most men by age 40 have experienced inconsistent erections, or sometimes only brief erections. Over 50 per cent of men between 50 and 70 years of age experience varying degrees of erectile dysfunction, though it is not an inevitable consequence of normal aging.

    Therefore, the more muscle mass you have; the more calories you will burn each day. You should try to stay fit with cardio and weight (resistance) training. One of the many herbal remedies you could try is gingko. Obesity: unfit men are the majority of impotent men. Inactivity: men who do not exercise will often times experience impotency. Masculine impotence may have a psychological cause or an organic one: Impotence: a psychological trouble Psychological problems can trigger erectile dysfunction. I’m finally impotent free. I now last long enough to satisfy my partner, and I can actually go again in minutes. Male impotence or erectile dysfunction is a sexual dysfunction that is characterized by the individual’s inability to develop or maintain a penile erection for satisfactory intercourse.

    Thus, you are able to get the strong and long lasting erections during the sexual intercourse. Exercise like running and walking on daily basis keeps your weight in control and reduce the chances of obesity that is found to be one of the major causes of erectile dysfunction. When you workout regularly your pelvic muscles, thighs, buttocks, arms, neck, and thorax get strong these things help you to perform well during the sexual intercourse. Researchers believe this is because compounds in grapefruit juice called furanocoumarins block the enzymes that normally break down these drugs in the body, and this can last for up to 24 hours after ingestion. This drug interaction was actually discovered accidentally by researchers when they used grapefruit juice to mask the taste of alcohol for their study, which was to see how an oral calcium-channel blocker called Plendil (felodipine) reacts to alcohol.

    Because water helps to flush the system and helps your body work more efficiently. If you need help with impotence, small erections, erection control etc or if you simply believe that penis exercises can enhance your sexual experiences and make you feel more confident, and then you should start by researching offers available on the internet. There is a lot of work to be done, there are a lot of web sites to check and a lot of important decisions to make, so take it easy. One of the main principles of erection therapy exercises is to improve circulation of the penis and to increase the volume of blood held within the erectile tissue. However, you should keep in mind the fact that there’s been very little scientific evidence that these claims are legitimate.

    Frequent erectile dysfunction can cause emotional and relationship problems, and often leads to diminished self-esteem. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response. Many men who experience physical causes for erectile dysfunction also experience psychological symptoms like stress, anxiety, guilt, and depression as a result. Sleep Apnea is found to be one of the reasons that give rise to the erectile dysfunction in men. So, please sleep well if you want to prevent the erectile dysfunction. Adequate sleep helps to run all the process in the body normally. The components of a bottle of Erectile Dysfunction Lotion vary. But a lot of manufacturers usually include herbal components in their product. These herbal stuffs were proven by research and experts to be effective in giving the penis a full erection.

    Sometimes the due to the stress men even refrain from any sexual activity. So, please avoid excessive stress in order to be active during the sex. Hence, by following these simple steps you would be able to prevent he problem of the erectile dysfunction. There are other techniques and exercises that help man to get rid of male impotency. Kegel exercise is also said to be very beneficial. Such exercises help the pelvic muscles to get strengthen and hence may also be beneficial in erectile dysfunction up to certain extent. But aside from these modes of treatment, many men employ other alternative therapies they have learned by browsing the webpage, or reading advertisements on magazines.

    There may have been no approved therapeutic claim on this product, but many people are already exclaiming their satisfaction over it. Indeed, it will not be long enough when people will turn to alternative therapies in finding relief for impotence, especially that pharmacological agents and surgical interventions are getting expensive, and more side effects are attached on these mode of therapies. This physical disorder affects their sexual as well as personal lives. The word Erectile Dysfunction regards to a range of common disorders affecting the sexual health of men. It includes prolonged erection during intercourse, unsatisfactory erection, inappropriate curvature of the penis and premature ejaculation.

    And that can make the world of difference! In the United States alone, there are fifteen to thirty million American men who are suffering form impotence of erectile dysfunction. Many of these men became less empowered, and have ended their marriage with their spouse in the dumps, after they failed to satisfy their partner’s desire during sexual intercourse. You have just relaxed for only a split second but many doctors are now suggesting breathing exercises to combat impotence. The idea behind this alternative treatment is that breathing reduces stress but also boosts circulation levels with deeper breaths. Cure Yourself by Tomorrow These tips are simple but they are only the foundation of the complete treatment! So, everyman wants to know how he can prevent himself from suffering with the erectile dysfunction.

    Some of the components of popular Erectile Dysfunction Lotion brands include the following: a. Siberian Ginseng – improves the person’s stamina during sexual intercourse, as well as enhancing sexual performance. Stress can raise the level of hormone Cortisol in your body that is known to inhibit the production of testosterone. Natural Erection Pills More importantly, there are some natural erection pills that can be of great help. Such pills are a potent mix of herbs, amino acids, minerals and other natural ingredients that not only increase blood flow and testosterone production but also boost nitric oxide production in your body. Exercise like running and walking on daily basis keeps your weight in control and reduce the chances of obesity that is found to be one of the major causes of erectile dysfunction.

    The idea behind this alternative treatment is that breathing reduces stress but also boosts circulation levels with deeper breaths. Cure Yourself by Tomorrow These tips are simple but they are only the foundation of the complete treatment! Imagine being impotent free by tomorrow! You should begin to eat healthier. You should try to lower your cholesterol intake by eliminating red meats, drinking fat free dairy and avoiding fattening foods (like fast food). Instead, eat healthier snacks like fruits and vegetables which are loaded with fiber. Excess fat impedes blood flow to penis.

    Side effects can include scarring. The cost per injection can be high. The theory goes that if the erectile tissue can be encouraged to hold a greater volume of blood than it could otherwise naturally accommodate, then this will in turn result in a larger penis size both when erect and flaccid. This muscle can be trained and it is the one most important thing that helps us maintain an erection. These two sheets of voluntary muscle wrap around the shaft of the penis like the belts on a radial tire.

    And worse, most of these men became depressed, anxious, or even jealous with other men who can give total pleasure and satisfaction to their wives. Many impotent men in the United States seek medical advice to treat their condition. Doctors will perform thorough diagnostic test to determine the cause and extent of the condition, and eventually prescribe the appropriate therapy for it. A Hard erection is also a sign of great male fertility, better libido, and shows a strong sex drive whereas a soft erection shows male weakness. A super hard erection is a turn on during sex.

    Neurological damage: damage caused to nerves leading to or from penis. Before however starting treatment for erectile dysfunction, one should consult a doctor to diagnose your condition perfectly and find out if there is any cause underneath. Many times, certain modifiable risk factors play a role in development of impotence in men that remain unnoticed by many. Resolving these issues can help cure erectile dysfunction naturally. Cures that increase the sex drive have been observed and used for centuries, but only with the advance of the medicine doctors were in a position to prove that they really work well and are the better alternative for curing impotency, particularly if you are after the long-term effects.

    Causes of Erectile Dysfunction There is no complete or exhaustive list of causes for erectile dysfunction, however the most prominent or common ones have been discussed below. Neurological disorders and cardiovascular problems have been related to erectile dysfunction. Most men by age 40 have experienced inconsistent erections, or sometimes only brief erections. Over 50 per cent of men between 50 and 70 years of age experience varying degrees of erectile dysfunction, though it is not an inevitable consequence of normal aging.

    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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