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Study Finds Viagra Works for Women

A new study has found that the impotence drug Viagra could ramp up the sex lives of women who take it, just as it has done for men.

The 12-week study focused on 202 post-menopausal or post-hysterectomy women who complained of female sexual arousal disorder. The women in the group who took Sildenafil — the little blue pill commonly known as Viagra — took notes after each sexual experience, and reported better overall sexual satisfaction compared with those who took a placebo.

Their enhanced sex lives included better arousal, lubrication and orgasm.

The study was conducted by Laura Berman, director of the Berman Center and a professor of OB-GYN and psychiatry at Northwestern University in Chicago, and Dr. Jennifer Berman, director of the Female Sexual Medicine Center at UCLA Medical Center in Los Angeles. The researchers say that the results are preliminary.

“In terms of ability to achieve orgasm, there was a statistically significant movement,” Laura Berman said on ABCNEWS’ Good Morning America.

“It increases blood flow to the genital area, increases the sensation of warmth, tingling and fullness,” she said.

More than 50 million women experience some type of sexual dysfunction.

Jennifer Berman said it’s important for women to remember that this pill can’t overcome mental and emotional barriers to a satisfying sex life.

“At this point, we can say that women with significant emotional or relationship problems and women that have desire problems related to their interest in being sexual might not be the best candidates,” Jennifer Berman said. “It’s for women who were satisfied with their sexual response at one point and now, for whatever medical reason, are no longer able to respond,” she said.

Increased Blood Flow Theory

Women who suffer from female sexual arousal disorder can experience a variety of symptoms, including lack of “excitement,” vaginal dryness, loss of sensation and sensitivity in the genitals and nipples and low blood flow to the genitals. Women in the study were screened to make sure that psychological or relationship issues were not the cause of the problem.

Since Viagra enhances sexual arousal in men by increasing the blood flow to the penis, the Bermans theorized that the drug could have a similar effect on women, increasing the blood flow to the female genitals and thereby producing better arousal, sensation and lubrication in the genital area.

Women in the study were given doses of 50 milligrams, which was increased to 100 milligrams only once during the study based on how well the lower dose was working, and the women’s tolerance to it. The pill was to be taken prior to sexual activity but no more than once daily.

Each patient had to engage in sexual activity at least once a week and keep a personal log about it. During the course of the study, neither the patients nor the doctors knew which patients were receiving the Viagra. Women taking Viagra reported mild to moderate side effects, including headache, flushing, nausea, and vision symptoms — the same side effects reported by men who take the drug.

Viagra Improves Sex for Some Women

From the WebMD Archives

Jan. 7, 2004 — Viagra can do wonders for men. But a new study shows it also improves sex for some postmenopausal women.

The findings come from a research team led by sexual-function gurus Jennifer R. Berman, MD, and Laura A. Berman, PhD. The placebo -controlled study, funded by Viagra maker Pfizer Inc. evaluated 202 postmenopausal women diagnosed with female sexual arousal disorder (FSAD). This disorder is defined as distress from an inability to attain or maintain sexual excitement.

Half the women were treated with Viagra; the other half got inactive placebo pills. Many of the women who got the placebo reported improved genital sensation. Some even reported more sexual satisfaction. But both of these improvements were much more common among women who took Viagra.

The little blue pill didn’t work for women who, in addition to FSAD, also had something called hypoactive sexual desire disorder or HSDD. While many women with FSAD have difficulties with genital blood flow — suggesting a physical problem that Viagra can help — women with HSDD may be more likely to have an underlying emotional or relationship problem leading to lack of sexual desire.

“Unresolved emotional or relational issues should be addressed before beginning medical therapies,” Berman and colleagues stress. Their report appears in the December 2003 issue of The Journal of Urology.

Viagra, Genital Sensation, and Sexual Satisfaction

Women were included in the study if they were postmenopausal or if they had a hysterectomy. Their ages ranged from 30 to 71 with an average age of about 51.

The Berman team focused on the women’s answers to two questions after taking Viagra or placebo:

  • After taking the study medication. the sensation/feeling in my genital (vagina. labia, clitoris) area during intercourse or stimulation seemed to be: (a) more than before, (b) less than before, or (c) unchanged.
  • After taking the study medication, intercourse and/or foreplay was (a) pleasant and satisfying; better than before taking the study medication; (b) unpleasant; worse than before the study medication; (c) unchanged; no difference; or (d) pleasant but still not like it used to be or I would like it to be.

Continued

Among placebo recipients, 44% reported improvement in the first question and 28% reported improvement in the second question.

Among all Viagra recipients, 57% reported improvement in the first question and 42% reported improvement in the second question.

But among Viagra recipients with sexual arousal disorder who did not have HSDD, the results were more striking: 69% reported improvement in the first question. This group was eight times more likely to report improvement than women without HSDD who got placebo.

Similarly, among Viagra recipients with sexual arousal disorder who did not have HSDD 50% reported improvement in the second question. This group was 11 times more likely to report improvement than non-HSDD women who got placebo.

The authors note that women who respond to Viagra may need to have normal levels of estrogen and testosterone. For many postmenopausal women, that may mean menopausal replacement therapy. In the present study, the women had normal hormone levels or were receiving menopausal replacement therapy.

SOURCE: Berman, J.R. The Journal of Urology. December 2003; vol 170: pp 2333-2338.

WebMD Health News

В© 2004 WebMD, Inc. All rights Reserved.

What happens when women take Viagra?

When a woman takes Viagra, she increases blood flow to her erectile tissues. Due to the non-congruence of women’s physiological sexual response with their perceived/emotional sexual response, not a lot happens.

Sexual arousal medications have huge placebo effects, so it’s perfectly possible — between 15-40%, I’d estimate — that a woman taking Viagra would experience an increase in desire, but she’d experience that taking two aspirin if her doctor assured her it would “increase her libido.”

We know Viagra isn’t effective in increasing women’s sexual desire because, in 11 years since it was first produced, no effect has been proven.

Medication isn’t effective, and there are behavioral, attitudinal, and experiential things you can do to increase desire/arousability for women.

This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.

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How to Get Viagra

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: How Young Is Too Young?

From the WebMD Archives

Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas Rangers slugger is only 37 and won’t admit to having erection problems, yet he recently agreed to appear in ads promoting the drug. The deal has made people wonder whether Palmeiro really represents men with erectile dysfunction. or whether Pfizer, the company that makes Viagra, wants to persuade young men to try it for fun.

It’s true that erectile dysfunction is more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree of erectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro’s age.

Urologist Myron Murdock, medical director of the Impotence Institute of America, says these men are likely to use Viagra because sexual performance is a high priority for them.

A younger man, Murdock says, “wants his V-12 Jaguar working just perfectly,” whereas an elderly gent may be content with less dependable erections. What’s more, the sexual partners of younger men “are more demanding of their performance,” Murdock says.

Pfizer denies that it’s promoting Viagra for recreational use. “We’ve consistently opposed that,” says spokesman Geoff Cook. Nevertheless, Murdock says it’s fine to pop the little blue pill to “optimize” your sexual performance.

We assume all young men have normal sexual functioning, “but they’re really not normal,” Murdock says. Hardening of the arteries. which restricts blood flow to the penis. can begin during the teen years, so that by the time a man is in his 20s, his ability to get and keep an erection has already begun to decline. Murdock says many men who seek Viagra for recreational use actually have minor erectile dysfunction.

There’s also some evidence that Viagra can shorten the time it takes a man to recover after sex and be ready for another round. This is called the “refractory period.” Normally it lasts 20 minutes or longer. One study, published in the journal Human Reproduction in January 2000, found that Viagra shortened the refractory period by about 10 minutes in healthy men .

Continued

What Viagra cannot do is increase your sexual appetite or make you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in San Francisco, says you shouldn’t expect your erections to reach staggering new proportions, either. “I don’t believe that Viagra can increase an erection beyond 100% of normal,” he says.

“Viagra is a super-safe drug,” Murdock says, assuming you have a healthy heart and don’t take nitrates.

Nitrates include nitroglycerin — a drug that many men take for chest pain from heart disease — and “poppers.” Poppers are little vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which gives a brief high when inhaled. It’s most often used to enhance sexual pleasure, and mostly by gay men. Poppers are not all that safe to use on their own, and they’re especially dangerous when you’re on Viagra.

Nitrates widen blood vessels, and Viagra increases that effect. Mixing the two can cause your blood pressure to drop drastically. A sudden drop in blood pressure can make you pass out, and you may die if your blood pressure stays too low for too long.

Preservatives like sodium nitrate — found in processed food — do not cause this problem, so you won’t die from eating a hot dog while on Viagra. Even so, it’s best to take it on an empty stomach. That way, the drug absorbs into your bloodstream faster. Wine may contain nitrates, but not the kind that cause problems with Viagra. It’s fine to play some Marvin Gaye on the stereo and sip a glass of Chardonnay, if that’s what puts you in the mood.

Although you may be tempted to order Viagra discreetly from one of the hundreds of Web sites that sell it, don’t. “It’s bad medicine,” Murdock says. You really must bring your doctor into your sex life if you want to use Viagra.

When you buy from an online pharmacy, you just have to answer some health questions before you proceed to the checkout page. If you answer honestly — and that might be a big “if” for those determined to get what they want — the questionnaire may catch some possible complications. But the pharmacists who fill your order don’t know your medical history, and no questionnaire can diagnose the root cause of your problem. Erectile dysfunction can have serious underlying causes, like diabetes. heart disease. liver disease, or thyroid disease.

Continued

Cook says Pfizer is opposed to Internet Viagra sales. “Our goal with any of our marketing is simply to reach men and encourage them to see a doctor,” he says.

It seems that Viagra can make sex better for women, too. Like the penis. the clitoris is erectile tissue — spongy tissue that becomes engorged with blood during sexual excitement. By increasing blood flow to the clitoris, Viagra may heighten a woman’s sensation and arousal. It also seems to increase vaginal lubrication.

Murdock says many couples like to heat things up by splitting a dose of Viagra. “It’s an interesting sexual situation,” he says. The recommended dosage for men is up to 100 milligrams per day, and that seems to be just as safe for women. Young people may get results from a smaller dose: As little as 25 mg may be enough.

The FDA has not approved Viagra for women, but Murdock says, “It’s just a matter of time.” He says he and other doctors who specialize in sexual medicine prescribe it to women, which is perfectly legal. Doctors are allowed to use their best judgment. Drug companies, however, can’t advertise any use that isn’t FDA-approved.

The studies being done to test Viagra’s safety and effectiveness in women have shown good results so far. “We’re cautiously optimistic,” Cook says.

Martin F. Downs is a health writer in New York City. He was formerly an editor at CBS HealthWatch. He has also written for Health.com, Salon.com, and POZ magazine and is the editor of the Alicubi Journal (alicubi.com).

В© 2002 WebMD, Inc. All rights reserved.

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Common use

The main component of Viagra is Sildenafil Citrate.
Sildenafil Citrate affects the response to sexual stimulation. It acts by enhancing smooth muscle relaxation using nitric oxide, a chemical that is normally released in response to sexual stimulation. This smooth muscle relaxation allows increased blood flow into certain areas of the penis, which leads to an erection.
Sildenafil Citrate is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension.
Sildenafil Citrate may also be used for other purposes not listed above.

Dosage and direction

Usually the recommended dose is 50 mg. It is taken approximately 0,5-1 hour before sexual activity. Do not take Viagra more then once a day.
A high fat meal may delay the time of the effect of this drug.
Try not to eat grapefruit or drink grapefruit juice while you are being treated with Sildenafil Citrate .

Precautions

Before you start taking Sildenafil Citrate. tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies.
Aged people may be more sensitive to the side effects of the drug.

Viagra is contraindicated in patients who take another medicine to treat impotence or using a nitrate drug for chest pain or heart problems.
This medicine should not be taken by women and children as well as in patients with a known hypersensitivity to any component of the tablet.

Possible side effect

The most common side effects are headache, flushing, heartburn, stomach upset, nasal stuffiness, lightheadedness, dizziness or diarrhea.
A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
Many people who use this medicine do not have serious side effects.
In case you notice any side effects not listed above, contact your doctor or pharmacist.

Drug interaction

This drug should not be used with nitrates and recreational drugs called “poppers” containing amyl or butyl nitrite; alpha-blocker medications; other medications for impotence; high blood pressure medicines, etc.
Consult your doctor or pharmacist for more details.

Missed dose

Viagra is used as needed, so you are unlikely to be on a dosing schedule.

Overdose

If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

Storage

Store your medicines at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

Disclaimer

We provide only general information about medications which does not cover all directions, possible drug integrations, or precautions. Information at the site cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with your health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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HЖ°б»›ng dбє«n sб»­ dụng: Hбє§u hбєїt các bệnh nhân Д‘Ж°б»Јc khuyбєїn cáo dùng liб»Ѓu 100mg, uб»‘ng trЖ°б»›c khi quan hệ tình dục khoбєЈng 1 giб»ќ. Dб»±a trên sб»± dung nбєЎp và tác dụng của thuб»‘c. liб»Ѓu có thб»ѓ tДѓng tб»›i mб»©c tб»‘i Д‘a là 100 mg hoбє·c giбєЈm tб»›i mб»©c 25 mg. Liб»Ѓu tб»‘i Д‘a là viagra100 mg, sб»‘ lбє§n dùng tб»‘i Д‘a là 1 lбє§n mб»—i ngày.

Chб»‘ng chỉ Д‘б»‹nh. Sildenafil là thành phбє§n giúp dЖ°ЖЎng vбє­t cЖ°ЖЎng cб»©ng có trong Viagra không dùng cho nhб»Їng bệnh nhân dб»‹ б»©ng vб»›i bất kб»і thành phбє§n nào của thuб»‘c. Sildenafil làm tДѓng tác dụng hбєЎ huyбєїt áp của cácnitrae cấp và mбєЎn tính.
Vì vбє­y chб»‘ng chỉ Д‘б»‹nh cho nhб»Їng bệnh nhân Д‘ang dùng nhб»Їng chất cung cấp nitric oxide, các nitrate hб»Їu cЖЎ hay nhб»Їng nitrite hб»Їu cЖЎ.

Cбє©n thбє­n dùng thuб»‘c vб»›i mб»™t sб»‘ bệnh tim mбєЎch, mб»™t sб»‘ ít bệnh nhân viêm võng mбєЎc sбєЇc tб»‘ có các rб»‘i loбєЎn vб»Ѓ gen phosphodiesterase б»џ võng mбєЎc cбє§n phбєЈi thбє­n trб»Ќng khi Д‘iб»Ѓu trб»‹ sildenafil б»џ nhб»Їng bệnh nhân này.

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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 Doesn’t Damage Vision

From the WebMD Archives

Jan. 8, 2003 — For men taking Viagra, an unnerving side effect — light sensitivity. bluish-colored vision — has been a concern. But there’s no evidence that Viagra causes eye damage, even in those who take high doses, according to a new study.

Since Viagra lowers blood pressure overall, there was a suspicion that the drug might decrease blood flow to optic nerves — nerves that control vision — which can cause nerve damage.

However, this study of 13 men at Stanford University found that high doses of Viagra by and large preserved the thickness of the choroid layer of the eye. indicating that blood flow was normal. There were some small variations in thickness, which indicated that some men with an underlying blood vessel condition — such as hardening of the arteries — may indeed have changes in vision.

The study appears in the November-December 2002 issue of Ophthalmologica.

Some of the men did have more difficulties discriminating between shades of blue and green. However, those men had trouble seeing the difference between many colors.

“Viagra can change blood vessel structure as well as general blood pressure, so we needed to answer the question whether the drug could change blood vessels in the eye,” says lead researcher Tim McCulley, MD, assistant professor of ophthalmology at Stanford University, in a news release.

“Our study may have had a small group of participants, but it showed very little change in blood vessels or blood flow in nearly all the patients,” he says.

WebMD Health News

Sources

SOURCES: Ophthalmologica. November-December 2002 • News release, University of California, Irvine.

В© 2003 WebMD, Inc. All rights reserved.

* Reported during post-marketing surveillance only

**Visual colour distortions: Chloropsia, Chromatopsia, Cyanopsia, Erythropsia and Xanthopsia

***Lacrimation disorders: Dry eye, Lacrimal disorder and Lacrimation increased

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard

Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL – Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie ; E-mail: medsafety@hpra.ie .

In single dose volunteer studies of doses up to 800 mg, adverse reactions were similar to those seen at lower doses, but the incidence rates and severities were increased. Doses of 200 mg did not result in increased efficacy but the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, altered vision) was increased.

In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not eliminated in the urine.

5. Pharmacological properties

5.1 Pharmacodynamic properties

Pharmacotherapeutic group: Urologicals; Drugs used in erectile dysfunction. ATC Code: G04B E03.

Mechanism of action

Sildenafil is an oral therapy for erectile dysfunction. In the natural setting, i.e. with sexual stimulation, it restores impaired erectile function by increasing blood flow to the penis.

The physiological mechanism responsible for erection of the penis involves the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum, where PDE5 is responsible for degradation of cGMP. Sildenafil has a peripheral site of action on erections. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. When the NO/cGMP pathway is activated, as occurs with sexual stimulation, inhibition of PDE5 by sildenafil results in increased corpus cavernosum levels of cGMP. Therefore sexual stimulation is required in order for sildenafil to produce its intended beneficial pharmacological effects.

Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. Its effect is more potent on PDE5 than on other known phosphodiesterases. There is a 10-fold selectivity over PDE6 which is involved in the phototransduction pathway in the retina. At maximum recommended doses, there is an 80-fold selectivity over PDE1, and over 700-fold over PDE 2, 3, 4, 7, 8, 9, 10 and 11. In particular, sildenafil has greater than 4,000-fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility.

Clinical efficacy and safety

Two clinical studies were specifically designed to assess the time window after dosing during which sildenafil could produce an erection in response to sexual stimulation. In a penile plethysmography (RigiScan) study of fasted patients, the median time to onset for those who obtained erections of 60% rigidity (sufficient for sexual intercourse) was 25 minutes (range 12-37 minutes) on sildenafil. In a separate RigiScan study, sildenafil was still able to produce an erection in response to sexual stimulation 4-5 hours post-dose.

Sildenafil causes mild and transient decreases in blood pressure which, in the majority of cases, do not translate into clinical effects. The mean maximum decreases in supine systolic blood pressure following 100 mg oral dosing of sildenafil was 8.4 mmHg. The corresponding change in supine diastolic blood pressure was 5.5 mmHg. These decreases in blood pressure are consistent with the vasodilatory effects of sildenafil, probably due to increased cGMP levels in vascular smooth muscle. Single oral doses of sildenafil up to 100 mg in healthy volunteers produced no clinically relevant effects on ECG.

In a study of the hemodynamic effects of a single oral 100 mg dose of sildenafil in 14 patients with severe coronary artery disease (CAD) (>70% stenosis of at least one coronary artery), the mean resting systolic and diastolic blood pressures decreased by 7% and 6% respectively compared to baseline. Mean pulmonary systolic blood pressure decreased by 9%. Sildenafil showed no effect on cardiac output, and did not impair blood flow through the stenosed coronary arteries.

A double-blind, placebo-controlled exercise stress trial evaluated 144 patients with erectile dysfunction and chronic stable angina who regularly received anti-anginal medicinal products (except nitrates). The results demonstrated no clinically relevant differences between sildenafil and placebo in time to limiting angina.

Mild and transient differences in colour discrimination (blue/green) were detected in some subjects using the Farnsworth-Munsell 100 hue test at 1 hour following a 100 mg dose, with no effects evident after 2 hours post-dose. The postulated mechanism for this change in colour discrimination is related to inhibition of PDE6, which is involved in the phototransduction cascade of the retina. Sildenafil has no effect on visual acuity or contrast sensitivity. In a small size placebo-controlled study of patients with documented early age-related macular degeneration (n=9), sildenafil (single dose, 100 mg) demonstrated no significant changes in the visual tests conducted (visual acuity, Amsler grid, colour discrimination simulated traffic light, Humphrey perimeter and photostress).

There was no effect on sperm motility or morphology after single 100 mg oral doses of sildenafil in healthy volunteers (see section 4.6).

Further information on clinical trials

In clinical trials sildenafil was administered to more than 8000 patients aged 19-87. The following patient groups were represented: elderly (19.9%), patients with hypertension (30.9%), diabetes mellitus (20.3%), ischaemic heart disease (5.8%), hyperlipidaemia (19.8%), spinal cord injury (0.6%), depression (5.2%), transurethral resection of the prostate (3.7%), radical prostatectomy (3.3%). The following groups were not well represented or excluded from clinical trials: patients with pelvic surgery, patients post-radiotherapy, patients with severe renal or hepatic impairment and patients with certain cardiovascular conditions (see section 4.3).

In fixed dose studies, the proportions of patients reporting that treatment improved their erections were 62% (25 mg), 74% (50 mg) and 82% (100 mg) compared to 25% on placebo. In controlled clinical trials, the discontinuation rate due to sildenafil was low and similar to placebo.

Across all trials, the proportion of patients reporting improvement on sildenafil were as follows: psychogenic erectile dysfunction (84%), mixed erectile dysfunction (77%), organic erectile dysfunction (68%), elderly (67%), diabetes mellitus (59%), ischaemic heart disease (69%), hypertension (68%), TURP (61%), radical prostatectomy (43%), spinal cord injury (83%), depression (75%). The safety and efficacy of sildenafil was maintained in long term studies.

The European Medicines Agency has waived the obligation to submit the results of studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. See section 4.2 for information on paediatric use.

5.2 Pharmacokinetic properties

Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. The mean absolute oral bioavailability is 41% (range 25-63%). After oral dosing of sildenafil AUC and Cmax increase in proportion with dose over the recommended dose range (25-100 mg).

When sildenafil is taken with food, the rate of absorption is reduced with a mean delay in tmax of 60 minutes and a mean reduction in Cmax of 29%.

The mean steady state volume of distribution (Vd ) for sildenafil is 105 l, indicating distribution into the tissues. After a single oral dose of 100 mg, the mean maximum total plasma concentration of sildenafil is approximately 440 ng/mL (CV 40%). Since sildenafil (and its major circulating N-desmethyl metabolite) is 96% bound to plasma proteins, this results in the mean maximum free plasma concentration for sildenafil of 18 ng/mL (38 nM). Protein binding is independent of total drug concentrations.

In healthy volunteers receiving sildenafil (100 mg single dose), less than 0.0002% (average 188 ng) of the administered dose was present in ejaculate 90 minutes after dosing.

Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-demethylation of sildenafil. This metabolite has a phosphodiesterase selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% that of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil. The N-desmethyl metabolite is further metabolised, with a terminal half life of approximately 4 h.

The total body clearance of sildenafil is 41 L/h with a resultant terminal phase half life of 3-5 h. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the faeces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of administered oral dose).

Pharmacokinetics in special patient groups

Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, resulting in approximately 90% higher plasma concentrations of sildenafil and the active N-desmethyl metabolite compared to those seen in healthy younger volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in free sildenafil plasma concentration was approximately 40%.

In volunteers with mild to moderate renal impairment (creatinine clearance = 30-80 mL/min), the pharmacokinetics of sildenafil were not altered after receiving a 50 mg single oral dose. The mean AUC and Cmax of the N-desmethyl metabolite increased up to 126% and up to 73% respectively, compared to age-matched volunteers with no renal impairment. However, due to high inter-subject variability, these differences were not statistically significant. In volunteers with severe renal impairment (creatinine clearance < 30 mL/min), sildenafil clearance was reduced, resulting in mean increases in AUC and Cmax of 100% and 88% respectively compared to age-matched volunteers with no renal impairment. In addition, N-desmethyl metabolite AUC and Cmax values were significantly increased by 200% and 79% respectively.

In volunteers with mild to moderate hepatic cirrhosis (Child-Pugh A and B) sildenafil clearance was reduced, resulting in increases in AUC (84%) and Cmax (47%) compared to age-matched volunteers with no hepatic impairment. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function have not been studied.

5.3 Preclinical safety data

Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and toxicity to reproduction and development.

6. Pharmaceutical particulars

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If you have no tolerance, 90mgs of Adderall is way way way to much. You’d be good from 20mgs, whether it be crushed XR or just IR tablets. Should be plenty to make sex feel great, I know it does for my girlfriend who hasn’t taken Adderall more than 10 times or so.

Plugging is the better ROA vs oral. Faster onset, hits harder and has a higher bioavailability. But with no tolerance, it’s just whatever you’d prefer to do. You will still feel it plenty orally, but you’ll get higher with plugging if you use the same dosage.

As far as if Adderall and Viagra is a safe combo, I can’t say for certain. However, Adderall is a vasoconstrictor while Viagra is a vasodilator. I tried finding some other threads on the topic and some people report unpleasant symptoms. Others say they feel fine, but Viagra’s effect is noticeably diminished. However, I don’t recommend taking a high dose of Viagra and to definitely stick with only 20mg of Adderall.

Take warning of this though:

The combination is quite dangerous and could lead to priapism, i.e. an erect cock that will not go down. It can be quite painful and commonly bad cases require medical treatment (even surgery on occasion). This combination and its risks have been well documented in the medical field.

It might not really be safe.

If you take 90mg if Adderall with no tolerance, Viagra probably won’t do shit for you no matter what the dose is.

Hello. I’m new here and I’m not sure if I should post my questions here. I started a thread but only got one reply so far.

I just ordered 13 30mg adderall ir’s. My best sexual experience was adderall combined with sex. no other drugs. However, whenever I do stims I get shriveled drug penis. which is pretty fucking embarassing and a confidence killer.

I have 100mg viagra and I want to combine one full 100mg viagra with 2 30mg adderall ir’s. Someone told me you can get an erection that won’t go away and you’ll have to go to the hospital. I think they called it a priopism or something that sounds like that anyway.

I have no tolerance for amp’s. I did meth once about 12 years ago and I took most of a bottle filled with 5 or 10mg adderall once.

Do you think 60 mg’s of adderall is too much for someone with no tolerance? I’m looking to get really fucked up. I have to time it just right because I’m on a methadone clinic and they drug test me once a week and I know they look for meth amp’s but IDK if the look for just plain amp’s. or if amp salts will give a false positive for meth. Anyway, they norm. test me on Monday or Tuesday and then I’m good till at least the following Monday. I’m normally home from the clinic but around 10am and I’m not working so I plan to plug the 60 mg’s as soon as I get home and hopefully I’ll be able to sleep at night. If I’m up all night I’ll prob. do a piece of one to keep me from looking like death when I get to the clinic.

I think I have ADD/ADHD but my psychiatrist will not diagnose me. I am schizo-affective and have major depressivce disorder. I also have a history of substance abuse so she’s not willing to even screen me. I ordered my adderall over the internet and I couldn’e find pure dexedrine anywhere so I’m stuck with adderall.

Thanks in advance for any advice you can provide.

From what I’ve read mixing Viagra and Amphetamines is a life threatening idea. I’ve done it in the past many times and survived but everyone is different. Also I really hate when people abuse this drug. It’s one thing to take it now and then for recreational purposes, but jeez man by doing this kind of risky behavior you’re just ruining it for the rest of us. You don’t take it to get "fucked up", you take it to be productive, social and a more efficient person. Euphoria is a welcomed side effect that can come without taking such high dosages. In fact, I’ve experienced some pretty negative, very non-euphoric effects from dosages too high. Be careful.

Also try to find a Dr. who will give you the medication. I wouldn’t ever suggest buying or taking them illegally but I do understand it’s hard for some people to get them the correct way, esp without insurance.

Last edited by Matt329; 24-04-2013 at 04:33.

From what I’ve read mixing Viagra and Amphetamines is a life threatening idea. I’ve done it in the past many times and survived but everyone is different. Also I really hate when people abuse this drug. It’s one thing to take it now and then for recreational purposes, but jeez man by doing this kind of risky behavior you’re just ruining it for the rest of us. You don’t take it to get "fucked up", you take it to be productive, social and a more efficient person. Euphoria is a welcomed side effect that can come without taking such high dosages. In fact, I’ve experienced some pretty negative, very non-euphoric effects from dosages too high. Be careful.

Also try to find a Dr. who will give you the medication. I wouldn’t ever suggest buying or taking them illegally but I do understand it’s hard for some people to get them the correct way, esp without insurance.

Well, thanks for the reply.

What makes viagra and adderall so dangerous? I’ll prob. misspell them, but someone told me that adderall is a vasoconstrictor and viagra is a vasodialator.

As far as the high dose, I really don’t know where to start. I’ll have the 30mg ir’s. I guess I’ll try one and see where it goes. To be honest, I don’t even know if the adderall is legit. I’ll know soon enough.

I think I really have ADHD. I’ve always had a hard time sitting still, esp. in school. My mind wanders, I talk too much and change subjects randomly without even taking a breath, my place is always a mess, I’m disorganized, etc. etc..

Unfortunately, I’m an alcoholic and drug addict. I’ve been going to AA for 5 years or so and I’ve only been sober 4 months. well, 2 days really. I took a "whip-it" off of a dying whipped cream bottle 2 days ago and didn’t even feel it. but the intention was still there.

I’m a veteran and get free health treatment at the VA. My psychiatrist won’t even hear me out about the ADD. I think it’s bc she knows I’m an addict and won’t prescribe any controlled substance. Once I told her that my anxiety was crippling me, and she responded right away, saying, "I won’t even consider writing you a controlled substance". She immediately thought I wanted benzos. The addict label can be annoying as shit.

I called an outside dr. and they said they would see me but want me to see a psychiatrist first. I don’t know if that’s reaslly common or not. I plan to try a new doc tomorrow.

What are your experiences getting a script for ADHD? Do just regular doctors prescribe it or did you all need to see a psychiatrist?

I don’t plan to tell them I have an addiction issue. They just plain won’t write a script for a controlled substance when they know you’re an addict.

Any info anyone can supply would be greatly appreciated.

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What Happens When You Overdose on Viagra?

The guitarist for the German emo band Tokio Hotel just overdosed on Viagra! What happens when you pop too many of the diamond-cut erection-makers? Sanjay Gupta didn't return our calls, so let's check Google.

According to the New York Post. 20 year-old Tom Kaulitz took multiple doses of Viagra while the band was on tour in Asia. Their side-effects so debilitated him that he had to take two days off to recover.

Why did the presumably virile Kaulitz decide to take multiple doses of Viagra? Maybe he is pioneering some new, extraordinarily painful guitar technique. Or it could be taking the well-documented trend of old person hipster style (big glasses, Pabst, mustaches) to its logical conclusion. In fact, researchers at California State University have found that recreational use of Viagra is associated with other drug use. Viagra is a hot club drug! Also, idiocy. That has to be a very large part of it. Plus, there's nothing to do in Asia, so he was probably bored.

Onset of symptoms: Kaulitz said that he bought the drugs and popped one, then popped another and "took a few more" when he got back to his hotel room. "The next morning, my head was pounding and everything in front of my eyes was blurry. It wasn't fun anymore. It was pretty bad," Kaulitz said. Kaulitz then had to take a two-day break from touring. Why so much pain from so innocuous a drug? Any guy who resorts to taking Viagara for fun is probably a prolific recreational drug user. Many of these drugs have nitrates. According to the prescription guidelines for Viagara, taking the drug with other drugs containing nitrates could cause your blood pressure to drop to the point hat you "get dizzy, faint, or even have a heart attack or stroke."

Symptoms. So, symptoms of Viagra overdose, according to Tom Kaulitz: blurry vision and head ache. Depending on the dose he may also have experienced irregular heart rhythm and chest pain. And of course uncomfortable penile super-function. This is called Priapsm (Named after the Greek god Priapus, 'noted for his disproportionately large and permanent erection.' He was the god of fist bumps, keg stands and Ultimate Fighting.) And although everyone makes fun of that line in the Viagra commercials urging you to seek medical attention for erections lasting longer than four hours, there is nothing funny about treating priapism. Let's just say it involves shunts.

Prognosis: Kaulitz is back churning out Tokio Hotel's euro pop punk schmaltz. He'll be fine. Unlike this "MAD RUSSIAN". A few women bet the guy 5,000 bucks that he couldn't have sex with them for 12 hours. He did it, but after winning he died of a heart attack. Other possible side effect: In a story that really is probably made up, a Brit claimed that taking too much Viagra turned his vision blue. Just like the pill! That's not how side-effects work, though, so he was probably just angling to get his own reality show.

Actually, this whole episode could open up a new world for drug marketing. Maybe Viagara should sponsor Tokio Hotel, like they do race car drivers. Each show could open with a drug rep shooting Viagra cannons into the crowd of screaming 14 year-olds.

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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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Por supuesto la gente puede sostener esta afirmaciГіn teniendo en cuenta que la verdad. Normalmente se tarda unos los menos un centenar de correos electrГіnicos para aplicar bien ningГєn filtro de spam. De una cosa estoy en una misma posiciГіn para juzgar los pacientes, y la gente normalmente acerca de dГіnde han escuchan sus ventajas y riesgos de las discusiones de mГ­, o la manera en que leen las etiquetas de mГЎs de-los-contadores, o que leen las hojas desmayado sobre las drogas por los farmacГ©uticos. Sildenafil inhibe una enzima llamada fosfodiesterasa-5 (PDE5) que destruye la c – GMP. Este viaje debe estar bien organizado hasta en el Гєltimo minuto durante las vacaciones. Durante los ensayos clГ­nicos de personas que estaban utilizando el fГЎrmaco dicho a los mГ©dicos acerca de los efectos negativos que estaban teniendo junto con la pГ­ldora azul. Genial, pensГі, “oportunidad Nadie debe saber con esta. Estas y frГ­as manos estГЎn utilizando algunos de los signos predominantes con este problema en particular. Aviso ll que simplemente teniendo en cuenta sus fotos que ofrece pura emociГіn. Usted puede comprar muy fГЎcilmente los medicamentos al igual que usted compra a otros medicamentos. Con la PDE5, una enzima, bloqueado, c – GMP podrГ­a desarrollar en el interior del pene y mejorar la circulaciГіn de la sangre allГ­ sin afectar a otras partes del cuerpo durante el uso. Se clasifica como una emergencia relacionada con la salud y un buen nГєmero de casos requieren la eliminaciГіn en el apГ©ndice dolorosa real, tanto con sГіlo laparotomГ­a o laparoscopia. If you might be one of the men, who hide this concern, avoid getting afraid to fix this crisis with cheap Viagra, Cialis or Levitra. Muchos casos diferentes tambiГ©n fueron vistos en celebridades respetables fueron vistos aproximadamente usar estos estilos, mejorando de forma natural el gran atractivo propagaciГіn junto con el pГєblico. La piel necesita cuidados especiales, a fin de tener una sensaciГіn muy suave e hidratada. Si usted vio la Biblia y que ha sido fabricado por Dios, o tal vez usted tiene confianza en la teorГ­a de Darwin de la evoluciГіn y ahora estamos evolucionado despuГ©s de algГєn tiempo, la salud reproductiva es crucial que ambos. En la actualidad, el Viagra para uso vaginal es simplemente no estГЎ disponible; Sin embargo, tal vez va a estar disponible en el futuro. A continuaciГіn, una parte podrГ­a ser agradable de inmediato una vez que llegue, que el paquete debe permitir que usted elija con una selecciГіn de 15 a 20 mujeres usted probablemente desea ver su tiempo con. Viagra genГ©rico puede aflojar con los mГєsculos en el abdomen y puede ayudar a las personas aumentan de libras y prevenir la deshidrataciГіn. Numerosas investigaciones Varios ha informado de que el tadalafil, el ingrediente que se encuentra en el Cialis, mejora sustancialmente las erecciones que se enfrentan los hombres afectados por leve, moderada, junto con la impotencia masculina severa. Estas y frГ­as manos estГЎn utilizando algunos de los signos predominantes con este problema en particular. Sin embargo, algunos salones profesionales expertos tambiГ©n estarГЎn proporcionando luz lГЎser suaves calmantes mГ©todos de tratamiento alternativas, mГ©todos de cirugГ­a de ojos suaves de luz lГЎser, la epidermis tratamientos grГЎficos y otros tipos de tratamientos de medicaciГіn alternativas como baГ±era de lodo y baГ±era de aire de calma. Yo empleado para tener el pelo rubio decolorado con rayas negras dentro de las explosiones que se utilizan de forma aleatoria en el cabello. En un estado no erecto, el flujo de sangre por las arterias estГЎ obligado, mientras que las venas son alrededor de drenaje de la sangre de distancia.

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Un estudio realizado por el profesor Mc Mahon y su equipo del St Luke’s Hospital Complex de Sydney sobre un total de 433 pacientes, revela que el citrato de sildenafilo (Viagra) constituye el tratamiento de elecciРїС—Р…n para la disfunciРїС—Р…n erРїС—Р…ctil.

Durante muchos aРїС—Р…os, la disfunciРїС—Р…n erРїС—Р…ctil ha sido un problema que ha preocupado y ha influido en el modo de vida de cientos de miles de personas en el mundo, fundamentalmente en los varones. Los avances en el campo de la medicina, han hecho que se descubra una sustancia, citrato de sildenafilo (Viagra), que actuando a travРїС—Р…s de unos mecanismos enzimРїС—Р…ticos va a favorecer la erecciРїС—Р…n del pene, y va a permitir el mantenimiento de relaciones sexuales en personas con disfunciРїС—Р…n erРїС—Р…ctil crРїС—Р…nica.

La erecciРїС—Р…n del pene se inicia por unos estРїС—Р…mulos neuropsicolРїС—Р…gicos (deseo sexual) que finalmente producen vasodilataciРїС—Р…n de los espacios sinusoidales y de las arterias situadas en ambos cuerpos cavernosos del pene.

En estado de flacidez, las arterias, arteriolas y espacios sinusoidales situados dentro de los cuerpos cavernosos estРїС—Р…n contraРїС—Р…dos, debido a la contracciРїС—Р…n de los mРїС—Р…sculos de estas estructuras. La erecciРїС—Р…n comienza cuando la relajaciРїС—Р…n de los mРїС—Р…sculos lisos sinusoidales ocasiona la dilataciРїС—Р…n de los sinusoides y el aumento de flujo sanguРїС—Р…neo a los mismos.

El mecanismo fisiolРїС—Р…gico responsable de la erecciРїС—Р…n del pene implica la liberaciРїС—Р…n de РїС—Р…xido nРїС—Р…trico (NO) en los cuerpos cavernoso durante la estimulaciРїС—Р…n sexual. Esta sustancia es un potente vasodilatador, pero para actuar va a utilizar un mediador que es el GMPC (guanosРїС—Р…n monofosfato cРїС—Р…clico).Este mediador producirРїС—Р… la relajaciРїС—Р…n del mРїС—Р…sculo liso del los cuerpos cavernoso del pene, permitiendo la afluencia de sangre y subsiguiente llenado de los mismos.

En los mecanismos de relajaciРїС—Р…n del pene va a intervenir otra enzima que es la fosfodiesterasa tipo 5 (FDE5).РїС—Р…sta va a degradar el GMPC, y por tanto se va a reestablecer la contracciРїС—Р…n de la musculatura lisa de los vasos y sinusoides, y se va a dificultar el flujo de sangre al pene, por lo que РїС—Р…ste retornarРїС—Р… a su estado de flacidez.

El citrato de sildenafilo (Viagra) es un inhibidor potente y selectivo de la fosfodiesterasa tipo 5(FDE5), por lo que al no degradarse el GMPC, aumentarРїС—Р… potentemente el efecto relajante del РїС—Р…xido nРїС—Р…trico, y favorecerРїС—Р… la erecciРїС—Р…n del pene.

El profesor Mc Mahon CG y su equipo del St. Luke’s Hospital Complex de Sydney (Australia), realizaron un estudio con el objetivo de poner de manifiesto la eficacia, seguridad y aceptaciРїС—Р…n por parte del paciente del citrato de sildenafilo (Viagra) como tratamiento para la disfunciРїС—Р…n erРїС—Р…ctil. РїС—Р…ste constaba de un total de 433 pacientes con disfunciРїС—Р…n erРїС—Р…ctil crРїС—Р…nica. La evaluaciРїС—Р…n se llevРїС—Р… a cabo mediante entrevistas periРїС—Р…dicas y mediante un cuestionario con 15 parРїС—Р…metros, tales como: grado de respuesta y satisfacciРїС—Р…n del tratamiento por parte del paciente y de la pareja, comparaciРїС—Р…n con otros tratamientos previos que hubiese recibido, efectos adversos y calidad de vida de paciente y pareja.

El estudio revela, que aquellos pacientes con disfunciРїС—Р…n erРїС—Р…ctil de causa psicolРїС—Р…gica responden mejor que aquellos que presentan una disfunciРїС—Р…n de causa orgРїС—Р…nica.

Un 30,8% de pacientes con disfunciРїС—Р…n erРїС—Р…ctil debido a prostatectomРїС—Р…a y un 80% debido a obstrucciРїС—Р…n de senos cavernosos, son capaces de obtener una erecciРїС—Р…n adecuada para mantener relaciones sexuales normales.

En cuanto a la comparaciРїС—Р…n de la terapia de inyecciРїС—Р…n intracavernosa de sustancias vasoactivas y la administraciРїС—Р…n de sildenafilo (Viagra) vРїС—Р…a oral, se puede apreciar que:

Un 29,9% de pacientes que han respondido bien a la inyecciРїС—Р…n intracavernosa, son refractarios al sildenafilo (Viagra), es decir, no responden ante РїС—Р…l.

Un 33,3% de pacientes que no han respondido a la inyecciРїС—Р…n intracavernosa, sРїС—Р… que van a responder al sildenafilo (Viagra).

Un 43,6% de pacientes que habРїС—Р…an sido tratados previamente con inyecciРїС—Р…n intracavernosa consideran que la respuesta obtenida con sildenafilo (Viagra) es inferior a la producida por la inyecciРїС—Р…n.

Un 62,4% de los pacientes van a apreciar efectos adversos en el tratamiento con sildenafilo (Viagra), siendo un 56,4% leves, un 38,3% moderados y un 5,3% severos. Esto va a provocar que un 6,1% de los pacientes abandone la terapia con sildenafilo (Viagra).

Enrojecimiento cutРїС—Р…neo (33,5%).

Dolores de cabeza (23,4%).

CongestiРїС—Р…n nasal (12,6%).

Dispepsia: digestiРїС—Р…n pesada y difРїС—Р…cil (10,1%).

La calidad de vida de los pacientes mejorРїС—Р… en un 51,5% y la de su pareja en un 43,1%.

Los resultados del estudio demuestran que el citrato de sildenafilo (Viagra) constituye el tratamiento de elecciРїС—Р…n para la disfunciРїС—Р…n erРїС—Р…ctil.

A pesar de que un alto porcentaje de pacientes se queja de efectos adversos, РїС—Р…stos son considerados como leves y rara vez condicionan el abandono del tratamiento.

Se ve tambiРїС—Р…n que existe una tendencia por parte de los pacientes que han sido tratados previamente con inyecciРїС—Р…n intracavernosa de sustancias vasoactivas, a continuar con esta terapia a pesar de haber respondido al sildenafilo (Viagra), por lo que tambiРїС—Р…n deberemos tenerla en cuenta como una alternativa en el arsenal terapРїС—Р…utico de la disfunciРїС—Р…n erРїС—Р…ctil.

"Eficacia, seguridad y aceptaciРїС—Р…n por parte del paciente del citrato de sildenafilo como tratamiento para la disfunciРїС—Р…n erРїС—Р…ctil".

Mc Mahon CG, Samali R, Johnson H.

J Urology 2000 Oct. 164:4-1192-6.

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