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Actavis Launches Generic Viagra® in Europe as Patents Expire

ZUG, SWITZERLAND–(Marketwired – Jun 24, 2013) – Actavis, Inc. ( NYSE. ACT ), a leading global specialty pharmaceutical company, today announced that it has launched Sildenafil Actavis 25 mg, 50 mg and 100 mg tablets in 11 major Western-European markets on market formation. Sildenafil Actavis, the generic equivalent of Pfizer’s Viagra®, is prescribed to treat erectile dysfunction.

Actavis’ product was launched immediately after the patents expired in Austria, Denmark, France, Germany, Ireland, Italy, The Netherlands, Spain, Sweden, Switzerland and the United Kingdom.

Actavis first launched Sildenafil tablets in Bulgaria in June 2009 – the first generic Sildenafil to enter the patent-free Bulgarian market – and has since launched the product in various other patent-free markets in Europe, including Iceland and Malta. Sildenafil Actavis is manufactured and developed by Actavis, in Malta and Iceland respectively.

According to IMS Health, Viagra® had sales of EUR382.2 million in Europe for the 12 months ending March 31, 2013.

Actavis, Inc. ( NYSE. ACT ) is a global, integrated specialty pharmaceutical company focused on developing, manufacturing and distributing generic, brand and biosimilar products. Actavis has global headquarters in Parsippany, New Jersey, USA.

Operating as Actavis Pharma, Actavis develops, manufactures and markets generic, branded generic, legacy brands and Over-the-Counter (OTC) products in more than 60 countries.

Actavis Specialty Brands is Actavis’ global branded specialty pharmaceutical business focused in the Urology and Women’s Health therapeutic categories. Actavis Specialty Brands also has a portfolio of five biosimilar products in development in Women’s Health and Oncology. Actavis Global Operations has more than 30 manufacturing and distribution facilities around the world, and includes Anda, Inc. a U.S. pharmaceutical product distributor.

For press release and other company information, visit Actavis’ Web site at www.actavis.com.

Statements contained in this press release that refer to non-historical facts are forward-looking statements that reflect Actavis’ current perspective of existing information as of the date of this release. It is important to note that Actavis’ goals and expectations are not predictions of actual performance. Actual results may differ materially from Actavis’ current expectations depending upon a number of factors, risks and uncertainties affecting Actavis’ business. These factors include, among others, the impact of competitive products and pricing; the timing and success of product launches; difficulties or delays in manufacturing; the availability and pricing of third party sourced products and materials; successful compliance with governmental laws, rules and regulations applicable to Actavis and its third party manufacturers’ facilities, products and/or businesses; changes in the laws and regulations affecting among other things, pricing and reimbursement of pharmaceutical products; and such other risks and uncertainties detailed in Actavis’ periodic public filings with the Securities and Exchange Commission, including but not limiting to Actavis’ Quarterly Report on Form 10-Q for the quarter ended March 31, 2013 and Actavis’ annual report on Form 10-K for the year ended December 31, 2012. Except as expressly required by law, Actavis disclaims any intent or obligation to update these forward-looking statements.

Viagra® is a registered trademark of Pfizer, Inc.

This announcement is distributed by Thomson Reuters on behalf of Thomson Reuters clients. The owner of this announcement warrants that:

(i) the releases contained herein are protected by copyright and other applicable laws; and

(ii) they are solely responsible for the content, accuracy and originality of the information contained therein.

Source: Actavis via Thomson Reuters ONE

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Hackmatack Playhouse was founded in 1972 by S. Carleton Buy Viagra In Europe. 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 Buy Viagra In Europe family farmstead. The property was purchased by the first Buy Viagra In Europe (then Gubtail) to make the long trip to “New England” from native British Isles in the mid 1600’s. Thomas Buy Viagra In Europe 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 Buy Viagra In Europe 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 Buy Viagra In Europe 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 Buy Viagra In Europes.

Prior to the year of 1972 when the theatre was established, the Buy Viagra In Europe 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 Buy Viagra In Europe 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 Buy Viagra In Europe’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 Buy Viagra In Europe 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 Buy Viagra In Europe 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 Buy Viagra In Europe 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 Buy Viagra In Europe, prepare a load of lumber for the newest construction project.

The Buy Viagra In Europe 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 Buy Viagra In Europe 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 Buy Viagra In Europe 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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Natural Form Of Viagra

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

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Does natural Viagra exist?

By Dr John Briffa 10:29 GMT 24 Oct 2001, updated 15:10 GMT 24 Oct 2001

A commonly held belief is that women reach their sexual peak later in life than men. This may be true, but a recent study published in the medical journal Fertility And Sterility found that women generally experience a reduction in their sexual responsiveness as they age.

While some of this may be due to the effects of the menopause, the research suggests it is also a product of the ageing process.

Dwindling sexuality does not seem to be confined to women, either, as shown by the runaway success of the drug Viagra. Despite Viagra’s popularity, however, a recent study found that little more than half the men who try the drug are using it three years later.

Also, a significant proportion of them found it necessary to use a substantially increased dose to get the same effect. Fortunately, nature offers various remedies for boosting libido and enhancing sexual pleasure.

Sexual responsiveness is very dependent on the supply of blood to the genitals. Enhanced blood flow to the penis can do much to improve a man’s ability to attain and maintain an erection.

In this respect, the herb Ginkgo biloba has much to offer. Renowned as a circulation enhancer, Ginkgo biloba was found in one study to help 78 per cent of men with impotence.

The beneficial effects of Ginkgo biloba may take three or more months to become apparent, though it does appear to be a safe, natural alternative to Viagra for men.

It may have significant benefits for women, too. There is growing awareness that improved blood supply to the female sexual organs can enhance sexual sensation.

I have seen several patients who experienced a subjective enhancement in sexual pleasure after taking Ginkgo biloba long-term.

Another herb which may help improve sexual function in both men and women is Damiana. Damiana, which grows wild in Central America and Mexico, was the favourite aphrodisiac of the ancient Mayan people.

While its precise effect on the body is not known, Damiana’s botanical name – Turnera aphrodisiaca – hints at its libido-enhancing effects.

Its effects take hold quite quickly after ingestion, making it ideal for use on an ‘as required’ basis.

For rapid absorption into the body, Damiana is probably best taken in tincture (alcoholic extract) form. One teaspoonful should be taken about one hour before sex.

The herb Panax ginseng is another sexual stimulant. This has been used for more than 2,000 years in Eastern medicine as a tonic.

Many women who take Panax ginseng find that it improves their libido. In men, one study found that it brought about a 60 per cent improvement in the symptoms of impotence, while at the same time enhancing sexual appetite.

Panax ginseng is usually taken for periods of two to three weeks, interspersed with break periods of one to two weeks.

Catuba, a species of evergreen tree which grows in the Amazon rainforest, is another natural remedy for enhancing libido. The inner bark of this tree has been revered as a potent aphrodisiac by the Brazilian people for hundreds of years.

When the Brazilian government researched more than 100 plants used to treat sexual problems, only three were singled out for further research. Catuaba was one of them. You can buy it in health food stores.

Another herb which is commonly used to help bolster sexual energy in women is Angelica sinensis.

In Asia, Angelica is considered to be the ‘female ginseng’. It is well known to have general tonic action in the female body, and is thought to improve gynaecological function.

Historically, Angelica has been the aphrodisiac of choice for women in the East. Angelica should be taken as directed on the packaging.

Next Stories 1/30

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler’s educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

For centuries, men have tried all sorts of natural remedies for erectile dysfunction (ED ) — the repeated inability to get or maintain an erection firm enough for sexual intercourse. But do they really work? It is simply not scientifically known at this point. Furthermore, you take these remedies at your own risk, because their safety profiles have not been established. What follows are commentaries by experts and reviews in the field of alternative treatments that are available over the counter for erectile dysfunction and impotence .

Causes of erectile dysfunction (impotence)

“Just because there is evidence doesn’t mean it’s good evidence,” says Andrew McCullough, MD, associate professor of clinical urology at New York University Langone Medical Center in New York City, and one of the original clinical investigators for the ED drug Viagra (sildenafil ). “And before men with ED start down the naturopathic route, it’s smart to make sure that there isn’t some underlying medical condition that needs to be corrected.” Moreover, it is estimated that 30 million American men have erectile dysfunction. and 70% of cases are a result of a potentially deadly condition like atherosclerosis. kidney disease. vascular disease. neurological disease, or diabetes. Additionally, ED can also be caused by certain medications, surgical injury, and psychological problems.

Medically Reviewed by a Doctor on 6/29/2016


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Cialis Viagra Levitra Comparison

The deciding factors that influence a person’s decision when choosing between Cialis, Viagra and Levitra are ultimately safety and dependability. You may also consider checking how each medication can be taken, when it should be taken and the risk of side effects during or after treatment before you make a purchase. This article attempts to shed light on these topics by weighing up the advantages of Cialis. Viagra and Levitra one by one. By offering clear, practical information on the aspects of these three brands of oral impotence treatment you can make an informed choice on how to tackle your impotence problem with medication.

Cialis, Viagra, Levitra – are they safe for me to use?

No prescription drug can be released for sale without authorisation from the FDA, (the Food and Drink Administration) the regulating body that has the final say on whether a medicinal aid is safe for public use. The manufacturers of Cialis, Viagra and Levitra have all had clearance from the FDA to market their products worldwide. The only legal way to obtain one of these genuine impotence drugs is to ask your doctor to write you a prescription or complete a medical consultation at an online clinic, such as 121doc.

Cialis, Viagra and Levitra – how do they work?

When reading about Cialis vs. Viagra vs. Levitra you will become familiar with the term PDE-5. It is a chemical compound that builds up within the body, restricting sufficient blood flow to the penis in impotent men. Cialis, Viagra and Levitra each work to inhibit PDE-5 by widening the vessels in your penis. This action allows blood to be trapped in the penis and harden, thereby causing a firm erection. The main difference in their mode of action is that Viagra and Levitra can achieve this for a limited amount of time, as each tablet has a life expectancy of 4-5 hours. Cialis however can last for up to 36 hours, you should be capable of getting a firmer erection at any time within this window providing you are aroused.

Cialis, Viagra, Levitra – when to take them

As shown in the comparison table below, each of the three drugs can be taken as and when you feel in the mood for sex, rather than on a fixed dosage schedule. Usually, these medications take affect within 30-60 minutes and can be used with or without water. When using Viagra or Levitra, no more than one tablet must be taken per 24 hours as this may heighten your risk of side effects. Men taking Cialis have greater flexibility and need only to take a tablet once every 36 hours, due to its longer lasting-effects.

Cialis, Viagra and Levitra – side effects and warnings

Another way to establish which medication is best suited to you is to consider the probability of side effects. The fact that Cialis, Viagra and Levitra affect the body is the same way means the amount and severity of side effects, if produced, will not be dissimilar. Some of the most commonly reported side effects include headache, facial flushing, stomach upset, and stuffy or runny nose. Before taking Cialis, Viagra or Levitra, make sure that you are not allergic to any of the ingredients used.

Levitra vs. Cialis and Viagra – clinical trials

Levitra also shares similar side effects to Cialis and Viagra, but this medication is more suited to men with underlying health conditions such as high blood pressure, high cholesterol and diabetes. Levitra has been proven to work in men who have failed to respond to a Viagra dosage, it is also seen as a sensible second choice for those men who cannot use Cialis.

Cialis vs. Viagra vs. Levitra – ordering online at 121doc

It’s important to choose the drug that you know is right for you and if for some reason these medications are not right for you then you can visit our ED treatment page for more impotence treatments. Cialis is quickly becoming the number one treatment for impotence as more men are seeking a trusted method of tackling impotence, such as Viagra but without such short-lived effects. If you too are thinking of obtaining a course of Cialis tablets you’ll be happy to know there is a fast and convenient way to do so. Select a treatment from the price table below and take a free online medical consultation at 121doc. If approved by our doctor, your Cialis tablets may be delivered within just 24 hours.

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Comparison of Viagra, Levitra and Cialis

Male sexual dysfunction is one of the most common health problems affecting men and is more common with increasing age. Chronic ED affects about 5% of men in their 40s and 15пїЅ25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70.

In around 95% of the cases, a satisfactory treatment can be found. Erectile dysfunction is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for erectile dysfunction.

Three PDE-5 inhibitors

Currently, there are three oral medications approved by the FDA for the treatment of erectile dysfunction: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They block the enzyme phosphodiesterase type 5 (PDE-5) and belong to a class called phosphodiesterase (PDE) inhibitors.

Since introduction of the first PDE-5 inhibitor Viagra, there has been a fundamental change in the treatment of erectile dysfunction. Although there are a number of options available for non-surgical treatment, it is clear that oral therapy has revolutionized the treatment approach to patients with erectile dysfunction. The development of the PDE-5 inhibitors Levitra and Cialis prompts the question of whether and how these sexual medications differ in terms of their efficacy and adverse effects.

Viagra was the first and is probably the most famous of the three PDE-5 inhibitors used to treat erectile dysfunction. Viagra was approved for erectile dysfunction in March 27, 1998. Viagra is manufactured by Pfizer, Inc.

Levitra was the second PDE-5 inhibitor to come to market in the United States, and it was approved by the FDA in August 19, 2003. Levitra is manufactured by Bayer Pharmaceuticals Corporation.

Cialis was the third PDE-5 inhibitor to come to market in the United States and was approved by the FDA at the end of November 21, 2003. Cialis is manufactured by Lilly ICOS LLC.

The major advantage of these medications for sexual enhancement is that they do not cause an erection at inappropriate times, because they act only in response to sexual stimulation. If there is no sexual stimulation drug remains in the background. All three are taken orally prior to planned sexual activity, acting to increase blood flow in the penis in response to sexual stimulation. However, there are important differences between the three, differences that could influence safety, specificity, duration of action, adverse effects, and ultimately, public acceptance within this class.

back pain, muscle aches, nasal congestion, facial flushing, dizziness

Mechanism of action

Sildenafil, vardenafil, and tadalafil do not directly cause an erection of the penis, but they alter the body’s response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area.

All PDE-5 inhibitors have demonstrated excellent efficacy in general and in specific populations (eg, men with diabetes mellitus or those who have undergone radical prostatectomy). Viagra, at 84%, is slightly more effective than Levitra at 80% and Cialis at 81%.

Viagra and Levitra differ only minimally in terms of their structure, while Cialis differs markedly from Viagra and Levitra in terms of its molecular structure, which is also reflected in pharmacokinetic differences.

  • Viagra. 25 mg, 50 mg 100 mg tablets
    • Onset of action. 30 minutes (effect delayed if taken with food)
    • Duration of action. 4 to 5 hours
  • Levitra. 2.5 mg, 5 mg, 10 mg, 20 mg tablets
    • Onset of action. 25 minutes (effect delayed by fatty meal)
    • Duration of action. 4 to 5 hours
  • Cialis. 5 mg, 10 mg, 20 mg tablets
    • Onset of action. 16-45 minutes (effect NOT delayed by food)
    • Duration of action. 36 hours

Viagra does not work as well as it would otherwise if you eat a high-fat meal around the time you take it. Viagra should be taken on an empty stomach. Levitra may be slightly less effective if you eat a high-fat meal, but a moderate-fat meal does not reduce its effectiveness. Cialis works without regard to what you eat.

Viagra and Levitra have similar half-lives, and onset and duration of action. Cialis has a slower onset of action and longer duration of action, which is attributed to its longer half-life.

Men who wish for spontaneity may opt for Cialis, which may allow for successful intercourse up to 36 hours postdose, even though it takes longer to reach peak effect. The considerably longer duration of effect for Cialis will likely allow less frequent dosing and greater impulsiveness between partners, but also could potentially prolong adverse effects.

PDE-5 inhibitors are primarily excreted via the fecal route with varying percentages eliminated renally.

The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient.

The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for men who take other medicines or have conditions that may decrease the body’s ability to use the drug. Levitra is also available in a 2.5 mg dose.

None of these PDE-5 inhibitors should be used more than once a day.

Most common side effects:

  • Viagra. headache, epistaxis, flushing, indigestion, dizziness, nasal congestion, abnormal vision
  • Levitra. headache, flushing, indigestion, nausea, dizziness, nasal congestion
  • Cialis. headache, indigestion, back pain

PDE-5 inhibitors are generally well tolerated. Side effects include headache, flushing, dyspepsia, and nasal congestion.

Visual abnormalities are encountered with Viagra, but are less likely with Levitra and unlikely with Cialis. Flushing and dyspepsia that are associated with Viagra and Levitra are less common with Cialis. Back pain and muscle aches (myalgia) may occur with Cialis, but are unusual with either Viagra or Levitra. Side effects of Cialis tend to last longer, but are less marked than with the other drugs.

Precautions and contraindications

All PDE-5 inhibitors are absolutely contraindicated in persons who take organic nitrates, because they induce vasodilation.

The FDA no longer considers concomitant use of alpha-blockers a contraindication to use of PDE-5 inhibitors. However, persons on alpha-blockers must be on a stable dose of alpha-blocker prior to using a PDE-5 inhibitor.

Since both Viagra and Levitra have moderate vasodilatory and hypotensive effects, they should not be given in the presence of marked arterial or orthostatic hypotension, and should only be administered with caution in aortic stenosis or hypertrophic obstructive cardiomyopathy.

Men who have had a heart attack or stroke within the past 6 months and those with certain medical conditions (e.g. uncontrolled high blood pressure, severe low blood pressure or liver disease, unstable angina) that make sexual activity inadvisable should not take Cialis. Dosages of the drug should be limited in patients with kidney or liver disorders.

The differences between the 3 drugs are not great. All appear to be effective and safe. Levitra has less side effects compared to Viagra and lasts about the same time as Viagra in the body. Cialis has few side effects and lasts longer in the body to increase spontaneity than either Levitra or Viagra and there is no reduction in absorption when Cialis is taken with food. However, the longer half-life imposes increased risk for drug interactions.

  • 1. The Merck Manual of Medical Information. Mark H. Beers et al. eds. 2nd Home Edition. Whitehouse Station, NJ: Merck; 2003.
  • 2. Doggrell SA. Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction. Expert Opin Pharmacother. 2005 Jan;6(1):75-84.
  • 3. Viagra Prescribing Information PDF
  • 4. Levitra Prescribing Information PDF
  • 5. Cialis Prescribing Information PDF

Published: May 05, 2007
Last updated: March 24, 2016

Compare Viagra, Levitra, Cialis

When a man can’t get an erection to have sex or can’t keep an erection long enough to finish having sex, it’s called erectile dysfunction. Erectile dysfunction is the preferred term rather than the more commonly used term of impotence. Sexual dysfunction is often associated with disorders such as diabetes, hypertension, coronary artery disease, neurologic disorders, and depression. In some patients, sexual dysfunction may be the presenting symptom of such disorders. Additionally, ED is often an adverse effect of many medications.

Although there are a number of options available for non-surgical treatment of sexual dysfunction, it is clear that oral therapy has revolutionized the treatment approach to men with erectile dysfunction.

The FDA approved Viagra in 1998, and it became the first oral therapy for erectile dysfunction on the market. Vardenafil hydrochloride (Levitra) was approved in September, 2003, and Tadalafil (Cialis) was approved in November, 2003. Viagra, Levitra and Cialis work in much the same way. These PDE-5 inhibitors share many similarities, but they have differences as well.

Although sildenafil citrate (Viagra), vardenafil HCl (Levitra) and tadalafil (Cialis) sometimes are called sexual enhancers, they do not directly cause an erection of the penis, but alter the body’s response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area.

PDE-5 inhibitors can be used to treat sexual dysfunction caused by high blood pressure, problems affecting nerve function, prostate surgery, side effects of medicines, emotional or psychological ED. Although they work in the similar way, they are not the same in all respects. Sildenafil and vardenafil have similar molecular structures, but tadalafil is structurally different.

  • The success rate of sildenafil amounts to an average of over 80%.
  • Several studies have shown a benefit of Viagra (sildenafil) for women with sexual arousal disorder, including an increased ability to lubricate, achieve orgasm, and experience sexual satisfaction.
  • Onset of action: 30-60 minutes.
  • Duration of action: up to 4 h.
  • Fatty food is known to delay the absorption of Viagra.
  • Contraindicated in persons taking organic nitrates; alpha-blockers (in the current labeling the interaction is considered a Precaution.)
  • Vision disturbances are more common after taking Viagra, than after other PDE-5 inhibitors. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases and a number of studies have linked sildenafil use with nonarteritic anterior ischemic optic neuropathy.
  • The patent on Viagra expires in the early 2012.
  • Vardenafil is more potent and selective biochemically than other PDE-5 inhibitors.
  • Onset of action: 25 minutes (the quickest).
  • Duration of action is up to 5-6 hours, little longer than that reported for Viagra.
  • Not recommended in patients taking type 1A (such as quinidine, or procainamide) or type 3 antiarrhythmics (such as sotalol, or amiodarone).
  • The advantage that vardenafil has over sildenafil is that it does not alter color perception, a rare side effect which occurs with sildenafil (because vardenafil does not inhibit phosphodiesterase-6).
  • Vardenafil is contraindicated in patients taking organic nitrates, alpha-blockers (in the current labeling the interaction is considered a Precaution).
  • Fatty food delays the absorption of vardenafil. However, it is less sensitive than Viagra to food intake.
  • The patent on Levitra expires in 2018.
  • The most astounding feature of tadalafil is its length of action. It has long half life, which ensures 36-hour duration of effectiveness, allowing for more flexibility and spontaneity in sexual relations. This feature greatly distinguishes Cialis from its two predecessors Viagra and Levitra.
  • Onset of action: 16 to 30 minutes.
  • Tadalafil has the lowest prevalence of visual side effects. However, the myalgia seems to be more common with tadalafil, approaching 10%.
  • Tadalafil is contraindicated in patients taking organic nitrates, alpha-blockers.
  • Cialis is protected by a patent until 2016.

From a safety perspective, all three Viagra, Levitra and Cialis share similar drug interactions involving CY3A4 inhibitors and a contraindication in the use of nitrates. The side effects are similar for all three PDE-5 inhibitors and include headache, flushing, nasal congestion, and dyspepsia.

Which is better Viagra, Cialis or Levitra?

Cialis clearly works for 36 hours or more, making it an ideal choice for men who are very sexually active.

For men who develop angina and therefore might require an organic nitrate (such as nitroglycerine), the longer duration of action is a disadvantage. Also, some people are uncomfortable having the active ingredient in their system for an extended period of time.

Levitra works a little longer than Viagra, and gives a quite sufficient window of effectiveness for spontaneous sexual experience. Vardenafil is the most potent molecule of all PDE-5 inhibitors and works better in hard-to-treat cases of impotence [2].

Viagra clearly works for women with sexual arousal disorder [1].

Implicit advantage of Viagra: Many men have been ordering high-dose pills and splitting them, because Pfizer’s Viagra blue pills are pretty large (14mm) and easy to split.

Levitra, a small hard orange 8mm pill, is much more difficult to cut. Cialis 12mm pills are also inconvenient to split because of their asymmetrical almond shape.

Keep in mind that you don’t have to make a definitive choice and stay on one ED medication all the time. You can choose all three and alternate between them depending on your requirements. For example, Viagra or Levitra on weekdays and Cialis on weekend or holiday.

  • 1. Schoen C, Bachmann G. Sildenafil citrate for female sexual arousal disorder: a future possibility? Nat Rev Urol. 2009 Apr;6(4):216-22.
  • 2. Wang HY, Huang YF. Vardenafil for refractory erectile dysfunction: the latest advances. Zhonghua Nan Ke Xue. 2009 Nov;15(11):1035-8.

Last Updated: December 14, 2013


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Comment les pilules fonctionnent-elles pour le traitement de la dysfonction Г©rectile? Est-ce qu’il y a de l’accoutumance quand on prend les pilules contre la dysfonction Г©rectile? Ne pas dГ©velopper la dГ©pendance aux pilules de l’Г©rection? Quels sont les effets secondaires et contre-indications? Quelles sont les interactions mГ©dicamenteuses les plus connues?

Donc, la pilule contre la dysfonction Г©rectile est une premiГЁre thГ©rapie par laquelle il faut commencer pour soigner les toutes formes de DE. Aujourd’hui le Viagra, le Cialis et le Levitra sont les mГ©dicaments en forme de comprimГ©s disponibles dans tout le monde qui sont vraiment trГЁs efficaces dans le traitement de la dysfonction Г©rectile. GГ©nГ©ralement l’efficacitГ© de toutes les autres pilules qui apparaissent dans les publicitГ©s est souvent inventГ©e (et l’efficacitГ© n’est pas toujours prouvГ©e) par leurs fabricants et ne diffГЁre pas d’ “amusette”. Tous ces “impazy”, ces “patins dorГ©s” nationals, les “veromaksy”, les “superyohimbeekstrakty” de l’étranger et beaucoup d’autres tisanes ne reprГ©sentent qu’un moyen de gagner de l’argent et sont orientГ©s Г  la population confiante Г  la publicitГ© primitive.

Les produits de ce groupe agissent sélectivement dans les tissus vasculaires du pénis et sont pratiquement inoffensifs. Ils ne causent pas d’effets négatifs persistants pendant la prise régulière et à long terme. L’accoutumance à des pilules contre la dysfonction érectile ne se développe pas. Sauf la dépendance purement psychologique. Une fois vous allez essayer une pilule contre la dysfonction érectile et vous allez sentir que la qualité est la meilleure, vous sentirez la sensualité que vous avez perdu avant, et vous ne voudrez plus lâcher le Viagra, le Cialis ou le Levitra. Quand une fois vous allez vous retrouver devant le volant d’une voiture de grande marque de meilleure qualité, vous ne voudrez plus reprendre le volant de la voiture Zhigulj. C’est la même situation avec les produits pour le traitement de la dysfunction érectile!

Les principaux effets secondaires du Viagra, du Cialis, du Levitra et leur frГ©quence sont rГ©sumГ©es au tableau в„–1.

Tableau №1. La fréquence (%) d’effets secondaires en certaines dosages (mg) de pililes contre la dysfunction érectile.

La frГ©quence d’effets secondaires dГ©pend de dosage et de sensibilitГ© individuelle. Cela dГ©pend aussi de la prise de la nourriture avant la prise d’une pilule pour une Г©rection bien forte. Quand vous avez bien mangГ© la frГ©quence d’effets secondaires, ainsi que l’efficacitГ© des mГ©dicaments est plus basse.

L’intolérance (allergie) et la prise simultanée de nitrates organiques (Nitroglycérine, Sustak, Nitrong, Nitrosorbid, Erhinite, et d’autres) sont les contre-indications principales des pilules pour le traitement de la dysfonction érectile. La prise simultanée de nitrates organiques avec les pilules contre la dysfonction érectile peut amener à la baisse de la pression artérielle fatale.

  • Service sГ©curisГ© & confidentiel Toutes vos informations mГ©dicales sont cryptГ©es et sont rГ©servГ©es Г  l’usage de nos docteurs. Vos commandes sont livrГ©es dans des colis neutres sans aucune mention de leur contenu ni de notre nom de marque.
  • Traitements authentiques Nos pharmacies sont duement homologuГ©es et ne dГ©livrent que des traitements authentiques, en provenance directe des plus grands laboratoires pharmaceutiques.
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Effets secondaires de Cialis

Cialis des laboratoires Lilly est vendu uniquement sur ordonnance. C’est un mГ©dicament largement adoptГ© par les personnes de sexe masculin souffrant de problГЁmes d’Г©rection. La plupart des hommes prennent ce traitement contre l’impuissance sans rencontrer le moindre effet secondaire. Cependant, comme tout mГ©dicament sur ordonnance Cialis peut provoquer chez certains des effets secondaires. Ces effets indГ©sirables de Cialis sont habituellement bГ©nins et ne prГ©sentent aucun danger. Il faut savoir que chaque personne rГ©agit diffГ©remment Г  un mГ©dicament. Certains vont ГЄtre sujets Г  plusieurs effets indГ©sirables alors que d’autres ne ressentiront aucun effet secondaire.

Les effets secondaires de Cialis sur l’organisme ont Г©tГ© largement Г©tudiГ©s Г  l’occasion de nombreux essais cliniques avant sa mise sur le marchГ©. Plus de 15 000 personnes ont Г©tГ© traitГ©s au Cialis durant ces Г©tudes. Depuis sa mise sur le marchГ©, Cialis a aidГ© des millions de couples Г  retrouver une vie sexuelle Г©panouie.

Effets secondaires communs

Certains effets indГ©sirables apparaissent communГ©ment en dГ©but de traitement. Ils sont gГ©nГ©ralement bГ©nins et disparaissent rapidement. En cas de persistance ou d’effets plus gГЄnants, il est conseillГ© de consulter un mГ©decin.

Effets secondaires peu frГ©quents

Rencontrer ce type d’effets (voir tableau ci-aprГЁs), ne doit pas vous alerter. Ces effets indГ©sirables sont moins frГ©quents bien que rencontrГ©s dans certains cas. Le plupart de ces symptГґmes disparaissent aprГЁs quelques heures. Si tel n’est pas le cas, il est recommandГ© de consulter un mГ©decin.

Effets secondaires rares

Ces effets secondaires de Cialis sont rares et plus sГ©rieux. Ils affectent environ 1 patient sur 10 000. Si l’un de ces effets se produit, vous devez contacter un mГ©decin au plus vite. Ces effets peuvent rГ©sulter de la prise de plusieurs traitements combinГ©s provoquant une interaction mГ©dicamenteuse. Il peut Г©galement s’agir d’une rГ©action allergique au tadanafil ou un autre problГЁme de santГ©. Dans tous les cas, un diagnostic mГ©dical est indispensable.

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Erectile Dysfunction Health Center

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

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

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

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

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

Alprostadil to the Rescue

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

Viagra, ED, and Alcoholic Drinks


Erectile dysfunction (ED) is a problem with getting and maintaining an erection that’s firm enough to have sexual intercourse. All men have trouble getting an erection from time to time, and the likelihood of this problem increases with age. If it happens to you often, though, you may have ED.

Viagra is a prescription drug that can help men with erectile dysfunction. For many people, romance means candlelight, soft music, and a glass of wine. The little blue pill, Viagra, can be part of this picture, but only if you drink small or moderate amounts of alcohol.

Viagra and alcohol

Drinking alcohol in moderation seems to be safe when you take Viagra. There seems to be no clear sign that the risks of alcohol use are made worse by Viagra. A study published in Clinical Pharmacology and Therapeutics found no adverse reactions between Viagra and red wine. However, research on this topic is limited.

Still, just because Viagra and alcohol don’t seem to interact doesn’t mean that it’s a good idea to use them together. This is because chronic alcohol use is a common cause of ED. It’s so common, in fact, that a slang term for ED in Great Britain is “brewer’s droop.” So while you’re treating ED with Viagra, you may be doing yourself a disservice by mixing the drug with alcohol.

Alcohol and ED

Scientists at Loyola University reviewed 25 years of research on the effects of alcohol use on the male reproductive system. Here are some of their findings. These effects have to do with alcohol in general and are not specific to combining Viagra with alcohol. Still, if you have erectile dysfunction, you may want to consider how alcohol can influence your sexual health and performance.

Effects on testosterone and estrogen

Both binge drinking and chronic alcohol use can affect testosterone and estrogen levels.

Testosterone in men is made in the testes. It plays a role in many functions of the body. It’s also the hormone most closely linked to male sexuality, and it’s responsible for the development of sexual organs and sperm.

Estrogen is mainly a female hormone, but it’s also found in men. It’s linked with the development of female sexual characteristics and reproduction.

If you’re a man, consuming more than a moderate amount of alcohol may lower your testosterone levels and raise your estrogen levels. Reduced testosterone levels combined with higher levels of estrogen may feminize your body. Your breasts may grow or you may lose body hair.

Effects on the testicles

Alcohol is toxic to testicles. Sources say consuming a lot of alcohol over time can cause shrinkage in your testicles. This reduces the volume and quality of your sperm.

Effects on the prostate

According to some sources. alcohol abuse may be associated with prostatitis (inflammation of the prostate gland). Symptoms may include swelling, pain, and problems with urination. Prostatitis may also be linked with erectile dysfunction.

Causes of erectile dysfunction

To understand why ED happens, it helps to know how an erection occurs. An erection actually starts in your head. When you become aroused, signals in your brain travel to other parts of your body. Your heart rate and blood flow increase. Chemicals are triggered that make blood flow into hollow chambers in your penis. This causes an erection.

In ED, however, an enzyme called protein phosphodiesterase type 5 (PDE5) interferes with this process. As a result, there’s not an increase in blood flow to the arteries in your penis. This stops you from getting an erection.

ED can be caused by a number of factors. These can include health issues such as:

  • increasing age
  • diabetes
  • medications, such as diuretics, blood pressure drugs, and antidepressants
  • multiple sclerosis
  • thyroid disease
  • Parkinson’s disease
  • high blood pressure
  • peripheral vascular disease
  • prostate cancer, if you’ve had your prostate removed
  • depression
  • anxiety

You can address some of these issues by trying these exercises to eliminate ED. Erectile dysfunction can also be caused by your habits, however. These can include:

  • smoking
  • illegal drug use
  • chronic alcohol use

How Viagra works

Viagra is the brand-name version of the drug sildenafil citrate. It was originally made to treat high blood pressure and chest pain, but clinical trials found it was not as effective as drugs that were already on the market. However, study participants showed an unusual side effect: a significant increase in erections. In 1998, Viagra was the first oral medication approved by the U.S. Food and Drug Administration (FDA) to treat ED.

Weill Cornell Medical College reports that Viagra works for about 65 percent of men who try it. It does so by blocking PDE5. This is the enzyme that interferes with the increase of blood flow to the penis during an erection.

Keeping the goal in mind

As for mixing Viagra and alcohol, a glass of wine isn’t dangerous. It may help you relax and enhance the romance. Keep in mind, though, that moderate or heavy alcohol use may make ED worse, which is counterproductive to taking Viagra.

If you have ED, you’re far from alone. The Urology Care Foundation says that between 15 and 30 million men in the United States have ED. There are many options for treating ED, so talk with your doctor about it. If you’re unsure where to start, check out Healthline’s guide to talking with your doctor about ED .

Article resources

  • Emanuele, M. A. & Emanuele, N. (n.d.). Alcohol and the male reproductive system. National Institute on Alcohol Abuse and Alcoholism. Retrieved from http://pubs.niaaa.nih.gov/publications/arh25-4/282-287.htm
  • Hanson, G. E. Venturelli, P. J. & Fleckenstein, A. E. (2006). Drugs and society (9 th ed.). Sudbury, MA: Jones and Bartlett Publishers.
  • Leslie, S. J. Atkins, G. Oliver, J. J. & Webb, D. J. (2004, October). No adverse hemodynamic interaction between sildenafil and red wine [Abstract]. Clinical Pharmacology & Therapeutics, 76 (4), 365-370. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15470336
  • Muller, A. & Mulhall, J. P. (2006, July). Sexual dysfunction in the patient with prostatitis. Current Urology Reports. 7(4), 307-312. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed?term=16930502
  • Paduch, D. A. (2013, April 9). Drugs for erection problems. Retrieved from https://www.cornellurology.com/clinical-conditions/erectile-dysfunction/drugs-for-erection-problems/
  • Urology Care Foundation. (n.d.) What is erectile dysfunction? Retrieved from http://www.urologyhealth.org/urology/index.cfm?article=60

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Sildenafil es un potente inhibidor selectivo de la fosfodiesterasa tipo 5 – (FDE-5), guanosinamonofosfato cíclico (GMP cíclico) específica.
La respuesta del tejido eréctil del pene es mediada por el óxido nítrico (NO) liberado por acción de las neuronas y las células endoteliales del pene durante el estímulo sexual. El NO a través de la activación enzimática de la guanilato-ciclasa, estimula la síntesis del mensajero
GMP cíclico, la que a su vez resulta en una cascada de eventos que finaliza con la relajación del músculo liso de los cuerpos cavernosos y un mayor ingreso de sangre a los mismos, que inicia el proceso de tumescencia peneana. Esta alcanza su máximo cuando por compresión, se produce la oclusión del retorno venoso. La inhibición de la actividad FDE-5 por efecto de sildenafil, impide la hidrólisis del GMP cíclico y por consiguiente obtiene una mayor concentración intracelular de este mensajero y una mayor y duradera erección. En los niveles de dosis recomendados, se han observado efectos del sildenafil sólo en presencia de estimulación sexual. La importancia de la alta selectividad de acción sobre la FDE-5 en relación con otras FDE, reside en la ausencia de efectos del sildenafil, en voluntarios sanos, sobre la contracción cardíaca in vitro y el electrocardiograma. Su menor selectividad con respecto a la FDE-6, que se encuentra principalmente en retina, explica algunos trastornos visuales observados con las dosis más altas, que los pacientes describen como sensibilidad a la luz o visión teñida de color.

Sildenafil está indicado para el tratamiento por vía oral de la disfunción eréctil.

La dosis media usual para la mayor parte de los pacientes es de 50 mg, administrados aproximadamente 1 hora antes de la actividad sexual. En algunos casos puede ser tomada entre 4 hs y 1/2 hora antes del acto sexual. Basados en la efectividad y tolerancia la dosis puede ser aumentada hasta un máximo de 100 mg o reducida hasta 25 mg según la respuesta individual de cada paciente. La máxima frecuencia recomendada de tomas es de una por día.
En pacientes mayores de 65 años o en aquellos con insuficiencia renal severa (depuración de creatinina < 30 ml/mim) o con cirrosis es conveniente comenzar con una dosis de 25 mg.

Acción Farmacológica
Reacciones adversas

La absorción de sildenafil es rápida después de su administración oral en ayunas, alcanzándose concentraciones máximas en sangre a los 60 minutos (30-120). Si se ingiere durante una comida con alto contenido graso, el pico máximo puede retrasarse unos 60 minutos. Sildenafil se distribuye ampliamente en los tejidos (volumen de distribución medio en estado estacionario: 105 L). Circula, junto con su metabolito principal N-desmetil sildenafil, en su mayor parte unido a las proteínas del plasma (>95%). Las concentraciones plasmáticas del metabolito alcanzan al 40% de las alcanzadas del sildenafil. Sólo una ínfima proporción de la dosis administrada (1/10000) aparece en el semen 90 minutos después de la toma. La vida media terminal es de unas 4 horas. Sildenafil es eliminado mediante el sistema microsomal hepático principalmente por la isoenzima CYP3A4 y en una pequeña proporción por la isoenzima CYP2C9. El N-desmetil sildenafil tiene un perfil de actividad similar al de la droga madre, con una potencia equivalente al 50%. Ambos se excretan predominantemente por las heces y en menor medida por la orina (80% y 13% de la dosis oral, respectivamente).
Las concentraciones plasmáticas pueden ser más elevadas que en los voluntarios de control en los mayores de 65 años sanos (> 40%), en pacientes con insuficiencia renal severa con depuración de creatinina < de 30 ml/min (100%) y en pacientes con cirrosis hepática (80%).

Hipersensibilidad conocida al sildenafil o a alguno de los componentes del producto. Pacientes en tratamiento con nitratos orgánicos o dadores de óxido nítrico.

Antes de indicar el tratamiento con sildenafil el paciente debe ser evaluado exhaustivamente para determinar la etiología de la disfunción eréctil. Sildenafil debe ser administrado con precaución en pacientes con anormalidades anatómicas del pene como angulación, fibrosis cavernosa (enfermedad de Peyronie) y en aquellos proclives a presentar priapismo u otros trastornos como anemia de células falciformes, mieloma múltiple o leucemia.
Si bien sildenafil administrado solo o en combinación con aspirina no afecta el tiempo de sangrado, estudios in vitro indican que potencia el efecto antiagregante del nitroprusiato de sodio (dador de óxido nítrico). sildenafil debe ser administrado con precaución en los pacientes
con riesgo de hemorragia o úlcera gastroduodenal activa.
Dado que la actividad sexual puede incrementar el riesgo de algunos trastornos cardíacos es conveniente evaluar la función cardiovascular antes de instaurar el tratamiento.
Sildenafil debe ser administrado con cautela en los pacientes con retinitis pigmentaria debido a que en algunos individuos que padecen esta patología existe un trastorno genético en las fosfodiesterasas de la retina.
La eficacia y seguridad del sildenafil administrado en asociación con otros tratamientos para la disfunción eréctil masculina no ha sido evaluada. Por lo tanto, no se recomienda su asociación hasta tanto no se lleven a cabo investigaciones apropiadas.
Carcinogénesis y tumorogénesis:
Sildenafil no ha demostrado carcinogénesis en las dos especies de roedores estudiadas.
Sildenafil no ha demostrado mutagenicidad en los ensayos in vitro con bacterias y células de ovario de hámster chino ni clastogénesis en los estudios in vitro sobre linfocitos humanos e in vivo en el ensayo de micronúcleo de ratón.
Embarazo y reproducción:
En ratas y conejos que recibieron dosis entre 20 y 40 veces superiores a la máxima recomendada en humanos sobre la base de mg/m2 no se evidenció teratogenicidad ni toxicidad sobre el embrión o el feto. No se han observado trastornos en la fertilidad de las ratas hembra
o macho. Dado que no se dispone de información suficiente sobre la mujer embarazada, sildenafil no debe ser administrado durante el embarazo.
No se han observado anormalidades morfológicas o funcionales de los espermatozoides en voluntarios sanos que recibían dosis únicas de 100 mg de sildenafil por vía oral.
Se desconoce si sildenafil aparece en la leche materna.
Empleo en pediatría :
Sildenafil no está indicado en niños.
Empleo en geriatría :
En las personas mayores de 65 años se recomienda ajustar la dosis.

Existe un potencial de riesgo cardíaco debido a la actividad sexual en pacientes con enfermedad cardiovascular preexistente. Por lo tanto, en general no deben utilizarse tratamientos para la disfunción eréctil, incluido sildenafil, en hombres para los cuales no es recomendable la actividad sexual debido a su estado cardiovascular subyacente.
Sildenafil posee propiedades vasodilatoras sistémicas que resultan en descensos transitorios de la presión sanguínea supina en voluntarios sanos (descenso máximo medio de 8,4/5,5 mmHg). Aunque esto no debería tener consecuencias en la mayoría de los pacientes, antes de prescribir sildenafil, los médicos deberían considerar cuidadosamente si los pacientes con enfermedad cardíaca subyacente podrían ser afectados adversamente por tales efectos vasodilatadores, especialmente en combinación con actividad sexual.
Los pacientes con las siguientes afecciones subyacentes pueden ser especialmente sensibles a las acciones de los vasodilatadores incluyendo el sildenafil, quienes poseen una obstrucción del flujo ventricular izquierdo (ej.; estenosis aórtica, estenosis subaórtica hipertrófica idiopática) y quienes poseen un control autonómico de la presión sanguínea seriamente deteriorado.
En raras oportunidades, se ha informado la presencia de neuropatía óptica isquémica anterior no arterítica (NOIA-NA), causa de la disminución de la visión o pérdida de la misma, luego de la comercialización con el uso de todos los inhibidores de PDE5, incluyendo el sildenafil. La mayoría de estos pacientes presentaban factores de riesgo como bajo índice excavación/disco ("disco apretado"), edad por encima de los 50 años, hipertensión, enfermedad de la arteria coronaria, hiperlipidemia y hábito de fumar. No se ha establecido una relación causal entre el uso de inhibidores de PDE5 y la NOIA-NO. Los médicos deben informar a sus pacientes acerca del riesgo de presentar NOIA-NA en individuos que ya han sufrido dicha enfermedad.
No existen datos clínicos controlados sobre la seguridad o eficacia de sildenafil en los grupos enumerados a continuación; si se prescribe, debe hacerse con precaución.
пїЅ Pacientes que han sufrido un infarto de miocardio, accidente cerebrovascular, o arritmia con amenaza para la vida dentro de los últimos seis meses;
пїЅ Pacientes con hipotensión (TA<90/50) o hipertensión (TA>170/110) en reposo;
пїЅ Pacientes con falla cardíaca o enfermedad arterial coronaria que causa angina inestable;
пїЅ Pacientes con retinitis pigmentaria (la minoría de estos pacientes presenta trastornos genéticos de las fosfodiesterasas retinales).
Luego de la aprobación para la comercialización de sildenafil, se han informado infrecuentemente erección prolongada de más de 4 horas y priapismo (erecciones dolorosas de más de 6 horas de duración). Si una erección persistiera por más de 4 horas, el paciente debe solicitar inmediata asistencia médica. Si el priapismo no es tratado inmediatamente, puede ocurrir daño del tejido peneano y pérdida permanete de potencia.
La administración concomitante del inhibidor de la proteasa ritonavir causó un incremento sustancial en las concentraciones séricas del sildenafil (incremento de 11 veces de AUC). Se debe tener precaución al prescribir sildenafil a pacientes en tratamiento con ritonavir. Existen pocos datos sobre individuos expuestos a niveles sistémicos elevados de sildenafil. En algunos voluntarios sanos expuestos a dosis altas de sildenafil (200-800 mg) se informaron descenso de la presión sanguínea, síncope y erección prolongada. Se recomienda disminuir la dosis del sildenafil en pacientes en tratamiento con ritonavir para disminuir la probabilidad de eventos adversos.

Interacciones con otras drogas:
La co-administración de 50 mg de sildenafil con cimetidina en voluntarios sanos, puede aumentar las concentraciones plasmáticas del sildenafil en alrededor del 56%.
La administración de una dosis única de 100 mg de sildenafil en pacientes bajo tratamiento con un inhibidor del CYP3A4 como la eritromicina (500 mg dos veces por día durante 5 días) produjo un aumento de 182% en el área bajo la curva (ABC) del sildenafil. Asimismo, los inhibidores más potentes del CYP3A4 como eritromicina, ketoconazol, itraconazol o mibefradil tienen la capacidad de reducir la eliminación del sildenafil. En pacientes en tratamiento con estos fármacos debe considerarse la reducción de la dosis de sildenafil a 25 mg.
Por el contrario, la administración del sildenafil con inductores del CYP3A4 como la rifampicina puede disminuir los niveles plasmáticos de éste.
La administración de una dosis única de antiácidos que contienen hidróxido de aluminio o de magnesio no afecta la biodisponibilidad del sildenafil.
Los inhibidores del CYP2C9 (tolbutamida, warfarina) o del CYP2D6 (inhibidores selectivos de la recaptación de serotonina, antidepresivos tricíclicos), los diuréticos tiazídicos, los inhibidores de la enzima convertidora de angiotensina o los bloqueantes de los canales de calcio no
afectan la farmacocinética del sildenafil.
El área bajo la curva (ABC) de su metabolito activo, el N-desmetil-sildenafil, se incrementa en un 62% con el uso de diuréticos ahorradores de potasio o diuréticos del asa y en un 102% con la administración de beta bloqueantes no selectivos. Sin embargo, no se prevé que estos
efectos sobre el metabolito activo del sildenafil tengan consecuencias clínicas significativas.
No se han encontrado interacciones significativas con tolbutamida o warfarina.
Sildenafil en las dosis recomendadas no potencia el efecto de 150 mg de aspirina sobre la coagulación. Tampoco potencia el efecto hipotensor del alcohol en voluntarios sanos. No se han hallado diferencias significativas en el perfil de efectos adversos presentado por los pacientes con o sin medicación antihipertensiva bajo tratamiento con sildenafil.

Reacciones Adversas:
En estudios clínicos controlados, el porcentaje de discontinuación debido a eventos adversos secundarios al sildenafil (2,5%) no es estadísticamente significativo con respecto al porcentaje de discontinuación hallado en el grupo placebo (2,3%). La incidencia de algunos
efectos adversos aumentó en relación a la dosis.
Se presenta a continuación el listado de reacciones adversas clasificadas por aparato y por frecuencia.
Se califica como frecuentes a las que se presentan con una incidencia mayor al 2%.
Se resaltan aquellas que aparecen con más frecuencia en el grupo activo de tratamiento que en el grupo placebo.
Se califica como ocasionales a las que se observan con una frecuencia menor al 2% y cuya relación con el sildenafil no ha sido aún establecida.
Frecuentes: síndrome gripal. Ocasionales: edema facial, sed, fotosensibilidad, shock, astenia, escalofríos, caídas accidentales, lesiones accidentales.
Ocasionales: dolor de pecho, bloqueo AV, taquicardia, palpitaciones, hipotensión, hipotensión ortostática, isquemia miocárdica, paro cardíaco, insuficiencia cardíaca, alteraciones electrocardiográficas, síncope, cardiomiopatía.
Frecuentes: dispepsia, diarrea. La dispepsia es más frecuente con la dosis de 100 mg con respecto a las anteriores. Ocasionales: dolor abdominal, vómitos, glositis, disfagia, gastritis, gastroenteritis, esofagitis, estomatitis, xerostomía, hemorragia rectal, gingivitis.
Ocasionales: gota, diabetes, edema periférico, hiperglucemia, hipoglucemia, hipernatremia, hiperuricemia.
Ocasionales: anemia, leucopenia.
Frecuentes: dolor lumbar, artralgia. Ocasionales: artritis, artrosis, mialgia, tenosinovitis, miastenia, dolor óseo, rotura tendinosa.
Frecuentes: cefalea, vértigo. Ocasionales: migraña, ataxia, hipertonía, neuropatía, temblor, mareos, hiporreflexia, parestesia, hiperestesia, midriasis, tinnitus.
Ocasionales: depresión, insomnio, pesadillas, somnolencia.
Frecuentes: infección del tracto respiratorio, congestión nasal. Ocasionales: asma, disnea, faringitis, laringitis, sinusitis, bronquitis, tos, incremento en la expectoración.
Frecuentes: rubefacción, rash. Ocasionales: herpes simplex, urticaria, prurito, úlcera, dermatitis por contacto, dermatitis exfoliativa, sudoración excesiva.
Frecuentes: infección urinaria. Ocasionales: cistitis, nocturia, eyaculación anormal, edema genital, anorgasmia, incontinencia urinaria, ginecomastia. No han sido reportados casos de priapismo.
Frecuentes: trastornos visuales (fotofobia, visión borrosa y trastorno en la visión de los colores). Estos son más frecuentes con la dosis de 100 mg con respecto a las menores. Ocasionales: conjuntivitis, fotofobia, dolor ocular, ojo seco, cataratas, hemorragia ocular,
sordera, otalgia.
Ocasionales: alteraciones en las pruebas de función hepática. La dispepsia y los trastornos visuales fueron más frecuentes con dosis de 100 mg que con dosis menores.

Con dosis de hasta 800 mg la incidencia de las reacciones adversas es superior a la referida con las dosis habituales.
Ante la eventualidad de una sobredosificación, concurrir al Hospital más cercano o comunicarse con los centros de Toxicología.

La información contenida en esta página está dirigida exclusivamente a profesionales de la salud.


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I take 25mg on an empty stomach with a tall glass of water at 8:00AM. It takes effect in 15 minutes on the average and out love-making session goes for over an hour every time. – Age 65, Florida

I decided to try a 25mg Viagra pill. I could feel my penis get erect within 15 minutes, getting harder than usual and lasting longer too – YT, Age 45, Nigeria

A full 100 mg. will give you a Ginsu carving knife that, if put to ultimate use, will render her suitable for burial in a Y-shaped coffin. For most of us, 50 mg. is plenty, ensuring that you can return to a deflated state between orgasms, if so desired. But you may have to picture your grandmother naked, to do so.

The effects last 3 or 4 hours, and it takes 30 to 45 minutes to kick in. 25 or 50 mg tabs work the same for me, no difference. Go for it. – Art, Age 62, Texas

I bought a pill cutter at the grocery store and cut a 50 mg pill in half. It worked faster than a 1/2 hour and I had the first complete sexual experience in over 6 YEARS! William, Age 42, Texas

25mg is best for me and I have found that Viagra makes me a super stud and the girl rides me and always has an orgasm or two. – Pablo, 42, Texas

I find that 25 mg two hours prior to sex is best for me, and allows sensitivity, to remain at its peak. When trying 50 or 100,mg, it took away much of the feeling, and you need stimulation to maintain erection. More is definitely not better, in my case. – Phil, Age 60, California

25mg begins to work in about 15 minutes to a half an hour and lasts for 3 hours or so, Able to have an erection and intercourse more than once in a few hours. – Age 65, New York City

My doctor prescribed 50 mg Viagra. Wow. Instant hard on that lasts for a long time. I take 50 mg about three times a week.

I have tried 100mg from time to time but actually seem to do better with the smaller doses. – JR, Age 65

You have to experiment with the dosage and time lag. I started with 50 mg (good to rev my engine, I think) but ultimately found that 25 mg about 90 minutes before sex is ideal for me. Lower dosage means less nasal congestion and more feeling during sex. But 25 mg still leaves me rock hard and able to hold off climaxing just about as long as I want.

I have experimented with dosage and now find that 25 mg about one half hour before sex is perfect for me. I’m rock hard and can go forever.

I have the pharmacist split a 100 mg pill in four for me so I take 25 mg at a time. When I want to go all night I take the full 100 mg.

I cut a 50 mg in half and find that to be enough.

We came at the same time, and boy did I cum. What force! What makes this whole experience ever better is that I only used half of a 50 mg pill.

I started off with 25 mg, and have reduced it down to 12.5 mg (roughly – I split the 100 mg pill to 8) and find that with this reduced dose, I can still have a rock hard erection as well as a greatly reduced headache.

I have since realized I only need 25mg to keep and maintain an erection. But originally, that night, I took 50mg. – Bill, Chicago, Age 42

Comment from: Jason9, 35-44 Female on Treatment for 1-2 years (Patient) Published: October 07

Very effective. Take without food to help absorption quickly and last longer. Effect does *not* run out in 4 hours. I have taken as little as 10-15 mg and felt the benefits for well over 12 hours. This of course will be different for everyone. Would recommend starting with a very, very low dose. My first dose of 25mg made my penis hurt due to the long lasting and persistent erections. Here are my recommendations and items to consider based on my personal experience: 1. Take without food 1 hour before love-time. It takes a bit to kick in. I have always felt a little “preview” effect of Viagra in about 15 minutes. but then it really kicks in after an hour. To get the Viagra flowing through your penis, manipulate yourself a little (may not take much. just an extra few giggles in the restroom). 2. Drink lots of water. Dehydration is BAD for erections. 3. Pop a couple of tums or rolaids. Viagra can make your stomach acidic. 4. Pop a breath mint as it can give you tart breath. 5. Take a very, very low dose the first time. Also, take it while you are alone so you can get used to how much you really need and the benefits. DON’T take it for the first time with your partner. 6. Don’t take it too often because it can make your prostate swell up. So don’t take it every other day so you can masturbate for 3 hours. 7. Headaches are common. pop a couple Advil with it. 8. Once you are having sex, it will keep your erection going even if what you are doing doesn’t feel that good. This is BAD. You don’t want to get used to having sex in positions that don’t feel good to you, since your erection will continue, but you may not be able to “get back into it” and have an orgasm. Certainly, there are times when this may be okay, but it gets awkward when you are in bed with a woman, have a rock hard erection, and you can’t have an orgasm. Women ask questions. And if she doesn’t know you are taking Viagra, she will probably figure it out. Good luck.

Comment from: New_user, 45-54 Female on Treatment for less than 1 month (Patient) Published: October 20

This drug worked extremely well for me. My doctor recommended that I start with 100 mg which I did with results that would put a teenager to shame. I experienced a mild headache the next morning and some nasal stuffiness. I also experience a very slight sensitivity to light. (These are all documented side effects and not considered unusual). I cut the dosage to 50 mg and the side effects virtually disappeared. without any noticable decrease of the drug’s effectiveness. I even tried 25 mg with good results. With 100 and 50 mg dosing, the effect of the drug kicked in after only 15-20 minutes. And the results lasted much longer than the advertised 4 hours – as much as 12 -14 hours for me. With this drug, I’ve been able to ejaculate every time and the erection does go away as promised (something I was concerned about after hearing the warning of the “4 hour erection” in the commercials). This drug has given me back my lovelife and in a way that has made it better than it’s ever been. If you’re having issues, but not sure what to do, I strongly encourage you to visit with your doctor and see if this drug (or similar) will work for you. I guarantee that, if it does (and my doctor tells me it is almost always effective), you will be the happiest guy on your block! Good luck!!

Comment from: working at it, 45-54 Female on Treatment for 2-5 years (Patient) Published: February 11

Guys, listen up.This is not a cure all. You have to experiment to see what works for you. First, you are paying by the pill and it’s crazy exspensive. Buy a pill splitter and cut your price in half or by 75% depending on the dossage you need. It takes practice to get a perfect cut but i’ts worth the effort. If you drink alcohol you’ll have to see how much you can consume with out diminishing results which is about 6 beers for me. Also I have found that I can take it at 10 or 11 at night and wake up with a raging hard on the next day which works out perfectly in my relationship and lasts till late afternoon. By the way I’m 50 and had a heart attack when I was 42.

Comment from: 35-44 Female on Treatment for less than 1 month (Patient) Published: December 24

Works great. I am only 40. Started having problems about a year ago. Got a sample pack from Dr. with 6 pills. The first three I took worked perfectly. Took on empty stomach or at least one hour after a meal. Within an hour, took effect. Makes my face flush and nose run (common side effects) The fourth time I took it, I split the pill in half to see if it would work at lower dose (I was taking a 50mg dose) This DID NOT work. I dont know if it was the lower dose, if it had something to do with what I ate beforehand (Mexican food), or if your not supposed to split them. Also, most of the time, it still has effects several hours after. Even up to the next morning if taken at night.

Comment from: CallhimMrHappy, 45-54 Female on Treatment for less than 1 month (Patient) Published: August 26

Am 46 years old and just started having problems getting erections. Tried “herbal” remedies, was hit or miss, mostly miss. Also libido was on the down turn, I just didn’t feel like I needed or wanted sex. Talked to Dr and was given free trial of 50 mg. Took one a hour before bed, and was very amazed at the erection it gave me when the wife and I started messing around! Not to mention waking up with morning wood, something that hasn’t happened in a LONG time!

Patient Comments are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified health provider because of something you have read on RxList. The opinions expressed in the comments section are of the author and the author alone. RxList does not endorse any specific product, service or treatment.

If you think you have a medical emergency, call your doctor or 911 immediately.

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

Which dosage of Viagra do I need?

Who can take 50 mg tablets?

50mg is the most common dosage for Viagra. Your doctor may recommend it if you are taking Viagra for the first time. Most men find that this dosage is sufficient to treat their erectile dysfunction and improve their sexual experience.

Who should use 100mg tablets?

100mg is the highest recommended dosage of Viagra. You mustn’t take more than 100mg per day. Viagra 100mg tablets are suitable for men who find that they don’t get an erection hard enough for penetration when taking the 50mg tablet. You should try the 50mg dose first and only increase your intake to 100mg if you find the effect insufficient. You should speak to your doctor before changing your dosage.

Who are 25mg tablets for?

Viagra 25mg tablets contain the lowest available dosage. You may be prescribed the 25mg tablets if you are taking certain types of medication. For example, drugs to control HIV or alpha-blockers for the treatment of high blood pressure. Taking alpha-blockers and Viagra at the same time increases the risk of side effects such as low blood pressure and dizziness, which is why the lower dose may be more suitable.

Does the dosage I need depend on my weight?

Regardless of your weight, your doctor will most likely prescribe Viagra 50mg tablets first. 

Does the dosage I need depend on my age?

Which dosage you need depends on your health and how effective drug is for you rather than your age. Certain age-related conditions may have an impact on the dose you need to take but there is no general advice on which dosage to take at certain ages.

Can I increase the dosage if it doesn’t work?

If you find that the dosage you are on is too weak, ask your prescribing doctor whether you can increase it. If you do not have any medical conditions and aren’t taking any other medications, it is likely that you can increase your dosage from 50mg to 100mg. However, you should ask your doctor first. If you believe that the dosage you are on is too strong you can reduce it to see whether a lower dose is sufficient for you.

How often can I take Viagra?

You mustn’t take Viagra more than once a day. If you have sex more than twice a week you may find that a different medication, Cialis daily, suits your needs better than Viagra. Cialis daily can be taken every day. It contains a low dosage of the active ingredient tadalafil and helps you to get an erection.

What happens if I take too much?

As with most medications, it is very important that you take exactly the dose you have been prescribed. Taking too much Viagra increases your risk of side effects. It could cause you to suffer from low blood pressure and faint. It also increases your risk of a condition called priapism, which can cause permanent damage to your penis. If you believe that you have accidentally taken too much Viagra, you should visit your local emergency department immediately.

Can I combine Viagra with other erectile dysfunction drugs?

You can’t take more than one erectile dysfunction drug at any one time. Taking more than one medication for ED will not increase the effects and will put you at risk of serious side effects. If you find that Viagra does not work for you, you may need to try a different erectile dysfunction medication or a different form of therapy such as penile injections or a penis pump. It has been proven that counselling can help men who suffer from ED caused by a psychological problem. Stopping smoking and following a healthy lifestyle will also help you improve your sexual function.

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