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Consultez votre docteur. Si vous souffrez de problГЁmes de l’Г©rection ou que vous n’arrivez pas Г  garder une Г©rection assez longtemps pour avoir des rapports sexuels, vous pourriez avoir besoin de prendre du viagra (le citrate de sildГ©nafil). Il est trГЁs important que vous discutiez de la prise de ce mГ©dicament avec votre docteur pour vous assurer que cela ne reprГ©sente aucun risque pour votre santГ©.

  • Mettez votre docteur au courant de vos allergies Г  certains mГ©dicaments, pour que celui-ci puisse savoir si vous allez ГЄtre allergique au viagra ou non. [1]
  • Parlez Г  votre docteur des autres mГ©dicaments que vous pourriez ГЄtre en train de prendre, ainsi que les supplГ©ments Г  base de plantes.

Ne prenez pas de viagra si vous prenez d’autres mГ©dicaments contenant des nitrates. Il est contre-indiquГ© de prendre du viagra en mГЄme temps que des mГ©dicaments avec de la trinitrine ou des nitrates de longue durГ©e utilisГ©s pour soigner les problГЁmes de douleur dans la poitrine. Il peut causer une baisse dangereuse de la tension artГ©rielle qui provoquera un arrГЄt cardiaque ou un AVC. [2]

Ne prenez pas de viagra si vous prenez dГ©jГ  des alpha bloquants. Ces mГ©dicaments sont prescrits pour les problГЁmes de tension artГ©rielle et de prostate et peuvent provoquer une baisse Г  des niveaux trop bas de la tension artГ©rielle lorsqu’ils sont pris en mГЄme temps que du viagra.

Prenez les pilules de viagra par voie orale comme indiquГ© par votre docteur ou votre pharmacien. La dose qui est en gГ©nГ©ral prescrite est de 50 mg, mais votre docteur pourrait dГ©cider de vous en prescrire plus ou moins. [3]

  • Vous trouverez des pilules de viagra de 25 mg, de 50 mg ou de 100 mg.
  • La dose maximale recommandГ©e est de 100 mg. N’ingГ©rez pas plus que cette quantitГ© Г  chaque prise de viagra.

Prenez du viagra entre 30 et 60 minutes avant un rapport sexuel. L’efficacitГ© du viagra est meilleure si vous le prenez pendant cette fourchette de temps, car les principes actifs du viagra ont besoin d’un peu de temps pour se rГ©pandre dans votre organisme et provoquer une Г©rection. Il a Г©tГ© cependant montrГ© que le viagra peut toujours faire effet mГЄme si vous l’avez pris 4 heures avant le rapport sexuel. [4]

Ne prenez pas du viagra plus d’une fois par jour. Il n’est pas recommandГ© de prendre du viagra plus d’une fois par jour, surtout si cela vous amГЁne Г  dГ©passer la limite des 100 mg.

Prenez des repas pauvres en graisse avant de prendre du viagra. Une quantitГ© de graisse consommГ©e au moment de la prise du viagra peut diminuer ses effets. Prenez des repas lГ©gers le jour oГ№ vous voulez prendre du viagra, Г©vitez surtout les repas lourds avec de la viande rouge, des aliments frits ainsi que tout autre aliment riche en gras. [5]

MГ©thode 3 sur 3:
Faites attention aux effets secondaires Modifier

Faites attention aux lГ©gers effets secondaires que le viagra pourrait avoir. Certaines personnes observent des effets secondaires aprГЁs la prise de viagra. Cela ne signifie pas nГ©cessairement que vous devez aller consulter un docteur, mais si vous ressentez des effets secondaires il vous faudra surtout diminuer les doses ou vous arrГЄter complГЁtement de prendre du viagra. Quelques exemples d’effets secondaires lГ©gers du viagra. [6]

  • Des rougeurs et une sensation de chaleur au niveau du visage et du cou
  • Des maux de tГЄte
  • Le nez bouchГ©
  • Des pertes de mГ©moire
  • Un mal au ventre ou des douleurs dans le dos

Consultez immГ©diatement un docteur si vous ressentez des effets secondaires sГ©rieux. Dans des cas heureusement rares, le viagra peut provoquer des effets secondaires qui nГ©cessitent une consultation chez un docteur. Si vous observez un des symptГґmes suivants, arrГЄtez immГ©diatement de prendre du viagra et prenez rendez-vous chez votre docteur. [7]

  • Une Г©rection douloureuse ou qui dure plus de 4 heures
  • Une perte de la vision
  • Des douleurs Г  la poitrine
  • Des palpitations au coeur
  • Des Г©tourdissements
  • Des gonflements au niveau des mains, des chevilles et des pieds
  • Des nausГ©es ou un sentiment gГ©nГ©ral de ne pas vous sentir bien

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Quand Prendre Son Viagra

Quand Prendre Son 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, Quand Prendre Son Viagra is the perfect place to spend a relaxing weekend or a lifetime.

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

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Couples In The Most Recent Cialis Commercial, Ranked

Commercials for erectile dysfunction drugs can really only go one of two ways, because, as much as they’d like to, pharmaceutical companies can’t just come right out and say “DUDE, THIS IS FOR YOUR BONER.” The first option is innuendo: rockets blasting off, virile gray-haired men zipping footballs through the holes in tire swings, etc. The second is more subtle, and includes couples of a certain age doing normal couple things, with the implication being “Hey, you. You know how you do things with your wife? Well what if you, like, get horny while you’re doing them? Better have a boner pill handy.” These are my favorites.

The most recent Cialis commercial — which has technically been on TV for a few months but is in heavy rotation now that football is back — takes this second route. It features three couples: one playing a doubles tennis match, one building a bench together in their driveway, and one going for a peaceful boat ride in a lake. I will now rank these couple from worst to best.

3. Bench-Making Couple

If I understand what this commercial is trying to say, and I think I do, the guy in Bench-Making Couple is taking Cialis because sometimes he and his wife get SUPER-TURNED-ON by woodworking (heh heh), and he doesn’t want to miss out on potential post- (or, I suppose, mid-) bench-making coitus right there in the driveway. “Hey, honey, I’m gonna run out and check the mail. Want to see if the new edition of the New Yorker is here y-… OH GODDAMMIT, Bob and Sharon and having sex in their driveway again.”

This is creepy and I do not like it. Also, they’ll get sawdust in all their sensitive places, and I can’t imagine that’s fun. Last place. F-

2. Boat-Rowing Couple

I know what you’re up to, Boat-Rowing Couple. You’re going to try to have sex in that boat. Oh sure, you’re all “No no no, we’re just going out for a nice boat ride. It’s romantic, and the rowing is good cardio, which our doctor is always on us about now that we’re getting a little older,” but you can’t fool me. You’ve been out there long enough that the sun is starting to set by the end of the commercial, and you’re starting to get mighty cuddly and nuzzly, and I know for a fact that you planned it so the Cialis kicked in right as most people are heading back to shore.

To be honest, I like your moxie. Having sex in a tiny rowboat seems like a difficult enough task for the young and limber, so the bravado on display here alone is admirable. But I imagine it also requires quite an exertion of effort, and you’ve still got to row all the way back to shore when you’re done. (Or, God forbid, swim, if you get a little carried away and end up capsizing that vessel.) You could get stranded out there all night! And then what? YOU COULD DROWN.

You’re not as young as you used to be, Boat-Rowing Couple. It might be time to accept that.

1. Tennis Couple

You know what I like about Tennis Couple? They are WINNERS. Just look at them: Mr. Tennis Couple, that silver-haired fox, out there playing doubles tennis with his wife, who not only still looks very good in a short tennis skirt, but also is a forehand-blasting ringer on the court. They’re probably club champions. In fact, I bet their friends won’t even play against them anymore because they’re tired of getting embarrassed. That couple they’re playing against in the commercial? Probably a pair of saps who just rolled into town looking for a friendly game of tennis, only to end up $10,000 in the hole to Tennis Couple. “I DON’T KNOW WHAT HAPPENED. IT WAS ALL GOING SO WELL. WE WERE UP $500. THEN WHEN THEY ASKED TO RAISE THE STAKES, THEY JUST GOT SO … SO … GOOD .” Now Tennis Couple is off in some suite in a fancy hotel, just waiting for the Cialis to kick in so they can make sweet love on a pile of grifted $100s. I bet they don’t even need the money. They just like the rush.

The Store Behind That Offensive 9/11 Mattress Ad Has Been Closed Indefinitely

TV Doctors From Turk To McDreamy Come Together For A New Commercial

Viagra’s New Ad Campaign Targets Women

A box of Viagra, typically used to treat erectile dysfunction, is seen in a pharmacy in Toronto January 31, 2008. Photo: Reuters

Viagra is for men, but a new ad campaign uses women to market the now-famous little blue pill. Pfizer will begin airing the campaign’s first TV commercial for the erectile dysfunction drug on Tuesday. The 60-second ad has a blonde, blue-eyed woman reclining on a bed in a tropical setting.

“So guys, it’s just you and your honey,” she says. “The setting is perfect. But then erectile dysfunction happens again. Plenty of guys have this issue — not just getting an erection, but keeping it.”

Instead of using the industry euphemism “ED,” the actress uses the word “erection” instead. In the past, ad campaigns typically featured middle-aged men doing construction work or fishing. They were “built around very subtle innuendo,” Pfizer’s marketing chief, Vic Clavelli, told the Associated Press. Besides the television spot, print ads will run in Esquire and Time magazine, encouraging women to speak with their partners about the problem.

BBDO New York, the creative agency behind the current campaign, says they went with a more direct approach.

“This is an example of a very simple, straightforward story well told via an execution that I would say uses a direct, honest, compassionate approach to simply let men with ED know they are not alone,” John Osborn, president of BBDO New York, told Ad Age. “It was our belief that this approach would put men at ease.”

“This is a fumble,” Katie Rogin, managing director of strategic planning of Havas Worldwide Tonic, told International Business Times about the new Viagra ads. She says the three major erectile dysfunction drugs have carved out three distinctive territories in the marketplace. “Levitra was about performance. Cialis was about a man’s relationship with his partner. Viagra was about function,” Rogin said. Viagra ads showed men doing manly things. “[The new ad] seems to violate that positioning.”

Not only does the new ad campaign take place outside a construction site, sailboat or ranch, but a man is never shown on screen. “It’s rare to see pharmaceutical spot that doesn’t show the target,” Rogin said. Strictly speaking, the ads might be considered misleading — which could be a violation of the US. Food and Drug Administration’s policies on prescription drug advertising.

The female-oriented advertising strategy is a first for Pfizer — the world’s second biggest drug maker — and comes after a new wave of cheaper generic versions of Viagra have entered the market since the company’s patent expired 15 months ago. Sales dropped 8 percent last year to $1.9 billion. A YCharts report predicts that all branded erectile dysfunction drug sales will fall at a compounded annual rate of 4.5 percent from 2013 to 2019. The new ad campaign may be trying to reach a broader audience before generic brands are offered in three years time.

Viagra costs about $35 a pill. the Associated Press reports. Medicare and many insurance plans do not cover erectile dysfunction drugs. If they do, insurers typically pay for four pills a month. But other options such as pumps, injections and surgical implants are covered. the New York Times reports.

Generic versions of Viagra are available in Europe. They are expected to hit U.S. markets in three years.

Introduced in 1998, Viagra was the first erectile dysfunction drug in the U.S. Cialis and Levitra followed in 2003. Since then, the little blue pills have been endorsed by former presidential nominee Bob Dole, actor Michael Douglas and have been a storyline on HBO’s “Sex and the City.”

Drug patents generally last for 20 years. After they expire, cheaper versions of the drug enter the market to compete with — and sometimes crush — brand-name competition.

Erectile dysfunction is big business. Last year, Viagra, Cialis and Levitra made more than $2.5 billion. NPR reports. According to a study conducted by Johns Hopkins Bloomberg School of Public Health, about 18 million men in the U.S. have ED.

Erectile dysfunction “happens to all men,” Dr. Jacob Rajfer, a urologist at UCLA Medical School told NPR. “Men in their forties have a 40 percent chance of having this problem,” Rajfer said. “For every decade after 40, there’s a 10 percent increase.”

Viagra’s new commercial will appear during the shows “CSI,” ”Blue Bloods” and “48 Hours” – hit primetime shows with older adult audiences. “No one has taken directly the perspective of a partner and used that as a way to motivate men,” Clavelli told Ad Age about the new Viagra ad. “We think we’re doing that here.”

The Viagra TV Commercial Controversy

Viagra has generated plenty of buzz with its advertising.

Viagra is no stranger to controversy.

Pfizer, the manufacturer of Viagra, spent $176 million in 2013 on advertising for the erectile dysfunction drug. One new ad in the US, which has run during NFL and MLB games is different for the company because a woman stars in it. In fact there are no men in it at all. In case you haven’t seen it, you can view the ad here .

This ad represents the first commercial for an erectile dysfunction drug featuring only a woman, played by British actress Linette Beaumont. Not only is it the first time Pfizer has used a woman to sell Viagra, it’s also the first ad where the word “erection” appears someplace other than the swiftly-spoken side effects disclaimer. In fact, she uses the word twice.

The Recent Viagra Ad Starring a Female Spokesperson

The new ad campaign features a beautiful blonde woman in a sexy blue dress lying on an open-air cabana in a dreamy tropical location. She addresses viewers directly, starting with, “So guys, it’s just you and your honey.” She continues, speaking in a cozy, conversational tone about the fact that many men have trouble getting and / or keeping an erection.

The ad has been dissected by numerous media outlets, including The Hollywood Reporter. The Daily Beast. and The New Yorker. It was even spoofed in a segment by comedian Ellen DeGeneres. Far from being “immune” to advertisements for drugs that treat erectile dysfunction, the American public is still quite attentive, particularly since this one is so different from older commercials.

Is the Ad Targeted Toward Women?

Pfizer says that they hope the new ad will prompt women whose male partners experience erectile dysfunction to broach the subject and encourage them to seek medical advice on the condition. In a sense, the ad is supposed to work on two levels, with men being directly appealed to by a lovely woman with a charming accent and women being indirectly moved to start conversations about the drug with their partners.

However, John Osborn, president of ad agency BBDO, which made the ad, says it’s not really about targeting women, though if it does that’s just fine. Rather, he explains. “This is an example of a very simple, straightforward story well told via an execution that I would say uses direct, honest, compassionate approach to simply let men with E.D. know they are not alone.”

Detractors: The Ad Should Be Removed

Some people think the ad should be taken off the air. It’s not to do with the fact that a woman is starring in it, but rather the feeling that such a direct and intimate ad is an intrusion on family time spent watching professional sports. Parents frankly don’t like it when they’re watching a game with their kids and are blindsided with an ad for a topic they believe is inappropriate for children. And it’s not necessarily prudishness at the heart of this concern, but rather a feeling of having their family privacy invaded.

Proponents: Grow Up and Let’s Talk About This Like Adults

Proponents of the ad say it’s refreshing to see the topic taken on in such a direct manner, and that it is leagues ahead of past ads for Viagra and other erectile dysfunction drugs that relied on sometimes silly double entendres. Levitra, for example, once featured an ad that involved a football being thrown through a tire swing. And people are still a bit puzzled by Cialis’s outdoor, his-and-her bathtubs .

The only other Viagra ad that was as straightforward as the current one in discussing the topic was nonetheless radically different from it: the original Viagra ad that featured former Senator and Presidential candidate Bob Dole. Like the new ad, the message then was: erectile dysfunction can be tough to talk about, but it affects millions of men and their partners, so let’s be adults and address it like adults.

The new ad says, “We’re grown-ups, and we should talk about this.”

Ads for Viagra in Other Countries

People in the US may be surprised to learn that in other countries, Viagra ads have embraced a more humorous take on erectile problems. Where US ads show men setting up campsites and engaging in manly occupations like commercial fishing, ads in South Africa have shown an older milkman buttoning his jacket back up after leaving a posh mansion – an ad-length wink and nudge. Even in conservative Saudi Arabia, a Viagra television ad featured the hands of a man boldly trying to pierce the lid of his beverage with a straw. These foreign ads clearly imply the feedback loop between pop culture and advertisements, as well as the humor that can be found there.

The Takeaway From All This

Whether you think of the new Viagra ad as a shameless attempt to draw in the female demographic or an intrepid proclamation that women need to be involved in the discussion (both privately and publicly) about erectile dysfunction, chances are, if you saw the ad on television, you remembered it. Will the new ad lead women to talk to their partners about erectile dysfunction and encourage them to seek help for it? Will it bring home the point to men that erection problems affect women profoundly too? It almost doesn’t matter, because Pfizer succeeded once again in making people talk about Viagra.

Viagra is still a major seller for Pfizer, and in the US at least, that will continue to be the case until the drug reaches the edge of the “patent cliff” in the year 2020. Until that time you can bet the company will continue to provoke and grab people’s attention with their television and other media ads.

If you are one of the millions of men who experience erectile dysfunction, help is available, and it starts with a conversation with a physician. AccessRx.com is an online medical facilitator that has, working alongside US-licensed pharmacists, dispensed Viagra and other erectile dysfunction drugs to over half a million men for over 15 years. AccessRx.com understands that erection problems are a sensitive topic, and that men want discretion and privacy when it comes to treating it. AccessRx.com uses fast, discreet shipping, offers unbeatable customer service, and provides customers with the latest in technology to protect their privacy and security online.

  • AccessRx is a USA corporation founded in 1998. Since, we have become one of the top online providers in FDA-approved, brand-name medications. We specializes in providing our over 500,000 customers with relevant product and condition information created by our professional editorial staff which includes our team of medical writers, medical practitioners and health educators. AccessRx Staff on Facebook

    Mary Hiers – AccessRx Medical Writer

    Mary Hiers is a full-time writer with a background in engineering and print journalism as well as writing about a wide variety of health care topics. She lives in Tennessee and is the author of two works of fiction. Mary earned her bachelor’s and master’s degrees from the University of Tennessee and the University of Tennessee Space Institute. Mary Hiers on Google+

    Lisa Furgison – AccessRx Medical Writer

    As a journalist Lisa enjoys writing about a variety of topics. Over the course of the last ten years she has been involved in television news as well as print and online publications. Medical news has always been a favorite for this native New Yorker because she gets to stay on top of the latest developments in a rapidly changing field. Lisa Furgison on Google+

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    The popularity of Viagra has skyrocketed over the past year. This marvelous little blue pill has brought passion and excitement back into people’s sex lives. Viagra has proven to be a bestseller with good reason: it’s effective for many people. Despite side effects such as headaches and anecdotal reports of possible links to heart attacks. it has helped millions.

    The problem with a short-term solution such as Viagra, is that it encourages people to forget about seeking treatment. Instead of visiting a doctor to correct the penile dysfunction, most men just pop a pill for instant (thirty minute) results. Viagra is currently the best treatment, but it should be used as a last resort and only after consulting a doctor.

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    No one can argue that popping a pill is convenient, but sexual dysfunction is a complex issue with many causes and manifestations. I caution people against the idea of taking a quick-fix approach to symptoms that are often part of a bigger problem.

    The first thing you should do before even thinking of taking Viagra or any other supplement, is review your overall health and current medications with your doctor. It’s also essential to address any psychological or relationship issues through counseling or other forms of therapy. This is very important, because sometimes the problem might be treatable. By taking a quick-fix pop-a-pill approach without investigating the problem, you will only be adding to the delay of treatment and lowering your probability of fully recuperating.

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    Viagra is very effective and fast acting — it typically boosts blood flow within 30 minutes to several hours — but some people prefer non-drug alternatives. Is there an alternative to Viagra, something more “natural” like an herb or supplement? And are any of these safe? Not every man requires the magic touch of Viagra; sometimes all one needs is a healthy diet, exercise and a little of Mother Nature’s touch. Several interesting supplements have recently come to light and may provide benefits within days to weeks.

    Ginkgo Biloba. An herb that is commonly taken as a memory booster may provide benefits. It presumably acts by enhancing blood flow and seems relatively free of side effects. In a study conducted at the University of California, ginkgo reversed sexual problems in 84% of men who were taking antidepressant drugs such as Prozac. The ones who might benefit from it are men on Prozac or other antidepressants. The suggested dose is 80 mg three times a day, standardized to contain 24% flavone glycosides and 6% terpene lactones.

    Arginine. An amino acid that also enhances blood flow. In a study of 50 men at Tel Aviv University, 31% of those with impotence improved after six weeks of taking arginine. The ones who might benefit from it are men who have circulatory disorders that may be contributing to sexual problems. The suggested dose is 1 gram three times a day; sold as L-arginine.

    As with Viagra, you should avoid arginine if you are taking the heart medication nitroglycerin because the combination may cause a dangerous drop in blood pressure. For the same reason, you should probably not take arginine with Viagra.

    DHEA. This supplement may also provide benefits for men who have low levels of this hormone. DHEA helps our bodies make estrogen and testosterone, and a recent trial at the University of Vienna found it helped men with impotence. The suggested dose is 5 mg each morning for men.

    Yohimbe. Some studies have shown that this herb may correct impotence. However, this herb can cause a dangerous rise in blood pressure, as well as anxiety and other side effects. Many doctors prefer the purified form of the herb, the FDA-approved drug yohimbine, instead, because it has a guaranteed purity and potency. I suggest that you opt for the prescription drug yohimbine instead. See your doctor.

    As for passion potions such as Super Sex and Biagra sold at health-food stores or pharmacies, there is no real evidence showing that they restore sex drive. These potions are made with blends of herbs such as those mentioned above and other questionable ingredients. Check the label to make sure the product contains an adequate dose of the herbs mentioned above. If it does not have the recommended dosages, then the product is not likely to be effective. Instead of a blend, you may be better off purchasing an individual ingredient tailored to your particular condition.

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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

    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.

    What should I discuss with my healthcare provider before taking tadalafil (Cialis)?

    You should not take tadalafil if you are allergic to it.

    Tadalafil should not be used together with nitrate medication, such as nitroglycerin (Nitro Dur, Nitrolingual, Nitrostat, Transderm Nitro, and others), isosorbide dinitrate (Dilatrate, Isordil, Isochron), isosorbide mononitrate (Imdur, ISMO, Monoket), or recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking tadalafil with a nitrate medicine for chest pain or heart problems can cause a sudden and serious decrease in blood pressure.

    To make sure you can safely take tadalafil, tell your doctor if you have any of these other conditions:

    • heart disease or heart rhythm problems;
    • a recent heart attack (within the past 90 days);
    • a recent history (in the past 6 months) of a stroke, or congestive heart failure;
    • angina (chest pain), high or low blood pressure;
    • liver disease;
    • kidney disease (or if you are on dialysis);
    • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
    • a bleeding disorder such as hemophilia;
    • a stomach ulcer;
    • retinitis pigmentosa (an inherited condition of the eye);
    • a physical deformity of the penis (such as Peyronie’s disease); or
    • if you have been told you should not have sexual intercourse for health reasons.

    Tadalafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking tadalafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.

    It is not clear whether tadalafil is the actual cause of vision loss. Stop using tadalafil and get emergency medical help if you have sudden vision loss.

    FDA pregnancy category B. Tadalafil is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment with Adcirca.

    It is not known whether tadalafil passes into breast milk or if it could harm a nursing baby. Do not use Adcirca without telling your doctor if you are breast-feeding a baby.

    How should I take tadalafil (Cialis)?

    Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

    Tadalafil can be taken with or without food.

    Do not break or split a Cialis tablet. Swallow it whole.

    Cialis is usually taken only once per day. Follow your doctor’s instructions. For erectile dysfunction, take the medicine just before sexual activity but not more than once per day.

    Cialis can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor’s instructions.

    Adcirca is usually taken once per day. Follow your doctor’s instructions. Do not take Cialis for erectile dysfunction if you are taking Adcirca for pulmonary arterial hypertension.

    Do not take tadalafil more than once a day. Allow 24 hours to pass between doses. If you take the medication daily, take it at the same time each day.

    Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

    Store at room temperature away from moisture and heat.

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