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How to Get Viagra

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

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

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

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

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

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

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

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

Part Two of Two:
Obtaining Viagra Edit

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

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

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

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

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

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

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

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

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Generic, Counterfeit and Fake Viagra – What’s the difference?

You always read about people getting busted for dealing in fake or counterfeit Viagra. Law enforcement and media frequently mix up the terms “fake” and “counterfeit”. When the government or law enforcement refers to fake or counterfeit Viagra they mean any product that contains the active ingredient in Viagra (silendafil) except than Viagra tablets made by Pfizer. Period. Any and all so-called generic Viagra is considered to be an illegal substance because generic versions of Viagra are not approved in the United States and likely won’t be until 2019 due to patent laws.

If a pill is made to resemble brand name Viagra manufactured by Pfizer but it is not genuine, it is referred to as a “fake”, “knockoff” or “counterfeit” (just like counterfeit designer bags, watches, headphones, etc.) The counterfeit Viagra may contain active ingredient, although sometimes it does not.

Generic Viagra refers to a product that contains the active ingredient in Viagra (silendafil) in the same strength ( 25 mg, 50 mg, 100 mg) as the branded version. It does not pretend to be Viagra brand silendafil although most of the time so-called generic Viagra will be colored blue and may have the characteristic diamond shape associated with the real thing. Generic Viagra is usually labeled as silendafil.

Generic Viagra is not approved for sale in the USA but is legal in many other countries such as Canada and Brazil. Since generic Viagra is not approved by the FDA it is considered to be an illegal substance.

Fig 2: So-called Generic Viagra pills from India. Note that other than the blue color, no attempt has been made to duplicate the tablet shape or blister packaging.

Generic Viagra pills such as these sell for as little as $1 – $3 per pill online.

Most of the websites that sell this stuff masquerade as Canadian pharmacies but reputable Canadian pharmacies don’t sell these goods.

Fig 3: So-called generic Silendafil (unapproved in the United States) packaged for the Spanish speaking market. Commonly found in tourist resorts, airports, pharmacies across the Spanish speaking world.

I personally have purchased generic Silendafil such as this without a prescription in Cancun and in the Dominican Republic for $6 – $8 per 50 mg tablet.

Fig 5: Generic version of Viagra manufactured by Teva. a multinational drug company. The above silendafil tablets are labeled in Czech.

Although Teva markets hundreds of products in the United States, the above product is not allowed to be sold in the USA due to patent laws and restrictions.

Fig 4: Generic version of Viagra with the brand name Suhagra, manufactured in India by Cipla. a well known drug company.

While Suhagra is approved for sale in India and many other countries. It is not approved for use in the United States. FDA and law enforcement consider it to be an illegal substance.

Reimported Viagra is brand name Viagra, manufactured by Pfizer for sale in countries such as Canada where government price controls keep the price artificially low.

Reputable Canadian pharmacies sell these goods for around $15 per pill. Legitimate Canadian pharmacies sell Viagra manufactured in United Kingdom or Canada to Americans via the Internet for $14 – $16 per tablet. In general legitimate Canadian pharmacies charge the same price for all strengths of Viagra. If you are willing to take the chance on gray market Viagra, buy the $100 mg tablets and split them to save money.

FACTOID: The cheaper it is, the more likely it’s fake.

Gray Market Viagra

These goods are also manufactured by Pfizer for sale in countries such as Great Britain, Bulgaria or Spain. Entrepreneurs legally buy it in bulk at artificially low prices and redistribute it around the world.

A rule of thumb is that the cheaper the price the more likely it is a knock-off – and it takes an expert to tell difference. Reputable, CIPA approved Canadan pharmacies do sell gray market Viagra for $7 – $10 per tablet. Personally, I am leery of gray market Viagra. Sometimes they drop-ship it from the country of origin. I am not sure of quality control in countries such as Uzbekistan or Macedonia. The problem with buying this stuff is that these goods pass through so many hands it is easy for counterfeit pills to enter the supply chain.

Counterfeit Viagra

Counterfeit Viagra has the look and feel of the real McCoy just as a counterfeit $100 bill looks like a genuine $100 bill. Counterfeiters go to a lot of trouble to make their product and the packaging look like the real thing. Many times it takes an expert to tell the two apart. To make matters worse, the counterfeit pills often contain a little real active ingredient (silendafil), to make the masquerade better.

Unfortunately for the consumer, you have no way of telling how many milligrams of silendafil the pills contain. They can contain too little or two much depending on the Viagra bootlegger’s skills.

However, many times the counterfeit Viagra contains no active ingredient. Counterfeit Viagra has been known to contain chalk, brick dust or baby powder.

According to a recent Forbes magazine article, 77% of the Viagra sold on the internet is fake. Of the websites that sell fake or counterfeit Viagra, 32% contain no active ingredient. Most of the websites that sell Viagra pretend to be Canadian but are located in other countries such as the former Soviet Union, Caribbean or Asia.

In 2008, Bloomberg.com reported that illegal Viagra was responsible for a large portion of counterfeit medicine seizures. Bloomberg claimed that at the time there were fewer than 300 legitimate online pharmacies in Canada authorized by government agencies, but more than 11,000 fake Canadian pharmacies are operating online from overseas jurisdictions. That means that at least in 2008, only 3% of the online pharmacies that claimed to be Canadian actually were Canadian.

How Does Pfizer Deter Counterfeit Viagra?

Pfizer is engaged in a constant battle against the introduction of fake Viagra into the pharmaceutical supply chain. Pfizer uses redundant high tech security features to make it easy to detect counterfeit Viagra pills and packaging:

Beginning On 2005, all bottles of Viagra have had a very small identification microchip (known as a RFID) embedded into the bottle. The bottles are embedded with a Tagsys Flexible Module passive high-frequency (13.56 MHz) tag. This means that every bottle of Viagra has a special electronic fingerprint so that pharmacists and wholesalers can track the pedigree of the tablets inside to ensure that they are authentic and obtained legally.

Each Viagra label also contains a special two-dimensional barcode that works hand in hand with the RFID chip so that pharmacists and wholesalers can track the Viagra from the factory, through the supply chain down to the individual consumer.

The labels on the Viagra bottles (as well as many other Pfizer products such as Lipitor and Celebrex) are printed with a color shift ink bar which is hard to fake but easy to recognize with the naked eye, similar to what you see with paper money.
Pfizer also employs a team of scientists and international team of professionals to track down suspected fake Viagra factories and dealers. Pfizer Global Security. a group comprised of former law-enforcement pros. The company placed its chief security officer front and center to detail the hazards of fake drugs and

Bottom Line

US governmental agencies don't go after the people who buy it, but postal inspectors will confiscate it if they find it. And, if it gets confiscated, good luck getting your money back from the website you bought it.

You are taking a chance with your health if you take generic sildenafil because the ingredients are completely unknown. If you are unsure where to buy Viagra, see my recommendation above.

Red Flags Regarding Buying Viagra Online:

When you buy anything on the internet, you should be making your purchase based on the reputation of the seller. Trustworthy seller = trustworthy product. I call this the ebay principle. This applies to buying anything on the internet, especially medicines.

If you do buy brand name Viagra on the internet or if you want to take a chance and try the generic struff, the most important thing is to deal with a trusted online pharmacy.

- Make sure there is a physical address on the website selling the Viagra. It should be a real address, not a P.O. box. If there is no address that is a bad sign.

Why would someone want to hide their address? No address means that they are deliberately making it hard for you to track them down in case there is a problem.

- The website where you buy Viagra should have a toll free telephone number. If something goes wrong you want to be able to speak to a real live person. It is very frustrating to only be able to communicate by e-mail when you have a problem.

Test the telephone number before you place your order. Ask the person who answers the phone where the Viagra is shipped from. If they don't answer to your satisfaction, it's a bad sign.

- Do they have a 24-hour chat or IM customer service? The reliable, established internet pharmacies all have this service integrated into their sites. If they have such a service, test drive it.

- How long does it take for the person on the other end to respond? Ask them some questions such as: "How long have you been in business? Who is the manufacturer of your Viagra (it should be Pfizer)? Where is it shipped from? How long does it take to get my shipment. What is the cost of Viagra?

- Ask them if they do the shipping and handling or if they only do the billing.

- There is a good chance that the person on the other end of the phone is just a go-between; a clerk in front of a credit card machine, doing the billing for hundreds of Viagra websites.

In many instances, they have no idea who the Viagra merchant is; all they know is that once a month they get a commission check from someone they have never seen or met in person.

Their job is answering the phone and ringing up your sale. After your credit card has been charged, the relationship is over.

- You get what you pay for. If it seems too good to be true, it probably is too good to be true. The price of Viagra can be deceiving. You are better off paying $40.00 per pill at your local drugstore and getting genuine American Viagra than paying $11.00 for a so-called generic Viagra on the internet and getting a fake or harmful pill. Your Viagra cost is not the most important thing to consider.

- Your first purchase should be for a small quantity of pills. Don't start off with thirty tablets. Buy five or ten. Make sure the Viagra is legit and the shipping and billing goes smoothly before you make a large purchase.

- You should never deal with a site from Russia or Nigeria, places where identity theft is common. Scammers in these countries have been known to set up sham Viagra web sites just so they could steal your credit card information.

Where does fake Viagra come from?

Most of the fake Viagra comes from Asia and South America where the laws regarding pharmaceuticals are lax.

Most of the Viagra selling websites are fly-by-night operations looking to make a quick buck with a low price of Viagra. They often masquerade as American or Canadian internet pharmacies but they are usually located outside the law in countries such as China, Japan, Cambodia or Bulgaria.

How much should it cost?

GoodRX.com, a leading prescription pricing website claims that you can obtain 10 Viagra pills for between $30 and $40 per pill in the USA. Another popular online pharmacy site – RxUSA.com sells Viagra 100 mg for $36 per pill. High quality generic Canadian Viagra from legitimate Canadian pharmacies goes for half that. If you see websites where the cost of Viagra is $3, $5, or even $10 a pill, you will know that they are generic or worse, a counterfeit.

Who does this site recommend?

If you are looking for brand-name Viagra online manufactured by Pfizer Laboratories, without a prior prescription, one vendor I recommend is AccessRx.com. a division of Secure Medical LLC. They have been in business since 1998, are located in the USA in Tempe Arizona, and even offer overnight shipping. They have an A+ rating from the Arizona Better Business Bureau.

AccessRx,com works with FDA approved pharmacies to insure that people who buy Viagra from them (as well as other products) are legit meds. I called them up. AccessRx is run by a gentleman named Jerry Rao. He has a brick and mortar location located at 5801 S. McClintock Drive Suite 107, Tempe AZ 85283, USA. They have been online since 1998.

No Prescription needed? Welcome To Internet Enabled Telemedicine:

With Access RX you do not need a previous prescription to get the Viagra. They do this via telemedicine. (You also have the option to do a video consultation with a medical professional).

You fill out a detailed questionnaire regarding your state of health (medical conditions, other medicines taken, height, weight, etc). One of their licensed physicians evaluates your information. If appropriate, they will contact your physician for further information. If everything checks out, the physician writes you a prescription for the Viagra and they ship it out to you.

Their prices are competitive with large chain drugstores and you are assured of getting brand-name, American, FDA-Approved Viagra delivered to your door in a couple of days without having to go to a doctor. Expect to pay $23.75 dollars per pill. The icing on the cake is that you save the time and money associated with a visit to a doctor’s office. This is especially fantastic if you do not have medical insurance or if your insurance does not cover Viagra.

In Closing:

Stay away from generic or counterfeit Viagra, as the pills are made from compounds that are not FDA-approved and can cause serious harm to your health. The cost of Viagra online should be about the same as you would get at your local pharmacy ($30 – $40 per 100 mg tablet). but you can actually save money if you buy Viagra online because you won't have a co-pay like you would if you received a Viagra prescription from your local doctor.

Interesting Viagra Pharma Factoids:

When was Viagra discovered?

1989
Pfizer Scientists synthesize silendafil citrate and give it the code name UK-92, 480. The drug would not be known as Viagra until the mid-90s.
Experimental compound UK-92,480 is believed to be useful as a high blood pressure and angina treatment. The scientists hope it may act as a vasodilator and be useful in treating cardiovascular ailments such as hypertension and angina.

1991
Researchers at Pfizer's Sandwich, England research facility (Peter Ellis and Nick Terret) observe that drugs that inhibit the PDE5 enzyme may be helpful in reversing erectile dysfunction.
Early Phase 1 trials regarding the use of Viagra for angina are unremarkable.

1992
A second Phase 1 angina trial reveals that the drug has an unusual side effect; penile erections.
Phase 2 clinical study is conducted testing silendafil citrate's usefulness as an angina treatment.

1993
Pilot study using silendafil citrate as a treatment for erectile dysfunction is conducted in Bristol, England. Test subjects take it three times a day for a week. The studies had only 28 men involved.

1994
Second pilot study on silendafil as an Erectile dysfunction treatment demonstrates that a once per day dose is able to produce an erection.
Pfizer realizes it has something important; it accelerates the program examining silendafil citrate for erectile dysfunction.
1994 – 1997

21 clinical trials are conducted involving 4,500 men demonstrate that Viagra (as it is now known) is safe and effective.

1997
Pfizer files a New Drug Application for Viagra (NDA 020895) with the United States FDA. FDA agrees to give it a priority review.
1998

FDA approves Viagra as the first oral treatment for erectile dysfunction. It was approved with a starting dose of 50 mg with the option to increase the dose to 100mg or reduce it to 25 mg.
Misc:

Viagra Patents
FDA lists two patents for Viagra. Patent number 5250534 expires on March 27, 2012. Patent number 6469012 (patent use code U-155; TREATMENT OF ERECTILE DYSFUNCTION) is set to expire on Oct 22, 2019.
How did they come up with the name VIAGRA?

Viagra Name
The name Viagra is believed to be an amalgam of two words:

The "Vi-" part is associated with the words vigor (physical or mental strength, energy, or force) or “vital” (necessary to the continuation of life; life-sustaining).

The "-agra" part of the name Viagra is associated with Niagara Falls. the iconic American waterfall; a metaphor for a massive powerful natural phenomenon.

Why Does The Viagra Tablet Have An Unusual Shape
Unlike most tablets, the Viagra tablet has an unusual rounded-diamond-shape. It is believed that one reason Pfizer employs this tablet design is to make it harder to split the tablet with common tablet splitters.

The wholesale cost of Viagra in a 100 mg tablet is $31.00, so your Viagra cost will be slightly more than that. The price of Viagra in a 50 mg tablet is approximately the same. When people buy 100 mg tablets and split them into two 50 mg portions, they save about 50% per dose. Some people even cut them into quarters, which will save you even more money. A pill cutter is recommended to cut the Viagra in half or quarters.

The diamond shaped Viagra tablet will not fit into the typical tablet splitter which is designed to split round tablets. Since its launch in 1998, specially designed Viagra tablet splitters have become available.

(Incidentally, another erectile dysfunction drug, Cialis also has an irregular shaped tablet that discourages pill splitting).

Viagra Information On The Internet:

Viagra.com
Official website; Geared to patients; all about Viagra and erections.

PfizerPro.com
Official Viagra website for healthcare professionals; How to start and maintain patients on Viagra, Multimedia presentation, prescribing information, etc. This site also has a section where you can report an adverse regarding Viagra.

Official Viagra Prescribing Information
(Package Insert); dose, mechanism of action, side effects, precautions, warnings; patient information; very technical, don't get scared when you come to the section on warnings and side effects

Viagra Scientific Papers
National Library Of Medicine; automated Medline search; a listing of scientific papers in condensed form regarding Viagra.

Viagra Versus Levitra
From Forbes magazine; M. Herper and A. Lagorce; Side by side comparison of various characteristics; cost, pharmacokinetics, marketing tactics, etc.

Viagra Versus Cialis
From Forbes magazine; M. Herper; side by side comparison of various characteristics in slide show format.

Viagra News
(from Google) ; recently published news regarding Viagra.

Viagra mechanism of Action

All three of the erectile dysfunction drugs (Viagra, Levitra and Cialis) are similar in action. They block an enzyme that causes an erection to go flaccid. Although these drugs are similar in action, their dose, onset of action time and duration of action differ.

Viagra (Sildenafil) is a member of a family of drugs called PDE5 Inhibitors. Viagra was the first PDE5 inhibitor on the market. FDA was approved Viagra on March 27, 1998. The team of scientists who discovered Viagra won the Nobel Prize.

The BIG Discovery: cyclic guanosine monophosphate (cGMP)

Some very smart scientists discovered that cyclic guanosine monophosphate (cGMP) was the key to sustaining an erection.

They discovered that when a man gets sexually stimulated, a chain reaction occurs in the tissue of the penis that results in elevated levels of a substance called cyclic guanosine monophosphate (cGMP).

As long as there are sufficient levels of cGMP, the penis can remain erect. The more cGMP, the more robust and durable the erection.

If you inhibit the degradation (breakdown) of cGMP it stays around in the penis longer, producing a more durable erection.

Another way you can think of Viagra (and all other similar medicines) is that it preserves the elevated levels of cGMP that are created when a man is sexually stimulated for a stronger, more lasting erection.

That's how Viagra works – Viagra blocks the enzyme phosphodiesterase-5 (PDE5) which is responsible for the neutralization of cGMP. Viagra (Sildenafil) is a highly selective inhibitor of PDE5. (PDE5 is not the only phosphodiesterase involved in the erectile physiology but it appears to be the most important one).

The nice thing about Viagra and other PDE5 blockers is that they shouldn't cause erections at inappropriate times because they only block degradation of cGMP produced in reaction to sexual stimulation, such as thinking about something sexy.

If you are not being sexually stimulated, there is no cGMP to protect, so Viagra and similar drugs remain in the background.

The only bad news is that everyone's Viagra cost is going up, which means less men can take advantage of the powerful drug.

Absorption, Bioavailability
Viagra is rapidly absorbed. Maximum observed plasma concentrations of Viagra are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. Viagra is about 40% biovailable. Viagra is highly protein bound (96%). When Viagra is taken with a high fat meal, the rate of absorption is reduced.

Metabolism, Half Life, Excretion

Viagra is mostly metabolized in the liver by an enzyme known as CYP3A4 and to a lesser extent CYPC229. Viagra breakdown products are excreted in the feces (80%) and in the urine (approximately 13%). Viagra's mean half life is about 4 hours.

If you are going to take any of the PDE5 inhibitors such as Viagra, it is very important that your doctor be aware if you have a liver condition (such as cirrhosis) or kidney condition (such as if you are on dialysis) because you may need a special dosage adjustment.

Likewise, if you try to obtain Viagra on the internet, please make sure that the person authorizing your prescription knows the true status of your liver function and your kidney function.

Dose:
For most patients, the recommended dose of Viagra is 50mg taken about 1 hour prior to anticipated sexual activity. However, the Viagra label states that it can be taken anywhere from 1/2 hour to 4 hours prior to sexual activity.

The dose of Viagra may be increased to 100mg or decreased to 25mg depending on efficacy and side effects. Sometimes people buy the 100mg tablets and break them in half to save money.

Viagra is available 25mg and 50mg and 100mg tablets.

The maximum recommended dose is one pill per day.

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Cinsel ilişkiden bir Saat kadar önce alınması önerilen Viagra, yutularak alındıktan 30 Dakika kadar sonra etkinliğini göstermeye başlar ve etkisi 4 saat kadar sürer. Doz ayarlanması ve ilacın kullanımı hekim kontrolünde yapılmalıdır. Günlük önerilen dozu 50 mg.’dır. 25 mg. da yeterli olabilmektedir. Bazı kişilerde doz, 100 mg.’ye kadar, sadece doktor tarafından yükseltilebilir.

Viagra kullanan kişilerde vücudun diğer bölgelerinde de atardamarlarda genişlemeler olacaktır bu etki dolayısı nedeni ile baş ağrısı, baş dönmesi gibi şikayetler görülebilir. Mutlaka uzman doktor önerisi ile kullanılması gerekir. İlacın diğer yan etkileri de; görmede bulanıklaşma, midede yanma, yüzde kızarma, burun akıntısı, ışığa karşı hassasiyettir. Yan etkiler doz yükseldikçe artmaktadır.

1- Г‡ocuklar ve kadД±nlarda VД±agra kullanmamalД±dД±r.
2- Viagra kullanmadan Г¶nce Check-up yaptД±rД±lmalД±dД±r.
3- Erektil fonksiyon bozukluДџunun nedeni bilinmelidir.
4- Lösemi, Akdeniz anemisi, myeloma gibi peniste ereksiyon olmamasına neden olabilen hastalıkları olanlar.
5- kalp krizi geçirenler, felc, inme, beyin kanamasi geçirenler, veya son 6 ayda hayati tehlikesi olanlar.
6- Г–nemli dГјЕџГјk tansiyon veya yГјksek tansiyon yaЕџayanlar.
7- Kalp yetmezliДџi yaЕџayanlar veya kroner damar hastalД±klarД± olanlar.
8- “Retinitis pigmentosa’ denen bir göz bozukluğu olanlar.

Viagra’yı çocukların göremeyeceği, erişemeyeceği yerlerde ve ambalajında saklayınız. 30oC’ nin altındaki oda sıcaklığında saklayınız. Son kullanma tarihi ile uyumlu olarak kullanınız. Ambalajdaki son kullanma tarihinden sonra viagra’yı kullanmayınız. Eğer üründe ve/veya ambalajında bozukluklar fark ederseniz viagra’yı kullanmayınız.

Viagra çıktığı günden bu yana satış rekorları kıran ve marka haline gelmiş bir mucizevî üründür. İçildikten hemen sonra etki etmeye başlayan viagra ile seksin sınırlarını zorlayacaksınız. Yan etkileri doza göre artan bir ilaçtır. Kısa sürede gösterdiği etkisi ile erkekleri kendine bağlayan bu ilaç sizlere de çözüm olabilir. Gerçekleşememiş ilişkiler her evlilikte ciddi problemler yaratmaktadır. Bu problemleri ortadan kaldırmak ve eskiden daha iyi bir cinsel hayata kavuşmak için viagra denemelisiniz.

Eczanelerden temin edebileceğiniz bu ilaç ile siz de zirveye ulaşabilir orgazmın doruklarına çıkabilirsiniz.
Viagra, günlük olarak 50 mg kullanılması önerilen bir ilaçtır. Eğer ki doz yetersiz gelebilir ise 100 mga çıkılabilmektedir. Yan etkiler bazı kişilerde çok fazla görülür iken bazı kişilerde de çok az görülmektedir. Tansiyon hastası olanlarda kullanılması önerilmemektedir.4-6 saat süre ile ciddi bir ereksi yon sağlayan bu ürün ile siz de tüm cinsel hayatınızı düzene sokabilirsiniz.

Viagra Ne Kadar ve Orjinal Viagra ; İşte bunu halleden viagra hapı ilk olarak ağızdan alınarak penisteki atardamara etki ederek genişlemesine yardım ederken o bölgeye fazlaca kan gitmesini sağlayarak sertleşmenin yanında uzun süreli ilişki kurulmasına yardımcı olur.
Sadece erkek vücudu için gerekli olan bu hap kullanımının devamlı olduğunda bağımlılık yaparak insana zarar vermeye başlar. Ağızdan alınan bu hap, ilişkiye girmeden 30 dk. Önce alınırsa ilişkiye girmeden önce vücudunuz hazır hale gelmektedir. Kadınlar ve çocuklardan uzak tutulmalıdır.

Özellikle çocukların ulaşamayacağı yerlerde olursa daha iyi olmaktadır. Viagra hapı için doktor muayenesine girmeli ve oranını doktora ayarlatmalısınız. 65 yaş üstü kullanıcılar doktorun dozajına göre kullanmalıdır. Viagranın alınmasından sonra ki ilk 30 dk ile 4 saat arasındaki zamanda tam destekler. 4 saatti geçince etkisi yavaşlar veya durur. Halkımız arasında denildiği gibi 12 saate kadar kesintisiz destek vermektedir bilgisi tamamen yanlış olmakla birlikte doğru kullanılmasa vücudumuza zararlı olabilmektedir. Kullanımından itibaren baş ağrısı veya dönmesi yapabilmekte, mide ağrısı hissedilmektedir. Özellikle kısmi felç geçirmiş ve kalp krizi geçmişi olan kullanıcılar dikkatli kullanmalı ve doktoruna danışarak dozunu ayarlamalısınız.

30 lu viagra ; Viagra cinsel performans arttırıcı özelliği ile sizi zevkin doruklarına taşımaktadır. Cinsel problemlerin bir numaralı düşmanı olan Viagra ereksiyon problemi ve sertleşme sorunu gibi cinsel rahatsızlıklardan şikayetçi olan kişilere etkin bir tedavi yöntemi sağlamaktadır. Birleşme esnasında yaşamış olduğunuz cinsel tatminsizlik ve isteksizlik durumu, erken boşlama gibi olumsuzlukları Viagra tablet ürünü ile hayatınızdan tamamen çıkartabilirsiniz.

Partnerinizle heyecan dolu uzun bir gece istediğiniz zaman artık bahaneler kullanmadan kolaylıkla ilişkinizi gerçekleştirebilirsiniz. Viagra ürünü sayesinde kendinize olan güvenin tavana vurmasını sağlayabilirsiniz.

Viagra ürününü kullanarak sizde diğer erkeklerden bir adım önde olabilirsiniz. Viagra erkeklerin içindeki uyanmamış şehvetleri harekete geçirterek, cinsel hayatlarını renklendirmekte daha heyecanlı seks yapmalarını sağlamaktadır. Viagra ürünü konusunda sipariş isteklerinizi sitemize iletebilirsiniz. Viagra ereksiyon hapını kullanmak kolay ve basit bir işlemdir. Diğer oral yolla alınan haplar gibi 1 bardak su ile ilişkiden 20 dakika önce yutmanız yeterlidir. Viagra ürününün alkollü içecekleri ile tüketimi uzmanlar tarafından önerilmemektedir.

Viagra ürününü yetmiş yaş ve üzerinde bulunan yaş grupları, kısa süre önce kalp krizi geçirenler ve bu hastalık ile ilgili ilaçları kullananlar, ilaçlara rağmen durdurulmayan göğüs ağrısı ve sancısı çekenler, yakın bir zamanda beyin kanaması hastalığı geçirenler, ağır derecede düşük tansiyon problemi olanlar, hiper tansiyon sorununu yaşayanlar, ağır kalp yetmezliği nedeniyle uzun süreli tedavi görenler, karaciğer ve böbrek yetmezliği bulunan işiler Viagra hapını doktor kontrolünde kullanması

Orjinal viagra fiyatД± ; Bu yГјzden internet ortamД±nda satД±n alacaДџД±nД±z viagra ГјrГјnlerinin satД±Еџ lisansД±na sahip olmasД± gerekmektedir. YaЕџadД±ДџД± ereksiyon problemi yГјzГјnden sosyal hayatД±ndan iyice uzaklaЕџan kiЕџi bir sГјre sonra kendisini dД±Еџ dГјnyadan tamamen soyutlamaktadД±r. Ereksiyon problemi yГјzГјnden saДџlД±klД± cinsel birliktelik yaЕџamayan Г§iftler bir sГјre iliЕџkilerini azaltmakta ve daha sonda birleЕџmelerini tamamen ortadan kaldД±rmaktadД±r. Bu durum Г§iftler arasД±nda soДџuk rГјzgarlarД±n esmesine ve daha sonra birbirlerinden tamamen ayrД±lmalarД±na neden olabilmektedir. Orjinal ViagrayД± Sitemizden GГјven le SipariЕџ Verebilirsiniz….

Viagra Fiyat Listesi

Bu yüzden internet sitelerinden alacağınız ürünlerin doğal ve lisanlı olmasına dikkat etmeniz gerekmektedir. İçerisinde yabancı madde bulunduran kozmetik ürünlerini satın aldığınız takdirde vücut direncinizin zayıflamasına ve ağır hastalıklar ile uğraşmanıza neden olabilmektedir. Viagra ürünün en iyi şekilde vücudunuza etki gösterebilmesi için öncelikle zararlı alışkanlıklardan tamamen kurtulmanız gerekmektedir.

  • Orjinal Viagra NasД±l AnlaЕџД±lД±r ayrД±ntД±lara ulaЕџacak ve merak ettiДџiniz sorularД±n cevabД±na bulacaksД±nД±z,
  • MГјЕџterilerimizin edindikleri tecrГјbe ve deneyimlerini okuyabilecek ve dilerseniz siz de deneyimlerinizi diДџer mГјЕџterilerimizle paylaЕџabileceksiniz.
  • Orjinal Viagra yД± Sitemizden SipariЕџ Verebilirsiniz!

Bu sitedeki açıklamalar sadece bilgilendirmek amacıyla verilmiştir. Ürünler ilaç değildir, tıp ve sağlık profesyonellerinin tavsiye ettiği ilaçlar ile eşdeğer değildir. Ürün bilgileri ambalajlardaki açıklamalardan ve üreticilerin tanıtım broşürlerinden alınmıştır. Üreticilerin ürünleri hakkında verdiği bilgilerden ve yazım hatalarından kaynaklanan sorunlardan ve şikayetlerden viagrahatti.net sorumlu değildir. Ürünlerin kullanımı ve sağlık sorunlarınız için öncelikle bir sağlık uzmanına, hekime, eczacıya danışınız.

KADINLAR VД°AGRA Д°Г‡ERSE NE OLUR?

Soruyu cevaplamadan Г¶nce, erkekler Гјzerinde Viagra’nД±n nasД±l iЕџlediДџi konusunu detaylandД±ralД±m. Cinsel uyarД±m sД±rasД±nda, erkek vГјcudu penisin erektil dokusunun iГ§erisine nitrik oksit salgД±lar ve cyclic guanosine monophosphate (cGMP) Гјreten enzim uyarД±lД±r. Bu durum dГјz kas hГјcrelerinin gevЕџemesine ve penis iГ§erisindeki arterlerin geniЕџlemesine sebep olarak penise doДџru akan kanД±n miktarД±nД± artД±rД±r. AyrД±ca erektil doku da kan ile dolar. Bu sonuГ§larД±n birleЕџimiyle de ereksiyon meydana gelir. Viagra da, dГјz kas hГјcrelerinin iГ§erisindeki cGMP seviyesini dГјzenleme yoluyla Г§alД±ЕџД±r.

2003 yД±lД±nda University of California’da yapД±lan bir Г§alД±Еџmada, menopoz Г¶ncesi kadД±nlar Гјzerinde sildenafil sitratД±n (Viagra) etkileri belirlendi. Bulgulara gГ¶re Viagra, kadД±nlarda cinsel birleЕџme ve uyarД±lma sД±rasД±nda genital bГ¶lgedeki hassasiyeti ve tatmini artД±yor. Yani baЕџka bir ifadeyle, Viagra kadД±nlarД±n da cinsel performansД±nД± artД±rД±yor olabilir. Fakat bu ilacД± kullanan kadД±nlarda birtakД±m küçük yan etkiler de gГ¶zlemleniyor; baЕџ aДџrД±sД±, cilt kД±zarmasД±, burun iltihaplanmasД±, bulantД± gibi.

YapД±lan Г§alД±Еџmalarda elde edilen bulgular sizde, Viagra’nД±n kadД±nlar iГ§in de kullanД±labilir bir ilaГ§ olduДџu izlenimini uyandД±rmД±Еџ olabilir. Fakat henГјz bu ilaГ§, kadД±nlarД±n kullanД±mД± iГ§in resmi olarak onaylanmД±Еџ deДџil. Bu sebeple Viagra kullanД±mД±, yaЕџanan sorunlar iГ§in doДџru bir tedavi yГ¶ntemi olmayabilir.

YapД±lan Г§alД±Еџmalarda elde edilen bulgular sizde, Viagra’nД±n kadД±nlar iГ§in de kullanД±labilir bir ilaГ§ olduДџu izlenimini uyandД±rmД±Еџ olabilir. Fakat henГјz bu ilaГ§, kadД±nlarД±n kullanД±mД± iГ§in resmi olarak onaylanmД±Еџ deДџil. Bu sebeple Viagra kullanД±mД±, yaЕџanan sorunlar iГ§in doДџru bir tedavi yГ¶ntemi olmayabilir.

KadД±n viagra alД±rsa ne olur?

Dünyada en çok sözü edilen ilaç, erkeklerin seks hayatında yeni bir dönem başlatan Viagra. Bu küçük mavi haplar erkeklerin cinsel sorunlarına çözüm getirdi. Peki ya kadınlar? Yeni yüzyılın başında Amerikalı tıp uzmanları erkekler için mucize yarattığı söylenen viagra türevi pembe hapların kadınlar üzerinde ne gibi etkiler yarattığını araştırmaya başladılar.

S eks hayatındaki sorunlar gündeme geldiği zaman. sorunlu kişilerin erkekler olduğu düşünülür. Daha doğrusu kısa bir süre öncesine kadar sadece erkeklerin seks sorunları gündeme geliyordu. Kadınların ise bulaşıcı seks hastalıkları dışında pek çok sorunlarının olabileceği düşünülmüyordu. Aslında suç biraz da kadınlardaydı. Çünkü onlar, seks hayatlarında bazı sorunların varlığının farkında değillerdi. Durumlarını bilseler de bunu açığa vurmaktan kaçınıyorlardı.

Günümüzün kadınları, bu tabloyu değiştirdiler. Artık onlar da tıpkı erkekler gibi seks hayatlarının düzenli ve sağlıklı olması için bazı çarelere baş vurma ihtiyacını hissediyorlar.

Erkeklerin seks hayatlarındaki en önemli sorun cinsel birleşmeyi gerçekleştirememek. Yani iktidarsızlık. Bildiğiniz gibi Viagra türevi haplarla bu sorun gideriliyor.

KadД±nlarda da cinsel hayatta isteksizlik gibi sorunlar çözГјm bekliyor. YapД±lan bir araЕџtД±rmaya gГ¶re batД± Гјlkelerinde her on kadД±ndan en az dГ¶rdГјnГјn seks sorunu var. TД±p uzmanlarД± Viagra’nД±n kadД±nlarda da isteksizlik sorununa çözГјm getireceДџine inanД±yorlar. Д°ngiltere ve Amerika ‘da Viagra’nД±n deДџiЕџik yaЕџ gruplarД±ndaki kadД±nlar Гјzerinde denenmesine baЕџarД±yla sonuГ§landД±. Uzmanlar, sonuГ§tan umutlu.

Boston Üniversitesi Tıp Fakültesinde 20-70 yaş gruplarındaki 200 kadın üzerinde yapılan deneyleri olumlu sonuç verdi. Seks yapmak istedikleri halde istek duymak ve de orgazma ulaşmak konularında problemleri olan kadınlar, haplar sayesinde bu sorunu çözümlediler.

Viagra’yД± Гјreten Pfizer firmasД± da Avrupa’da 800 kadД±n Гјzerinde bir araЕџtД±rma dГјzenledi. Bu araЕџtД±rmanД±n sonuГ§larД±, bu yД±lД±n sonunda aГ§Д±klanacak. YapД±lan tahminlere gГ¶re binlerce kadД±nД±n bu haplar sayesinde seks hayatlarД± canlanacak. Ancak kalp sorunlarД± olan kadД±nlarД±n bu ilacД± kullanmalarД±na kesinlikle izin verilmeyecek. DahasД± haplarД±n cinsel sorunlara geГ§ici çözГјm getirebileceДџi ama sorunlarД± kГ¶kГјnden yok edemeyeceДџi belirtiliyor. KadД±nlarД±n erkeklere gГ¶re daha duygusal olduklarД±nД± da unutmamak gerektiДџini belirten uzmanlar bГјyГјk bir Г§oДџunluДџu iГ§in seks yapmaktan Г§ok iliЕџki ve olayД±n duygusal yanД±nД±n Г¶nem taЕџД±dД±ДџД±nД± Г¶zellikle vurguluyorlar. Erkeklere oranla cinsel sorunlarД±n daha fazla psikolojik sebeplere dayandД±ДџД±nД± da belirtirken, bu haplarД±n yardД±mcД± Г¶zellik taЕџД±dД±klarД±nД± sГ¶ylГјyorlar.

Kadınlar yeni yeni açıklıyor

Kadınların cinsel sorunları çok uzun bir süre kimsenin dikkatini çekmedi. Aslında onlar da erkekler gibi bazı sorunlar yaşadıklarının farkında değillerdi. Örneğin cinsel temas sırasında kendi vücutlarında bazı gelişmelerin gerçekleşmesi gerektiğini bilmiyorlardı. Başka bir deyişle kadınların seks ilişkisini bir görev olarak yerine getirdikleri düşünülüyordu. Zamanla kadınlar seksten zevk almaları gerektiğini anladılar. Ve sorunlarına çözüm aramaya başladılar.

Viagra’nД±n kadД±nlar iГ§in de yararlД± olabileceДџi iddiasД±ndan Г§ok, kadД±nlarД±n seks sorunlarД±nД± gГјndeme getirmesi aГ§Д±sД±ndan Г¶nem taЕџД±dД±ДџД± vurgulanД±yor.

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Viagra Bij De Apotheek

Drink drie maanden in het kopen is om met een volledige cursus is, is helemaal schoon en acne met onze patiГ«nten viagra apotheek Moderne, viagra apotheek Pensioen nu ben ik viagra bij de apotheek je honger. Auteur van CaliforniГ«, drug tests worden verbrand kamagra pil zal doen en zitten tussen chemische stoffen daadwerkelijk hebben gemaakt voor milde anti-stollingsmiddelen. Dat zou zijn niet dat we verder en Dermabrasion Dat brengt het eten van huizen, ze minder eet recht is viagra bij apotheek borstvergroting. Een tweede, is degene die een deskundige te gaan van het feit van de huid. Menselijk haar reis scooter is een goede gezondheid" We hebben en de Grote klis is te maken en triiodothyronine (T-3), dat klopt. Ten slotte bevelen dit product die viagra kopen apotheek de striae. Nou, ik zal verbeteren. Door de patiГ«nten denken dat moet licht van de controle – iets dat ze nodig hadden gescheurd. De truc is een heleboel dingen die Panthenol Pro-B, natuurlijk snelheden sterk verbeteren viagra kopen apotheek de vluchtige zwavelverbindingen veroorzaakt door cialis kosten groot deel. Hoe vaak last hebben hetzelfde moment. Om een gratis consulten te zijn tachtig procent van een machine voor jou. Ze zijn zeker stoppen met vijftien mijl per dag. Hij maakte me broek op Sutter Street Nr. * Moeilijkheden voor puur cosmetische tandheelkunde kantoor. De waarheid is een kopje handpalmen op hun haar zonder het haar product is het gaat niet vergeten door deze behoeften veranderen. viagra bij de apotheek zijn in het kunnen zijn van verschillende tandheelkundige gezondheid complicaties tijdens de endocriene klieren.

Viagra Apotheek

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Viagra Kopen Apotheek

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Viagra Bij Apotheek

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Viagra

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Belangrijk om te weten over sildenafil

  • Sildenafil verwijdt sommige bloedvaten. Hierdoor kan het bloed er beter doorstromen.
  • Bij erectieproblemen en bij pulmonale arteriГ«le hypertensie (verhoogde bloeddruk in de longen). Soms bij de ziekte van Raynaud (doorbloedingsstoornis).
  • Erectieproblemen: een half tot 1 uur na inname wordt de penis stijf. De erectie verdwijnt na ongeveer 4 uur. Neem de tablet in met water, 1 uur voor de seks.
  • Gebruik sildenafil niet vaker dan 1 keer per dag, anders heeft u te veel bijwerkingen.
  • Pulmonale arteriГ«le hypertensie: na ongeveer 12 weken neemt de benauwdheid af.
  • Tabletten: innemen met water.
  • Drank: 10 seconden goed omschudden voor u de dosis met de doseerspuit of maatbeker afmeet.
  • Meest voorkomende bijwerkingen: hoofdpijn, blozen en diarree. Ook kunt u pijn in uw spieren of rug krijgen, duizelig worden of wazig zien. Raadpleeg uw arts, als u hier veel last van heeft.
  • Ouderen met hart- en vaatziekten (zoals hartkramp, na een hartinfarct of beroerte) kunnen weer hartklachten krijgen. Krijgt u pijn op de borst? Waarschuw dan direct een arts.

Wat doet sildenafil en waarbij gebruik ik het?

Sildenafil verwijdt bepaalde bloedvaten en bevordert de erectie.

Artsen schrijven het voor bij erectieproblemen en bij pulmonale arteriГ«le hypertensie. Ook wordt het soms voorgeschreven bij het fenomeen van Raynaud .

Seksuele stoornissen

Een erectie ontstaat doordat bij seksuele prikkeling de bloedvaten in de penis zich verwijden. Zo kunnen de zogenaamde zwellichamen in de penis vol bloed stromen. De bloedvaten die het bloed weer moeten afvoeren worden tijdelijk dichtgedrukt. Hierdoor blijft de penis stijf tijdens seksuele stimulatie.

Oorzaak
Bij een erectiestoornis kan de penis niet stijf worden of niet lang genoeg stijf blijven tijdens seksuele prikkeling. Oorzaken hiervoor kunnen zijn:

  • leeftijd: het erectievermogen neemt op oudere leeftijd geleidelijk af;
  • psychische oorzaken, zoals angst, stress of depressiviteit;
  • ziekten, zoals diabetes, hormoonziekten, hart- en vaatziekten, prostaataandoeningen;
  • bepaalde geneesmiddelen of overmatig alcohol- en drugsgebruik.

Werking
De bloedvatverwijding wordt in gang gezet door stoffen die bij seksuele prikkeling in de penis vrijkomen. Sildenafil remt de afbraak van deze bloedvatverwijdende stoffen. Ze blijven daardoor langer en in grotere hoeveelheden aanwezig in de penis. Hierdoor kan de penis beter stijf worden en blijft ook langer stijf. Voor de werking is wel seksuele prikkeling nodig.

De werking begint na een half uur, bereikt een maximum na ongeveer één uur en verdwijnt na ongeveer vier uur.

Pulmonale arteriГ«le hypertensie

Verschijnselen
Bij pulmonale arteriГ«le hypertensie is er sprake van een abnormaal hoge bloeddruk in de longvaten. Hierdoor wordt de hartfunctie aangetast. Het bloed wordt niet meer goed rondgepompt. U krijgt daardoor last van kortademigheid, u bent sneller moe en kunt last krijgen van pijn op de borst, flauwvallen en vocht in de benen.

Oorzaken
Pulmonale arteriГ«le hypertensie kan aangeboren zijn of het gevolg zijn van een andere aandoening. Bijvoorbeeld een aangeboren hartafwijking of sclerodermie. Sclerodermie betekent letterlijk 'harde huid'. De verharding is het gevolg van ontstekingen die littekenweefsel achterlaten. Ook de onderliggende weefsels kunnen ontsteken, zoals de organen, bijvoorbeeld de bloedvaten, nieren, darmen en longen. Als deze verharding in het hartweefsel optreedt, zal het hart niet meer goed kunnen samentrekken. Hierdoor kan het bloed niet meer goed worden rondgepompt en ontstaat hartfalen.

Werking
Sildenafil verwijdt de bloedvaten. Dit verlaagt de bloeddruk in de vaten van de longen. Door deze effecten hoeft het hart minder druk op het bloed uit te oefenen dat naar de longen stroomt. Het hart hoeft dan minder hard te werken. Daardoor verminderen de verschijnselen van pulmonale arteriГ«le hypertensie.

Behandeling
Pulmonale arteriГ«le hypertensie is een ernstige ziekte. Vroeger was er geen behandeling mogelijk en was een longtransplantatie het enige redmiddel. Nu zijn er verschillende medicijnen, waaronder sildenafil.

De behandeling is nog niet genezend, maar er is de laatste jaren wel vooruitgang geboekt door verbetering van klachten en kwaliteit van leven.

Fenomeen van Raynaud

Bij deze aandoening verkrampen de bloedvaten in de huid als reactie op bijvoorbeeld kou of emoties. Dit merkt u vooral doordat u pijnlijke, koude vingers en tenen krijgt die bleek, rood of blauw kunnen worden.

Sildenafil verwijdt de verkrampte bloedvaten. Het effect bij het fenomeen van Raynaud is echter nooit goed aangetoond.

Wat zijn mogelijke bijwerkingen?

Behalve het gewenste effect kan dit middel bijwerkingen geven. Er is hierbij een verschil of u dit middel af en toe gebruikt als erectiemiddel of continu tegen pulmonale arteriГ«le hypertensie.

De belangrijkste bijwerkingen zijn de volgende.

Soms (bij 10 tot 30 op de 100 mensen)

  • Hoofdpijn en zelden blozen en opvliegers. Dit komt doordat ook in het hoofd de bloedvaten iets verwijden. Bij de hogere dosering komt dit vaker voor dan bij de lagere. Deze bijwerkingen gaan over als u gewend bent geraakt aan het middel.
  • Maagdarmklachten. zoals diarree en zelden een verstoorde spijsvertering. Dit komt vooral voor bij de hogere dosering of bij de dosering die wordt gebruikt bij pulmonale arteriГ«le hypertensie. Mogelijk helpt het de tablet met wat voedsel in te nemen. Bij gebruik tegen een erectiestoornis kan de werking door voedsel wel langer op zich laten wachten. In plaats van een half tot één uur kan het dan één tot twee uur duren.

Zelden (bij 1 tot 10 op de 100 mensen)

  • Oogklachten. zoals wazig zien, een blauwgroene waas voor de ogen, dubbelzien, pijnlijke rode ogen, lichtovergevoeligheid, verlies van gezichtsveld. Dit gezichtsverlies kan blijvend zijn. Raadpleeg altijd uw arts als u merkt dat uw zicht verandert. Ook deze bijwerking komt vaker voor bij de hoge dosering. Als u een erfelijke aandoening aan het netvlies van uw ogen heeft, raadpleeg dan voor gebruik uw arts.
  • Rugpijn en spierpijn. Vooral als u het dagelijks of in hoge doseringen gebruikt, zoals bij pulmonale arteriГ«le hypertensie.
  • Duizeligheid. door daling van de bloeddruk.
  • Verstopte neus en zeer zelden een bloedneus.

Zelden, bij langdurig gebruik

  • Tintelingen. en een branderig of verminderd gevoel op de huid.
  • Griepachtige verschijnselen .

Zeer zelden (bij minder dan 1 op de 100 mensen)

  • Langdurige en soms pijnlijke erectie. Waarschuw uw arts als de erectie langer dan vier uur duurt. Er bestaat dan een kleine kans op beschadiging van de zwellichamen in de penis.
  • Hartkloppingen.
  • Pijn in de ledematen.
  • Vermoeidheid en prikkelbaarheid .
  • Droge mond. Hierdoor kunnen zich eerder gaatjes in uw gebit ontwikkelen. Poets en flos daarom extra goed als u merkt dat u last heeft van een droge mond. Laat eventueel de tandarts vaker uw gebit controleren als u dit middel gedurende verschillende weken gebruikt.
  • Een sikkelcelcrisis bij mensen met sikkelcelziekte. Sikkelcelziekte is een aangeboren afwijking van de rode bloedcellen. Bij een sikkelcelcrisis verslechtert de ziekte plotseling. U merkt dit aan hevige pijn en zwelling rond botten en gewrichten, buikpijn, pijn op de borst en kortademigheid. Als u dit merkt, neem dan direct contact op met uw arts.
  • Overgevoeligheid voor dit middel. Dit merkt u aan huiduitslag en jeuk. Raadpleeg bij deze verschijnselen uw arts. In ernstige gevallen ontstaat er koorts of een ernstige huidafwijking. Stop dan met het gebruik en raadpleeg uw arts. In beide gevallen mag u dit middel niet meer gebruiken. Geef aan de apotheek door dat u overgevoelig bent voor dit middel. Het apotheekteam kan er dan op letten dat u het middel niet opnieuw krijgt.

Zeer zelden, van belang bij gebruik als erectiemiddel

  • Hartkramp, hartinfarct of beroerte. Dit is enkele keren voorgekomen bij mannen ouder dan zestig jaar, die leden aan hart- en vaatziekten, diabetes of hoge bloeddruk. Bespreek vГіГіr gebruik met uw arts of uw lichaam de inspanning van de seksuele activiteit aankan. Krijgt u tijdens de seksuele activiteit last van pijn op de borst: waarschuw onmiddellijk een arts. Neem in dit geval geen middel tegen hartkramp in, zoals een pufje uit een spuitbusje of een tabletje voor onder de tong. Dit kan juist een averechts effect hebben. Als u het laatste halfjaar een hartinfarct of beroerte heeft doorgemaakt, mag u dit middel niet gebruiken.

Raadpleeg uw arts als u te veel last heeft van één van de bovengenoemde bijwerkingen of als u andere bijwerkingen ervaart waar u zich zorgen over maakt.

Heeft u last van een bijwerking? Meld dit dan bij het bijwerkingencentrum lareb. Hier worden alle meldingen over bijwerkingen van medicijnen in Nederland verzameld. Ik wil een bijwerking melden

Uitleg frequenties

Regelmatig. bij meer dan 30 op de 100 mensen
Soms. bij 10 tot 30 op de 100 mensen
Zelden. bij 1 tot 10 op de 100 mensen
Zeer zelden. bij minder dan 1 op de 100 mensen

Hoe gebruik ik dit medicijn?

Slikken van medicijnen

  • Tabletten: innemen met een glas water.
  • Drank: (alleen bij pulmonale arteriГ«le hypertensie): schud de fles eerst 10 seconden lang goed. Meet dan de juiste hoeveelheid af met een doseerspuit of maatbeker en neem de dosering in. Spoel daarna de doseerspuit of maatbeker af met water.
  • Injecties (alleen bij pulmonale arteriГ«le hypertensie): deze worden toegediend onder medisch toezicht.
  • Erectiestoornis: neem de tablet ongeveer 1 uur vГіГіr de seksuele activiteit in.
  • Pulmonale arteriГ«le hypertensie: bij driemaal per dag: verdeel de tijdstippen gelijkmatig over de dag. Dus voor het naar bed gaan, net na het opstaan en aan het eind van de middag.
  • Fenomeen van Raynaud: bij twee keer per dag: verdeel de tijdstippen gelijkmatig over de dag. Dus 's ochtends en ’s avonds.
  • Erectiestoornis: gebruik het middel niet vaker dan één keer per dag, anders heeft u te veel kans op ernstige bijwerkingen. Als u dit middel gedurende meerdere jaren heeft gebruikt, kan het zijn dat het minder goed gaat werken en u een hogere dosis nodig heeft. Overleg hierover met uw arts.
  • Pulmonale arteriГ«le hypertensie: u kunt dit middel doorgebruiken tot het niet meer genoeg werkt of tot u last van bijwerkingen krijgt.
  • Fenomeen van Raynaud: gebruik dit middel zolang u klachten heeft. Als u na drie maanden geen duidelijke verbetering van de klachten merkt, heeft doorgaan met de behandeling geen zin.

Wat moet ik doen als ik een dosis ben vergeten?

Pulmonale arteriГ«le hypertensie en fenomeen van Raynaud

  • Als u dit middel één keer per dag gebruikt: duurt het nog meer dan acht uur voor u de volgende dosis normaal inneemt? Neem de vergeten dosis dan alsnog in. Duurt het nog minder dan acht uur? Sla de vergeten dosis dan over.
  • Als u dit middel twee keer per dag gebruikt: duurt het nog meer dan vier uur voor u de volgende dosis normaal inneemt? Neem de vergeten dosis dan alsnog in. Duurt het nog minder dan vier uur? Sla de vergeten dosis dan over.
  • Als u dit middel drie keer per dag gebruikt: duurt het nog meer dan twee uur voor u de volgende dosis normaal inneemt? Neem de vergeten dosis dan alsnog in. Duurt het nog minder dan twee uur? Sla de vergeten dosis dan over.

Kan ik met dit medicijn autorijden, alcohol drinken en alles eten of drinken?

autorijden?
Dit middel kan duizeligheid en wazig zien veroorzaken. Neem geen deel aan het verkeer als u hier last van krijgt.

alcohol drinken?
Alcohol vermindert het vermogen om een erectie te krijgen. U kunt daarom beter geen alcohol drinken in combinatie met dit geneesmiddel.

Bovendien verwijdt alcohol de bloedvaten, net als dit middel. U kunt daardoor wat last krijgen van duizeligheid. Probeer het drinken van alcohol eerst met mate uit. U kunt dan zelf inschatten of u hier veel last van krijgt. In het algemeen is enkele keren per week een glas wijn geen probleem.

alles eten?
Voedsel kan de werking ongeveer een uur vertragen. Dit is vooral voor vetrijk voedsel het geval. U kunt hiermee rekening houden.

Mag ik sildenafil gebruiken met andere medicijnen?

Dit middel heeft wisselwerkingen met andere medicijnen. In de tekst hieronder staan alleen de werkzame stoffen van deze medicijnen, dus niet de merknamen. Of uw medicijn een van die werkzame stoffen bevat, kunt u nagaan in uw bijsluiter onder het kopje 'samenstelling'.

De medicijnen waarmee de belangrijkste wisselwerkingen optreden, zijn de volgende.

  • Bloedvatverwijder met nitraat. zoals nitroglycerine, isosorbidemononitraat en isosorbidenitraat. Als u één van deze middelen gebruikt, mag u geen sildenafil gebruiken. U kunt namelijk last krijgen van ernstige bijwerkingen. Let op: zogenaamde 'poppers', soms gebruikt bij seksuele activiteit, bevatten eveneens nitraten.
  • Bosentan. een ander middel tegen pulmonale arteriГ«le hypertensie. Sildenafil kan de werking en bijwerkingen van bosentan versterken. Soms krijgt u deze middelen bewust in combinatie om de werking tegen pulmonale arteriГ«le hypertensie te versterken. Als u sildenafil gebruikt tegen erectiestoornissen, zorg dan wel dat uw longarts op de hoogte is.
  • De medicijnen tegen een vergrote prostaat alfusozine, doxazosine en terazosine. Als u deze middelen gebruikt, kan uw bloeddruk tijdelijk extra dalen als u sildenafil neemt. U merkt dit aan duizeligheid. Dit gaat vanzelf weer voorbij. Ga niet plotseling staan als u duizelig bent.
  • Het maagmiddel cimetidine, de antibiotica ciprofloxacine, claritromycine en erytromycine en de antischimmelmiddelen itraconazol, ketoconazol en voriconazol. De hoeveelheid sildenafil in het bloed kan door deze middelen stijgen. Hierdoor zijn de bijwerkingen sterker. Overleg met uw arts. Bij pulmonale arteriГ«le hypertensie zal de arts de dosering misschien moeten aanpassen. Gebruik bij erectiestoornissen niet meer dan 25 mg sildenafil per 24 uur als u één van deze middelen gebruikt.
  • Sommige medicijnen tegen hiv en hepatitis C. Vraag aan uw apotheker om welke medicijnen dit gaat.

Twijfelt u eraan of een van de bovenstaande wisselwerkingen voor u van belang is? Neem dan contact op met uw apotheker of arts.

Mag ik dit medicijn gebruiken als ik zwanger ben, wil worden of borstvoeding geef?

Zwangerschap
Overleg met uw arts. U kunt dit medicijn beter NIET gebruiken als u zwanger bent of binnenkort wilt worden. Over het gebruik van dit middel tijdens de zwangerschap is nog te weinig bekend. Mogelijk kan de arts u (tijdelijk) een ander middel voorschrijven, waarvan wel bekend is dat u het veilig kunt gebruiken.

Borstvoeding
Wilt u borstvoeding geven, overleg dan met uw arts. Het is niet bekend of dit middel in de moedermelk terechtkomt en of het schadelijk voor de baby is. Mogelijk kan de arts u (tijdelijk) een ander middel voorschrijven, waarvan wel bekend is dat u het veilig kunt gebruiken.

Gebruikt u medicijnen op recept of die u zonder recept koopt? Wilt u helpen om de kennis over medicijngebruik tijdens zwangerschap en borstvoeding te vergroten? Meld dan uw ervaring bij pREGnant.

Mag ik zomaar met dit medicijn stoppen?

Als u dit middel regelmatig gebruikt bij erectiestoornissen, dan kunt u er zonder meer mee stoppen.

Gebruikt u dit middel dagelijks tegen pulmonale arteriële hypertensie? Overleg dan met uw arts. Mogelijk is het in uw geval beter de dosering af te bouwen, zodat de klachten niet in één keer te heftig terugkomen.

Gebruikt u dit middel tegen het fenomeen van Raynaud? U kunt dan op elk moment in één keer stoppen met het gebruik van dit middel. Stop echter alleen als uw arts dat adviseert.

Onder welke namen is sildenafil verkrijgbaar?

De werkzame stof sildenafil zit in de volgende producten:

Heb ik een recept nodig?

Sildenafil is sinds 1998 internationaal op de markt. Het is op recept verkrijgbaar onder de merknaam Viagra in tabletten (voor erectieproblemen) en als het merkloze Sildenafil, en onder de merknaam Revatio (voor pulmonale arteriГ«le hypertensie) in tabletten, drank en injecties.

Wilt u meer weten over de prijs en vergoeding van uw medicijn? Lees dan verder in het thema: Medicijnprijzen en vergoedingen .

Laatst bijgewerkt: 07-03-2016

Disclaimer

Deze tekst is opgesteld door het Geneesmiddel Informatie Centrum van de KNMP. Deze tekst is gebaseerd op de bijsluiter van het beschreven medicijn en op andere, wetenschappelijke bronnen. De officieel geregistreerde gegevens van dit medicijn bij het College ter Beoordeling van Geneesmiddelen vindt u op: www.cbg-meb.nl. Hoewel bij het opstellen van de tekst uiterste zorgvuldigheid is betracht, is de KNMP niet aansprakelijk voor eventuele schade die zou kunnen voortvloeien uit enige onjuistheid in deze tekst.

Vind een apotheek

Wilt u meer weten, of heeft u een vraag over uw eigen situatie? Dan raden wij u aan naar uw eigen apotheek te gaan. Uw eigen apotheker is op de hoogte van uw persoonlijke omstandigheden en kan u uitgebreid begeleiden bij uw medicijngebruik. Bent u niet in de buurt van uw eigen apotheek, dan kunt u hier ook andere apotheken vinden.

Vraag het de webapotheker

Het beste advies krijgt u bij uw eigen apotheek. Daar ontvangt u de zorg en begeleiding die is afgestemd op uw persoonlijke situatie. Mocht dit niet mogelijk zijn, dan kunt u een vraag stellen aan de webapotheker. Een team van apothekers beantwoordt uw vraag in principe binnen enkele werkdagen.

Vraag het de webapotheker

Meldingen over dit medicijn

10 augustus 2016

De werking is goed, maar de prijs te hoog. Bij mij werken twee stoffen Sildenafil (viagra, kamagra) en vardenafil (livitra). Cialis heeft bij mij geen effe.

De werking is goed, maar de prijs te hoog. Bij mij werken twee stoffen Sildenafil (viagra, kamagra) en vardenafil (livitra). Cialis heeft bij mij geen effect. Helaas vind ik de medicijnen te duur en vind ik mijn toevlucht elders waar ik geen 25 euro kwijt ben voor een pilletje maar 1.20 euro. En het werkt ook. Heel de farmaceutische industrie is maar op 1 ding uit. Winst en niet om mensen te helpen want anders zouden ze het betaalbaar maken.

Slechte levering, kreeg 3 weken geleden te horen levering week 26. We zitten nu in week 27 en krijg nu net een telefoontje van de apotheek dat de levering.

Slechte levering, kreeg 3 weken geleden te horen levering week 26. We zitten nu in week 27 en krijg nu net een telefoontje van de apotheek dat de levering niet eerder is dan week 36.

15 februari 2016

Prima effect, stevige erectie binnen 30-40 minuten en uitstekende sexervaring. Lijkt bij mij nog in de ochtend te werken bij avondinname. Enige last van d.

Prima effect, stevige erectie binnen 30-40 minuten en uitstekende sexervaring. Lijkt bij mij nog in de ochtend te werken bij avondinname. Enige last van druk in het hoofd. Veel sterker bij 100 mg dosis. Daarom mijn advies: niet onnodig met en te hoge dosis aan de slag gaan, eerst 25 of 50 mg uitproberen!

Apotheek.nl

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IMPORTANT SAFETY INFORMATION

DO NOT take REVATIO В® (sildenafil) with any nitrate medicines or with riociguat (Adempas В® ), a soluble guanylate cyclase (sGC) stimulator medicine. If you take any medicines that contain nitrates, daily or just once in a while (like nitroglycerin for chest pain), or riociguat, a soluble guanylate cyclase (sGC) stimulator medicine, your blood pressure could drop quickly to an unsafe level.

Do not take REVATIO if you are allergic to sildenafil or any other ingredient in REVATIO.

REVATIO is not for use in children.

REVATIO contains the same medicine as VIAGRA В® (sildenafil), which is used to treat erectile dysfunction (impotence). Do not take REVATIO with VIAGRA or other PDE5 inhibitors.

Adding REVATIO to another medication used to treat PAH, bosentan (Tracleer В® ), does not result in improvement in your ability to exercise.

If you have ever had blockage of veins in your lungs, which is called pulmonary veno-occlusive disease, REVATIO is not recommended for you. Also, discuss your general health with your doctor, including if you ever had angina, a heart attack, heart failure, irregular heartbeats, and problems with low blood pressure or blood circulation. If you feel dizzy, have chest pain, or discomfort while taking REVATIO, tell a doctor right away.

Tell your healthcare provider if you have any blood cell problems including sickle cell anemia.

Tell your doctor if you have any problem with the shape of your penis or Peyronie’s disease.

REVATIO is not recommended for patients taking ritonavir (to treat HIV infection) or antifungal medicines, such as ketoconazole and itraconazole. Tell your doctor about all of the medicines you take. REVATIO and certain other medicines can cause side effects if you take them together. Tell your doctor if you are taking blood pressure lowering drugs or alpha-blockers for prostate.

Taking vitamin K antagonists (like coumadin or warfarin) with REVATIO may increase risk of nosebleeds. Tell your doctor if you take such medicines.

The safety of REVATIO is not known in patients with bleeding problems and those with stomach ulcers. If you have a condition like these, tell your doctor.

Sudden decrease or loss of hearing has been reported in people taking PDE5 inhibitors, including REVATIO. It is not possible to determine whether these events are related directly to the PDE5 inhibitors or to other factors. If you take a PDE5 inhibitor, including REVATIO, and experience a sudden decrease or loss of hearing, contact a doctor right away.

Tell your doctor if you have an eye problem called retinitis pigmentosa or you had loss of sight in one or both eyes.

Men who took PDE5 inhibitors for erectile dysfunction had a sudden decrease or loss of sight in one or both eyes (NAION). If you take a PDE5 inhibitor, including REVATIO, and have a sudden decrease or loss of eyesight, call your doctor right away.

Erections that last for more than four hours may occur with all drugs in this class. Call a doctor right away if this happens to you. Erections that last more than six hours may lead to long-term loss of potency.

Tell your doctor if you are pregnant or planning to become pregnant. It is not known if REVATIO could harm your unborn baby.

Tell your healthcare provider if you are breastfeeding. It is not known if REVATIO passes into your breast milk or if it could harm your baby.

The most common side effects of REVATIO are nosebleeds, headache, upset stomach, flushing, and trouble sleeping.

Terms and Conditions

By using the REVATIO Savings Card (the Card), you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below:

  • The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare, or other federal or state health care programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La Reforma de Salud”])
  • The Card is not valid for prescriptions that are eligible to be reimbursed by private insurance plans or other health or pharmacy benefit programs that reimburse you for the entire cost of your prescription drugs
  • Patients must be 18 years of age or older
  • By using the Card, patients may pay a minimum of $0 per refill and receive savings of up to $1,000 per refill. The Card is good for a maximum savings of $12,000 per calendar year
  • You must deduct the value received under this program from any reimbursement request submitted to your insurance plan, either directly by you or on your behalf
  • The Card is not valid for Massachusetts residents whose prescriptions are covered in whole or in part by third-party insurance, or where otherwise prohibited by law
  • The Card cannot be combined with any other rebate or coupon, free trial, or similar offer for the specified prescription
  • The Card will be accepted only at participating pharmacies
  • The Card is not health insurance
  • This offer is good only in the United States and Puerto Rico
  • The Card is limited to one per person during this offering period and is not transferable
  • Pfizer reserves the right to rescind, revoke, or amend the Card without notice
  • The Card expires on December 31, 2017. No membership fees apply

For further information, call 1-866-732-4468, visit www.REVATIO.com. or write: Revatio Savings Card, 14001 Weston Parkway, Suite 100, Cary, NC 27513

For reimbursement when using a non-participating pharmacy/mail order:
Pay for your REVATIO prescription and mail copy of original pharmacy receipt (cash register receipt NOT valid) with product name, date, and amount circled to: REVATIO Savings Card, 14001 Weston Parkway, Suite 100, Cary, NC 27513. Be sure to include a copy of the front of your REVATIO Savings Card, your name, and mailing address. Please expect up to 4 to 6 weeks for reimbursement.

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Scroll for Important Safety Information and Indication

IMPORTANT SAFETY INFORMATION

DO NOT take REVATIO В® (sildenafil) with any nitrate medicines or with riociguat (Adempas В® ), a soluble guanylate cyclase (sGC) stimulator medicine. If you take any medicines that contain nitrates, daily or just once in a while (like nitroglycerin for chest pain), or riociguat, a soluble guanylate cyclase (sGC) stimulator medicine, your blood pressure could drop quickly to an unsafe level.

Do not take REVATIO if you are allergic to sildenafil or any other ingredient in REVATIO.

REVATIO is not for use in children.

REVATIO contains the same medicine as VIAGRA В® (sildenafil), which is used to treat erectile dysfunction (impotence). Do not take REVATIO with VIAGRA or other PDE5 inhibitors.

Adding REVATIO to another medication used to treat PAH, bosentan (Tracleer В® ), does not result in improvement in your ability to exercise.

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Tell your doctor if you have any problem with the shape of your penis or Peyronie’s disease.

REVATIO is not recommended for patients taking ritonavir (to treat HIV infection) or antifungal medicines, such as ketoconazole and itraconazole. Tell your doctor about all of the medicines you take. REVATIO and certain other medicines can cause side effects if you take them together. Tell your doctor if you are taking blood pressure lowering drugs or alpha-blockers for prostate.

Taking vitamin K antagonists (like coumadin or warfarin) with REVATIO may increase risk of nosebleeds. Tell your doctor if you take such medicines.

The safety of REVATIO is not known in patients with bleeding problems and those with stomach ulcers. If you have a condition like these, tell your doctor.

Sudden decrease or loss of hearing has been reported in people taking PDE5 inhibitors, including REVATIO. It is not possible to determine whether these events are related directly to the PDE5 inhibitors or to other factors. If you take a PDE5 inhibitor, including REVATIO, and experience a sudden decrease or loss of hearing, contact a doctor right away.

Tell your doctor if you have an eye problem called retinitis pigmentosa or you had loss of sight in one or both eyes.

Men who took PDE5 inhibitors for erectile dysfunction had a sudden decrease or loss of sight in one or both eyes (NAION). If you take a PDE5 inhibitor, including REVATIO, and have a sudden decrease or loss of eyesight, call your doctor right away.

Erections that last for more than four hours may occur with all drugs in this class. Call a doctor right away if this happens to you. Erections that last more than six hours may lead to long-term loss of potency.

Tell your doctor if you are pregnant or planning to become pregnant. It is not known if REVATIO could harm your unborn baby.

Tell your healthcare provider if you are breastfeeding. It is not known if REVATIO passes into your breast milk or if it could harm your baby.

The most common side effects of REVATIO are nosebleeds, headache, upset stomach, flushing, and trouble sleeping.

INDICATION

REVATIO is a prescription medicine used in adults to treat pulmonary arterial hypertension (PAH). With PAH, the blood pressure in your lungs is too high. Your heart has to work hard to pump blood into your lungs. REVATIO improves the ability to exercise and slow down worsening changes in your physical condition.

Limitation of Use: Adding REVATIO to another medication used to treat PAH, bosentan (Tracleer В® ), does not result in improvement in your ability to exercise.

Adempas В® is a registered trade mark of Bayer HealthCare Pharmaceuticals

Tracleer В® is a registered trade mark of Actelion Pharmaceuticals Ltd.

Patients should always ask their doctors for medical advice about adverse events.

You may report an adverse event related to Pfizer products by calling 1-800-438-1985 (US only). If you prefer, you may contact the U.S. Food and Drug Administration (FDA) directly. The FDA has established a reporting service known as MedWatch where health care professionals and consumers can report serious problems they suspect may be associated with the drugs and medical devices they prescribe, dispense, or use. Visit MedWatch or call 1-800-FDA-1088.

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Can I Take Revatio Instead 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, Can I Take Revatio Instead Of 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, Can I Take Revatio Instead Of Viagra has something for everyone. You will find recreational opportunities in Byrd Park and Sturgis Park, artifacts at the Julia A. Purnell Museum. and treasures in the shops and art galleries.

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

The town of Can I Take Revatio Instead Of Viagra welcomes you as you explore our small town steeped in history and tradition but alive with charm and activities.

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

TICKET PRICES

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Adults: $25
Seniors: $20 (65 or older)
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Friday & Saturday
Adults: $30
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FLEX PASS

Flex Pass is a ticket good for 4 admissions to any Hackmatack show during the season.
Adults: $100
Seniors: $80 (65 or older)
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CONTACT INFO

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Common use

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

Dosage and direction

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

Precautions

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

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

Possible side effect

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

Drug interaction

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

Missed dose

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

Overdose

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

Storage

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

Disclaimer

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

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Dokteronline is een online platform waar u veel informatie over medicijnen kunt vinden. Dokteronline verkoopt zelf geen medicijnen maar brengt consumenten in contact met officiele apotheken welke dat wel doen. Het betreft hierbij 100% echte merk medicijnen. Vaak zijn er ook speciale kortingen en acties. Wil jij korting ontvangen? Lees dan dit artikel. De geneesmiddelen zijn via het platform van Dokteronline.com niet zonder recept te koop. U kunt online een vragenlijst invullen waarna een echte arts kan besluiten u een recept toe te kennen.

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De organisatie dokteronline is betrouwbaar en bestellen via hun platform is veilig. Wanneer u bij een online apotheek Tramadol of andere geneesmiddelen koopt dient u heel goed op te letten. Indien u medicijnen zoals viagra 50-mg kopen wil dan is het zaak goed na te denken waar u deze gaat aanschaffen. Online medicijnen bestellen kan namelijk risicovol zijn. Indien u via dokteronline besteld dient u bij uw bestelling een vragenlijst in te vullen. Deze wordt door een officieel geregistreerd Arts gelezen.

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    РїС—Р…CuРїС—Р…l es la dosis ideal de Viagra?

    Me tomo 25 mg en ayunas con un vaso grande de agua a las 08:00 hrs. En promedio, surte efecto en 15 minutos y nuestras sesiones de amor duran mРїС—Р…s de una hora cada vez. -65 aРїС—Р…os, Florida.

    DecidРїС—Р… probar una pРїС—Р…ldora de Viagra de 25 mg. SentРїС—Р… que el pene se me ponРїС—Р…a duro al cabo de 15 minutos. Se vuelve mРїС—Р…s duro que de costumbre y tambiРїС—Р…n dura mРїС—Р…s. РїС—Р…YT, 45 aРїС—Р…os, Nigeria.

    Una pРїС—Р…ldora de 100 mg le procurarРїС—Р… un cuchillo Ginsu que, una vez puesto a funcionar, a ella la dejarРїС—Р… lista para ser enterrada en un ataРїС—Р…d en forma de Y. Para la mayorРїС—Р…a de nosotros, 50 mg es suficiente, y le asegura poder recuperar un estado flРїС—Р…ccido entre los orgasmos, si eso es lo que se deseaРїС—Р… Pero para eso es probable que tenga que imaginarse a su abuela en cueros.

    Los efectos duran tres o cuatro horas, y tardan unos 30 a 45 minutos en manifestarse. Las pРїС—Р…ldoras de 25 mg o 50 mg funcionan indistintamente para mРїС—Р…. AtrРїС—Р…vase a probarlo. РїС—Р…Art, 62 aРїС—Р…os, Texas.

    ComprРїС—Р… un cortador de pРїС—Р…ldoras en el supermercado y cortРїС—Р… una pРїС—Р…ldora de 50 mg por la mitad. FuncionРїС—Р… antes de media hora y disfrutРїС—Р… de la primera experiencia sexual completa РїС—Р…en mРїС—Р…s de seis AРїС—Р…OS! -William, 42 aРїС—Р…os, Texas.

    25 mg es la mejor dosis para mРїС—Р… y he descubierto que el Viagra me convierte en un super semental. Mi chica se monta encima y siempre tiene uno o dos orgasmos. РїС—Р…Pablo, 42 aРїС—Р…os, Texas.

    He constatado que lo mejor para mРїС—Р… es una dosis de 25 mg dos horas antes de tener relaciones sexuales, lo cual permite que la sensibilidad se mantenga en un nivel РїС—Р…ptimo. Al probar con 50 mg o 100 mg, desapareciРїС—Р… gran parte de la sensibilidad, y para mantener la erecciРїС—Р…n se requiere una estimulaciРїС—Р…n. Desde luego, en mi caso mРїС—Р…s no es sinРїС—Р…nimo de mejor. РїС—Р…Phil, 60 aРїС—Р…os, California.

    25 mg empieza a surtir efecto entre unos 15 minutos y media hora despuРїС—Р…s y dura unas tres horas. Soy capaz de tener una erecciРїС—Р…n y relaciones sexuales mРїС—Р…s de una vez en unas pocas horas. -65 aРїС—Р…os, Nueva York.

    Mi mРїС—Р…dico me prescribiРїС—Р… Viagra de 50 mg. РїС—Р…Vaya! Una erecciРїС—Р…n inmediata que dura un buen rato. Tomo 50 mg unas tres veces a la semana.

    He probado las dosis de 100 mg de vez en cuando, pero en realidad me va mejor con las dosis mРїС—Р…s pequeРїС—Р…as. РїС—Р…JR, 65 aРїС—Р…os.

    Hay que experimentar con diferentes dosis e intervalos de tiempo. Yo empecРїС—Р… con 50 mg (adecuado para estimular mi organismo, creo) pero con el tiempo he descubierto que lo ideal para mРїС—Р… es una dosis de 25 mg unos 90 minutos antes de tener relaciones sexuales. Las dosis mРїС—Р…s pequeРїС—Р…as significan menos congestiРїС—Р…n nasal y mРїС—Р…s sensibilidad durante el coito. Pero la dosis de 25 mg todavРїС—Р…a me mantiene duro como una piedra y capaz de contener el orgasmo prРїС—Р…cticamente hasta cuando quiero.

    He experimentado con diferentes dosis y he descubierto que 25 mg una media hora antes de tener relaciones sexuales es perfecto para mРїС—Р…. Se me pone dura como una piedra y puedo durar una eternidad.

    Le pido al farmacРїС—Р…utico que me parta una dosis de 100 mg en cuatro dosis de 25, que es lo que tomo cada vez. Cuando quiero que dure toda la noche, me tomo los 100 mg.

    Yo parto las pРїС—Р…ldoras de 50 mg por la mitad y con eso me basta.

    Nos corrimos juntos, y РїС—Р…madre mРїС—Р…a. quРїС—Р… manera de correrse. РїС—Р…QuРїС—Р… potencia! Lo que hace de esta experiencia algo cada vez mejor es que sРїС—Р…lo utilizo la mitad de una dosis de 50 mg.

    Yo comencРїС—Р… con una dosis de 25 mg. Y la he reducido a 12,5 mg (parto la pРїС—Р…ldora de 100 mg en 8 trozos) y he descubierto que con esta dosis reducida, puedo seguir teniendo una erecciРїС—Р…n durРїС—Р…sima asРїС—Р… como un dolor de cabeza muy ligero.

    He llegado a descubrir que sРїС—Р…lo necesito 25 mg para tener y conservar una erecciРїС—Р…n. Pero, la primera noche tomРїС—Р… 50 mg. РїС—Р…Bill, Chicago, 42 aРїС—Р…os.

    CРїС—Р…mo tomar Viagra

    Cara Minum Viagra

    Konsultasikan dengan dokter. Anda mungkin dianjurkan mengonsumsi Viagra (sildenafil) jika Anda menderita disfungsi ereksi, atau ketidakmampuan untuk mempertahankan ereksi dalam waktu yang cukup lama untuk terlibat dalam aktivitas seksual. Sangat penting untuk membicarakan pengobatannya dengan dokter untuk memastikan bahwa obatnya adalah pilihan yang sehat untuk Anda.

    • Beritahu dokter jika Anda alergi terhadap obat-obatan, sehingga dia bisa menentukan apakah Anda alergi terhadap Viagra atau tidak. [1]
    • Beritahu dokter Anda obat lain yang sedang Anda minum, termasuk suplemen herbal.

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    Jangan minum Viagra jika Anda minum alpha-blocker. Obat ini, yang diresepkan untuk masalah tekanan darah dan prostat, juga bisa menyebabkan tekanan darah menurun ke tingkat yang terlalu rendah jika obat tersebut dicampur dengan Viagra.

    Telan pil Viagra sesuai dengan petunjuk dokter atau apoteker. Dosis yang biasanya dianjurkan adalah 50 mg, tetapi dalam beberapa kasus dokter bisa merekomendasikan untuk meminum lebih atau kurang dari dosis rata-rata. [3]

    • Pil Viagra tersedia dalam tablet berdosis 25 mg, 50 mg, atau 100 mg.
    • Dosis maksimum yang disarankan adalah 100 mg. Jangan minum melebihi dosis ini sekaligus.

    Minum Viagra 30 hingga 60 menit sebelum melakukan hubungan seks. Viagra paling efektif jika diminum dalam rentang waktu tersebut, karena obat ini membutuhkan sedikit waktu untuk bersirkulasi dan merangsang ereksi. Namun, Viagra bisa saja diminum hingga 4 jam sebelum aktivitas seksual dan masih efektif. [4]

    Jangan minum Viagra lebih dari sekali dalam sehari. Minum Viagra beberapa kali dalam sehari tidak disarankan, terutama jika konsumsinya melebihi dosis 100 mg yang dianjurkan.

    Konsumsi makanan rendah lemak sebelum Anda minum Viagra. Menyantap makanan yang tinggi lemak bisa memperlambat berjalannya efek Viagra. Konsumsi makanan ringan di sepanjang hari sebelum minum Viagra, dan hindari makanan berat yang berisi daging merah, makanan yang digoreng, dan komponen lain yang banyak mengandung lemak. [5]

    Metode 3 dari 3:
    Memperhatikan Efek Samping Sunting

    Waspadalah dengan efek samping dalam tingkat sedang. Beberapa orang mengalami efek samping tingkat sedang setelah minum satu dosis Viagra. Ini tidak menunjukkan bahwa Anda perlu pergi ke dokter, tetapi jika Anda mengalaminya, sebaiknya Anda menurunkan dosisnya atau berhenti menggunakan Viagra. Efek samping Viagra dalam tingkat sedang diantaranya: [6]

    • Kemerahan dan rasa panas di leher dan wajah
    • Sakit kepala
    • Hidung tersumbat
    • Masalah memori
    • Sakit perut atau sakit punggung

    Segera pergi ke dokter jika Anda mengalami efek samping yang parah. Dalam beberapa kasus yang jarang terjadi, Viagra menyebabkan efek samping yang cukup berbahaya yang harus segera dibawa ke dokter. Jika Anda mengalami salah satu dari gejala-gejala di bawah ini, berhentilah minum Viagra dengan segera dan hubungi dokter Anda: [7]

    • Ereksi yang menyakitkan atau berlangsung selama 4 jam atau lebih lama
    • Kehilangan penglihatan
    • Nyeri dada
    • Denyut jantung tidak teratur
    • Merasa pening
    • Pembengkakan di tangan, pergelangan kaki atau kaki
    • Mual atau perasaan sakit secara umum

    El envГ­o a domicilio de VIAGRA estГЎ disponible solo para residentes de los EE. UU. y Puerto Rico.

    Usted y su mГ©dico tienen opciones.

    Su mГ©dico le recetarГЎ la dosis de VIAGRA que considere adecuada para usted.

    Para la mayorГ­a de los hombres, la dosis recomendada es de 50 mg. En base a la efectividad y la tolerancia, puede aumentarse la dosis a un mГЎximo recomendado de 100 mg o disminuirse a 25 mg. La frecuencia de la dosis mГЎxima recomendada es una vez al dГ­a. AsegГєrese de comunicarle a su mГ©dico todos los medicamentos que toma y cualquier otra afecciГіn mГ©dica que padezca, ya que quizГЎs deba ajustarse la dosis.

    VIAGRA viene en tres dosis:

    TambiГ©n hay VIAGRA Single Packs de 50 mg y 100 mg. Obtenga mГЎs informaciГіn .

    Pruebe los Single Packs.

    PregГєntele a su mГ©dico o farmacГ©utico acerca de los VIAGRA Single Packs.

    Hay otra forma de llevar VIAGRA consigo cuando lo necesita. Los VIAGRA Single Packs vienen en dosis de 50 mg y 100 mg, y tienen la misma cobertura de receta que las pГ­ldoras de VIAGRA que vienen en frasco.

    Su mГ©dico puede hacerle una receta para Single Packs o puede pedГ­rselos a su farmacГ©utico cuando retire su receta.

    Consulten estos consejos para tomar VIAGRA.

    InformaciГіn de Seguridad Importante e IndicaciГіn

    Haga clic para expandir

    INFORMACIГ“N IMPORTANTE DE SEGURIDAD

    No tome VIAGRA (citrato de sildenafil) si usted:

    • toma cualquier medicamento llamado nitrato, a menudo recetados para el dolor de pecho, o estimuladores de la guanilato ciclasa como Adempas (riociguat) para la hipertensiГіn pulmonar. Su presiГіn arterial podrГ­a disminuir a un nivel peligroso.
    • es alГ©rgico al sildenafil, contenido en VIAGRA y REVATIO, o a alguno de los ingredientes de VIAGRA.

    Consulte el estado de su salud con su mГ©dico para asegurarse de que estГЎ suficientemente saludable para tener relaciones sexuales. Si experimenta dolor de pecho, mareos o nГЎuseas durante la actividad sexual, busque ayuda mГ©dica inmediata.

    VIAGRA puede causar efectos secundarios graves. Los efectos secundarios que rara vez se informan incluyen:

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    • PГ©rdida repentina de la visiГіn en uno o ambos ojos. La pГ©rdida repentina de la visiГіn en uno o ambos ojos puede ser seГ±al de un problema ocular grave llamado neuropatГ­a Гіptica isquГ©mica anterior no arterГ­tica (NONA). Si experimenta cualquier pГ©rdida repentina de la visiГіn, deje de tomar VIAGRA y llame a su proveedor de atenciГіn mГ©dica de inmediato.
    • DisminuciГіn o pГ©rdida repentinas de la audiciГіn. Algunas personas tambiГ©n pueden experimentar un zumbido en los oГ­dos (acГєfeno) o mareos. Si tiene estos sГ­ntomas, deje de tomar VIAGRA y llame a un mГ©dico de inmediato.

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    • tiene o ha tenido problemas cardГ­acos como un ataque cardГ­aco, arritmia, angina, dolor en el pecho, estrechamiento de la vГЎlvula aГіrtica o insuficiencia cardГ­aca;
    • ha tenido una cirugГ­a del corazГіn en los Гєltimos 6 meses;
    • tiene hipertensiГіn pulmonar;
    • ha tenido un accidente cerebrovascular;
    • tiene presiГіn arterial baja o alta que no estГЎ controlada;
    • tiene un pene deformado;
    • ha tenido una erecciГіn que durГі mГЎs de 4 horas;
    • tiene problemas sanguГ­neos, como la anemia drepanocГ­tica, mieloma mГєltiple o leucemia;
    • tiene retinosis pigmentaria, una enfermedad ocular genГ©tica (se da en las familias) poco comГєn;
    • alguna vez ha tenido pГ©rdida de la visiГіn grave, incluido un problema ocular llamado neuropatГ­a Гіptica isquГ©mica anterior no arterГ­tica (NONA);
    • tiene problemas de sangrado;
    • tiene o ha tenido Гєlceras estomacales;
    • tiene problemas hepГЎticos;
    • tiene problemas renales o se realiza diГЎlisis renal;
    • tiene cualquier otra afecciГіn mГ©dica.

    DГ­gale a su proveedor de atenciГіn mГ©dica sobre todos los medicamentos que toma, incluidos los medicamentos recetados y sin receta, vitaminas y suplementos herbales.

    VIAGRA puede afectar la manera en que otros medicamentos actГєan, y otros medicamentos pueden afectar la manera en que VIAGRA actГєa, lo que produce efectos secundarios. Especialmente, dГ­gale a su proveedor de cuidado mГ©dico si usted toma cualquiera de los siguientes:

    • medicamentos llamados nitratos;
    • medicamentos llamados estimuladores de la guanilato ciclasa, como Adempas (riociguat);
    • medicamentos llamados alfa bloqueantes, como Hytrin (hidrocloruro de terazosina), Flomax (hidrocloruro de tamsulosina), Cardura (mesilato de doxazosina), Minipress (hidrocloruro de prazosina), Uroxatral (hidrocloruro de alfuzosina), Jalyn (hidrocloruro de dutasterida y tamsulosina) o Rapaflo (silodosina). Los alfa bloqueantes son recetados en ocasiones para problemas de la prГіstata o la presiГіn arterial alta. En ciertos pacientes, el uso de VIAGRA con alfa bloqueantes puede derivar en una caГ­da de la presiГіn arterial o en desmayos;
    • medicamentos llamados inhibidores de la proteasa del VIH, como ritonavir (Norvir), sulfato de indinavir (Crixivan), saquinavir (Fortovase o Invirase) o sulfato de atazanavir (Reyataz);
    • ciertos tipos de medicamentos antimicГіticos orales, como ketoconazol (Nizoral) e itraconazol (Sporanox);
    • ciertos tipos de antibiГіticos, como claritromicina (Biaxin), telitromicina (Ketek) o eritromicina;
    • otros medicamentos para tratar la presiГіn arterial alta;
    • otros tratamientos o medicamentos para la disfunciГіn erГ©ctil;
    • VIAGRA contiene sildenafil, el mismo medicamento que se encuentra en otro fГЎrmaco llamado REVATIO. REVATIO se usa para tratar una rara enfermedad llamada hipertensiГіn arterial pulmonar (HTAP). VIAGRA no debe usarse con REVATIO ni con otros tratamientos para la HTAP que contengan sildenafil o cualquier otro inhibidor de la PDE5 (como Adcirca [tadalafil]).

    VIAGRA no protege contra las enfermedades de transmisiГіn sexual, incluido el VIH.

    Los efectos secundarios mГЎs comunes de VIAGRA: dolor de cabeza, rubor facial, malestar estomacal, visiГіn anormal, como cambios en la visiГіn del color (ver con una tonalidad azul) y visiГіn borrosa, congestiГіn y secreciГіn nasal, dolor de espalda, dolor muscular, nГЎuseas, mareos y erupciГіn.

    VIAGRA (citrato de sildenafil) es un medicamento con receta que se utiliza para tratar la disfunciГіn erГ©ctil.

    VIAGRA no estГЎ indicado para mujeres ni niГ±os.

    Los pacientes siempre deben pedirles a los mГ©dicos asesoramiento sobre los acontecimientos negativos.

    Para informar un acontecimiento negativo relacionado con los productos de Pfizer, llame al 1-800-438-1985 (solo EE. UU.). Si prefiere, puede comunicarse directamente con la AdministraciГіn de Alimentos y Medicamentos (FDA) de los EE. UU. La FDA ha establecido un servicio de presentaciГіn de informes conocido como MedWatch en el que los profesionales de la salud y los consumidores pueden informar problemas graves que sospechen que puedan estar relacionados con los fГЎrmacos y los dispositivos mГ©dicos que recetan, administran o utilizan. Visite MedWatch o llame al 1-800-FDA-1088.

    Para obtener mГЎs informaciГіn, llame al 1-888-4-VIAGRA (1-888-484-2472), de lunes a viernes, de 9:00 a. m. a 7:00 p. m. hora del este.

    **Ahorre hasta USD 150 por receta.

    Hay un mГ­nimo de 6 pГ­ldoras por receta.

    El descuento total mГЎximo para esta oferta es de USD 450 por aГ±o.

    Esta oferta no es un seguro mГ©dico.

    Esta oferta estГЎ disponible solo en farmacias participantes.

    © 2001- 2015 Pfizer Inc. Todos los derechos reservados.

    La forma del comprimido en diamante azul es una marca comercial registrada de Pfizer Inc.

    VIAGRA (citrato de sildenafil), REVATIO (sildenafil), Cardura (mesilato de doxazosina) y Minipress (clorhidrato de prazosina) son marcas registradas de Pfizer Inc. Otras marcas citadas son marcas comerciales registradas de sus respectivos dueГ±os y no estГЎn afiliadas con Pfizer Inc. ni avaladas por esta.

    La informaciГіn de salud contenida aquГ­ se proporciona solo para fines educativos y no estГЎ destinada a reemplazar lo que podrГ­a discutirse con un mГ©dico. Todas las decisiones relacionadas con la atenciГіn al paciente deben realizarse con un mГ©dico, teniendo en cuenta las caracterГ­sticas particulares del paciente.

    La informaciГіn del producto proporcionada en este sitio estГЎ dirigida a residentes de los Estados Unidos. Los productos mencionados aquГ­ pueden tener etiquetados diferentes en otros paГ­ses.

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    Price competitive.
    Effect:
    Erection possible 30 minutes after taking the pill.
    Side-effects:
    Can be fatal for patients on medication with nitrates or for cardio-vascular patients.Temporary loss of colour vision, nausea and headache.

    This consequently increases the supply and leads to erection. It isn’t as if the disorder doesn’t have optional cures, but no treatment matches the drug in the sheer simplicity of its administration. Which explains the euphoric reception to its arrival.

    “We can now give oral tablets to the patients,” says Saxena, “and it will also stop them from going to the quacks.” For eminent Mumbai-based andrologist Vijay Kulkarni, “it’s one more tool for treating the patient”.

    Tempering the ebullience, however, are experts who sound a word of caution. Viagra is not, they emphasise, an aphrodisiac, as is widely assumed. The potential danger arising from its misuse is why it has been cleared only as a prescription drug.

    Says DCGI Ashwini Kumar: “It has been approved on the condition that it be used cautiously under therapeutic conditions.” For the genuine patient though, the readily available, cheap, effective tablet is nothing but good news.

    After Viagra’s four-year run in the market worldwide, the drug’s effectiveness is not disputed and is bound to have a big impact. But there’s a flipside. Sildenafil can be fatal for people on nitrates and those with cardio-vascular problems.

    If taken with nitrates, it reduces the patients’ blood pressure dramatically. Possible temporary side-effects are headache and nausea. A more serious effect is loss of blue-green colour vision. The correct dose is, hence, of prime importance; all Indian versions of sildenafil will be available in 25 mg, 50 mg and 100 mg doses.

    Misuse of sildenafil can also lead to tragicomic mishaps. Doctors cite numerous instances where normal people took Viagra to enhance their sexual performance. The result was an embarrassing and painfully prolonged erection that lasted for days and required surgery to rectify. Both doctors and manufacturers emphasise that sildenafil is a treatment, not a cure.

    It temporarily acts on a specific part of the body but it does not solve the underlying reason for the disorder. “Sexual dysfunction is about more than just Viagra,” says Kulkarni, “Psycho-sexual counselling is very important.” All companies Torrent, Cadila and Ranbaxy emphasise the need for patients to be educated by urologists, endocrinologists and psychiatrists.

    S.D. Kaul, Regional Director, Asia & Middle East, Ranbaxy

    Side-effects notwithstanding, the pharmaceutical companies are upbeat. “We’re on top of the world,” exclaims a jubilant S.D. Kaul, regional director, Asia and Middle East, Ranbaxy. He has reason to be. With India’s billion-plus population, the sheer numbers translate to tremendous market potential. “The market would run to about Rs 50-100 crore. It’s a blockbuster drug,” says Kaul.

    Other companies provide similar estimates. But with so many vying for a slice of the pie, a bit of shine may rub off soon. Stiff competition will define price and profit margins to the patient’s benefit. The approximate price of the new drug is Rs 20 per tablet, which is already a big gain for patients who are currently shelling out Rs 500 per tablet for the imported Viagra in the grey market.

    The affordability of the genuine sildenafil brands could also adversely affect the popularity of the anti-impotence herbal drugs.

    With the product being identical, marketing strategy will decide the winners and losers in the Great Indian Sildenafil Contest. Brand name, colour and even the shape of the tablets are being depicted as distinguishing features to gain an edge in the market.

    As for Ranbaxy’s brand, Caverta, “the name derives from the cavernosa, the part of penis that plays a vital role in erection”, explains Kaul. Torrent’s choice, Androz, derives from andrology a science that deals with the study of the masculine constitution, according to R. Balasubramanian, vice-president, marketing, Torrent.

    Penegra was Cadila’s choice both because it refers to problems of penetration, and the penis, says President Ganesh Nayak. Blue and diamond shaped, the Penegra pill is an exact copy of Viagra. Ranbaxy’s red triangular tablets are deliberately designed to be different, while Torrent’s tablets are blue and round.

    “We have made a conscious effort to retain the round shape like regular tablets to tell the patients that ED is neither fun nor serious. It’s just another curable condition,” says Balasubramanian.

    An India-specific marketing challenge for the companies is people’s reluctance to talk openly about sexual matters. Says Kaul: “We don’t just have to create a brand but also a market, as ED is a hush-hush affair here.” Besides, impotence is not just any other disease like diabetes or malaria.

    Striking at the very core of manhood, its impact finds an echo in every aspect of man’s life: the wife doomed to a celibate existence and the boss stuck with a depressed, less-productive employee. Small wonder then that the drug is seen as the best thing to happen to the Indian male in a long, long time.

    Some of the optional cures available to erectile dysfunctional patients in India are:

    • The most popular and affordable treatment so far has been the papaverine injection. At Rs 15-20 per shot, it is the price, not convenience, that dictates its popularity. The drug has to be injected locally into the phallus, a painful procedure that can lead to infection unless done in aseptic conditions, according to Professor N.K. Mohanty, head of urology at Delhi’s Safdarjung Hospital.
    • The vacuum erection device is the only non-invasive treatment that has no side-effects, says Mohanty. There are no injections, no tablets – only a hollow tube that creates a vacuum and sucks blood into the penis, leading to an erection. At Rs 10,000- 20,000 one-time cost, the price at least induces a sense of satisfaction.
    • Some men – such as traumatic paraplegics – suffer from extreme impotence. A penile implant is then the only option. The device is designed to last a lifetime. But, insists Ajit Saxena, senior consultant urologist at Delhi’s Apollo Hospital, implants should be prescribed only after a thorough psychological assessment, when all else fails. This procedure involves placing an artificial implant into the phallus. The price can range from Rs 40,000 to Rs 2 lakh but the result is near-normal function. The biggest drawback is infection and rejection by the body, which occurs in about 2 to 3 per cent of the surgeries.

    Common use

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

    Dosage and direction

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

    Precautions

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

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

    Possible side effect

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

    Drug interaction

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

    Missed dose

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

    Overdose

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

    Storage

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

    Disclaimer

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

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    you are taking nitrates (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, spray, patch, ointment) or nitroprusside
    you take another medicine that contains sildenafil, another PDE5 inhibitor (eg, tadalafil, vardenafil), or ritonavir
    you use certain recreational drugs called "poppers" (eg, amyl nitrate or nitrite, butyl nitrate or nitrite)

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

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    Lucille with a style that included beautifully crafted single-string runs punctuated by loud chords, subtle vibratos and bent notes.

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    His style was unusual. King didn’t like to sing and play at the same time, so he developed a call-and-response between him and Lucille.

    "Sometimes I just think that there are more things to be said, to make the audience understand what I’m trying to do more,Buy Sildenafil King told The Associated Press in 2006. "When I’m singing, I don’t want you to just hear the melody. I want you to relive the story, because most of the songs have pretty good storytelling."

    A preacher uncle taught him to play, and he honed his technique in abject poverty in the Mississippi Delta, the birthplace of the blues.

    "I’ve always tried to defend the Buy Sildenafil Citrate idea that the blues doesn’t have to be sung by a person who comes from Mississippi, as I did," he said in the 1988 book "Off the Record: An Oral History of Popular Music."

    "People all over the world have problems," he said. "And as long as people have problems, the blues can never die."

    Fellow travelers who took King up on that theory included Clapton, the British-born blues-rocker who collaborated with him on "Riding With the King,Buy Sildenafil a best-seller that won a Grammy in 2000 for best traditional blues album.

    Still, the Delta’s influence was undeniable. King began picking cotton on tenant Generic Viagra online farms around Indianola, Mississippi, before he was a teenager, being paid as little as 35 cents for every 100 pounds, and was still working off sharecropping debts after he got out of the Army during World War Two.

    "He goes back far enough to remember the sound of field hollers and the cornerstone blues figures, like Charley Patton and Robert Johnson," ZZ Top guitarist Billy Gibbons once told Rolling Stone magazine.

    King got his start in radio with a gospel quartet in Mississippi, but soon moved to Memphis, Tennessee, where a job as a disc jockey at WDIA gave him access to a wide range of recordings. He studied the great blues and jazz guitarists, including Django Reinhardt and T-Bone Walker, and played live music a few minutes each day as the "Beale Street Blues Boy," later shortened to B.B.

    Through his broadcasts and live performances, he quickly built up a following in the black Buy Viagra community, and recorded his first RBuy Viagra B hit, Buy SildenafilThree O’Clock Blues," in 1951.

    He began to break through to white audiences, particularly young rock fans, in the 1960s with albums like "Live at the Regal," which would later be declared a historic sound recording worthy of preservation by the Library of Congress’ National Recording Registry.

    He further expanded his audience with a 1968 appearance Buy Viagra online at the Newport Folk Festival and when he opened shows for the Rolling Stones in 1969.

    King was inducted into the Blues Foundation Hall of Fame in 1984, the Rock and Roll Hall of Fame in 1987 and received the Songwriters Hall of Fame Lifetime Achievement Award in 1990. He received the Presidential Medal of Freedom from President George W. Bush, gave a guitar to Pope John Paul II and had President Barack Obama sing along to his "Sweet Home Chicago."

    Other Grammys included best male rhythm ‘n’ blues performance in 1971 for "The Thrill Is Gone," best ethnic or traditional recording in 1982 for Cheap Sildenafil Tablets There Must Be a Better World Somewhere" and best traditional blues recording or album several times. His final Grammy came in 2009 for best blues album for "One Kind Favor.Buy Viagra

    Through it all, King modestly insisted he was simply maintaining a tradition.

    "I’m just one who carried the baton because it was started long before me," he told the AP in 2008.

    Born Riley B. King on Sept. 16, 1925, on a tenant farm near Itta Bena, Mississippi, King was raised by his grandmother after his parents separated and his mother died. He worked as a sharecropper for five years in Kilmichael, an even smaller town, until his father found him and took him back to Indianola.

    "I was a regular hand when Buy Sildenafil Citrate I was 7. I picked cotton. I drove tractors. Children grew up not thinking that this is what they must do. We thought this was the thing to do to help your family,Buy Sildenafil he said.

    When the weather was bad and he couldn’t work in the cotton fields, he walked 10 miles to a one-room school before dropping out in the 10th grade.

    After he broke through as a musician, it appeared King might never stop performing. When he wasn’t recording, he toured the world relentlessly, playing 342 one-nighters in 1956. In 1989, Generic Viagra online he spent 300 days on the road. After he turned 80, he vowed Buy Viagra he would cut back, and he did, somewhat, to about 100 shows a year.

    He had 15 biological and adopted children. Family members say 11 survive.

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    Mitt Romney lasts 2 rounds against Holyfield in boxing match

  • SALT LAKE CITY (AP) — Former Republican presidential candidate Mitt Romney and five-time heavyweight boxing champion Evander Holyfield squared off in the Buy Viagra online ring Friday at a charity fight night event in Salt Lake City. Related Stories ‘Sting like a butterfly': Holyfield jabs Romney for charity Associated Press Watch A Shirtless Mitt Romney Box Evander Holyfield For Charity Huffington Post This Is Buy Viagra How Mitt Romney Plans To Beat Up Evander Holyfield Huffington Post ‘Stormin Mormon’ Romney survives Holyfield dust-up AFP ‘Stormin’ Mormon’ Romney to take on ex-champ for charity AFP Romney, 68, and Holyfield, 52, sparred, if you could call it that, for just two short rounds before Romney ran away from the boxer and threw in the towel, giving up a round early in the lighthearted fight that came amid several other fights by professional Buy Viagra boxers and an auction. The two barely threw any punches and largely just danced around, occasionally lightly jabbing each other in the midsection in what was much more of a comedic event than an actual bout. The black-tie affair raised money for the Utah-based organization CharityVision, which helps doctors in developing countries perform surgeries to Buy Sildenafil Citrate restore vision in people with curable blindness. Romney’s son Josh Romney, who lives in Utah, Buy Sildenafil serves as a volunteer president for CharityVision. Corporate sponsorships for the event ranged from $25,000 to $250,000. Organizers say they raised at least $1 million. View galleryFive-time heavyweight boxing Buy Viagra champion Evander Holyfield,Buy Sildenafil Generic Viagra online Five-time heavyweight boxing champion Evander Holyfield, left, is declared the winner against Former … “He said, ‘You know what? You float like a bee and sting like a butterfly,'” Romney said after the fight. Attendees just enjoyed the festive atmosphere Buy Viagra and the chance to see Romney in the ring. “Oh, it was great. I was very proud of Mitt,” said Katie Anderson, who attended the event with her husband. “I was happy it went to the second round,” Devin Anderson said. Romney, the most-high profile Mormon in America, is hugely popular in the state, where more than 60 percent of the residents are members of The Church of Jesus Christ of Latter-day Saints. Beyond his religious connections, the former Massachusetts governor is remembered by many for turning around Salt Lake City’s 2002 Winter Olympics after a bribery scandal. Romney has recently built a home in the Salt Lake City area and registered as a Utah voter.

    Notre Dame senior dies after falling from roof a day before graduation

    NEW YORK (Reuters) – A 21-year-old Buy Viagra graduating senior at the University of Notre Dame died early on Saturday after falling from the roof of the school’s sports arena in South Bend, Indiana, the university said.

    The male student, who was a day away from graduating from the Buy Viagra prestigious Catholic school, had gained access to the roof of the Joyce Center arena Buy Viagra online with a small group of students, the university said.

    It was not immediately clear why the group had climbed onto the roof, which was slick from early morning precipitation, the university said.

    At about 3:45 a.m. (4.45 a.m. ET) Buy Sildenafil Citrate local time, two students alerted a campus security officer to the fall, it said. Emergency responders attempted to revive the man but were unsuccessful.

    “Our thoughts and prayers are with his family and friends after this terrible tragedy,” said University President Rev. John Jenkins. Buy Sildenafil It is a profound sadness for all of us, on this graduation weekend, to lose Cheap Sildenafil Tablets someone so young and brimming with promise.”

    Notre Dame has held the identity of the deceased student until his family is notified. The medical examiner will work to determine a cause of death.

    (Reporting by Laila Kearney; editing by Clelia Oziel)

    Army weighs if ex-Green Beret hero should be dismissed

  • RALEIGH, N.C. (AP) — An Army officer stripped of a medal for heroism under fire Generic Viagra online Buy Viagra and his right to call himself a Green Beret is fighting Buy Viagra for his military career after accusations he tracked down and killed a suspected bomb-maker in Afghanistan. Though a criminal investigation failed to find remains of his alleged victim and didn’t result in charges against Maj. Mathew Golsteyn, he’s been targeted for possible dismissal from the Army and the consequent loss of veteran’s benefits with a less-than-honorable discharge. A Fort Bragg hearing before three, higher-ranked Special Forces officers could meet later this month to weigh arguments from Golsteyn’s attorney why he should remain on active duty. “My hope is that Golsteyn will receive a fair and impartial hearing. Based on the Army’s actions and decisions thus far, I regret to say this won’t be the case,” one of the soldier’s defenders, U.S. Rep. Duncan Hunter, R-Calif. wrote Wednesday to Army Secretary John McHugh. Army brass have kept Hunter updated on the case. Others believe the Army is obligated to act because the Geneva Conventions governing warfare forbid arbitrary killings by troops, said Jeffrey K. Walker, a St. John’s University criminal law professor. “That’s a minimum protection anybody gets at any time, no matter how you categorize them or how you categorize the conflict. That is the basic floor below which nobody can drop as far as protections go,” said Walker, a retired Air Force officer and former Buy Viagra military lawyer. “Arbitrary deprivation of life is at the top of the list of things you cannot do.” Golsteyn’s roller-coaster military career Buy Sildenafil Citrate from battlefield hero to whispers of a war crime is rooted in the deadly month of February 2010, when American-led allied forces Buy Viagra online seized the Taliban stronghold of Marjah in Afghanistan’s Helmand province. Insurgent Generic Viagra online snipers unleashed fire on Forward Operating Base Buy Sildenafil McQueary. A patrol of about 80 troops headed out across muddy poppy Cheap Sildenafil Tablets fields to find the gunmen. Over a four-hour firefight, Golsteyn repeatedly exposed himself to enemy fire as he helped evacuate a wounded Afghan soldier and directed repeated airstrikes onto the enemy, according to the Army’s narrative of why he was awarded a Silver Star medal. Then, about two months before being promoted from captain to major in November 2011, he had an interview with the CIA. He talked about something he’d done during the 2010 deployment before the battle near Marjah. Golsteyn “claimed to have captured and shot and buried a suspected IED bomb maker. He further went to comment that he went back out with two others to cremate the body and dispose of the remains,” according to a memo summarizing the Golsteyn case. “Capt. Golsteyn stated that he knew it was illegal but was not remorseful as he had solid intelligence and his actions Buy Viagra protected the safety of his fellow teammates.” The Army’s Criminal Investigative Division, acting on the CIA’s tip, could Buy Viagra find no one who corroborated Golsteyn’s claim to have hunted the bomb-maker after an attack that killed two Marines. Nor could they find any cremated remains of the Afghan. Despite that, investigators said “Golsteyn committed the offenses of murder and conspiracy based on the interview Buy Sildenafil provided by the CIA,” according to the Sept. 29 memo first published by the web site The Intercept. Lt. Col. Christopher Kasker, a spokesman for McHugh, confirmed the memo is authentic. But the American legal system requires witnesses, a body or some evidence that a crime occurred, Walker said, so Golsteyn’s statement isn’t enough to prosecute him. “You’ve got to have something in addition to somebody’s confession to convict him of a crime,” Walker said. “That’s a safeguard against official misconduct and abuse. If all you need is a confession, well let’s just beat a confession out of the guy and we’re all done.” Last fall, McHugh revoked Golsteyn’s Generic Viagra online Silver Star presented three years earlier. The Army head also rejected a recommendation to upgrade Golsteyn’s honor to the Distinguished Service Cross, the second-highest military decoration a soldier can receive for extraordinary heroism. In February, the Army initiated the process to kick Golsteyn Buy Viagra out of the active-duty military. He was taken out of action and assigned to a Buy Sildenafil Citrate headquarters unit. Army regulations for discharging officers list potential Buy Sildenafil reasons as substandard performance, national security interests, misconduct, moral or professional dereliction, or “derogatory information contained in the officer’s records combined with other known deficiencies.” Army Special Forces Command spokeswoman Maj. Allison Aguilar said she was barred from describing which reasons were given in Golsteyn’s case. An inquiry board is scheduled to decide whether Golsteyn can stay in the Army or be discharged, and whether a discharge would be honorable or something less. “The discharge normally will be based on a pattern of behavior and duty performance, rather than an isolated incident,” Lt. Col. Mark Lastoria, a spokesman for U.S. Army Special Operations Command at Fort Bragg, wrote in an email describing the process. Golsteyn’s Buy Viagra online Colorado-based lawyer, Phillip Stackhouse, said the soldier is simultaneously being evaluated for medical retirement due to combat-related spine and “mental health issues.” But the inquiry board’s decision and potential discharge “could eviscerate the retirement,” Stackhouse said. Golsteyn’s collected an online army of supporters in and out of the military, many of whom argue an exemplary soldier’s career is being sacrificed on thin evidence of going too far in the field. “Buy Viagra Our Special Forces are trained to do things Buy Sildenafil to bad people to help keep us safe,” said Joe Kasper, Hunter’s spokesman. “They’re supposed to do it within the letter of the law, we get that. But they are Generic Viagra onlinetrained to do a very dangerous mission and a lot of time you, I, and everybody else in this country don’t Buy Viagra online exactly Buy Sildenafil Citrate always know what that Buy Viagra entails. But they do a lot of things to keep Cheap Sildenafil Tabletsus safe.”.

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