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"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no Warrants shall issue, but upon probable cause. "

- Fourth Amendment to the United States Constitution

The Electronic Communications Privacy Act (ECPA) was a forward-looking statute when enacted in 1986. It specified standards for law enforcement access to electronic communications and associated data, affording important privacy protections to subscribers of emerging wireless and Internet technologies. Technology has advanced dramatically since 1986, and ECPA has been outpaced. The statute has not undergone a significant revision since it was enacted in 1986 – eons ago in Internet time.

As a result, ECPA is a patchwork of confusing standards that have been interpreted inconsistently by the courts, creating uncertainty for both service providers and law enforcement agencies. ECPA can no longer be applied in a clear and consistent way, and, consequently, the vast amount of personal information generated by today’s digital communication services may no longer be adequately protected. At the same time, ECPA must be flexible enough to allow law enforcement agencies and services providers to work effectively together to combat increasingly sophisticated cyber-criminals or sexual predators.

The time for an update to ECPA is now. Privacy advocates, trade associations, think tanks, legal scholars, start-ups, and major Internet and communications companies have developed consensus around the notion of a core set of principles intended to simplify, clarify, and unify the ECPA standards; provide clearer privacy protections for subscribers taking into account changes in technology and usage patterns; and preserve the legal tools necessary for government agencies to enforce the laws and protect the public.

Changes in Technology Have Outpaced the Law

Justice Brandeis famously called privacy “the most comprehensive of rights, and the right most valued by a free people.” Of course, privacy must be balanced against other societal interests. Electronic communications and associated data can provide key evidence in the investigation of many crimes, and the assistance of service providers is often necessary to access such evidence. With respect to communications privacy and law enforcement investigations, the courts and Congress have sought to develop rules for government surveillance that balance three interests: the individual’s constitutional right to privacy, the government’s need for tools to conduct investigations, and the interest of service providers in clarity and customer trust.

Since enactment of ECPA, there have been fundamental changes in communications technology and the way people use it, including –

  • Email: Most Americans have embraced email in their professional and personal lives and use it daily for confidential communications of a personal or business nature. Because of the importance of email and unlimited storage capabilities available today, most people save their email indefinitely, just as they previously saved letters and other correspondence. The difference, of course, is that it is easier to save, search and retrieve digital communications. Many of us now have many years worth of stored email. Moreover, for many people, much of that email is stored on the computers of service providers.
  • Mobile location: Cell phones and mobile Internet devices constantly generate location data that supports both the underlying service and a growing range of location-based services of great convenience and value. This location data can be intercepted in realtime, and is often stored in easily accessible logs files. Location data can reveal a person’s movements, from which inferences can be drawn about activities and associations. Location data is augmented by very precise GPS data in many devices.
  • Cloud computing: Increasingly, businesses and individuals are storing data “in the cloud,” with potentially huge benefits in terms of cost, security, flexibility and the ability to share and collaborate.
  • Social networking: One of the most striking developments of the past few years has been the remarkable growth of social networking. Hundreds of millions of people now use social media services to share information with friends and as an alternative platform for private communications.

In the face of these developments, ECPA does not provide protection suited to the way technology is used today:

  • Conflicting standards and illogical distinctions: ECPA sets rules for governmental access to email and stored documents that are not consistent. A single email is subject to multiple different legal standards in its lifecycle, from the moment it is being typed to the moment it is opened by the recipient to the time it is stored with the email service provider. To take another example, a document stored on a desktop computer is protected by the warrant requirement of the Fourth Amendment, but ECPA says that the same document stored with a service provider may not be subject to the warrant requirement.
  • Unclear standards: ECPA does not clearly state the standard for governmental access to location information.
  • Judicial criticism: The courts have repeatedly criticized ECPA for being confusing and difficult to apply. The Ninth Circuit in 2002 said that Internet surveillance was “a confusing and uncertain area of the law.” In the past 5 years, no fewer than 30 federal opinions have been published on government access to cell phone location information, reaching a variety of conclusions.
  • Constitutional uncertainty: The courts have been slow to address the application of the Fourth Amendment to new services and information. So far, among the regular federal appellate courts, only the Sixth Circuit has held that the Constitution protects stored email (Warshak), while the Ninth Circuit has held that there is a Constitutional privacy right in stored text messages (Quon). The Supreme Court has ruled that prolonged tracking with a GPS device is a search under the Fourth Amendment, but it has not yet ruled on use of cell tower data for tracking over time.

This murky legal landscape does not serve the government, customers or service providers well. Customers are, at best, confused about the security of their data in response to an access request from law enforcement. Companies are uncertain of their responsibilities and unable to assure their customers that subscriber data will be uniformly protected. The current state of the law does not well serve law enforcement interests either, as resources are wasted on litigation over applicable standards, and prosecutions are in jeopardy should the courts ultimately rule on the Constitutional questions.

The solution is a clear set of rules for law enforcement access that will safeguard end-user privacy, provide clarity for service providers, and enable law enforcement officials to conduct effective and efficient investigations.

Guiding Principles for ECPA Reform

The overarching goal of our ECPA reform principles is to balance the law enforcement interests of the government, the privacy interests of users, and the interests of communications service providers in certainty, efficiency and public confidence.

We are guided by the following concepts:

  • Technology and Platform Neutrality: A particular kind of information (for example, the content of private communications) should receive the same level of protection regardless of the technology, platform or business model used to create, communicate or store it.
  • Assurance of Law Enforcement Access: The reform principles would preserve all of the building blocks of criminal investigations – subpoenas, court orders, pen register orders, trap and trace orders, and warrants – as well as the sliding scale that allows the government to escalate its investigative efforts.
  • Equality Between Transit and Storage: Generally, a particular category of information should be afforded the same level of protection whether it is in transit or in storage.
  • Consistency: The content of communications should be protected by a court order based on probable cause, regardless of how old the communication is and whether it has been “opened” or not.
  • Simplicity and Clarity: All stakeholders – service providers, users and government investigators – deserve clear and simple rules.
  • Recognition of All Existing Exceptions: Over the years, a variety of exceptions have been written into the ECPA, such as provisions allowing disclosures to the government without court orders in emergency cases. These principles should leave all those exceptions in place.

Rather than attempt a full rewrite of ECPA, which might have unintended consequences, our recommendations focus on just a handful of the most important issues – those that are arising daily under the current law: access to email and other private communications stored in the cloud, access to location information, and the use of subpoenas to obtain transactional data.

Our principles do not seek to answer all questions or concerns about ECPA. Though members of the coalition may differ on the specifics, and some individual members would support additional changes, we all agree that these principles provide a framework for opening a public dialogue on the issue.

Specific Background on ECPA Reform Principles

1. The government should obtain a search warrant based on probable cause before it can compel a service provider to disclose a user’s private communications or documents stored online.

  • This principle applies the safeguards that the law has traditionally provided for the privacy of our phone calls or the physical files we store in our homes to private communications, documents and other private user content stored in or transmitted through the Internet "cloud"– private emails, instant messages, text messages, word processing documents and spreadsheets, photos, Internet search queries and private posts made over social networks.
  • This change was first proposed in bi-partisan legislation introduced in 1998 by Senators John Ashcroft and Patrick Leahy. It is consistent with appeals court decisions holding that emails and SMS text messages stored by communications providers are protected by the Fourth Amendment, and is also consistent with the leading legal scholarship on the issue.

2. The government should obtain a search warrant based on probable cause before it can track, prospectively or retrospectively, the location of a cell phone or other mobile communications device.

  • This principle addresses the treatment of the growing quantity and quality of data based on the location of cell phones, laptops and other mobile devices, which is currently the subject of conflicting court decisions; it proposes the conclusion reached by a majority of the courts that a search warrant is required for real-time cell phone tracking, and would apply the same standard to access to stored location data.
  • A warrant for mobile location information was first proposed in 1998 as part of the bipartisan Ashcroft-Leahy bill. It was approved 20 to 1 by the House Judiciary Committee in 2000.

3. Before obtaining transactional data in real time about when and with whom an individual communicates using email, instant messaging, text messaging, the telephone or any other communications technology, the government should demonstrate to a court that such data is relevant to an authorized criminal investigation.

  • In 2001, the law governing “pen registers and trap & trace devices”—technologies used to obtain transactional data in real time about when and with whom individuals communicate over the phone—was expanded to also allow monitoring of communications made over the Internet. In particular, the data at issue includes information on who individuals email with, who individuals IM with, who individuals send text messages to, and the Internet Protocol addresses of the Internet sites individuals visit.
  • This principle would update the law to reflect modern technology by establishing judicial review of surveillance requests for this data based on a factual showing of reasonable grounds to believe that the information sought is relevant to a crime being investigated.

4. Before obtaining transactional data about multiple unidentified users of communications or other online services when trying to track down a suspect, the government should first demonstrate to a court that the data is needed for its criminal investigation.

  • This principle addresses the circumstance when the government uses subpoenas to get information in bulk about broad categories of telephone or Internet users, rather than seeking the records of specific individuals that are relevant to an investigation. For example, there have been reported cases of bulk requests for information about everyone that visited a particular web site on a particular day, or everyone that used the Internet to sell products in a particular jurisdiction.
  • Because such bulk requests for information on classes of unidentified individuals implicate unique privacy interests, this principle applies a standard requiring a showing to the court that the bulk data is relevant to an investigation.

To simplify, clarify, and unify the ECPA standards, providing stronger privacy protections for communications and associated data in response to changes in technology and new services and usage patterns, while preserving the legal tools necessary for government agencies to enforce the laws, respond to emergency circumstances and protect the public.

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July 1, 2008 — Men hoping for some fireworks in their love life this Fourth of July may want to skip the burgers and beer at the barbecue and eat plenty of watermelon.

Watermelon may be a natural Viagra, says a researcher. That’s because the popular summer fruit is richer than experts believed in an amino acid called citrulline, which relaxes and dilates blood vessels much like Viagra and other drugs meant to treat erectile dysfunction (ED).

“We have known that watermelon has citrulline,” says Bhimu Patil, PHD, director of the Fruit and Vegetable Improvement Center at Texas A&M University, College Station. Until recently, he tells WebMD, scientists thought most of the citrulline was in the watermelon rind. “Watermelon has more citrulline in the edible part than previously believed,” he says.

How could watermelon be a natural Viagra? The amino acid citrulline is converted into the amino acid arginine. Patil says. “This is a precursor for nitric oxide, and the nitric oxide will help in blood vessel dilation.”

So, the burning question: How much watermelon does it take?

“That is a good question,” Patil says. Unfortunately, “I don’t have an answer for that.”

He does know that a typical 4-ounce serving of watermelon (about 10 watermelon balls) has about 150 milligrams of citrulline. But he can’t say how much citrulline is needed to have Viagra-like effects.

He’s hopeful that someone will pick up on his research and study the fruit’s effect on penile erections.

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On hearing about the Texas finding, Irwin Goldstein, MD, editor-in-chief of The Journal of Sexual Medicine, was underwhelmed. Suggesting a man feast on watermelon to boost performance, he says, “would be the equivalent of someone dropping a beer bottle in Minneapolis, where the Mississippi River starts, and hoping to see it make an impact on someone in New Orleans.”

“To say that watermelon is Viagra-like is sort of fun,” says Goldstein. “But to even vaguely hope that eating watermelon will alleviate ED is misleading.”

“The vast majority of Americans produce enough arginine,” adds Goldstein, medical director of Alvarado Hospital Medical Center, San Diego, and clinical professor of surgery, University of California San Diego School of Medicine. “Men with ED are not deficient in arginine.”

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The Hollywood Reporter

Meet the Sexy British Actress at the Center of the Viagra Commercial Controversy (Exclusive)

Five things to know about the new (female) face of the iconic blue pill

In the past, erectile dysfunction ads have kept their imagery firmly in the realm of inference or lifestyle choices; middle-aged men fishing, or perhaps a couple dancing at sunset or snuggling on a porch. In contrast, the newest campaign from Viagra gets straight to the point. So much so that it's drawn ire for its bluntness .

"So guys," a sexy blonde woman in her forties says directly into the camera with a British accent and a come-hither look. "It's just you and your honey. The setting is perfect. But then erectile dysfunction happens again."

The stateside debut of British actress Linette Beaumont signals a marketing shift for Viagra's maker, Pfizer. It's the first time the drug company has used a woman to sell the little blue pill, and the spot also goes where no ED commercial has gone before by actually letting her slip in the "e" word (previously ads only mentioned "erection" in the side-effects disclaimer).

But the spot, which has aired during primetime sports (including the World Series) has drawn protests — particularly from parents watching TV with their kids. Even Pfizer's former president of global research and development, John LaMattina. objected in a Forbes column titled "New Viagra TV Ad Should Be Dropped."

Outlets from the TheNew Yorker to Adweek have dissected the commercial, bringing Beaumont a surge of publicity; Ellen DeGeneres has spoofed the ad. So who is the actress Viagra is pinning its hopes upon? The Hollywood Reporter caught up with 44-year-old Beaumont over the phone.

1. She's a classically trained ballet dancer.
She began studying dance at the age of three; an injury later thrust her into the world of acting.

2. She graduated from the prestigious Drama Centre London.
Dubbed the "Trauma Centre" for its intense method acting program, Beaumont bonded with classmates Russell Brand . Michael Fassbender and Tom Hardy . "Everyone gets close, and I don't mean that in a sexual way," she says.

3. Russell Brand is her personal "superhero."
As a first-year student Beaumont appeared in a play alongside Brand. She got knocked off the stage — deliberately or by accident, she's still not sure — and Brand "was the one who came to my rescue."

4. In Britain, she's been on several TV shows.
She's appeared on the popular EastEnders. Holby City. Casualty. The Bill. Barbara and Doctors. She's also played her dream role of Lady MacBeth onstage several times.

5. She comes from humble beginnings.
Beaumont's father was a herdsman and farmer, and her mother was an opera singer in her youth. She worked in fast food restaurants and as a waitress to put herself through drama school.

AdAge says Pfizer spent $176 million last year on media for Viagra, according to Kantar Media, and with the new ad already appearing during NFL and MLB games the spending doesn't appear to be slowing. That doesn't mean the drug manufacturer is interested in giving away too many intimate details about the new ad, however. A company spokesperson told THR that it was against policy for Pfizer to allow interviews with actors in its ads.
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    Revealed: The ‘reassuring’ British blonde soap actress who’s become a US TV sensation as the first woman ever to advertise Viagra

    • Linette Beaumont, 44, is the first woman to star in a Viagra commercial
    • Drug makers Pfizer polled men, who admitted a woman would motivate them to go to the doctor

    Published: 13:15 GMT, 14 October 2014 | Updated: 15:39 GMT, 14 October 2014

    With her smooth and sultry tones, Linette Beaumont has become the first woman to star in a commercial for Viagra.

    If the English actress looks vaguely familiar, it’s because she’s made brief appearances in most of Britain’s most popular TV soaps.

    The 44-year-old blonde was picked, according to Viagra makers Pfizer, after the company polled men suffering with erectile dysfunction who admitted that a woman would ‘reassure’ them – as well as motivating them to contact their doctor.

    Scroll down for video

    The new face of erectile dysfunction: Linette Beamont stars in the first Viagra TV commercial that targets the less-obvious sufferers of the sexual condition: women

    New approach: In the new 60-second commercial, Linette Beaumont reclines on a bed in a tropical setting as she addresses the problems that couples encounter when a man is impotent

    The advert was rolled out last month and Linette’s US debut has entranced American viewers, with one, Patrick Cox, tweeting: ‘ Don’t need Viagra. Just need the hot blonde with the British accent’.

    Linette, who lives in the UK, has had parts on British soaps including EastEnders, Holby City, Casualty and The Bill – and appeared in a video called The Taliban Don’t Like My Knickers.

    She’s appeared in campaigns for brands including Burberry, as well as adverts for Sony, Perrier and Schwarzkopf.

    She filmed the Viagra advert for Pfizer, directed by Jonas Ackerlund, in August. However, she was forced to keep the project a secret up until its release, according to a source.

    Reclining in a tropical destination, Linette tells viewers: ‘So guys, it’s just you and your honey. The setting is perfect. But then erectile dysfunction happens again,’ she says before encouraging men to ask their doctor about Viagra. ‘Plenty of guys have this issue – not just getting an erection, but keeping it.’

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Najczęściej zadawane pytania na temat Viagry

Wielu naszych klientГіw szuka rzetelnych informacji na temat Viagry. Dla państwa wygody umieściliśmy tu kilka najczęściej zadawanych pytań wraz z odpowiedziami poniżej.

Jak długo będzie trwała moja erekcja po zażyciu Viagry?

Zanim będzie można uzyskać wzwГіd, ktГіry jest wystarczający, aby uprawiać seks trwa to około 25 minut. Istnieją oczywiście rГіżne (indywidualne) czynniki, ktГіre mogą wpłynąć na czas osiągnięcia erekcji. Aby upewnić się, i aby uniknąć fałszywych obietnic, zachęcamy więc do zarzycia Viagry około 1 godzinę przed stosunkiem seksualnym.

Co się dzieje w moim organizmie podczas dzialania Viagry?

Viagra może panstwu pomГіc uzyskać erekcje lub uleprzyć jej utrzymanie. Aby uzyskać erekcję stymulacja seksualna jest jednak konieczna.

Podczas pobudzenia seksualnego w naczyniach krwionośnych penisa zostają produkowane pewne substancje, dzięki czemu wypełnia się on krwią. Penis puchnie i występuje wzwГіd. Substancje te zostają zwykle po jakimś czasie zdegradowane przez enzym, co powoduje że penis rozluźnia się. Substancja czynna preparatu Viagra, Syldenafil, hamuje produkcję tego enzymu, co utrzymuje wzwГіd. Substancje powodujące erekcje w penisie pozostają przez to aktywne, dzięki czemu erekcja nadal trwa.

W ten sposГіb łatwiej jest uzyskać erekcję j można ją dłużej otrzymać. Badania wykazały, że Viagra pomaga w 50-70% mężczyznom z zaburzeniami erekcji.

Czy Viagra jest szkodliwa (i czy istnieją skutki uboczne) w połączeniu z innymi lekami?

Viagra zwiększa działanie lekГіw zawierających azotany lub ktГіre wydzielają tlenki azotu takie jak azotan. Leki te często przepisywane są na bГіl w klatce piersiowej. Należy poinformować lekarza o lekach (na receptę), ktГіre zażywamy. Nie należy także używać Viagry w połączeniu z innymi środkami na problemy z erekcją.

Więcej informacji znajduje się w zalaczonej do opakowania ulotce. Nie nalezy spodziewać się wielu skutkГіw ubocznych, za to zawsze należy zapoznac się z ulotką, a w przypadku wątpliwości, skonsultowac się z lekarzem lub farmaceutą.

Dla kogo jest przeznaczona Viagra?

Viagra jest lekiem dla mężczyzn z zaburzeniami erekcji. Kiedy mężczyzna nie jest w stanie uzyskać erekcji lub jej utrzymać w stanie wystarczającym do aktywności seksualnej. Viagra nie jest przeznaczona dla kobiet. Żeńskie narządy płciowe są tak rГіżne od męskich narządГіw, że Viagra ma ma żadnego pozytywnego działania na żeński organizm.

Viagra dla kobiet?

Preparat Viagra zarejestrowany jest tylko jako lek dla mężczyzn z zaburzeniami erekcji. Wyniki z badania wykonanych do tej pory, nie były ani pozytywne, ani negatywne i nie wykazały zadnych wplywow na ciało kobiety. Problemy seksualne u kobiet są bardziej złożone i obejmują objawy, ktГіre są trudne do identyfikacji, pomiaru i leczenia. Lekarz rodzinny lub seksuolog, jest idealną osobą do dalszego udzielania pomocy.

Czy Viagra automatycznie powoduje erekcję?

Nie, także przy Viagrze konieczne jest podniecenie seksualne, wtedy dopiero dochodzi do erekcji. Viagra nie jest hormonem lub pigułką miłości, ktГіra powoduje, że wszystko dzieje się automatycznie.

Czy Viagra może być stosowana w połączeniu z lekami redukującymi ciśnienie krwi?

Tak, Viagrę możesz stosować w połączeniu z lekami obniżającymi ciśnienie krwi. Należy jednak pamiętać że Viagry nie wolno stosować w połączeniu z azotanami. Jednoczesne stosowanie Viagry i azotanГіw może spowodować gwałtowne i duże spadki ciśnienia krwi, co jest bardzo niebezpieczne.

Mam MS (Stwardnienie rozsiane) i rzez to cierpię na zaburzenia erekcji. Czy mogę używać Viagrę?
Tak, nie ma żadnego problemu. Dotyczą cię te same przeciwwskazania jak w przypadku innych pacjentow.

Czy Viagra działa zawsze i na wszystkich?

Viagra działa średnio na czterech z pięciu mężczyzn. Efekt leczenia zależy od dawki, jakiej zażywasz. Nie znaczy też, że Viagra już przy pierwszym użyciu bezpośrednio doprowadzi do wystarczającej i zadowalającej erekcji. SprГіbuj przynajmniej 8 razy zanim zrezygnujesz. Bardzo prawdopodobne jest że pierwszy raz może być stresujący i niepokojący zarГіwno dla użytkownika jak i jego partnera.

Czy Viagra jest ostateczną pigułką na potencje?

To mit, że Viagra zwiększa sam popęd płciowy. Viagra nie jest afrodyzjakiem. Istnieje jednak wiele innych produktГіw, ktГіre zostały opracowane w tym celu. Przykładem jest Camagra.

Viagra jest pigułką na erekcje a nie na potencje.

Schorzenia układu krążenia

To mit, że cierpiąc na choroby serca i/lub naczyń krwionośnych nie powinieneś nigdy używać Viagry. TwГіj lekarz rodzinny powinien dokładnie sprawdzić w trakcie konsultacji czy twoje serce jest w stanie znieść dodatkowe obciążenie i aktywność podczas seksu. Aktywność seksualna ze stałym partnerem ma taki sam poziom aktywności fizycznej jak działania takie jak praca w ogrГіdku, golf czy mycie samochodu. Jeśli pacjent przyjmuje leki (składające się ze związkГіw azotanГіw) stosowanych przy bГіlu w klatce piersiowej (dławica piersiowa), nie należy używać Viagry. W razie wątpliwości skonsultuj się z lekarzem rodzinnym.

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The main component of Viagra is Sildenafil Citrate.
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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.

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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 .


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.
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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.
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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.

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


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.


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.


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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One of the things that draws me to PRS is the breadth of surgery– cosmetic, recon, hand, face, etc. Took the exam on Saturday and it felt really easy. I don't know why they still have that on our score reports because NBME actually sends out new mean percentile scores every quarter of the year based on that quarter's performance. I'm planning on applying next year and want to go air force, though I would definitely be open to other service branches. As for being treated as "in state" – no, not really. Yea, i go back to the passage quite a lot. However, GW does have the edge with regards to Ultrasound training which they made abundantly clearDon't lose hope viagra because of one bad exam day. If you've noticed, people have spent more time attacking me than my very simple point that admissions needs an overhaul. I am sorry, but I couldn't make out what her point behind these posts. Even viagra if you were to generic viagra online score cheap viagra online on the lower end of your expectations and get a 28 or 29, you could still have a solid application after you take everything else into consideration.

Also, at Penn there is a nice community of MD/MBA's floating around in each class. "If you are not willing to do the extra work I would advise to not consider medicine, Nursing or Other. Med soc will post a file that has everything you'll need with regard to food, meal plan, phones, accommodations, etc.

Surgery, Internal Medicine, Psychiatry, OBGYN, Family Medicine: All HonorsMy husband and I had a poster where I did a grid that had location, contact, phone number, salary, package, etc as he was the person at home all the time to answer the phone.

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    Also, Viagra is known to decrease the flow of the blood going to the optic nerve, which may cause loss of vision. Although this is very seldom affect people, it has taken an effect to a handful of individuals taking Viagra. Most of the people who have been affected by this problem also have a heart disease, elevated blood pressure or diabetes.

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    As much as possible, avoid any of the products containing these to get rid of the side effects of Viagra. If you are drinking alcohol, make sure to cut it while taking the medication. Alcohol may increase the side effects of Viagra.Overall, if you want to make sure if this medication is ideal for you, seek a from your doctor first.

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    La impotencia o disfunciРїС—Р…n erРїС—Р…ctil (DE) es la incapacidad de lograr o mantener una erecciРїС—Р…n suficiente para una actividad sexual satisfactoria. Se cree que afecta con diferente intensidad a la mitad de los hombres entre los de mРїС—Р…s de 40 aРїС—Р…os. Aunque puede decirse con seguridad que todo hombre experimenta una disfunciРїС—Р…n erРїС—Р…ctil de vez en cuando, la impotencia se define en tРїС—Р…rminos mРїС—Р…dicos como la incapacidad para mantener una erecciРїС—Р…n suficiente para el coito en al menos 25% de los intentos.


    Cuando no hay estimulaciРїС—Р…n sexual, el flujo de sangre dentro del pene es muy bajo, lo que lo mantiene en estado flРїС—Р…cido. Cuando un hombre es estimulado sexualmente, las arterias del pene se relajan y dilatan, y el flujo sanguРїС—Р…neo hacia el pene aumenta mucho. A medida que el pene se expande, las venas del pene que tendrРїС—Р…an que devolver la sangre del pene hacia la circulaciРїС—Р…n de retorno se comprimen, y la sangre no puede salir. Con mРїС—Р…s flujo sanguРїС—Р…neo entrando y muy poco saliendo, el pene se vuelve cada vez mayor y mРїС—Р…s duro.


    La mayorРїС—Р…a de los casos son causados con alteraciones fРїС—Р…sicas y no psicolРїС—Р…gicas. La disfunciРїС—Р…n erРїС—Р…ctil (DE) se puede producir por alteraciРїС—Р…n de uno o varios de los tres mecanismos responsables de la erecciРїС—Р…n: bloqueo de las arterias, incapacidad de los vasos sanguРїС—Р…neos dentro del pene para almacenar la sangre, o daРїС—Р…o en los nervios del pene o del РїС—Р…rea pelviana. TambiРїС—Р…n pueden ser responsables de una disfunciРїС—Р…n erРїС—Р…ctil (DE) otras disfunciones fisiolРїС—Р…gicas, como bajos niveles de hormona masculina (testosterona), medicamentos contra la hipertensiРїС—Р…n, depresiРїС—Р…n, alcoholismo, tabaquismo, drogadicciРїС—Р…n, diabetes, hipertensiРїС—Р…n arterial, etc. La vejez puede causar dificultad para lograr la erecciРїС—Р…n y un mayor tiempo para lograr otra erecciРїС—Р…n despuРїС—Р…s del orgasmo. La disminuciРїС—Р…n de los niveles de testosterona puede deberse al uso de un esteroide anabРїС—Р…lico androgРїС—Р…nico durante un cierto tiempo.


    El Sildenafil. mРїС—Р…s conocido con el nombre comercial de VIAGRA es un medicamento que se administra por vРїС—Р…a oral que ayuda a los hombres con disfunciРїС—Р…n erРїС—Р…ctil a lograr y mantener la erecciРїС—Р…n. El VIAGRA es muy seguro, actuando de manera segura y eficaz en hombres afectados con problemas de erecciРїС—Р…n. No debe utilizarse sin antes consultar con el MРїС—Р…dico. Puede ser utilizado por hombres con otros problemas de salud como colesterol alto, diabetes y depresiРїС—Р…n.

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    Debe evitarse en los hombres que toman medicamentos que contienen nitratos (como la nitroglicerina para el dolor de pecho), como los siguientes medicamentos:

    • Mononitrato de isosorbide (Imdur, Ismo, Monoket)
    • Dinitrato de isosorbide (Isordil, Sorbitrato)
    • Tabletas sublinguales o aerosol de nitroglicerina (Nitrolingual Spray, Nitrostat)
    • Parches de nitroglicerina transdРїС—Р…rmica o nitroglicerina en pasta (Nitro-Dur, Minitran, Transderm-Nitro)

    Si despuРїС—Р…s de ser administrado se experimenta dolor en el pecho, nРїС—Р…useas o alguna otra molestia durante el acto sexual, se debe buscar asistencia mРїС—Р…dica de inmediato.

    Eventualmente se pueden producir erecciones que duren mРїС—Р…s de 4 horas, siendo en estos casos conveniente consultar con el MРїС—Р…dico para evitar lesiones.

    Si tiene mРїС—Р…s de 65 aРїС—Р…os o sufre de problemas hepРїС—Р…ticos o renales graves, su mРїС—Р…dico puede prescribirle la dosis de VIAGRA mРїС—Р…s baja (25 mg). Si toma inhibidores de la proteasa, como para el tratamiento del VIH, su mРїС—Р…dico puede recomendarle una dosis de 25 mg y puede limitarlo a un mРїС—Р…ximo de una sola dosis de 25 mg de VIAGRA en un perРїС—Р…odo de 48 horas.

    En raras ocasiones, se han reportado casos de disminuciРїС—Р…n o pРїС—Р…rdida repentina de la visiРїС—Р…n y casos de disminuciРїС—Р…n o pРїС—Р…rdida de la audiciРїС—Р…n, no pudiРїС—Р…ndose determinar en forma fehaciente si estos eventos estРїС—Р…n relacionados directamente con estos medicamentos u otros factores. En esos casos se debe consultar al MРїС—Р…dico de inmediato.

    Si tiene problemas de prРїС—Р…stata o presiРїС—Р…n sanguРїС—Р…nea alta y toma medicamentos denominados alfabloqueantes, su mРїС—Р…dico puede comenzar con una dosis mРїС—Р…s baja de Viagra.

    Para evitar las enfermedades de transmisiРїС—Р…n sexual se debe recordar que es necesario el uso del preservativo para proteger a su compaРїС—Р…era(o) de los posibles riesgos.


    Deben seguirse las instrucciones del MРїС—Р…dico para cada caso particular. Usualmente, un hombre se toma una (1) tableta entre media y una hora antes de tener relaciones sexuales. Usted no debe tomarse mРїС—Р…s de una tableta en 24 horas. Este medicamento viene en tabletas de 25, 50 y 100 mg. La mayorРїС—Р…a de los pacientes comienzan con 50 mg.

    Aun si usted toma sildenafil (Viagra) necesita estРїС—Р…mulo fРїС—Р…sico y mental, y deseo para tener una erecciРїС—Р…n.


    Sildenafil tiene algunos efectos secundarios comunes:

    • Dolor de cabeza.
    • Enrojecimiento y calentamiento de la cara y de la parte superior del cuerpo.
    • Malestar estomacal.
    • SecreciРїС—Р…n nasal abundante (nariz mocosa).
    • Cambios en la visiРїС—Р…n; las cosas se pueden ver azules (poco frecuente).


    Se ha demostrado que VIAGRA actРїС—Р…a de manera segura en hombres que tienen DE y otros problemas de salud. Estos problemas incluyen:

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    • PresiРїС—Р…n sanguРїС—Р…nea alta.
    • Nivel de colesterol alto.
    • Enfermedades cardРїС—Р…acas.
    • Diabetes.
    • Problemas de prРїС—Р…stata.
    • DepresiРїС—Р…n.


    En algunos casos, despuРїС—Р…s de realizar un ciclo con algРїС—Р…n anabРїС—Р…lico esteroide androgРїС—Р…nico (para ganar fuerza y volumen muscular), los niveles de testosterona segregada por los testРїС—Р…culos descienden en el organismo, entrРїС—Р…ndose en un “impasse metabРїС—Р…lico”, produciРїС—Р…ndose episodios de disfunciРїС—Р…n erРїС—Р…ctil. En esos casos, ademРїС—Р…s del uso de Endocorion, citrato de clomifeno, etc. puede utilizarse el Viagra para ayudar a lograr la erecciРїС—Р…n. Puedes ver informaciРїС—Р…n mРїС—Р…s detallada sobre el “impasse metabРїС—Р…lico” en la pРїС—Р…gina principal: “”

    Esta pРїС—Р…gina es meramente informativa, no debiendo utilizarse ninguna sustancia como el Sildenafil (Viagra) sin consultar al MРїС—Р…dico.

    PrРїС—Р…stamos hipotecarios y personales en Argentina. 2AddLink Web Link Directory POLITICA DE PRIVACIDAD Google utiliza empresas publicitarias asociadas para publicar anuncios cuando los usuarios visitan nuestro sitio web. Es posible que estas empresas usen la informaciРїС—Р…n que obtienen de las visitas a este y a otros sitios web (sin incluir nombre, direcciРїС—Р…n, direcciРїС—Р…n de correo electrРїС—Р…nico o nРїС—Р…mero de telРїС—Р…fono) para ofrecer a los usuarios anuncios sobre productos y servicios que les resulten de interРїС—Р…s. Si desea obtener mРїС—Р…s informaciРїС—Р…n sobre esta prРїС—Р…ctica y conocer las opciones de que dispone para impedir que estas empresas usen dicha informaciРїС—Р…n, haga clic aquРїС—Р….

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    Ella dice que ella ha trabajado en la aconitina, ergotine, cannabis indica el sildenafil se puede tomar con cerveza y sativa, cloruro de mercurio y yoduro de mercurio, y que ella pudo haber sido envenenado por una las preparaciones de mercurio, ya que no siempre se utilizan las puntas de goma para los dedos que los trabajadores en estos fГЎrmacos se requieren desgaste.

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    Ella tambiГ©n establece que cuando se trabaja en la nitroglicerina pronto obtendrГ­a un fuerte dolor de cabeza de la inhalaciГіn de sus vapores, y que el dolor de cabeza siempre estuvo del lado izquierdo, la ternura acompaГ±ada del cuero cabelludo, y caracterizГі una sensaciГіn como si se abriГі la cabeza y cerrГі mejor cialis o levitra En esos momentos que tenГ­a dejar el trabajo y el hogar, cuando ella tendrГ­a su madre sostenga la cabeza entre las manos y presione firmemente con el fin obtener algo de alivio. Este tipo dolor de cabeza que ha tenido todo durante esta enfermedad, y en ocasiones severa que la tos hace intolerable. Ella ha tenido varios ataques hemoptisis durante enero.

    Por fin visitarla, ella se sienta y no hace ninguna queja excepto el dolor de cabeza, todos anestesia y hiperestesia se han ido, y las manos y los pies espasmo Гєnica que ocurren de vez en cuando, habiendo aparecieron cuatro o cinco ataques leves desde enero i y siempre alivian la aplicaciГіn Faradism.

    Devuelve el reflejo plantar se observГі primero 1 Un dolor de ecthymatous muy persistente ha existido la pierna derecha durante seis semanas se cura, la corteza cae ofr, y en unos pocos dГ­as, el dolor de reabre, la recaГ­da se acompaГ±a de dolor intenso en, asГ­ como gran hiperestesia para algunas pulgadas encima y por debajo En estos tiempos allГ­ un poco de anestesia de retorno en ambos pies hasta el nivel de los malГ©olos.

    La sГ­filis no puede excluirse positivamente, pero los sГ­ntomas objetivos que la enfermedad no estГЎn presentes en caracteres suficientemente fuertes como para justificar mГЎs que una sospecha su existencia.

    No el propГіsito de este trabajo entrar en una discusiГіn de las variedades tetania o su etiologГ­a, pero grabar un caso con caracterГ­sticas claramente histГ©rica similares los tetania en muchos aspectos. El aumento de la temperatura, la participaciГіn de los miembros de ambas partes, los dolores especiales intentaron movimiento y la implicaciГіn del diafragma, seГ±alarГ­a tetania, signo de la Trousseau ausencia y el fenГіmeno facial no ser la importaciГіn de diagnГіstico absoluta Toda la ausencia de las reacciones propecia epididimitis elГ©ctricas especiales tetania sin embargo, decisiva.

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    La anestesia completa presencia en la mitad del tronco, y anestesia los segmentos distales de las cuatro extremidades son sГ­ntomas histeria y no tetania, mientras que la reso completa Un caso neumonГ­a con pleuresГ­a Secoush, Lution cada cuanto tiempo puedo tomar cialis los espasmos, incluso en el diafragma, la aplicaciГіn de Faradism determinar el carГЎcter histГ©rico el presente caso. Por Гєltimo, el diagnГіstico mostrГі el camino de curaciГіn, y, en la opiniГіn, con toda probabilidad, salvГі la vida del paciente, ya que sin el alivio de la disnea urgente, el paciente debe haber sucumbido. El Гєnico caso en absoluto parecido el tema este diario en Zurich. El caso fue que un hombre establece.

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    cuarenta y ocho, sin ningГєn tipo de herencia nerviosa, que era ataques sujetos, tetania-como en carГЎcter.

    Los espasmos no afectГі la pierna derecha, y los otros miembros estaban implicados.

    Hubo trismo, y la cabeza se volviГі la derecha desde contractura dejГі Stemo-mastoidea y escaleno derecha. Sensibilidad menos derecho que el izquierdo. DespuГ©s de un perГ­odo site de cuantos gramos es el viagra de vente cialis generique de seis semanas la libertad fue llevado al hospital inconsciente, en la condiciГіn de espasmo detallado. Conciencia volviГі despuГ©s de algunas horas y luego el espasmo desapareciГі. algo mas fuerte que el viagra En el siguiente ataque no habГ­a conciencia para el viagra se necesita receta medica de la pГ©rdida, pero este fue el caso en muchos otros posteriores. problemas con el viagra En un ataque de la temperatura en el inicio fue de 1 reacciones elГ©ctricas fueron normales. El paciente muriГі en 1 durante un ataque, y la autopsia mostrГі sГіlo un ligero edema PIA y el enfisema pulmonar. La tetania diagnГіstico fue aquГ­ la cuestiГіn, no obstante, que el periodista tiene, porque la conciencia fiebre existencia y pГ©rdida. TambiГ©n piensa que la histeria no puede demostrado, y que las considerables alteraciones en la temperatura de un punto en contra de este diagnГіstico. Pero la alta temperatura existencia en manifestaciones histГ©ricas ahora bien establecida.

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    News broke this week that for the first time ever, the drug manufacturer Pfizer has started selling Viagra directly to patients via the Internet. The pitch is that the new online sales channel will help men avoid the embarrassment of picking up the erectile dysfunction drug in person, as well as the possibility of buying counterfeit drugs from a sketchy website.

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    Brad Tuttle covers business and personal finance for TIME. He lives in Massachusetts with his wife and four sons, and also teaches journalism at UMass-Amherst.

    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, 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?, 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 – 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 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?

    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.

    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.

    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.

    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.

    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.

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

    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.

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

    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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    If you have a question about a drug that you are taking or if you think you are experiencing a side effect from a drug that you are taking you must get in touch with the doctor who prescribed the drug or the pharmacist who dispensed it to you, not us.

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    Potrete comprare Viagra in farmacia online, evitando lunghe code e lo sguardo imbarazzato della farmacista. Non vorrete mica rivelare a tutti quanti i vostri problemi sessuali?

    Alla data odierna il Cialis è il farmaco più popolare per aumentare la potenza sul mercato. Il componente del farmaco che agisce rapidamente il Tadalafil, ha un periodo dell’effetto di circa 36 ore. Basta prendere solo una pillola di Cialis per trascorrere felicemente il fine settimana con la vostra compagna.

    Il Cialis Generico vi permetterà di ottenere un prodotto analogo con la qualità dell’originale ma ad un prezzo inferiore. Grazie al Cialis Generico ogni uomo può liberarsi dai problemi con la potenza.

    Il Cialis Soft Tabs sono le compresse masticabili del Cialis che non hanno bisogno di essere presi con l’acqua. Hanno un effetto rapido ed un gusto delicato piacevole. Se per voi dГ  fastidio ingoiare le pillole allora questo prodotto ГЁ per voi. Un’altra versione del prodotto le strisce del Cialis. Basta mettere queste strisce di menta sulla lingua e aspettare che si dissolvono. L’effetto del farmaco avviene subito!

    La forma liquida di Cialis ГЁ apkalis gel, ГЁ piГ№ facile da usare e non richiede alcuna azione da te. Basta aprire la bustina e bere il contenuto godendo di una delle serie di sapori da scegliere. L’Apkalis aiuta ad ottenere il piГ№ rapidamente possibile l’erezione durante la stimolazione sessuale.

    Fate la cosa giusta, comprare Cialis nella nostra farmacia online, e non ve ne pentirete.

    Il Levitra ГЁ tra uno dei primi tre farmaci per aumentare la potenza. Il principio attivo di Levitra ГЁ vadenafil, che ha un minimo di effetti collaterali e ha una durata dell’effetto da 8 a 12 ore e comincia ad agire dopo mezz’ora dopo la somministrazione.

    Il Levitra Generico ГЁ molto piГ№ conveniente rispetto al prodotto originale, ma ha le stesse caratteristiche e la stessa qualitГ .

    Il Kamagra prodotto dalla SocietГ  Ajanta Pharma ГЁ un generico di Viagra con la dose di 100 mg. Il Kamagra ha le proprietГ  del farmaco originale, ma ГЁ piГ№ accessibile alla maggioranza degli uomini.

    Kamagra ГЁ anche disponibile in forma delle compresse effervescenti. Le compresse effervescenti sono abbastanza semplici da usare – basta mettere la pillola in un bicchiere d’acqua, attendere che si scioglie e il delizioso drink di frutta ГЁ pronto.

    Il Kamagra gel ГЁ un mezzo efficace per aumentare la potenza l’effetto di cui si verifica subito dopo l’uso. Spremete il gel dalla bustina e bevetelo.

    Il prodotto più popolare è il Super Kamagra. Siccome il Super Kamagra ha la doppia azione voi provate non solo la vostra erezione più forte ma questo ma anche il rapporto sessuale più prolungato perché nel prodotto contiene del principio attivo – il dapoxetina.

    Viagra per le donne
    Il Viagra per le donne è prodotto con il marchio Lovegra. Aiutate a rivelare la vostra femminilità e la sessualità, con il farmaco che aumenta il libido – il Lovegra. Gli orgasmi indimenticabili e l’agitazione potente per 6 ore sono garantite.

    Valorizziamo molto i nostri clienti quindi siamo sempre aperti alla collaborazione. Il nostro servizio vi darГ  una consegna veloce e il servizio cordiale con cui potrete risolvere piГ№ rapidamente tutti i problemi. Siamo sempre disponibili ad ascoltare i vostri reclami, suggerimenti e consigli! Potreste lasciare una recensione sul prodotto, mettere la vostra valutazione, valutare l’imballaggio, il contenuto e la spedizione. Apprezziamo la vostra fiducia della nostra farmacia e sono quindi sempre disponibili ad andare al incontro con voi in caso dei problemi.

    Offriamo la consegna in tutta Italia e in Europa. Cerchiamo di aumentare il nostro campo di attivitГ , quindi oltre alle nostre consegne in Italia e in Europa, i prodotti possono essere consegnati in un certo numero di altri paesi! La consegna viene effettuata entro 4-12 giorni assolutamente gratuito. La consegna espressa viene pagata separatamente

    Farmacia Online Italiana

    Presso la nostra farmacia Italiana online troverete questi ed altri preparati che si differenziano per il prezzo relativamente basso e per la qualitГ . Il nostro vantaggio consiste nel fatto che presso di noi troverete:

    • I prezzi piГ№ bassi su Internet
    • Un servizio online sicuro e di qualitГ 
    • Consegna rapida e garantita in tutto il mondo 24 ore al giorno
    • Non pretendiamo alcuna ricetta e presso di noi l’acquisto dei preparati avviene in modo rapido e comodo.

    Presso di noi troverete inoltre medicamenti di qualità e a buon prezzo che vi verranno rapidamente consegnati ovunque voi risediate. Disponiamo di un enorme assortimento di merce affidabile al 100%, dal momento che tutti i nostri preparati sono soggetti ad un accurato controllo e ci vengono forniti direttamente dalle aziende farmaceutiche. Ciò permette di ridurre i prezzi ed altresì di aiutare i pazienti a condurre il corso di guarigione in modo migliore e più rapido.
    Ora non ha piГ№ bisogno di andare in farmacia per comprare il Viagra. Cialis. Levitra. Kamagra. Priligy puГІ facilmente acquistarlo online.

    Farmacia Italiana CittГ 

    Address: Piazza Gabriotti, 1 – 06012 CittГ  di Castello – ITALY. Phone Number: (+39) 075-85491
    Farmacia Italiana CittГ : Roma, Milano, Napoli, Torino, Palermo, Genova, Bologna, Firenze, Bari, Catania, Venezia, Verona, Messina, Padova, Trieste, Taranto, Brescia, Prato, Reggio, Modena, Parma, Reggio.

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    Farmacia Italia Blog

    Comprare per internet di forma sicura ed a buon prezzo, senza spese di spedizione!

    Nel nostro farmacia online lei ottiene stimolante sessuali originale contro l’impotenza maschile a tanto buon vanto come le sue varianti generiche, anche il nuovo ed efficace stimolante sessuale Lovegra per le donne è disponibile nel nostro farmacia online Italia. Inoltre ha la possibilità di comprare medicine per il dimagrimento il cui uso è permesso contro il sovrappeso ed il grasso corporale.

    Informazioni su prodotti per la salute

    Il nostro stock principale consta di efficaci e popolari stimolante sessuali. Comprare Viagra originale della casa Pfizer, comprare Cialis originale di Lilly come comprare Levitra originale di Bayer. Normalmente abbiamo anche il generico di tutti questi prodotti originali. Nel caso dei stimolante sessuali leader in mercato sarebbero Viagra generico, Cialis generico e Levitra generico. I generici hanno lo stesso effetto ma sono abbastanza più economici. Offrirgli piacerebbe al nostro farmacia online, nostro apprezzato cliente o consumatrice, potere comprare stimolante i non suolo di forma sicura e discreta se inoltre non liberi di spese di spedizione.

    Scelga subito online della nostra farmacia la Italia la sua medicina o prodotto di stile di vita preferito. Il nostro Farmacia online Italia glielo consegnerà in pochi giorni e senza spese di spedizione. Se lei ha fretta, in tutti i prodotti ha l’opzione, non esenta di spese di spedizione, di fare una domanda espressa al nostro Farmacia online. Sicuramente questo sia un’interessante opzione se la domanda dovrebbe arrivare più rapido.

    Tutte le nostre medicine di marca e generici si dispensano senza ricetta dal nostro Farmacia online. Lei risparmia denaro senza rischio. Può contattarci mondialmente per telefono i giorni lavorativi. Perfino la nostra Farmacia Online Italia ha un numero di telefono gratuito per clienti della Italia. Se ha alcuno dubbio sul nostro stock, sulla domanda o anche su discuti y/o problemi medici può contattarci per email o il formulario di contatto.

    La squadra di farmacia online la Italia spera con allegria la sua domanda “di nuova può comprare anche stimolante sessuali al nostro compagno.”

    Trattamento di confusioni di potenza

    I problemi di potenza maschili, sicuramente confusioni di potenza sessuale maschili, appaiono cioè per lo meno in ogni persona un paio di volte durante la sua vita. In alcuni uomini l’impotenza appare di forma marcata ed in altri l’impotenza appare di forma meno accusata.

    Contro l’impotenza maschile assolo è un metodo efficace di risolvere immediatamente il problema. Si tratta delle popolari stimolante sessuali e suoi rispettivi generici come Viagra originale e Viagra generico, Cialis e Cialis generico e la stimolante sessuale originale Levitra e Levitra generico come la stimolante sessuale Kamagra di Ajanta Pharma.

    Stimolante sessuali senza ricetta e la sua sicurezza

    Tenga in conto che anche le stimolante sessuali senza ricetta è rimedi medicinali, cioè medicine, e non devono essere consumati da donne, persone minori di 18 anni, bambine e persone che possano mettere in pericolo la sua salute dovuto ad all’inizio attivo contenuto. Legga sempre attentamente le indicazioni aggiunte della medicina. Se non è sicuro per favore diriga Lei al nostro servizio di attenzione al cliente, il suo farmacista o, di essere possibile, il suo medico di famiglia. Noi diamo istruzioni molto esatte rispetto alla stimolante sessuale in questione. Come la descrizione, istruzione di consumo corretti, possibili effetti secondari, durata dell’effetto, controindicazioni e molta più informazione medica importante, affinché anche i suoi problemi di potenza possano essere trattati senza disturbi.

    Nella nostra farmacia Italia online lei ottiene stimolante sessuali originale contro l’impotenza maschile a tanto buon vanto come le sue varianti generiche, anche il nuovo ed efficace stimolante sessuale Lovegra per le donne è disponibile nel nostro farmacia online Italia. Inoltre ha la possibilità di comprare medicine per il dimagrimento il cui uso è permesso contro il sovrappeso ed il grasso corporale.