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Viagra Is Misunderstood
Despite Name Recognition
So How Do You Get It to Start Working?
Viagra gets the blood flowing, but your brain has to be in the mood as well. “The biggest misperception is that it changes your psychology and makes you want sex,” says the editor of MagicBluePill.com (http://www.magicbluepill.com/). which claims to document the experiences of real people who take Viagra. “But if you’re sitting talking to Grandma and you pop a Viagra, unless you have issues, nothing’s going to happen.”
Does Taking Viagra Make a Man More Virile?
Does Viagra Work for Everyone?
Who Is The Typical Viagra User?
What Happens if You Take Viagra and You Don’t Really Need It?
What Happens If a Woman Takes Viagra?
What Are the Most Common Side Effects, and Does Everyone Get Them?
What Types of Erectile Dysfunction Are Most Easily Treated With Viagra?
Does Viagra Work Differently Among People of Different Races?
Has Anyone Ever Died After Taking Viagra?
What Happens If I Take More Than the Recommended Dose?
Do the New Erectile-Dysfunction Drugs Work as Well as Viagra?
– Ms. Parker-Pope, who writes the Wall Street Journal’s weekly Health Journal column, served as contributing editor of this report.
Viagra: How Young Is Too Young?
From the WebMD Archives
Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas Rangers slugger is only 37 and won’t admit to having erection problems, yet he recently agreed to appear in ads promoting the drug. The deal has made people wonder whether Palmeiro really represents men with erectile dysfunction. or whether Pfizer, the company that makes Viagra, wants to persuade young men to try it for fun.
It’s true that erectile dysfunction is more common in older men, but many potential Viagra users are hardly senior citizens: About 40% of 40-year-old men in the U.S. have some degree of erectile dysfunction. Most Viagra users today, according to Pfizer, are in their early to mid 50s. So it makes sense that the company would want to reach more men around Palmeiro’s age.
Urologist Myron Murdock, medical director of the Impotence Institute of America, says these men are likely to use Viagra because sexual performance is a high priority for them.
A younger man, Murdock says, “wants his V-12 Jaguar working just perfectly,” whereas an elderly gent may be content with less dependable erections. What’s more, the sexual partners of younger men “are more demanding of their performance,” Murdock says.
Pfizer denies that it’s promoting Viagra for recreational use. “We’ve consistently opposed that,” says spokesman Geoff Cook. Nevertheless, Murdock says it’s fine to pop the little blue pill to “optimize” your sexual performance.
We assume all young men have normal sexual functioning, “but they’re really not normal,” Murdock says. Hardening of the arteries. which restricts blood flow to the penis. can begin during the teen years, so that by the time a man is in his 20s, his ability to get and keep an erection has already begun to decline. Murdock says many men who seek Viagra for recreational use actually have minor erectile dysfunction.
There’s also some evidence that Viagra can shorten the time it takes a man to recover after sex and be ready for another round. This is called the “refractory period.” Normally it lasts 20 minutes or longer. One study, published in the journal Human Reproduction in January 2000, found that Viagra shortened the refractory period by about 10 minutes in healthy men .
What Viagra cannot do is increase your sexual appetite or make you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in San Francisco, says you shouldn’t expect your erections to reach staggering new proportions, either. “I don’t believe that Viagra can increase an erection beyond 100% of normal,” he says.
“Viagra is a super-safe drug,” Murdock says, assuming you have a healthy heart and don’t take nitrates.
Nitrates include nitroglycerin — a drug that many men take for chest pain from heart disease — and “poppers.” Poppers are little vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which gives a brief high when inhaled. It’s most often used to enhance sexual pleasure, and mostly by gay men. Poppers are not all that safe to use on their own, and they’re especially dangerous when you’re on Viagra.
Nitrates widen blood vessels, and Viagra increases that effect. Mixing the two can cause your blood pressure to drop drastically. A sudden drop in blood pressure can make you pass out, and you may die if your blood pressure stays too low for too long.
Preservatives like sodium nitrate — found in processed food — do not cause this problem, so you won’t die from eating a hot dog while on Viagra. Even so, it’s best to take it on an empty stomach. That way, the drug absorbs into your bloodstream faster. Wine may contain nitrates, but not the kind that cause problems with Viagra. It’s fine to play some Marvin Gaye on the stereo and sip a glass of Chardonnay, if that’s what puts you in the mood.
Although you may be tempted to order Viagra discreetly from one of the hundreds of Web sites that sell it, don’t. “It’s bad medicine,” Murdock says. You really must bring your doctor into your sex life if you want to use Viagra.
When you buy from an online pharmacy, you just have to answer some health questions before you proceed to the checkout page. If you answer honestly — and that might be a big “if” for those determined to get what they want — the questionnaire may catch some possible complications. But the pharmacists who fill your order don’t know your medical history, and no questionnaire can diagnose the root cause of your problem. Erectile dysfunction can have serious underlying causes, like diabetes. heart disease. liver disease, or thyroid disease.
Cook says Pfizer is opposed to Internet Viagra sales. “Our goal with any of our marketing is simply to reach men and encourage them to see a doctor,” he says.
It seems that Viagra can make sex better for women, too. Like the penis. the clitoris is erectile tissue — spongy tissue that becomes engorged with blood during sexual excitement. By increasing blood flow to the clitoris, Viagra may heighten a woman’s sensation and arousal. It also seems to increase vaginal lubrication.
Murdock says many couples like to heat things up by splitting a dose of Viagra. “It’s an interesting sexual situation,” he says. The recommended dosage for men is up to 100 milligrams per day, and that seems to be just as safe for women. Young people may get results from a smaller dose: As little as 25 mg may be enough.
The FDA has not approved Viagra for women, but Murdock says, “It’s just a matter of time.” He says he and other doctors who specialize in sexual medicine prescribe it to women, which is perfectly legal. Doctors are allowed to use their best judgment. Drug companies, however, can’t advertise any use that isn’t FDA-approved.
The studies being done to test Viagra’s safety and effectiveness in women have shown good results so far. “We’re cautiously optimistic,” Cook says.
Martin F. Downs is a health writer in New York City. He was formerly an editor at CBS HealthWatch. He has also written for Health.com, Salon.com, and POZ magazine and is the editor of the Alicubi Journal (alicubi.com).
В© 2002 WebMD, Inc. All rights reserved.
Viagra is indicated for the treatment of erectile dysfunction in men. Viagra is a phosphodiesterase type 5 (PDE5) inhibitor. It works by helping to increase blood flow into the penis during sexual stimulation. This helps you to achieve and maintain an erection.
Use Viagra as directed by your doctor.
- Take Viagra by mouth with or without food. Viagra may not work as quickly if you take it with a high-fat meal.
- Viagra is usually taken about 1 hour before sexual activity; however, it may be taken anywhere from 4 hours to a half hour before sexual activity. Talk with your doctor about the best way to take Viagra.
- Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
- Do not take more than the recommended dose or take it more often than once daily, or as directed by your doctor.
- If you miss a dose of Viagra and you still intend to engage in sexual activity, take it as soon as you remember. Continue to take it as directed by your doctor.
For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, Viagra may be taken anywhere from 4 hours to 0.5 hour before sexual activity. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.
Ask your health care provider any questions you may have about how to use Viagra.
Store Viagra at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Viagra out of the reach of children and away from pets.
Active Ingredient: Sildenafil citrate.
Inactive Ingredients: Microcrystalline cellulose, anhydrous dibasic calcium phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose, triacetin, and FD & C Blue #2 aluminum lake.
Do NOT use Viagra if:
- you are allergic to any ingredient in Viagra
- you have been advised by your doctor to avoid sexual activity because of heart problems
- you are taking nitrates (eg, isosorbide, nitroglycerin) in any form (eg, tablet, capsule, patch, ointment), or nitroprusside
- you use certain recreational drugs called “poppers” (eg, amyl nitrate or nitrite, butyl nitrate or nitrite)
- you take another PDE5 inhibitor (eg, tadalafil, vardenafil) or another medicine that contains sildenafil.
Contact your doctor or health care provider right away if any of these apply to you.
Some medical conditions may interact with Viagra. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have a deformed penis (eg, cavernosal fibrosis, Peyronie disease), blood cell problems (eg, leukemia, multiple myeloma, sickle cell anemia), or any other condition that may increase the risk of a prolonged erection (priapism)
- if you have a history of a prolonged (more than 4 hours) or painful erection (priapism)
- if you have a history of certain eye problems (eg, macular degeneration, optic neuropathy, retinitis pigmentosa, sudden vision loss in one or both eyes) or hearing problems (eg, ringing in the ears, decreased hearing, hearing loss)
- if you have a history of liver or kidney problems, lung problems (eg, pulmonary veno-occlusive disease), high or low blood pressure, ulcers, bleeding problems, heart problems (eg, angina, aortic stenosis, heart failure, irregular heartbeat), or blood vessel problems
- if you have a history of heart attack, stroke, or life-threatening irregular heartbeat, especially within the past 6 months.
Some medicines may interact with Viagra. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Alpha-blockers (eg, doxazosin), medicines for high blood pressure, nitrates (eg, isosorbide, nitroglycerin), or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur
- Azole antifungals (eg, itraconazole, ketoconazole), H2 antagonists (eg, cimetidine), HIV protease inhibitors (eg, ritonavir, saquinavir), macrolide antibiotics (eg, erythromycin), narcotic analgesics (eg, dihydrocodeine), or telithromycin because they may increase the risk of Viagra’s side effects
- Bosentan or rifampin because they may decrease Viagra’s effectiveness.
This may not be a complete list of all interactions that may occur. Ask your health care provider if Viagra may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Important safety information:
- Viagra may cause dizziness, drowsiness, fainting, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Viagra with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it.
- Viagra may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
- Patients with heart problems who take Viagra may be at increased risk for heart-related side effects, including heart attack or stroke. Symptoms of a heart attack may include chest, shoulder, neck, or jaw pain; numbness of an arm or leg; severe dizziness, headache, nausea, stomach pain, or vomiting; fainting; or vision changes. Symptoms of a stroke may include confusion, vision or speech changes, one-sided weakness, or fainting. Contact your doctor or seek medical attention right away if you experience these symptoms.
- Viagra may rarely cause a prolonged (eg, more than 4 hours) or painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if you have an erection that lasts more than 4 hours.
- Viagra does not stop the spread of HIV or other sexually transmitted diseases (STDs) to others through sexual contact. Use barrier methods of birth control (eg, condoms) if you have HIV infection or an STD.
- Viagra will not prevent pregnancy. If your partner may become pregnant and you wish to avoid pregnancy, be sure to use an effective form of birth control.
- Viagra may uncommonly cause mild, temporary vision changes (eg, blurred vision, sensitivity to light, blue/green color tint to vision). Contact your doctor if vision changes persist or are severe.
- Rarely, an eye problem called nonarteritic anterior ischemic optic neuropathy (NAION) has been reported in patients who took Viagra. This may lead to decreased vision or permanent loss of vision in some cases. If you notice a sudden decrease in vision or loss of vision in one or both eyes, contact your doctor right away.
- Sudden decreases in hearing and loss of hearing have been reported in some patients who have taken Viagra. Sometimes they also noticed ringing in the ears or dizziness. If you notice a sudden decrease or loss of hearing, contact your doctor right away.
- Do not use other medicines or treatments for ED while you are taking Viagra without first checking with your doctor.
- Use Viagra with caution in the elderly; they may be more sensitive to its effects.
- Viagra is not recommended for use in children younger 18 years.
All medicines may cause side effects, but many people have no, or minor, side effects.
Check with your doctor if any of these most common side effects persist or become bothersome:
Diarrhea; dizziness; flushing; headache; heartburn; stuffy nose; upset stomach.
Seek medical attention right away if any of these severe side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; fast or irregular heartbeat; memory loss; numbness of an arm or leg; one-sided weakness; painful or prolonged erection; ringing in the ears; seizure; severe or persistent dizziness; severe or persistent vision changes; sudden decrease or loss of hearing; sudden decrease or loss of vision in one or both eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.
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