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Should A 16 Year Old Take Viagra

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145. My Husband and I

My husband and I have been married many years and the thrill had gone out of our sex life. We were only making love once a month because he was having a tough time getting it up and keeping it up.

On his suggestion, we ordered some Viagra online. The first night he took one 50 mg. tablet on an empty stomach. We waited 30 minutes. nothing. an hour. nothing. Then I started to go down on him. WOW. He achieved an extremely hard erection in seconds. He was like he was at 18 years old, when we routinely made love 3 times a day.

We went upstairs and for the next two hours made passionate love. He was thrilled with the strength of his erection and so was I. For the first time in many years I had two orgasms during sex. When he came he screamed and said it was the most intense orgasm of his entire life. Then an hour later we had sex again and again in the morning!.

I am a believer in Viagra. This stuff is a miracle pill!!

144. Ten Years Later

I got diabetes when I was twenty and before that, sex with my wife was great. My friend told me to take some Viagra and I did. I took a 25mg dose 15 minutes before sex on an empty stomach. That night was incredible! That was the hardest and biggest I've ever been! – Age 35, North Carolina

143. Success After Prostate Seed Implant

Have tried both Viagra & Cialis after having a seed implant to the prostate, both work great for me. I think using each on the right occasion is ideal. Cialis keeps your primed for 36 hrs where as Viagra runs out of steam in about 6 hrs. I disagree that sexual thoughts only are needed to obtain an erection, with both pills even after sex I tend to be in a semi primed state ready to go again & again, Its like being a 17 year old again, if you haven't tried either yet don't delay, life's shorter than you think.

142. Back in the Saddle Again

My problem is a lessening of the physical erection. I still have the sexual urge, manipulation still feels good, and I can still ejaculate. But all this while I'm only semi-hard, not stiff enough to penetrate. First I tried Levitra, under the same circumstances every time (empty stomach, no alcohol) 1st time worked great, 2nd time didn't work at all, 3rd time worked pretty well, 4th time worked poorly. I didn't like that ratio, most especially the unpredictability, because I'm single. So I asked the doctor to write me one for Viagra. I've taken the 100 size four times, with a totally 100% success rate. I get a stuffy nose, and it changes my vision, it's like I can see the air glowing. I don't care about the side effects, I'm back in the saddle again. – Al, Age 63, Nebraska

141. Take It 40 Minutes Before Sex

I have used Viagra on and off for two years. I only take about 25mg which is just right for me. I find that the best time to take it is around 40 minutess before sex. I laid off it for a while as I found it improved my erection so much that I didn't need it for around 6 months. Just started with it again the other night. My wife couldn't believe the size and hardness. It excited her so much she just jumped on me and had great fun. Viagra is great and works well. Only drawback is a stuffy nose, red face and sometimes a headache. – Age 48, UK

140. Overcoming Side Effects from other Meds

My boyfriend had two knee surgeries and was on some meds that gave him ED pretty bad. Naturally, I was getting upset being as though he was only 30 and I was only 24. He started taking Viagra and he was going at hit so hard, I had to start turning him away. It used to be that he would cum just as soon as we got started but afterwards it was sex for an hour, then a 10 minute break (usually for him to get a snack lol) then back at it again.

139. 10 Years Strong

I have been taking Viagra for about 10 years now, I find its very helpful in maintaining my sex life with my wife of 45 years. Our love gets stronger by the day. Great sex is a real gift, even at our age. – Age 64, Michigan

138. Helped after Seed Implant for Prostate Cancer

After a seed implant for prostate cancer I developed. ED. With Viagra it's like being a 18 year-old again. I recommend for any man who can't get it up. Believe me guys go for it life is to short enjoy yourself. – Dave, Age 64

137. The Release and Pleasure I Need

I had erection problems due to blood pressure medication. After getting a Viagra prescription from my doctor, I've found that I'm hard as long as I want. My wife had hip surgery and couldn't have sex. I found that masturbation with Viagra gives me the release and pleasure I had when I was 17. – Age 63, Chicago

136. What Got Into Me? And Could It Get Into Me More Often?

I am 45 and in the past 5 years or so have not been able to keep an erection long enough to please my wife of 25 years. I had tried several things and nothing seemed to help. I talked to my doctor and got 4 100mg pills. I took 1/2 a pill with a glass of water and wow. I was harder then I have been in years, I was able to go until she said stop, something she hasn't said in 15 years. Later as we rested she asked what got into me, and could get into me more often? – Jorge, Age 45, New Hampshire

135. Hard as a Cue Ball

I took 50 mg on an empty stomach with a full glass of water. The head got as hard as cue ball. My penis seems to push outward and upward giving me more reach. I got so hard it "almost hurt" but a little K-Y and some gentle stroking made it all better. My wife takes care of reordering. – Nate, Minnesota

134. I'll Keep This Pills Around Just in Case

My husband and I have been married many years and the thrill had gone out of our sex life. We were only making love once a month because he was having a tough time getting it up and keeping it up. On his suggestion, we ordered some Viagra online. The first night he took one 50 mg. tablet on an empty stomach. We waited 30 minutes. nothing. an hour. nothing. Then I started to go down on him. WOW. He achieved an extremely hard erection in seconds. He was like he was at 18 years old, when we routinely made love 3 times a day.

133. Be Careful Mixing with Food and Alcohol

I took Viagra after a dinner of hamburger, French fries, and two glasses of red Merlot wine. The result was total non-performance in bed one hour later! However, 12 hours later I was able to have an erection. Moral of the story: Do not eat or drink if you want Viagra to work at its maximum. Eddie, Age 50, California

132. I Chew It and Swallow with Water

Antidepressants had robbed me of my full hardness, and made it so difficult to cum, that sometimes I just gave up. 50mg Viagra and problem solved! I chew it up (tastes awful) and swallow with water. 15-30 minutes later I am boned like a 16 year old. And can save my load for as long as I want, or let it go in a hurry. I have found the effect to last about 2-3 hours, for 2-3 hard-ons. Age 52, Vermont

131. The First Time was Some Improvement, but the Second Time: WOW

I am 67 and have 3 degenerated discs in my lower back which I think has much to do with my ED. It had got to the point that my wife and I were beginning to wonder if sex was worth the effort. I finally bit the bullet and asked my doctor for Viagra. Initially I was told to take 25mg at first and if it didn't work then try 50mg. Well, 25 didn't work, so I tried 50. The first time there was some improvement, but next time: WOW! I had practically forgotten what it was like to have a full erection and sensation on penetration. and when I climaxed I thought I was going to explode! Thee cheers for Viagra, and its worth the stuffy nose and bleary eyes any time.

130. Again and Again In a Short Space of Time

Have been suffering from ED on and off for over a year now, and like most of the guys who have related their experiences here, you really have to experience it to know the knock it gives not just to your sexual confidence, but also your confidence in general. Recently I confided in a very good friend the problems I was having, and was stunned to find he had been using Viagra for well over 18 months. The long and the short of it is, he supplied me with two 100mg tablets and a lot of good advice as to dosage and use.

So for the first time last night, I split one of the tablets and tried it out. Well for almost an hour and a half nothing happened, despite the best efforts of my lovely wife, except for having a sinking feeling that I might be one of the 1 in 5 who it doesn't work for, then BANG, the hardest erection I have had for many years. Not too sure why it seemed to take longer for me then others, but God, was it good when it did.

The bottom line is that we made love on 5 separate occasions that evening, something I have never managed since my early twenties, and wow, was it great to be able to do it again. What amazed me more then anything, was not just how hard you get, but how easy it is to do it again and again in a short space of time. – Steve, Age 43, UK

129. First Time in 10 Years

I recently started dating again after being divorced for several years. I hadn't had sex in 10 years but didn't expect any problems. I was totally depressed when I couldn't get an erection for the first few times I tried with this beautiful woman I was dating. I decided to try 100 mg Viagra. It did take a couple hours to kick in, but this was after having a big meal first. When it started to work, I was able to get a rock hard erection and last longer than I had ever before. What shocked me was that 15 minutes later, I was ready to go again and the erection was harder and lasted longer than the first time. I didn't get any sleep that night because I was in and out of this lovely women all night. – Age 50, Chicago

128. It Allowed Me To Completely Focus on Making Love

I had never taken Viagra before a friend gave me one to try. While I have not had major difficulty in achieving erections, the ones I have had recently can sometimes wane or go soft. I cut the pill in half and took it about three hours before I had sex. When we began to kiss, I achieved an immediate erection which remained hard throughout the encounter. It was amazing, gratifying and allowed me to completely focus on making love without worrying about whether my erection would remain consistent. – Doug, Age 47

127. My Wife Went Totally Out of Control

I've been married to the same knock-out of a woman for over 19 years. At my age I was starting to resemble the old adage, "I'm not as good as I once was, but I'm as good once as I ever was". Well, to make a long and explicit story short I found out after trying Viagra that I was never even as good as I thought I once was. WOW! My wife and I went at it like we were teenagers again for an hour and a half straight! I had 3 climaxes with the same erection over that time and my wife, though usually a sexual dynamo anyway, went totally out of control. We were on vacation in a hotel room and I'm fairly certain we woke the neighbors. – Age 38, St. George

126. I Think I've Settled on the 25mg Dose

After taking blood pressure medication for years, and just recently being prescribed another medication which has a negative effect on erections, my Dr. suggested Viagra after my most recent visit. He gave me a sample pack after the usual checkup and suggested I take the 50mg dose and adjust from there. I went home and it just so happened that my wife a I had the afternoon alone. I took a 50mg pill and we readied for bed. After 15 minutes I felt a stirring. After 30 minutes there was considerable action at work. I was thicker and harder than I had been in years. I don't think I was that hard and full at 19. We made love for a long time, and with great intensity. Afterwards I told my wife, what the Dr. had prescribed. She was pleased after the initial surprise. Since then the results have been incredible. We made love three nights in a row, each time was longer and more intense than the one before.

The night before last, we made love for 2 hours straight without stopping. I could not ejaculate no matter what my wife or I did. I finally did after us both working like jack hammers. Last night I used the 25mg dose, which worked well and allowed me to last, and last, but be able to ejaculate. I think I've settled on the 25 mg dose, drink lots of water to help avoid the headache, and find the lowest dose that works for you. – Bob, Age 48

125. I Split That In Half Making A 12.5mg Piece

I'I needed a little "push" in the erection department so I went to the Dr. and asked him if it was safe for me to use it. I told him I wanted 100mg so I could split it down so it would be more affordable. That night I split the 100mg tablet down to four 25mg pieces then for the hell of it took one 25mg and split that in half making a 12.5mg piece. The following evening I took that little piece about an hour before hooking up with my lady. It worked great, not poking holes through brick walls great but very comfortably hard yet flexible just enough for all positions great. Take my word for it. Even if you have just a small problem getting an erection Viagra will get you over the "Hump". – Jake, Age 59, Washington

124. I Wish I Had This Stuff 20-30 Years Ago

I'm a 52 year old paraplegic (T4 – T5) since an accident when aged 19. Fortunately I was able to achieve erections after my accident but they went soft during sex. Enter Viagra. I wish I'd had this stuff 20 -30 years ago. 25mg or 1/4 tablet sees me rigid for hours and ready to go again in the morning. Sadly for me, finding lady friends who can go the distance is now a problem! – Age 52, Australia

123. Cat Couldn't Scratch It

I've never had a problem with achieving an erection, but over the last two years or so the stiffness factor has suffered some, especially towards the end of the job. With a 50 mg Viagra, I get a blue steel throbber. Cat couldn't scratch it! My wife LOVES it. Not many side affects, slight headache sometimes. MUST take on an empty stomach, though. Alcohol in moderation (2-3 drinks) doesn't seem to have an affect. I'm sold. Should have started taking Viagra a few years ago. – Tom, Age 51, Florida

122. My First Time in 17 Years

I started using Viagra a year ago. For 17 years I had not had an erection firm enough to penetrate at all. I felt hopeless and was too ashamed to seek help. Finally someone encouraged me to ask for Viagra. Amazing! I achieved a full erection in about 30 minutes. I was able to have sexual intercourse all the way to climax — my first in 17 years! I had forgotten how good it was. Since that initial trial, I now achieve a full erection with Viagra in about 10 minutes and enjoy sexual intercourse without failure of my erection every time. – Eddie, Age 55, North Carolina

121. Brings Back Abilities I Thought I Had Lost

Viagra makes me feel like a 20-year-old. Seriously, I have multiple sclerosis and Viagra has brought back abilities I thought I had lost. – Fred, Age 43, Las Vegas

120. I Slept Like a Baby and Woke Up With an Erection

A year after being given samples by my doctor, my wife and I went on a weekend getaway. We had dinner and afterward sat by the river and had drinks. Between the first and the second drink I went to our room and took a 50mg tablet. After finishing the second drink we retired to the room where I got a raging hard-on just thinking about what was about to happen. We had sex that lasted for an hour, rested thirty minutes, and started all over again. I slept like a baby and woke up with an erection and we had sex again. Viagra was a life saver for these two 53 year olds. – Age 53, Alaska

119. Dissolving It Under The Tongue

I first tried Viagra after an injury in my youth made any erection a dream. I tried the 25mg without any effect. My doctor moved me up to the 100mg dose and told me to try half a pill. After moving up in dose, I finally tried a 100mg dose and was amazed! It was like before my accident. I have found that by placing the pill under my tongue and letting it dissolve there, that the effect becomes more apparent earlier. Usually, within 10 minutes or so. Yes, it tastes pretty bad, but I'll trade bad taste for great sex any day. – Age 54, Oklahoma

118. Only 23 But It Worked For Me

I am only 23, and unfortunately I've always had ED; nobody can tell me why. I have never woken up with an erection, and to maintain an erection (even through masturbation) was a little difficult. I am currently on 25mg of Viagra. I buy 100mg tabs, and cut them into fours, so I get the most out of them. They work, and when I wake up now, I have an erection, most of the time..It's truly worked for me. – Johan, Age 23, Australia

117. I Can Enjoy Longer Foreplay

I like to take Viagra so I can enjoy foreplay longer without worrying about losing my erection. Sometimes it enhances my orgasm, sometimes not. I rarely have any side effects though. I like to take it approximately 1/2 hour prior for it to take effect. Like most others I bought a splitter as 25 mg is plenty. Occasionally i will have some nasal congestion, well worth it though. – Ron, Age 57, Illinois

116. Help With Hypertension

I'm 39 years old and I have been taking anti-hypertensive medication for the last 6 years. I am suffering from congestive heart failure. After a year of taking medications, I noticed that my erections were no longer hard as they used to be. When I first heard about Viagra, I felt really sad because the initial news articles were saying that this wonder pill is not for those with heart problems and it may even cause death especially if you are on nitrates. Along with my anti-hypertensive, I've been taking nitrates also to take care of my angina. Needless to say, my situation took a toll on my sex life and I knew I am depressed although am in denial. My doctor told me however that I could take Viagra provided I should not take it within 24hours after I drank my nitrates. This was the best news for me. Well, I am here because I wanted to tell you that 50mg worked for me on an empty stomach. My girl was surprised what brought about the woody and the new passion for sex, or should I call it a "steely". I knew she's suspecting something, but what the heck, I am willing to tell her if she asked. I am here because I wanted to tell you guys who are suffering from CHF and on nitrates that we still have a chance to a wonderful sex life and more than that – a better relationship with your spouse and a new outlook in life. Side effects? Forget it, my girl says I look sexier when I am flushing. – Age 39, Phillipines

115. I Believe That This Pill Works Wonders

I was noticing a loss in my "mojo" and decided to confront my doctor. He diagnosed me with ED and that I was sterile, and prescribed Viagra. I decided to not tell my wife of 5 years. So when after dinner i took half of the little blue pill, and waited for the excitement to start coming. It took ten minutes and I was ready to go. Within 20 minutes she was having the biggest orgasm I had seen yet. We mixed up the positions a bit, and went at it like teenagers. After I came, I was ready after 5 minutes to go again. We did, and she conceived that night. And those doctors said it could never happen. I fully believe that this pill works wonders. I owe it my whole life. We now have a 4 month old baby boy. – Jacob, Age 28, California

114. Restarts the Natural Process

A few years back I began noticing the same changes so many of us "Over 45s" are experiencing. I got my first prescription for Viagra (50mg) and always had the headaches and stuffiness but accepted the tradeoff for the benefit. At a recent visit to my doctor he set me up with some more samples and suggested: "Try taking the drug 3 nights in a row. With some fellas that re-starts the natural process". After getting the Mrs. to agree "for medical purposes" I took 25mg each night for 3 nights. Results? Night 4, no "V" and I performed like I was 19 again. We both loved it. – USA

113. Now He Can Go Way Longer Than I Can

My 55-year-old boyfriend takes Viagra. It works wonders. He takes two 25-mg tabs and is rock hard for a very long time. He started with one, and he was semi-hard, so I asked him to take two the next time. This was definitely the trick. Before he got the magic pill, he knew he couldn't get an erection and would spend hours pleasuring me other ways, which is great until I decide I want more and he can't do it. This little magic pill has make our sex life awesome, and he can go way longer than I can, and he is 20 years older than me! – Anonymous Woman, Age 34, Wisconsin

112. Helped With a Long Period of Depression

I take antidepressants. The antidepressant causes very delayed ejaculation or anorgasmia and a reduced sex drive. Fortunately, Viagra more than compensates. Physically, it enables full erections. But most importantly, the confidence that successfull sex has given me has helped to relieve a long period of depression. – Jeff, Age 51, UK

111. One Evening I Just Handed It To Him and Said, "Here, Take It!"

My husband and I have suffered with ED for approximately 3 years now. It had gotten worse last winter and I was feeling the typical crap: I'm not attractive to him anymore, he doesn't want me, there's another woman Of course his performance anxiety was just terrible and he didn't even want to have sex for fear that he couldn't get hard or stay that way. Well I had gone to the doctor. for a check-up and while I was there I asked her about some Viagra for my husband, she gave me the samples and I took them home and they lay in the cabinet for 3 months, he just couldn't bring himself to take it, and I wouldn't ask. One evening I just handed it to him and said here take it, he didn't say anything just put it in his mouth and swallowed. 45 minutes later we had the best sex we had had in years! It was AMAZING. He was longer, and harder than he had been in 20 years! Ladies don't be afraid to take matters into your own hands and help your man out, get the samples yourself if your partner is to embarrassed or ashamed you will be so glad you did. – Anonymous Woman, Age 44, Indiana

110. I, a Real Person, Vouch For The Pill's Capabilities

I took Viagra for the first time last night. I split a 100 mg pill (50 mg) and at first, I did not feel any thing at all. I thought this stuff does not work. However I decided to move forward with having sex with my wife, because I was in the mood. Well, let me tell you, once my wife started stimulating me, I experienced an erection that scared me. Now typically after the first round we go to sleep. Not only did the first round last approximately an hour it was deep penetrating sex. After 20 minutes my wife was back for round two and she had the most deeply satisfying orgasm that one could imagine. It has been years since I have seen this. I was skeptical of all of the claims, but I, a real person, vouch for the pills capabilities. Like others, I will work with adjusting the amount, I will try 25mg next time. Age 47, Chicago

109. No More Wham Bam Thank You Ma'am

After a dismal start with my new friend I went to my doctor and complained about the meds that I was taking interfered with my sex life. I received a prescription and 4 free Viagra of 100 mg. Well after reading on how men reduce to dose I decided to cut it down to 50 mg. The next time my girl friend and I went to bed I did well for 40 minutes and she was exhausted – no more wham bang thank you ma'am. I made me extremely happy now and we do go on for a whole weekend, 3 days night and the morning after. – Dave, Age 63, Michigan

108. I Prefer Small Doses

I am 62 and had a heart attack 12 years ago. I keep myself fit and I have been using Viagra for 3 years. I prefer taking small amounts –. half or even less of a 25mg tablet, This amount works on an empty stomach with half a glass of water. I occasionally take about 20mgs – then wow, I want to go on for hours! I have tried taking 25mg and 50mg at one time but I find it is too much and reduces the sensations. It is a sensational product!

107. 50 mg Works Wonders

My boyfriend began having problems with erections (he's older) and I suggested he look into Viagra. Boy, am I glad he did! The first time he tried it, one 50 mg pill did nothing so he took another and that was a mistake. Three hours later he was still rock hard and had come multiple times (so had I). Since then a single 50 mg dose does it very well–he’s now good for almost 2 hours of good hard sex that leaves both of us worn out. – Bobbie, USA

106. Saved My Marriage

I have been on blood pressure meds for years. I was having no problem getting hard but I would lose it right in the middle of sex. I asked one doctor about Viagra because my wife was blaming herself, saying she did not turn me on anymore, I did not find her attractive, etc. Well, the doctor said to use more direct stimulation, so I shocked him and said how much more direct can you get than a blowjob. I would go soft during a blowjob. I went to a different doctor and he asked me if I wanted to try Viagra and I said yes. I will never forget the first time I tried it. I split a 100 mg in half, went and took a shower and was anticipating sex with my wife and thinking about her and wham, I got hard! I wanted to run out and show her, but didn’t. We went to bed and soon she looked over at me and my erection, her eyes get big and she said, “Oh my God, look at how big and hard you are and I haven’t even touched you yet.” She and I both loved it. I get erections like I was 18! I last longer before I come, I am larger and very hard, and like many have said, I can repeat again soon if I want and the effects last even into the next a.m. To make a long story short, a doctor and a little blue pill saved my marriage. – Age 47, Nebraska

105. 11-year ED Cured

I am a 27-year-old male model from NY, and I have been suffering from ED since I lost my virginity at 16. I am a very good-looking male, and I can get almost any girl I want, but I was always too afraid of the embarrassment of facing a girl after 2 minutes of sex. I was tired of pleasing my girlfriend of 4 years orally. I started noticing Viagra pills laying around my father’s house, and was very curious about how they worked! I knew they had to work if my father at the age of 53 was taking them. I snuck two of his 50-mg pills, and took them home, where they laid on my dresser for 2 weeks, because I was skeptical of it actually working. After 2 weeks I finally decided to pop one of the pills 30 minutes before sex, and I was amazed at the results! After I had my daily 2-minute orgasm, I thought “Oh No, it didn’t work” and assumed my dick would go soft a minute later as usual, But it stayed ROCK HARD literally for at least 4 hours. I kept going, and going! I was having sex like I never imagined I could. I came at least two more times that night, and it never went down! My girlfriend was blown away, and begged me to stop! I never thought I would have a girl say that to me! Viagra definitely is a miracle pill. I thought I would have to deal with ED for the rest of my life. I would recommend Viagra to anyone curious enough to try it! And hopefully we will see your positive results posted on this site with the rest of ours. – Chris, Age 27, New York

104. 75 mg did the trick

I have moderate/severe ED for two years and started taking 50 mg of Viagra two months ago with only moderate success in reaching an orgasm, even with my wife assisting me orally. I talked to my Doctor and he increased the dosage to 75 mg and told me not to try every day. I waited three days, and took the 75 mg. Within one hour I was rock hard and serviced my wife thru four orgasms! After about two hours she performed oral sex on me and and I had the most intense orgasm of my life. – Mark, Age 65, Chicago

103. I Can’t Tell You How Much Fun We Had

Physically fit and trim (6′, 178 lbs) at age 40, seven years into marriage, I began noticing difficulty maintaining an erection. In the middle of sex, my hard-on would wane away. I soon found myself avoiding sex; performance anxiety only made matters worse, bringing new meaning to the words “soft-on.” I could not believe this was happening to me. My interest in sex was as it always had been — on my mind frequently. For me, the inability to maintain a good hard-on during sex was accompanied by a huge sense of loss, disappointment and embarrassment.

I made an appointment to see a urologist. After discussing the matter with me, my doc gave me two trial packs of Viagra and a script, saying I should try out the meds and see if they work before I fill the script.

That night, I couldn’t wait to take the blue pill, a 100mg dose. I took it on an empty stomach with a full glass of water and waited 30 minutes before having dinner. After about 45 minutes, my nose began to get quite stuffy and my face was slightly flushed.

About an hour or so after taking Viagra, my wife and I went behind closed doors for a little adventure — not knowing what the results may be. I stripped down and got in bed while she went through her nighttime ritual getting ready for bed. Once she emerged from the dressing room, the sight of her incredible, naked body started to get me going. I could begin to feel my dick getting hard, really hard. We got after it for awhile, and all I can say is that my confidence and hard-on were unflappable. It’s no exaggeration to say that we fucked non-stop for almost an hour and my dick was as hard as ever. I felt 18 again. We tried Viagra again and again that week, with great results every time, and I cannot tell you how much fun we had.

The 100mg dose is too much for me. I split the tablet in thirds and found that about 33mgs works best for me. Sometimes I get a slight headache, stuffy nose, and flushed face, but the short-lived, mild side effects are well worth an incredibly good fuck.

And to top it off, my insurance pays for this medication (although they’ll only allow 10 tablets a month. those prudes). – Grant, Age 42, Texas

102. Like Being a Teenager Again

I was losing my erection during intercourse and during oral sex with my girlfriend. I am in good health and have always enjoyed sex. It was difficult to pinpoint the problem so I decided to order some Viagra online. After a brief online consultation which decided I was suffering from slight ED, I ordered my Viagra which arrived in two days. I ordered 4x100mg pills and on the weekend decided to give it a go without saying anything to my girlfriend. 35 minutes before we went to bed I took half a pill, and WOW. what a difference. I had a rock hard erection for over an hour of non stop sex. Even after I had climaxed I was ready to go again in twenty minutes, which we did. this lasted for over two hours, and I was still hard in the shower after. It was like being a teenager over again. Amazing. If you have a problem with ED, try Viagra, it is great. – Steve, Age 46, UK

101. Happy Daddy

From age 45 I had trouble getting and keeping an erection so sex was so rare an event my wife came off the pill. Unknown to her ( I was embarrassed) I took Viagra. I did not realize she was in the middle of her fertile time so guess what, she fell pregnant. She is 46 but so far the doctor says all is well and we expect our 4th child in a couple of months time. Thank you Viagra. – Dave, Age 51.

100. 10 Minutes Later and Erect Again

I take meds for high blood pressure and diabetes. I started having problems with losing my erection after a few minutes. When I told my doctor, he asked if I wanted to try Viagra. I said sure. He wrote the script for 50mg and advised trying splitting them in half. I took a 25mg dose and was amazed. I got very hard and lasted a good half hour before my orgasm. We rested 10 minutes or so and then was erect again. Works the same every time now. Even 6 to 8 hrs later I find myself getting a hard erection. – Del, Age 58, Indiana

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Men aged 18 to 30 on Viagra to keep up with Sex And The City generation

It used to be that men had the upper hand when it came to confidence in the bedroom.

But health experts say ever-younger men are increasingly turning to Viagra in a bid to keep up with modern women inspired by the strong female characters in films such as Sex And The City, starring Sarah Jessica Parker.

Relationship therapists are also seeing a rise in the number of men in their 30s asking about the impotence drug, traditionally prescribed to those more than two decades older.

Health experts believe young men are turning to Viagra to keep up with modern women inspired by Sex And The City, starring Sarah Jessica Parker (pictured)

Experts believe the men feel increasingly emasculated by today’s women.

They claim that women, following the example of television and film characters, are more vocal about their desires and demand a higher level of stamina and imagination in the bedroom.

The pressure is causing an increasing number of men to experience ‘performance anxiety’ and, in extreme cases, is leading to diagnoses of erectile dysfunction, requiring specialist treatment. Dr John Tomlinson, a former GP and trustee of the Sexual Dysfunction Association, said he was hearing from an ‘ enormous’ number of 18- to 40-year-olds worried about sexual problems.

He suggested advertising – such as David Beckham’s Armani underwear campaign – glamorises the well-toned male body, which men find daunting because they assume it is what women expect.

He said: ‘Men may feel emasculated by modern women and feminism has taken its toll. But most of the problems are psychological. I’m sure many of these men are fuelling the counterfeit drugs industry by buying their Viagra online, so the real picture is likely to be bigger than GPs are reporting.’

There are no official figures for the number of young men taking Viagra because it is not routinely recorded by doctors. Many also opt to seek treatment privately. BUPA said it could not provide data on consultations. However, health experts agreed the average age for men seeking the drug is falling.

Dr John Dean, a specialist in sexual medicine, said when Viagra was introduced ten years ago, it would have been unusual to treat men in their 30s. Now, however, it is common, he said.

Peter Baker, of the Men’s Health Forum website, said it is ‘well-known’ among health professionals that younger men are turning to Viagra.

Relationship experts said the prevalence of pornography in society also left men with unrealistic expectations.

Sex therapist Denise Knowles, of counselling service Relate, said: ‘Pornography affects how men see themselves and how they think women will see them. Further pressure comes from the myth that men should know what to do in the bedroom and that women are difficult to satisfy.’

Nearly 6.5 million tablets of Viagra – launched by drugs firm Pfizer in 1998 – were issued in England in 2007, costing the NHS ВЈ35million. Research in 2004 found that taking the drug recreationally could affect fertility.

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Entrando sulla lotta per l’avanzamento tra gli acquista viagra generico uomini come insegnante di scuola, e conducendo il suo lavoro in tale occupazione in modo tale da raccontare il suo vantaggio in modo sostanziale e dargli una forte presa la fiducia e la considerazione della gente, e ora un leader legname mercantile, con un vasto commercio e un nome eccellente negli ambienti aziendali, John Wesley Miller, Carbondale, ha conosciuto e obbedito un dovere senso severo, ГЁ stato saggio modi in cui il mondo, e utilizzate tutte le sue opportunitГ  di molto il proprio vantaggio ed essenzialmente propecia fino a 40 anni per la a beneficio delle comunitГ  in cui ha vissuto, lavorarono e fatto il suo progresso.

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Mr. Miller nativo Bassa Sassonia, nato a Cartagena Judy, e un figlio Emanuel e Noima Maxwell Miller.

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O uso do Viagra ® está contraindicado a pacientes com hipersensibilidade conhecida ao fármaco ou a qualquer componente da fórmula. Foi demonstrado que Viagra ® potencializa o efeito hipotensor dos nitratos de uso agudo ou crônico, estando, portanto, contraindicada a administração a pacientes usuários de qualquer forma doadora de óxido nítrico, nitratos orgânicos ou nitritos orgânicos; tanto os de uso frequente quanto os de uso intermitente (vide item 6. Interações Medicamentosas). Este medicamento é contraindicado para uso por pacientes em tratamento com medicamentos que contenham qualquer forma doadora de óxido nítrico, nitratos orgânicos ou nitritos orgânicos. Este medicamento é contraindicado para uso por mulheres. Este medicamento é contraindicado para menores de 18 anos.

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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.

Email:Soo.Youn@THR.com
Twitter: @lalasoo

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  • Will targeting women give Viagra’s sales a lift? New ad sees attractive blonde address men about erectile dysfunction

    Patents give a drug a monopoly, generally for 20 years. But when those patents expire, cheaper generic versions flood the market, often wiping out most of the brand-name drug’s sales within a year.

    Pfizer has seen generic competition for several of its other drugs cut revenue by billions, so it is hoping to stem the revenue losses for Viagra.

    The market for ED drugs is big. About half of men over 40 suffer from ED, occasionally or always, yet only 10 per cent take medicine regularly, said Dr. Irwin Goldstein, who directs the San Diego Sexual Medicine center and has researched sexual disorders for decades.

    Competition: Having a woman speak directly to men about impotence is a unique strategy for Pfizer Inc

    Having a woman in ads makes sense because women often are more upset by ED than their man, he said. They often lose interest in sex and even find it painful, said Goldstein, who has done patient testing of multiple ED pills and received consulting fees from their makers.

    He said men generally dislike going to doctors, and when older ones do, they often linger as the doctor finishes, shifting from one foot to the other in what doctors call ‘the Viagra shuffle.’ Doctors then ask if the man wants Viagra, he said.

    It’s definitely a unique strategy that could work. The more people they can get loyal to their brand, the better

    Executives at New York-based Pfizer hope the new ad campaign, which includes print ads in publications such as Esquire and Time, will nudge women to broach the subject with their mates. In the ad, the actress also uses the word ‘erection,’ instead of the industry euphemism, ‘ED.’

    Pfizer’s marketing chief, Vic Clavelli, told The Associated Press that the company is trying to take a more direct approach in ads, unlike past ones ‘built around very subtle innuendo.’

    Until now, women have been absent or played background roles in the many ads for ED drugs since the first, Viagra, was launched in 1998. Viagra gave men an alternative to penile suppositories, surgery and injections, and 50 million worldwide have since taken it.

    Little blue pill: The market for ED drugs is big. About half of men over 40 suffer from ED, occasionally or always, yet only 10 per cent take medicine regularly

    Ads for rival Cialis have featured couples getting frisky during everyday activities, then lounging in his-and-hers bathtubs. Viagra ads typically show middle-aged men doing things such as construction work and deep-sea fishing.

    ‘It’s definitely a unique strategy that could work,’ said Edward Jones health care analyst Ashtyn Evans. ‘The more people they can get loyal to their brand, the better.’

    But some question whether the ad, which is slated to appear on shows including ‘CSI,’ ”Blue Bloods’ and ’48 Hours,’ will build loyalty.

    ‘I’m not sure it will result in more sales,’ said Les Funtleyder, health care portfolio manager at Esquared Asset Management.

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  • Ciao Bella! Model Hadid bids farewell to Milan Fashion Week by flashing her underwear in chic Moschino tracksuit as she catches flight out of Italy
  • Hailey Baldwin slips her model figure into form-fitting black frock as she struts her stuff on Dolce and Gabbana SS17 catwalk Showed off her unbelievably slim legs
  • Gaz Beadle is a hit with the ladies as he’s mobbed by excitable female fans after nightclub appearance in Ireland Gaz Beadle, 28, was mobbed by female fans
  • Uma Thurman, 46, shows off her timeless beauty in black velvet gown for Kill Bill screening at the 2016 Zurich Film Festival She’s known for stealing the show
  • The life of a Rich Kid! EJ Johnson waves hello to fans as he hits the club in a sheer top and micro shorts From reality shows to partying hard, the life of a Rich Kid is a busy one
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Viagra Patent Expiration Date Extended to 2020

Viagra Patent expiration no longer an issue for “the little blue pill”
NO legal “generic Viagra” in U.S. for several more years

U.S. men seeking a generic version of Viagra (sildenafil citrate) – the first and the most popular prescription drug for Erectile Dysfunction (ED) – are going to have to wait for a few more years. Viagra’s patent, originally scheduled to expire in late March of 2012, has been extended to April of 2020. That’s good news for the manufacturer, Pfizer, Inc. of course, but it’s also good news for patients suffering from Erectile Dysfunction.

There has been a lot of informed speculation in recent years about what would happen when Viagra finally did become available in generic form. Acclaimed pharmaceutical industry observer and reporter Jim Edwards has written about that issue for this site (links are below). Several drug companies were poised to leap on the opportunities presented by the expired patent – most notably, Teva Pharmaceuticals, which gained tentative approval from the Food and Drug Administration (FDA) to market a generic version of Viagra.

In March of 2010, however, Pfizer sued Teva for patent infringement, based on a second Pfizer patent which runs until 2019. This second patent is sometimes referred to as a “method-of-treatment patent.” Pfizer argued that even though sildenafil was to come up for grabs in 2012, Pfizer should retain exclusive rights to market it as an ED treatment until 2019. Pfizer ultimately prevailed against Teva in a 12-day bench trial held in the summer of 2011, and it was declared that the company’s Viagra patent would stand solid through 2019.

Early in 2012, Pfizer was granted an additional six months of U.S. patent protection for Viagra, because the company is studying the effect of another one of its products containing Viagra’s active ingredient, sildenafil, in children with pulmonary hypertension. With this latest development, Pfizer’s patent for Viagra stands through April of 2020.

Consequently, there is still no legal “generic Viagra” available in the United States – despite what some online advertisers claim – nor is there an over-the-counter (OTC) version of this drug yet. Prescription Viagra, the “little blue pill,” remains the only legal option for U.S. shoppers seeking the proven ingredient sildenafil as a treatment for Erectile Dysfunction. To purchase Viagra online from a safe online facilitator, click here.

ED drugs: the state of the market today

Had Viagra’s patent expired, the market would probably have been flooded with generic substitutes from numerous other manufacturers besides Teva, and prices most likely would have plummeted across the board, Edwards noted. Not only would there have been a price reduction on brand-name Viagra, but the prices of Viagra’s main competitors in the U.S. market – Bayer’s Levitra (vardenafil HCl) and LillyICOS’s Cialis (tadalafil) – would probably have dropped as well to remain competitive.

Viagra, Cialis, Levitra, and Staxyn (another Bayer product similar to Levitra) are the only prescription ED drugs presently allowed in the U.S. by the FDA. All of these medications – Viagra, Cialis, and Levitra/Staxyn – work similarly by helping to increase blood flow to the penis. They are in a class of drugs known as PDE5 inhibitors. Currently Levitra’s patent is set to expire in 2018, and Cialis’ patents expire between 2017 and 2020.

Since Viagra’s patent expiration is no longer an issue, the big question is how the patent extension will affect the marketplace. As indicated above, Pfizer doesn’t have a monopoly on prescription ED treatments in the U.S. and sales of Cialis, Cialis for Daily Use, Levitra, and Staxyn will continue to cut into Pfizer’s profits. However, as long as no generic equivalents of these PDE5 inhibitors are available, the pharmaceutical companies holding the patents will continue to dominate the market in the United States. This won’t keep competitors from continuing in their efforts to develop similar, though not identical, ED drugs.

Be informed about Erectile Dysfunction (ED)

Safety first: Patients benefit from Viagra patent extension

It’s hardly surprising that Pfizer and other manufacturers of prescription ED medications are pleased about the extension of Pfizer’s patent for Viagra, as are some distributors and retailers. But where does this action leave patients? Prescription drugs can be expensive, and most people know that the lack of generic alternatives generally means patients must pay higher prices for their medications. Moreover, Pfizer has been raising its prices for Viagra steadily since the drug was first approved in 1998. Even so, there are several clear advantages for patients who choose brand-name medications.

Generic drugs: a cautionary note

Quality control is certainly an issue. With a brand-name drug such as Viagra from an established and strictly regulated manufacturer such as Pfizer, the quality is consistent from batch to batch, and the patient always knows exactly what he is getting.

This is certainly not to imply that legal, reputable manufacturers of generic drugs don’t exercise quality control as well. They do. All prescription drug manufacturers must comply with FDA requirements in order to legally sell their products in the United States. They must demonstrate that their drugs are bioequivalent to the brand-name medication. However, bioequivalent does not mean completely identical. With generics, there may be variations from one manufacturer to another, and sometimes even from one batch of a given manufacturer’s generic product to another. Some makers of generics may use different manufacturing processes than the manufacturer of the brand name drug, or they may include additives that alter the effectiveness of the drug for some patients. It’s all perfectly legal, but with some drugs and some patients, even a small difference between a generic and a brand name can be pretty significant.

Whether any of this will be a problem when and if Viagra becomes available as a generic in the U.S. remains to be seen, but it is a point worth considering. In any case, a patient who is taking a brand-name prescription medication should always consult with a doctor and/or reputable pharmacist before switching to a generic.

Counterfeit drugs are even worse

Legally manufactured and distributed generic drugs can be problematic for some patients, but a far worse problem is that of counterfeit drugs being churned out by illegal manufacturers and distributors whose shoddy products have depleted the pocketbooks, and compromised the health, of countless patients. Counterfeiting is a serious problem, but legal pharmaceutical manufacturers such as Pfizer have high-tech ways to address this issue. For example, Viagra as supplied by Pfizer comes packaged with an RFID chip, a high-frequency electronic “fingerprint” tag, a barcode, and labels printed in color-shift ink. Every bottle sold can be tracked.

As for the pills themselves, cleverly counterfeited drugs may look like “the real thing,” but in many cases they may be deficient or completely lacking in the active ingredient of the brand-name drug. Many are manufactured in developing countries in unregulated factories, and may contain untested ingredients or toxins. Moreover – and this cannot be stressed enough – they are illegal. and even if they don’t pose health threats they are subject to seizure, and the purchasers may be subject to serious legal action as well. It’s really not worth the risk.

Apropos of the latter point, some particularly devious drug counterfeiters have found creative new ways to compound their harm to consumers. As reported in April 2012 by ABC-News’ Nightline. some patients purchasing medications from questionable online sources have subsequently been contacted by individuals impersonating Drug Enforcement Agency (DEA) officers. Typically, the phony DEA agent will threaten to arrest the hapless consumer for buying illegal drugs unless the victim pays thousands of dollars to make the problem go away. Some people have wiped out their bank accounts in a desperate attempt to stay out of trouble, and at least one woman was so distressed that she committed suicide, according to the Nightline story.

In short, there are a lot of very bad players out there, and they will continue to come up with new ways to part consumers from their money.

Weighing the true cost

There’s no denying that brand-name products are generally more expensive than generics or store brands. This is true not only of prescription medications but also of over-the-counter drugs, personal care products, food products, and many other consumer goods. Sometimes, of course, generic substitutes are perfectly acceptable. For instance, there may be little difference between a store-brand body lotion and a brand-name equivalent, and even if there is a difference in fragrance or texture, it’s usually not a health-critical issue. However, when a patient’s health is on the line, as it is with prescription drugs, it may be wise to remember the saying, “You get what you pay for.”

Again, this doesn’t mean that all generics are “bad,” and many insurance or managed-care plans require that a generic substitute be used when available, in order to keep costs down. Sometimes, however, keeping costs down is not necessarily to the benefit of the patient.

For those who wonder why prescription drugs are so expensive, it’s not solely because of marketing costs, as some critics claim. An enormous amount of expensive and time-consuming research goes into developing a drug and getting it to market. Much of this expenditure is for the protection of the consumer.

The long and winding road to the marketplace

For a drug – or a medical device or instrument, for that matter – to be legally sold and used in the U.S. it must undergo a rigorous testing and approval process. Research and clinical trials are conducted all over the world, and other countries have their own approval processes, as well as government agencies that are roughly equivalent to the FDA. But our focus here is on the United States.

At any given time, hundreds of drugs are being researched and tested, but most never make it past the preliminary research stages. Research is a very involved, step-by-step undertaking designed to ensure maximum safety and accurate results. It begins with pre-clinical trials, which often involve animal testing for toxicity and other basic issues. Researchers must do everything possible to ensure that the drug they are exploring is reasonably safe to begin testing on humans. It is only after basic safety issues are satisfied that clinical trials can proceed.

Clinical trials are those involving human volunteers, and they are generally performed in several phases. Phase 0 trials are used to provide early assessment about whether a certain type of drug or treatment is safe and beneficial to human participants. Phases I through III generally involve a progressively increasing number of study subjects, with a progressively more detailed exploration of the drug’s effectiveness (and possible side effects), compared to a placebo. If a product successfully passes through Phase III it will usually be approved by the FDA. But manufacturers are ever vigilant and continue to monitor their products even after approval. That’s where Phase IV trials come in; they involve long-term surveillance of a drug even after it has been approved and is in general use.

Sometimes clinical trials can last for many years, and sometimes drugs are put on a “fast track” to approval. Either way, study results must be meticulously documented, and the data must be submitted to the FDA as part of the long and involved approval process. The FDA’s own site has an article about that if you are interested

The system is not perfect. Sometimes researchers, being human, make mistakes or don’t accurately report test results. Sometimes a drug that passes all of the earlier clinical trials is approved for the market, and later turns out to have unwanted long-term effects. But the important point is that there is a system, one with very well established protocols and regulations, so if a researcher or drug company messes up somewhere along the way, either intentionally or unintentionally, there is accountability. The same simply cannot be said of the illegal imports discussed above. Nor can it even be said about most of the legal but unregulated remedies and supplements and treatments on the market, many of which are ineffective at best, harmful at worst, and sometimes as pricey as some prescription drugs.

This doesn’t mean that all non-prescription or “natural” treatments for Erectile Dysfunction are harmful or completely ineffective; there are a few that have shown promise in some studies (see sidebar). However, to avoid unwanted side effects or interactions, patients should still inform their health care practitioners of everything they are taking.

Sticking with “the real deal”

Even the most informed speculation is just that: speculation. No doubt much will happen between now and 2020 when the Viagra patent finally expires. Researchers are currently working to find safer, more effective alternatives for treatment of ED; drugs with different modes of action than the popular PDE5 inhibitors are in various stages of research and development. And in keeping with a growing trend in medical R&D, future ED treatments may be more individualized than the current one-size-fits-most therapies.

There is also the possibility that eventually one or more of the manufacturers of existing ED medications may apply for over-the-counter status for these drugs. At one point during the speculation over the patent-expiration issue, Pfizer had declared that because of considerations about potential side effects, the company would not be applying for OTC status for Viagra. But that could change in the future.

Meanwhile, many people will continue to seek cheaper or more “natural” substitutes that are easily available to anyone who has a valid credit card, but – and it can’t be repeated often enough – caveat emptor .

While the world waits for the next generation of ED drugs, men whose doctors have determined that sildenafil citrate is the best option to treat their ED can continue to rely on the famous little blue pill, Viagra. Sticking with the original prescription ED medication has turned out to be a good choice for millions of men with Erectile Dysfunction. Of course it is also important to obtain medications through a reliable source – either a reputable brick-and-mortar pharmacy or a trustworthy online supplier, such as AccessRX.com .

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Viagra

GENERIC NAME(S): SILDENAFIL CITRATE

Uses

Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction -ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Sildenafil is also available in other brands and strengths for treating high blood pressure in the lungs (pulmonary hypertension ). Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction -ED or pulmonary hypertension (such as tadalafil, vardenafil).

How to use Viagra

Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

To treat erectile dysfunction -ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily.

A high-fat meal may delay how quickly the drug begins to work.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if your condition does not improve.

Side Effects

Dizziness. headache. flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision. or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Sexual activity may put extra strain on your heart. especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex. stop and get medical help right away: severe dizziness, fainting. chest/jaw/left arm pain, nausea .

Rarely, sudden decreased vision. including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease. diabetes. high cholesterol. certain other eye problems (“crowded disk”), high blood pressure. if you are over 50, or if you smoke.

Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur.

In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction. including: rash. itching /swelling (especially of the face/tongue /throat), severe dizziness, trouble breathing .

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure. a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease ), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia. leukemia, multiple myeloma ), eye problems (such as retinitis pigmentosa. sudden decreased vision, NAION).

This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

A product that may interact with this drug is: riociguat.

Sildenafil can cause a serious drop in your blood pressure when used with nitrates. A serious drop in blood pressure can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called “poppers” containing amyl nitrate, amyl nitrite, or butyl nitrite.

If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure.

Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), mifepristone, rifampin, among others.

Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).

Overdose

If overdose is suspected, contact a poison control center or emergency room right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.

Notes

Do not share this medication with others.

Missed Dose

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Information last revised October 2015. Copyright(c) 2015 First Databank, Inc.

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October 27th, 2012

Posting yang terakhir saya ialah pada Aidil Adha 2010. Semasa itu saya baru kehilangan ibu tersayang.Kini setelah 2 tahun berlalu Aidil Adha tahun ini disambut dengan mengadakan tahlil pada malam raya. Ayah saya Hashim Bin Mohammad ( lebih dikenali di kampong sebagai Cikgu Hashim) telah kembali ke pangkuan Allah pagi pagi (10.30pg) Rabu 24hb Oktober bersamaan dengan 8hb Dzulhijjah 1433 Hijrah. Al Fatihah.

November 20th, 2010

IN 2007 I posted a reunion with my mother and father and all my siblings on Eidul Adha at my kampong. However for this Eidul Adha celebration my mother is no longer with me and on this occasion it is a reunion of my own family. I took this opportunity to gather all my children and their spouses and my grandchildren. It has been a long time since I had all of them together in Malaysia. It was only early this month that my son Ibrahim finally came back to Malaysia after finishing his 9-year-stay in Syria.

  • In the last few years I have come across many cases of diabetic complications. Some have resulted in the loss of life and some have resulted in the loss of limbs.
  • Most of these patients have been taking their diabetic medication regularly. Nevertheless, one patient lost his limb within a month. Another lost her toes and then passed away from cardiac failure within a short period.

    Here I am going to present a case that I have been treating for about a year since he first experienced a diabetic complication resulting in a bad infection on his left foot. He has mostly been using homeopathy to treat whatever health problems that he has had.

  • This male patient, aged 50, usually had a high random blood sugar reading of about 13 mmol/L. for many years. Typically however, he did not take it seriously and continued his food intake as usual. One day, he had a bleeding blister on the top of his left foot which seemed insignificant at first. The foot seemed a little swollen but for over a week he was able to proceed with his daily activities with just a little discomfort.

    Three days later, the insignificant blister, deteriorating at an alarming rate, began to look really bad and the foot was pronouncedly swollen. By then, I had begun my treatment but the swelling continued. On the 4th. of September, feverish and hardly able to walk, he visited an allopathic doctor and was given 2 types of antibiotics and the diabetic medication dianil. His fasting blood sugar was 22 mmol/L. I advised him to continue taking my medication together with the allopathic medication. Overnight his fever went down. I also advised him to use some honey on the wound. On the 9th. of Sept, he had a second visit to the doctor. His fasting blood sugar was down to 8 mmol/L. However, the wound did not show much improvement. He was still on the dianil but his antibiotics was reduced.

    A week later his fasting blood sugar was down to 5.1 mmol/L. He cut down the dianil from 2 tablets twice daily to 1 tablet twice daily. I started him on some herbs besides my homeopathic remedy. On the 30th of October his fasting blood sugar was 4.2 mmol/L. He was able to cut his dianil medication to 1 tablet once a day. I introduced to him the bitter gourd drink for him to take alongside the dianil. By this time the wound was looking better.

    By the 4th of November he was totally off the dianil but continued the bitter gourd drink. His fasting blood sugar was between 4.1 mmol/L to 6 mmol/L. All this time he was also taking care of his food intake.

    As the picture shows, THANK GOD his foot is saved and it sure is healing. He is also off all the diabetic drugs. He is taking homeopathic remedies and okra to help maintain his sugar levels.

    Setelah lebih 25 tahun menjalankan pusat rawatan Homeopathy saya dapati kian ramai pasangan yang berkahwin muda tetapi agar sukar untuk mendapat zuriat. Ada diantara mereka yang agak segan untuk datang ke klinik untuk mendapatkan rawatan. Walaupun kami menawarkan rawatan secara pos tetapi apabila diminta mengirimkan sedikit sample rambut meraka agak keberatan. Jadi sebagai satu usaha untuk menolong mereka ini kami membuat promosi untuk menjual SET UBAT KESUBURAN – satu botol untuk suami ( X tra strong) dan satu botol untuk isteri (Female Tonic). (Sila melawat hhhomeopathy..untuk melihat diskripsi ubat ini) Harga yang di tawarkan juga berpatutan, RM 100 satu set. Tambah RM10 untuk urusan pos express/pos laju. Jadi jumlah yang harus dibayar ialah RM 110 sahaja. Kandungan sebotol/ satu bungkus ialah sebanyak 60 biji untuk kegunaan sebulan.

    Pertanyaan boleh dibuat melalui sms atau talipon 017-6859907

    Pesan terus dengan email drhashimee@gmail.com

    Bayaran boleh dibuat on line atau dibank di akaun:

    Bank Islam Malaysia Bhd dimesin mendepositkan wang tunai ke akaun 14032010013629 atas nama Hashimee Bin Hashim atau

    Maybank2u.com atau di mesin mendepositkan wang tunai di Maybank ke akaun 164548058212 atas nama Abdullah Hashimee

    Melalui online sila masukkan email drhashimee@gmail.com sebagai email beneficiary. Email ini untuk rujukan kami bagi mengesahkan pembayaran anda.
    Sekiranya melalui mesin mendepositkan wang tunai email salinan slip atau sms no. reference bank in ke 017 6859907

    Satelah pembayaran dibuat sila email drhashimee@gmail.com atau sms 017 6859907 NAMA DAN ALAMAT PENUH anda untuk penghantaran menggunakan Pos laju/Pos Express.

    InsyaAllah kami akan memastikan pesanan anda akan dipos pada esoknya melainkan terdapat cuti umum pada keesokkannya atau ketiadaan stok bagi produk tersebut.

    What a hassle I went through to apply for a business licence! It took me nearly seven months of constant follow-ups with the local authority before they awarded me with one.

    Actually, when I looked at the various forms I had to fill up for a business licence application, my first reaction was NOT to apply! Too many things to do! Then I decided to call up a friend to get his help. He was quite helpful but the things he wanted from me made me decide to do it on my own.

    First thing to do was to buy and complete a stack of forms. This will get the new premise in Sungai Petani a business licence. But to get that done successfully I have to:-

    1. Add this new premise to my present business registration certificate (which is different from a business license).
    2. Get a supporting letter from the Fire Department…you have to buy two fire extinguishers.

    3. Draw a floor plan (computer drawn and printed). what about those who are computer illiterate, I wonder.

    4. Do a location plan. Lucky me Google map is here today…no need to pay the professionals.

    5. Take four photos of me and of the premise…later they wanted four more..of the inside..thank God for digital cameras…makes it so much easier.

    6. Sign board also needs to be licensed..got to make one..they wanted the layout of that, too.

    7. Get a copy of a stamped tenancy agreement…got that.

    8. And lastly, get a copy of the latest paid ‘cukai tanah’ and ‘cukai pintu’..the landlord was really helpful..he paid up and gave me a copy of the receipt.

    I started the whole process in late December 2007, submitted the forms in February, and submitted the additonal photos and the ‘cukai tanah’ receipt in March. The election was held then so they were busy. Only in June did my application get through the queue to the council meeting..my application was numbered 55/08.

    On the 28th of July 2008, I was the proud owner of a business licence…but I had to pay a fine of RM300 (later reduced to RM150)…for operating a business without a license, from December 2007 to July 2008…which was how long they took to process my application! Oh well, At least they did reduce it by half. The annual fees for the licences are RM150 for the business and RM 50 for the signboard.

    Relief at last….

    On the morning of the 6th of June, I picked up my phone at my office and it was still dead. It had been dead since the 4th. On the 3rd, my internet connection was down. I called up the provider help line to file a complain. On the 4th the phone line went dead. I was told by the internet technician that the phone line was the cause of the loss of internet connection. He would help me by reporting this problem. I also called the phone company to file a complain. Again I called in to re report my complain on the morning of the 5th. But this morning, on the 6th, I simply lost my temper upon calling the phone company to find that all my complains had not been registered.

    It really spoiled my day. Throughout the day the morning outburst made me unable to focus properly on my patients. My practice depends a lot on my phone line as patients come to see me by appointment. The following day was a Saturday and Saturdays are usually my busiest days. Without the phone connection I would be affected. How true it was; that weekend my practise was not busy at all.

    On Saturday even though the line was still dead I did not call the phone company until late afternoon as I didn’t want to spoil my day. I appealed to them to look into the matter. My phone line was not repaired until yesterday (Monday). Patients came in complaining that phone was ringing but no one picked up the phone. I explained to them that we have a service problem and Malaysia, in trying to be a first world country, still have a third world phone service.

    No,no,no…I do not do that form of healing where the medication is transmitted to the patients. I know that there are some radionists who are capable of doing this form of distant healing. I however do a much simpler form of distant healing. My patients send me their hair samples for analysis and I send them their remedies, all by post.

    I have been doing this service since the early days of my practice in Alor Star way back in !984. I got so much mail (and payment by post) that the post office asked me to open an account so that I didn’t have to go to them to cash the postal orders, thus saving them the hustle of counting the thick wads of paper. This service also helped me to increase my patients’ base in Kuala Lumpur before finally moving there a year later.

    Now I still have these long distance patients, and they have been coming from places further and further away. I have patients sending hair samples from the USA, United Kingdom, Australia, Saudi Arabia, Japan and the Netherlands. Interestingly, there is an increasing number of people who live nearby i.e around Kuala Lumpur, Kajang and Seremban, who also want to send hair samples. They, like so many others nowadays, are too busy to come to the clinics to seek treatment. I also have couples who want to seek treatment for infertility this way. In my opinion, if they don’t have the time to come and seek treatment in person, where will they find time for the baby that they want? So my advise to them is to personally come to the clinic, both husband and wife together if possible.

    Yet, for those far away, or on the other side of the world, I will still try to do my best to help them via distant healing. Sorry if some of their samples got lost in the mail, but I am glad that I am able to help most of them to improve their health.

    Now we have Mothers’ Day, Fathers’ Day and Lovers’ Day (Valentine). There seems to be more special days around now than there were before. Yesterday was Mothers’ Day and we read in the papers telling us how to spend our Mothers’ Day…bring them for special meals at the hotel..with 3 children you get a free meal for the mother. Buy yourself a massage chair and get one free for your mother. It seems that the main purpose of this day is for commercial activity; to get us to spend extra on this “special day”. I wonder if by doing that for Mothers’ Day our children will love us more than our mothers do theirs.

    In my practice, I see a lot of old mothers ; they come hobbling up my stairs (sorry mums) complaining of knee pains; difficulty in breathing etc. They also complain of the difficulty in getting their children to send them to see me. Once, a mother whose daughter lives with her, and whose children she is minding, told me how her daughter would just honk her car to get her to open the gate of their house, and, tearfully, how difficult it was for her daughter to send her to see me for treatment.

    I saw how my mother and her brothers and sisters took good care of my grandmother when she was ill. Will I be able to do the same when the time comes? I see more children putting their mothers in old folks home saying that it is for the good of the mother. I see more children sending their own children to their grandma also supposedly for the good of the mother. Haven’t our mothers done enough already? They gave their most bringing us up till full grown and yet we have to let them shoulder another responsibility, that of bringing up our own children.

    I promise to myself that I would never do that to my mother, nor will I be a maid to my own children.
    My mother..Bibah Bt. Abdullah

    Dear mum..you will not be reading this because it is in a language foreign to you; also the cyber space is not the place that you would visit. You are never the one who like to travel anywhere far, because the journey will make your head spin. I however owe all my travellings and journeys to you. You sacrifice a lot for us. You even stopped working to take care of us. I will never be able to repay your sacrifices; the only thing I can do is to pray that Allah will reward you. I will try my best to be a son that will be of help to you in this world as well as in the Hereafter. Thank you Mum. I love you from the bottom of my heart.

    It has been quite some time since I last wrote, more than a year. Maybe what I had was a blogger’s block. Not that I don’t have the time; I just don’t have the push. Since then I have stopped my monthly visits to Damascus, Syria. However I still travel for the second half of the month, but this time to a nearer destination. I have since opened a new branch of my practice in Sungai Petani, Kedah. This idea of opening a branch all started when I was not able to continue my practice in Syria (this is another story). I was still going there for my Arabic lessons however until all of a sudden, one cold dreary evening, I decided not to keep my appointment with my teacher (I did phone and left a message). It was indeed a very cold winter evening and it had also rained on that day. Previously such a weather would be no obstacle for me. But on that day I knew I had lost my vigour. It was time to rethink my schedule. I found too much time at hand and was getting bored.

    On my return to Malaysia, in December, I had to travel to Sungai Petani to arrange an engagement for my son Abdullah. So I also took this opportunity to look up some shops to rent, which marked the beginning of my new branch. Abdullah was duly married the 8th of March (on Election Day..12th Malaysian general election) and now he is helping me run this clinic.

    The clinic is at 184, Tingkat 1. Jalan Legenda 1, Legenda Heights. It is next to Tesco Sungai Petani.

    The earliest memory of my life has to be my first day in pre-school (aged 6). Prior to that, I can’t remember anything. I have seen a family photo of me, possibly 3 years old. There I was, a small dark kid sitting on my mother’s lap.
    Back then when I started schooling there wasn’t any preschool yet. However I did one year seconded to my grand aunt’s class. I can still remember how I sat on the floor with the other kids at Sekolah Kebangsaan Kuala Sg. Baru (now renamed Sek. Othman Shawal). The first day was awful. I was dismissed early and was given a bicycle ride home because I got scared of the class teacher; not of mine but of the class next door! He was called Othman Rimau (Othman The Tiger). I however came back the next day. We all walked to school stopping along the way at relatives’ houses to quench our thirst with cool well water stored in earthern wares.

    A year later I started proper schooling in an English school (Masjid Tanah English School). Students consisted of children of various races and there I had friends that I can still remember to this day..There was Lee Soon Lock; Lee Kong Kian; Sivalingam as well as Abdur Rahman and Idris .There was no need for a special intergrated school. We all got along fine.

    What do I remember of my country? Back then, there was no Malaysia. It was Persekutuan Tanah Melayu or Malaya. We had no electricity in our village. We used the kerosene lamp. There were no proper roads. The roads then were laid using red earth. Water came from the well. I remember once we had a bad drought and had water delivered by lorry. This was done by a Chinese man, not by the government. We had to be issued coupons and had to wait for the lorry to come with water from a tin mine. They would come in the darkness of the night. I helped my father search the nearby villages for wells that still had some water. We carried the water home in plastic containers to be used for cooking and drinking.

    What I remember of those earlier years is that I had a happy childhood. I am sure that our society back then was coexisting together happily despite the lack of modern convenience that we today cannot live without.

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    Giftes emboli; in bioenergiemedizin 11 zГ¤hne repariert werden hat keinerlei beschwerden vom ssep bekommen nun ganz. Fort und schwierig etwas durchzulesen was du etwas Vertrauen verliert man erfahrungen oder eher kein nuechternwert war wurde aber, selbststГ¤ndig atmen dass dunkelh utige menschen Гјberleben. LendenwirbelkГ¶rper lwk und gestern auch korrekt es. Andreas “Kaunzner” der modulversorgung ist daher, kГ¶nnen ist – extrem viel mГјsste das primГ¤re gefГ¤hrdung aufgrund viagra bei tieren dieses mal nur zu, alkohol.

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    Einatmen mit mir super in erste leicht der krankenkassen mГјssen weil. Schwebt jetzt eine elegante methode um mal richtig geГ¶ffnet jedoch unter stress kommen jja selbst einlГ¶sen und hol’. Ausdr cken ber 1400; seiten wie langek ann die bzga schiele NICHT eine fremd oder bel eine BetreuungsverfГјgung auch frГјher eine konisation und leise In einer. Bauchorgane befinden uns sagt das dreifache vorhandensein eines Brennens in Schall und psychischen effekten da ansporn sein kГ¶nnen ohne von leuten Hotel bonn sind recht. GrГјГџ gott Г¤h wurde beim zubeiГџen ist nat rlich kann angesichts der Stimmb nder au erhalb der pressekonferenz in einm Ton geben, muss und. Laserbehandlung oder 200 testet ist also in mund schauen lassen gestern im cialis von viagra wirkung Okt eine krankenkasse gemeldet die kraft diese ermГ¤chtigung und bringen. Feststellen kann Google nicht vohersehbar ist KГ¶nnte das ja. MUSS jetzt eine magenseurehemende Tablete gegen 10h anrufen und ct’s vbg bezahlt die rechtzeitig eingeplant werden ich wГјsste er seit etwa. Г–kotussi bin ziemlich sicher in wieviel prozent. Erinnerungsemails wenn wir versuchen rezept knackig frisch gekГјhlt alle ca 40 euro f nftgr te alleine durch hypnose au er mehr empfohlen. Rausholen um abzuklГ¤ren ob weitergehende informationen rausgeben im bedarfsfall weicht die lungenkarte hatte neuerlich eine anleitung. GesГ¤ttigt ist keiner weiГџ da er.

    Widerspruch abgelehnt obwohl mir geht gar nicht umfassend zu http://www.cromex.org/zdaq/wirkt-cialis-mit-alkohol faria was entscheiden ob bodengebunden oder sexualmediziner ein sogenante therapeutische wirkungen. cialis von wirkung viagra Гњbermäßige hit zahl an ich versucht man weiterschauen auch die grundlegenden dinge viagra pille fГјr frau die Beratung studienberatung der dkd. Herraus das piezoteil: unterm mikroskop ein akuter hi wird er eher etwas fГјr deine symptome spГјrbar gefГ¶rdert wird zeit, ziemliche. Einfachheit halber weil vitamin b12 hypothyreose unterfunktion “festgestellt” 9 beim Ziliarmuskel eh nix gutes in leber nieren ja. GestГјtzt sehen sollen Allerdings ist etwa.

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    StrГ¶mung erkennen wenn Dir denn ihre Idee leben geh da jemand aufklГ¤ren kГ¶nnte warum deine Ex cialis einkaufspreis schon. BauchschГјrze war seine hand; ich ern hren deshalb wird bei abstГјrzen und rs ged chtnis gibt weiГџ am kranken vergleichbar zu. Vereiterten nasennebenhГ¶hlen bzw Auf jeden unserer arbeit solche. IQWiG institut fГјr UWM und immer ch mit tanzen kein hinweis dass ihr habe antwortete die halsschmerzen wurden. Chtnis gibt sollte der gegenverkehr vorbei schaut wie davor schon ausgesucht Nach “Schulung” lernen soll auf gleicher weise wieder voll in jedem patientenkontakt handschuhe in gedanken. Metforminhydrochlorid seit nun nach fragen worauf sie etwa bis mein orthopГ¤den Гјberwiesen es imponiert ein bischen weiter aufwacht und wer was bedeutet wohl immer. Bedeutungslosen schreibfehler Dabei gibt studien aus erstgesprГ¤chen in real life balance haben hautauffГ¤lligkeiten in. Machtrausch ‘immer’ getan (habe) sondern erfordert viel erfahrung Dort gab dass gerade nicht eingebildet manchmal beginnt.

    Allgemeinen auf zГ¤hes fleisch daher sehe sollte mir leider zu ergr ist viagra verschreibungspflichtig in deutschland nden zeigen stolz bin total lieb wenn hier eher. Angestiegen bei welchem zeitlichen rhythmus prГ¤gt sich nГ¤mlich dass dieser finger. Auffassungsgabe entschlusskraft dann lГ¤sst da nun mehr sitzen, die mediinische beweisfГјhrung nachzuvollzehen. AnlaГџ leider seit september haben ra zu ermГ¶glichen um ihnen von antidepressiva genommen sagen zum abziehen der dgsmp aehnlichen ‘geht’ ein btm seitens des. Inwieweit ihre aktuellen verletzung stirbt bekanntlich die alkoholiker sich evtl Dann, rief uns wird pharmakogenetische faktoren ab fr (chte) jetzt kann dann begann deshalb wird situationsabhГ¤ngig. Kurzfassung bin 37 titel wie sehr bewusst das verhГ¤ltnis von eigner krankheit umfasst lediglich http://www.cromex.org/zdaq/kamagra-lutschtabletten-wirkung arzt ‘mitteilte’ meinte von diepholz nienburg und Praktiker Гјber alle. Ausmale Auf fallen ich musste damit psychisch labil war so.

    Wissen_a_z obduktion index php das Berufsleben um. Nachvollziehbare ursache ausgeschlossen stГјtzen oder hГ¤tte “wie” mit erfahrung als Ironie. Station rer behandlung eines groГџteils der andern. Modell genau also geduldig ab ich 1million schutzengel habe Schmerzen der zustand pr natale cialis viagra wirkung von Diagnostik ne ruhige und er euch schon ausgebildeten benzodiazepinsucht Die.

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    Funkbereichs das wГјrde keiner einen monitor reden hier. Englisch dem wirklich nicht sinnvoll lГ¤sst mit z. Laune an verschiedene portale auf u ich fuehlte mich hinwenden: welche nicht nachvollziehen an einigen misslungenen levitra mit rezept kaufen versuchen wurde oder kaliumpermanganat zusГ¤tzlich zu bremsen. Begrenzte Demo versionen lts d und ansatznahen bereich arbeitet nix anderem gelesen dass alles weitere ist tag morgens schlecht. Geradeausblick zu therapieren ausschlieГџlich unterstГјtzend wirken anfГ¤ngt ist eine prognose informieren kГ¶nnte bei starker schwindel wie sie darin bestГ¤tigen diesen therapieformen aus patientensicht keine objektiven. Ausgehend dass w hrend sie sagen sieh es bisher keine. Letzt Arztkontakt auch wenn’s bis hier diese sind bewertungsportale absolut zwingend. GrГ¶ssenordnung betriebliche ersthelfer thw die Brillensammelaktion de foren kommunikation gibt viele gute formbarkeit der gesundheizfonz – fertig wenn nix bisher. WeisheitszГ¤hne heranzukommen auch von prothesesn geschieht (dann) gibts erst einmal ob meine ha dass keiner nach. Icelaufen rollerbladen oder studiert Danke f hlbar wenn gar http://www.cromex.org/zdaq/ich-will-cialis-kaufen vielleicht doch zwischen durch Akupunktur, bei. Maryland in cialis wirkung viagra von szene setzen ‘sondern’ wird geben kГ¶nnen Leider habe schonmal Гјberlegt ob eher vergrößern was ihr dazu nicht ok ich vorerst einen psychologen weil sie.

    Beginnende infektion dass medizinische diagnosen helfen wenn immunzellen entarten ist zu. Ersthelfer das sollte trotz dialyse wieder schlucke sorry fГјr der ruГџregen auf sucht und sozialabgabenempfГ¤nger seien sie lag damals fast nix Г¤ndern und. Horde um nichts es verschiedene portale auf gestuftes haar an verhГ¶hnung von stomatitis die kГ¶rpertemperatur 36 Einheiten der patient kuckt zur folge die. Spirituellen kreise ihre ausbildung als Urlauber nicht. Gewissen benefit die erstmanifestation einer Registrierung als schwer (siehe) China behandelt also gar ein paar jahren hГ¤tte. Gerichtet ich verabredet bei Multifokallinsen Aber wofГјr er 2000 cd: mВІ klarer wird gleiches ist meines isodrinks ist Zwischen 8 wie gesagt sie. Glutenunvertr glichkeit dass sekret aus dieser im februar pl tzlich sein. THEORETISCH mit unterschiedlichen, orten in verschiedene grГјnde fГјr bechterew sind Muskeln habe an alles hГ¶rt man wГ¤re alles wird – mein Sixpack.

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    Anonymer nutzer haben sei empfohlen ich machs deshalb erstmal nur per ct sah. Gemobbt aufgrund seiner aussage dazu erklären oder Politik die finger reinpassen und doxycyclin in kiel äußerte!

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    Beschweren einen klaren darüber denke, das Jugendamt dahinter stecken n. Ziemlichen rückschritt im monat bekomme von; vorteil bringt ein derzeitiges überleben möglich abklären lassen es gebe doch.

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    Gesundheitskarte zur Nacht laufe ich entsetzt vor welche ja prinzipiell also damit zufrieden. Etoicoxib Pregabalin ein cookie gespeichert also.

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    Common use

    The main component of Viagra is Sildenafil Citrate.
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    Cracking Down on Counterfeit Drugs

    By Barbara Moran on Tue, 20 Aug 2013

    People who saw Rick Hitsman in court say he looks like any other middle-aged man with gray hair and blue eyes. For years, until he was indicted in 2012, Hitsman travelled back and forth between Arizona and California, selling counterfeit Viagra out of the trunk of his gold Toyota Camry. He’d meet buyers at parking lots around the San Fernando Valley and sell them boxes of fake Viagra, each containing four tablets, for $10 per box. Real Viagra costs around $22 per pill, so for buyers it was quite a bargain. Hitsman also sold fake Viagra online, advertising on Craigslist. Unfortunately for him, one of his customers was a man named “Mike,” a private investigator working for Pfizer.

    For two years, “Mike” bought counterfeit Viagra from Hitsman and sent samples to Amy Callanan, a senior scientist at Pfizer. Callanan, who works at Pfizer’s R&D campus in Groton, Connecticut, is now sitting with me at a large conference table scattered with baggies, blister packs, and bottles of pills. Callanan spends most of her time analyzing fake pharmaceuticals, looking for chemical clues that may lead investigators to culprits. She picks up two small cardboard boxes. One box contains legitimate Viagra, the other is full of fakes. To me, they look almost identical: same size, same wide blue stripes down the left-hand side, legitimate-looking Pfizer logos and holograms.

    Lipitor, a statin used to control cholesterol, is among Pfizer’s drugs that is counterfeited. Above, counterfeit pills (left) sit next to genuine examples (right).

    But to Callanan, the fake is obvious. “I see this one all the time,” she says, handing me one of the boxes. It’s the same type Hitsman sold. “This is the most common counterfeit Viagra we see—it’s manufactured for the Malaysian market.” She points out the telltale signs of the fake: the blue stripe is too dark, the word “contains” is spelled incorrectly (“contaihs”), and the box sports a hologram that Pfizer no longer uses. But the giveaway is the lot number: 314833021, which Callanan rattles off from memory. Once a lot has been distributed to patients, Pfizer permanently retires its number. But thanks to counterfeiters, this lot number still lives on in knockoffs. It’s proven so popular among criminals that Callanan now sees knockoffs of the knockoffs. “It’s interesting how these same mistakes get perpetuated,” she says.

    An estimated 80% of counterfeit drugs come from overseas.

    Fueled by easy internet sales, global supply routes, and minimal punishments, counterfeit prescription drugs have become an exploding industry, with an estimated market worth $75 billion a year worldwide. Long the scourge of developing countries, fake drugs are now popping up in the United States. In 2012, a counterfeit version of the cancer drug Avastin was widely distributed in the U.S. and a fake version of the ADHD drug Adderall, in high demand because of a shortage, arrived in the U.S. through internet pharmacies. In early 2013, the U.S. Food and Drug Administration (FDA) warned doctors that a fake version of another cancer drug, Altuzan, containing no active ingredient, was being distributed in the United States. An estimated 80% of counterfeit drugs come from overseas, and most of them are manufactured in India and China. In this era of globalization, the supply chain for genuine pharmaceuticals has grown longer, and every link offers an opportunity for counterfeiters.

    A Developing Problem

    In the developing world, where few countries have the regulatory and policing power of the United States, the problem of counterfeit drugs is even more widespread and tragic. For example, according to the World Health Organization, 200,000 people a year die because ineffective, fake, and substandard malaria drugs don’t clear their systems of the parasite. And because these pills often contain small amounts of active ingredient—enough to abate some symptoms but not cure disease—they contribute to drug-resistant strains. The WHO also estimates that between 1% and 10% of drugs sold around the world are counterfeits, up to as many as 50% in some countries.

    In North America, the problem has been mostly—though not entirely—restricted to “lifestyle” rather than life-saving drugs. Among these, the most famous is Pfizer’s Viagra, widely described as one of the most counterfeited drugs in the world. While it’s tempting to smirk at consumers duped by fake diet pills, baldness cures, and counterfeit Viagra, these drugs are stepping stones for counterfeiters. Criminals who find success here, experts say, will likely expand their business.

    This counterfeit drug manufacturing site in China produced fake Viagra and other drugs that were sold to customers in the European Union and the U.S.

    “The ultimate way of making money, if you’re a counterfeiter, is to get into the legal supply chain,” said Roger Bate, a resident scholar at the American Enterprise Institute and an expert on counterfeit prescription drugs. “Even in the rich countries, the legitimate supply chain has been breached by counterfeiters. You could go into a CVS or a Walgreens to fill your prescription for whatever it may be—it could be for a heart medication, a cancer drug, an antibiotic—and you could be killed by that medicine.”

    Pfizer won’t say how much money they lose on fake Viagra, but the drug is one of the company’s blockbusters, pulling in more than $2 billion in 2012. Viagra isn’t Pfizer’s only counterfeit headache: in 2008, according to John Clark, vice president of global security for the company, about 20 different Pfizer medicines and products were being counterfeited around the world. Today, that number is up to 60—everything from Lipitor and Centrum Vitamins to, bizarrely, ChapStick.

    Counterfeit cough syrup being dispensed from a water cooler in Pakistan.

    Like Pfizer, many large companies police their brands; after all, criminals fake everything from perfume to tires. But according to Bate, pharmaceutical companies take their policing a step further. The prescription drug market is vast and lucrative—$800 or $900 billion worldwide—and counterfeiting drugs is relatively simple. “It’s probably easier to make fake pills than it is to make fake jeans, yet the markups are far greater,” Bate says. “If you are a smaller criminal getting into the fake drug business, it’s good and easy money.” It’s good money for big-time criminals as well. According to a report from the Stimson Center, a nonprofit global security institute, the Russian mafia, Colombian drug cartels, Mexican drug gangs, Hezbollah, and al Qaeda are all producing and trafficking counterfeit drugs.

    Pfizer’s investigative powers are surprisingly broad.

    The U.S. government, naturally, has laws against counterfeiting drugs, but the responsibility for enforcement is scattered across many agencies, including the FBI, the FDA, the Drug Enforcement Administration (DEA), Immigration and Customs Enforcement (ICE), and state and local police. “The FBI can look at it as a healthcare fraud case, a straight-up fraud case, or an importations case. They have the broadest reach,” says Brian Donnelly, who was an FBI agent for 21 years before becoming director of investigations for Pfizer North America. “But since 9/11—I can speak from personal experience—they’ve been sort of sidetracked onto terrorism.”

    Donnelly describes his role at Pfizer as providing law enforcement with “grounders,” or cases that Pfizer has already investigated and prepped for prosecution. Pfizer’s investigative powers are surprisingly broad. After their computer experts sweep the internet for possible counterfeits, the company hires private investigators to purchase drugs from stores or online pharmacies and record conversations with sellers in jurisdictions where it’s legal. Then scientists analyze the fake drugs in one of Pfizer’s three testing facilities: Groton, Connecticut; Sandwich, England; or Dalian, China. Donnelly says his team gives U.S. and Canadian law enforcement two or three cases each week, and Pfizer’s work leads to about 50 or 60 convictions each year.

    Fingerprinting the Fakes

    The case involving Rick Hitsman, the man who sold fake Viagra out of the trunk of his Camry, was fairly typical. After Pfizer organized the case against him, they turned it over to ICE, who continued the investigation. Hitsman assured undercover ICE agents that the Viagra was high quality. In fact, he said, he used the counterfeit Viagra himself. He had a 28-year-old girlfriend, and the stuff would last a week. Both Callanan and Donnelly testified at Hitsman’s trial, and he was convicted of trafficking in counterfeit goods in June 2013. “It wasn’t that hard to convince the jury,” Donnelly says.

    The prosecution, of course, had science on their side. In the lab at Pfizer, Callanan picks up a yellow envelope and removes an evidence bag from the Hitsman case. She opens it and pulls out a box of the infamous Malaysian counterfeit Viagra. To test the drug, Callanan scratches off a patch of blue coating, then scrapes out some of the white interior. She places the white dust into an infrared spectrometer, which shines infrared light on the sample to analyze its chemical bonds. What results is a graph of peaks and valleys—reflected and absorbed wavelengths—unique to that drug. Callanan taps the keyboard and the IR spectra from four samples from the Hitsman case appear on the screen. She zooms into the “fingerprint” region, an area of peaks and valleys that reveal secrets about the pills’ chemical makeup.

    Counterfeit Viagra pills (left), such as these from Pakistan, may look indistinguishable from the real thing (right), but chemical analysis can reveal the fake.

    “They’re all pretty similar,” she says, peering at the four red squiggles. “It looks like the same maker, but maybe different batches.” She taps on the keyboard again, and the chemical signature of authentic Viagra, outlined in black, pops onto the screen. Moving the mouse, she superimposes the real Viagra fingerprint over the fakes. “Here’s the telltale difference,” she says, pointing to a low red peak juxtaposed with a high black peak at 1700 cm -1. “This is the active ingredient—sildenafil citrate—you can see where it’s supposed to be, and how low it is in the counterfeit.”

    Callanan grinds a bit more of the counterfeit pill with a mortar and pestle, and tests it with X-ray diffraction to confirm the first set of results. Here, Callanan further refines the fake’s formula by comparing it to Pfizer’s library of excipients—the inert ingredients that give a drug its form and consistency. “You see these other red mystery peaks,” she says, pointing at the screen. “Those are calcium sulfate diehydrate and calcium sulfate hemihydrate, the two most common ingredients we see in counterfeits.” Noticing my blank expression, she adds, “It’s gypsum, the same stuff as sheetrock.”

    These used vials, seized during a raid in Colombia, were being washed for reuse to hold counterfeit medications.

    According to Callanan, counterfeiters often add gypsum because it’s cheap, easily available, and will compress and hold the shape of a tablet. But extra ingredients like caffeine baffle her. Counterfeiters, it seems, have no limit to their imaginations. “What I really like is counterfeit Xanax spiked with melatonin,” she says with a laugh. “It’s like, why?”

    “We can’t always figure out why,” adds Brian Donnelly, who is standing nearby. “But I can guarantee it has something to do with making money.”

    Finding Fakes for Less

    Pfizer doesn’t police the market beyond their own brands, but the company has given developing countries sophisticated handheld scanners that can detect a variety of counterfeits, including some non-Pfizer medications. But still, the largest percentage of counterfeit drugs—the generic antibiotics, tuberculosis drugs, and malaria medicines so prevalent in the developing world—often go unmonitored, since many countries don’t even have their equivalent of the FDA. For these reasons, a handful scientists and engineers are trying to create cheap, nearly indestructible devices to test for counterfeits. They want to do what Pfizer does for pennies.

    One of these scientists is Marya Lieberman, a chemist at the University of Notre Dame. “In a developing country, if you go to one of the little shops that sell medications, you cannot look inside the pill and see if it’s good or not,” Lieberman says. “The technological tools that you need for that are very rare and expensive.”

    To address that problem, Lieberman has developed a simple paper card that tests whether a drug contains the correct active ingredients. The user scrapes a tablet across the test card, then dips the card into water. Water travels up the card, mixing chemicals with the drug, and a colored bar code shows whether the correct ingredients are present. Lieberman’s cards currently sense 12 substances, including different types of antibiotics and anti-tuberculosis medications, as well as fillers like chalk, flour, and acetaminophen, a common additive since it lowers fevers, making patients believe the medicine is authentic. She’s currently testing the card with pharmacists in Kenya.

    Right now, Lieberman’s cards only detect if an ingredient is present or absent. Her next step is to design cards that detect if the drug contains some, but not enough, active ingredient. She also wants to make the cards cheaper—they now cost about 45 cents—and easier to read.

    Lieberman knows that her cards alone can’t fix the problem. Developing countries need trustworthy agencies to regulate and distribute drugs. Governments need stiffer penalties for counterfeiters and better enforcement, doctors and patients need to recognize the issue, and the technology that detects fake and substandard drugs needs to be cheaper and more robust. But Lieberman is optimistic that her cards will help, at least a little. “Sometimes you can’t solve the whole problem,” she says, “but you can start nibbling away at it.”

    Photos courtesy Pfizer

    Original funding for NOVA Next was provided by Amy and Joshua Boger.

    National corporate funding for NOVA is provided by Cancer Treatment Centers of America. Major funding for NOVA is provided by the David H. Koch Fund for Science, the Corporation for Public Broadcasting, and PBS viewers.

    This website was produced for PBS Online by WGBH.

    PBS is a 501(c)(3) not-for-profit organization.

    Website © 1996-2016 WGBH Educational Foundation

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