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This content has not been reviewed within the past year and may not represent WebMD’s most up-to-date information.

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“>WebMD News Archive

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

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

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

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

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

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

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

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

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Watermelon’s Viagra-Like Effects

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

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

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

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Horny Goat Weed is a legendary aphrodisiac/Viagra used for thousands of years in China.

It got it’s name when a goat herder noticed that when goats grazed on the plant they started mating excessively!

A woodland plant of the genus Epimedium it prefers shade or partial shade.

The dried or fresh leaves can be chopped up finely to make a tinture or tea.

BENEFITS OF HORNY GOAT WEED

The active ingredient (Icariin) gives the following benefits.

1 Opens up the blood vessels to the penis.

Icariin allows the blood vessels to relax opening them up.

2 Increases sexual desire

Icariin stimulates the sensory nerves especially in the groin.

3 Lowers blood pressure

Consult a doctor if you have a heart condition.

Chop up the fresh or dried leaves finely.

Add the following proportions of goat weed and alcohol (usually vodka) into a jar,shake regularly,store in a cool dark place and start using after 2 weeks.

1 part fresh goat weed to 2 parts alcohol.

1 part dried goat weed to 5 parts alcohol.

Strain through a tea strainer.

1 tablespoon = 1 dose.

Chop up the fresh or dried leaves finely.

Add the following proportions of boiled water and goat weed into a tea pot.

2 tablespoons of fresh leaves to 1 cup of boiled water.

1 tablespoon of dried leaves to 1 cup of boiled water.

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Article 1. Erectile dysfunction and how herbal viagra can fail before the first blue pill is swallowed!

Article 2. Relationships and Impotence

Article 3: The top blue pill for libido and long sex

Article 4: Causes of Erectile Disfunction

How to make Natural Viagra at home (Works 100%)

In order to make your home made Viagra, first you will need the main ingredients which are commonly available in grocery stores and are very potent aphrodisiacs.

Everyone knows that Viagra В® is a powerful drug for men, used to enhance sexual function and performance, but very few people know the secret that it can also be made at home by using foods which are commonly available in grocery stores and are very potent aphrodisiacs.

These natural foods work very similar to Viagra when mixed together, and are perfect for both men and women.

In order to make your home made Viagra, first you will need the main ingredients which are watermelon and lemon. Watermelon contains various nutrients and has aphrodisiac properties which includes Citrulline and Lycopene. Do not use sugar, salt, spices or any other flavours which might reduce the effectiveness of the two main ingredients.

Chop the watermelon into small pieces and put the pieces into a juicer to obtain about one liter of watermelon juice. The white stuff inside the shell of watermelon is also very high in concentrated Citrulline and should not be wasted and need to be juiced.

Pour the juice into a pot and let it boil for few minutes then squeeze the lemon juice into the pot and mix it well with the boiling watermelon juice. Continue boiling until most of the liquid evaporate and the content in the pot reduce to about half.

Let it cool down for about an hour or so.Transfer the potion to a washed and cleaned glass bottle and store it in a cool and dry place such as refrigerator.

This powerful love potion works best when taken empty stomach, ideally early in the morning and before dinner and anywhere between 2 tablespoons to 1/3 of the cup, depending on the body weight and size. The mixture of the chemicals found in the watermelon and lemon juice aids in sending more blood flow to the private area for better performance and strength. This homemade Viagra is safe and effective for people of all ages and genders.

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Viagra (sildenafil) được sử dụng để điều trị rối loạn chức năng cương dương. Đó là một phosphodiesterase-5 (PDE5) chất ức chế. Tác dụng phụ thường gặp của thuốc Viagra bao gồm đỏ mặt, đau đầu, đau dạ dày, nghẹt mũi, buồn nôn, tiêu chảy, và không có khả năng phân biệt giữa các màu xanh lá cây và xanh dương. Mất thính giác, ù tai và chóng mặt có thể xảy ra.

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Liều khuyến cáo của Viagra là 25-100 mg uống 30 phút đến 4 giờ trước khi hoạt động tình dục. Viagra làm tăng tác dụng của thuốc hạ huyết áp. Nó cũng làm tăng huyết áp làm giảm tác động của nitrat (ví dụ, isosorbide dinitrate) được sử dụng chủ yếu để điều trị đau thắt ngực. Bệnh nhân dùng nitrate không nên dùng Viagra. Viagra không nên được kết hợp với Revatio hoặc chất ức chế PDE5 khác (ví dụ, Levitra [vardenafil], Cialis [tadalafil]). Tagamet (cimetidin), erythromycin, ketoconazole, Sporanox (itraconazole), và Posicor (mibefradil) có thể gây ra đánh dấu sự gia tăng số lượng Viagra trong cơ thể. Bệnh nhân dùng các loại thuốc này nên được theo dõi cẩn thận nếu Viagra được sử dụng.

Theo dõi các tác dụng phụ của viagra chúng tôi cung cấp một cái nhìn toàn diện về thông tin thuốc có sẵn trên các tác dụng phụ tiềm tàng khi dùng thuốc này.

Đây không phải là một danh sách đầy đủ các tác dụng phụ của viagra và những người khác có thể xảy ra. Gọi cho bác sĩ để được tư vấn y tế về tác dụng phụ. Bạn có thể báo cáo tác dụng phụ để FDA tại số 1-800-FDA-1088.

Viagra trong chi tiбєїt – ThГґng tin bệnh nhГўn: tГЎc dụng phụ của viagra
Nhận trợ giúp y tế khẩn cấp nếu bạn có bất cứ dấu hiệu của một phản ứng dị ứng: nổi mề đay; khó thở; sưng mặt, môi, lưỡi, hoặc họng.

Trong quá trình hoạt động tình dục, nếu bạn bị chóng mặt hoặc buồn nôn, hoặc bị đau, tê hoặc ngứa ran ở ngực, cánh tay, cổ, hoặc hàm, dừng lại và gọi cho bác sĩ ngay lập tức. Bạn có thể gặp phải một tác dụng phụ của viagra bất cứ lúc nào, và nó cũng sẽ ảnh hưởng đến cuộc quan hệ

Ngừng sử dụng viagra và gọi bác sĩ ngay lập tức nếu bạn có một tác dụng phụ nghiêm trọng như:

mất thị lực đột ngột;
ù tai hoặc mất thính lực đột ngột;
đau ngực hoặc cảm giác nặng, đau lan ra cánh tay hoặc vai, buồn nôn, ra mồ hôi, cảm giác bị bệnh nói chung;
nhб»‹p tim khГґng Д‘б»Ѓu;
sЖ°ng б»џ tay, cб»• chГўn, hoбє·c bГ n chГўn;
khГі thб»џ;
thay đổi tầm nhìn;
cảm thấy choáng váng, ngất xỉu; hoặc
cЖ°ЖЎng cб»©ng dЖ°ЖЎng vбє­t Д‘au Д‘б»›n hoбє·c kГ©o dГ i 4 giб»ќ hoбє·c lГўu hЖЎn.
Ít tác dụng phụ nghiêm trọng có thể bao gồm:

Tác dụng phụ của viagra

ấm áp hay đỏ ở mặt, cổ, hoặc ngực;
nghбє№t mЕ©i;
Д‘au Д‘бє§u;
vấn đề bộ nhớ;
đau bụng; hoặc
Д‘au lЖ°ng.
Đây không phải là một danh sách đầy đủ các tác dụng phụ và những người khác có thể xảy ra. Gọi cho bác sĩ để được tư vấn y tế về tác dụng phụ của viagra. Bạn có thể báo cáo tác dụng phụ để FDA tại số 1-800-FDA-1088.

Đọc toàn bộ bệnh nhân chuyên khảo chi tiết cho Viagra (Sildenafil Citrate) »

Viagra Tб»•ng quan – ThГґng tin bệnh nhГўn: tГЎc dụng phụ của viagra
Tác dụng phụ của viagra. Chóng mặt, nhức đầu, đỏ bừng mặt, hoặc khó chịu dạ dày có thể xảy ra. Thay đổi thị lực như tăng nhạy cảm với ánh sáng, mắt mờ, hoặc khó nói với màu xanh và màu xanh lá cây ngoài cũng có thể xảy ra. Nếu bất cứ phản ứng vẫn tồn tại hoặc xấu đi, cho bác sĩ hoặc dược sĩ của bạn ngay lập tức.
Дђб»ѓ giбєЈm nguy cЖЎ bб»‹ chГіng mбє·t vГ  Д‘бє§u Гіc quay cuб»“ng, Д‘б»©ng dбє­y tб»« tб»« khi tДѓng tб»« tЖ° thбєї ngб»“i hoбє·c nбє±m vб»‹ trГ­.

Hãy nhớ rằng bác sĩ đã kê đơn thuốc này bởi vì họ đã được đánh giá là có lợi cho bạn lớn hơn nguy cơ tác dụng phụ của viagra. Nhiều người sử dụng thuốc này không có tác dụng phụ nghiêm trọng.

Hoạt động tình dục có thể khiến căng thẳng thêm vào trái tim của bạn, đặc biệt là nếu bạn có vấn đề về tim. Nếu bạn có vấn đề về tim và gặp bất kỳ những tác dụng phụ của viagra nghiêm trọng, trong khi quan hệ tình dục, ngăn chặn và trợ giúp y tế ngay lập tức: nghiêm trọng chóng mặt, ngất xỉu, ngực / hàm / đau cánh tay trái, buồn nôn.

Hiбєїm khi, Д‘б»™t ngб»™t giбєЈm thб»‹ lб»±c б»џ mб»™t hoбє·c cбєЈ hai mбєЇt (NAION) cГі thб»ѓ xбєЈy ra. Hiệu б»©ng nГ y cГі thб»ѓ hoбє·c khГґng thб»ѓ Д‘Ж°б»Јc gГўy ra bб»џi sildenafil. Nбєїu vấn Д‘б»Ѓ nghiГЄm trб»Ќng nГ y xбєЈy ra, ngЖ°ng dГ№ng sildenafil vГ  nhбє­n Д‘Ж°б»Јc trб»Ј giГєp y tбєї ngay lбє­p tб»©c. BбєЎn cГі mб»™t cЖЎ hб»™i lб»›n hЖЎn mб»™t chГєt phГЎt triб»ѓn NAION nбєїu bбєЎn cГі bệnh tim, tiб»ѓu Д‘Ж°б»ќng, cholesterol cao, mб»™t sб»‘ vấn Д‘б»Ѓ vб»Ѓ mбєЇt khГЎc (“Д‘Д©a Д‘Гґng Д‘Гєc”), cao huyбєїt ГЎp, nбєїu bбєЎn trГЄn 50 tuб»•i, hoбє·c nбєїu bбєЎn hГєt thuб»‘c.

Hiếm khi giảm đột ngột hoặc mất thính, đôi khi có ù tai và chóng mặt, có thể xảy ra. Ngưng dùng sildenafil và nhận được trợ giúp y tế ngay lập tức nếu những hiệu ứng này xảy ra.

Trong trường hợp hiếm hoi bạn có một cương cứng đau đớn kéo dài hoặc kéo dài trong 4 giờ hoặc hơn, ngừng sử dụng thuốc này và nhận được trợ giúp y tế ngay lập tức, hoặc các vấn đề vĩnh viễn có thể xảy ra.

Một phản ứng dị ứng nghiêm trọng với thuốc này là rất hiếm. Tuy nhiên, có được trợ giúp y tế ngay lập tức nếu bạn nhận thấy bất kỳ triệu chứng của phản ứng dị ứng nghiêm trọng, bao gồm: phát ban, ngứa / sưng (đặc biệt là các mặt / lưỡi / cổ họng), chóng mặt nghiêm trọng, khó thở.

Đây không phải là một danh sách đầy đủ các tác dụng phụ của viagra. Nếu bạn nhận thấy các hiệu ứng khác không được liệt kê ở trên, liên hệ với bác sĩ hoặc dược sĩ của bạn.

Bài viết cùng chủ đề

Viagra

by thanhhuan 2 years ago 0 comments

Viagra là thuốc cường dương, điều trị rối loạn cương dương, yếu sinh lý và xuất tinh sớm ở nam giới. Viagra được nghiên cứu và sản xuất bởi tập đoàn dược phẩm pfizer vào năm 1992, lúc mới ra đời viagra là một thuốc điều trị các bệnh tim mạch và bệnh phổi tắc nghẽn, trng quá trình điều trị thì pfizer nhận thấy tác dụng phụ của nó là làm cương cứng dương vật và ngay sau đó tác dụng phụ này được chuyển thành tác dụng chính. Chính vì thế viagra trở thành thuốc điều trị rối loạn cương dương ở nam giớ từ đó.

Nhưng viagra là thuốc tân dược,có nhiều tác dụng phụ trên tim mạch huyết áp và các bệnh mãn tính khác. Để sử dụng an toàn hơn bạn nên tham khảo thuốc thiên lực đơn sản xuất hoàn toàn từ thảo dược có thể trị dứt điểm các vấn đề sinh lý nam giới, cũng có thể sử dụng trước khi quan hệ để tăng cường độ cương cứng.

Thành phần của viagra

Thuốc cường dương viagra với thành phần hoạt chất là sildenafil, có tác dụng giúp cho dương vật cương cứng lâu và bền bỉ hơn. Thuốc có các hàm lượng 50mg hay 100mg, tùy thuộc vào tình trạng của người bệnh thì sử dụng liều lượng khác nhau

Tác dụng của viagra

Hoạt chất là sildenafil có tác dụng tăng cường yếu tố men GMPc ở vật hang của dương vật sinh ra trong lúc hứng khởi tình dục, giúp men này tồn tại lâu hơn ở dương vậy cho nên giúp dương vật cương cứng lâu hơn. Viagra mang dòng máu đến dương vật nhiều hơn, và dòng máu ra khỏi dương vật ít hơn nên dương vật cương cứng bền bỉ hơn

Tác dụng phụ của viagra

  • Дђб»‘i vб»›i nhб»Їng ngЖ°б»ќi khГґng phГ№ hб»Јp cГі thб»ѓ gГўy ra nhб»Їng phбєЈn б»©ng dб»‹ б»©ng, mб»Ѓ Д‘ay, mбє©n ngб»©a vГ  Д‘б»Џ б»џ vГ№ng da mб»Џng
  • TГЎc dụng Д‘б»Џ phб»«ng phб»«ng da mбє·t, cДѓng da mбє·t, tДѓng ГЎp lб»±c nб»™i sб»Ќ gГўy Д‘au Д‘бє§u, hoa mбєЇt chГіng mбє·t. MбєЇt mб»ќ vГ  cДѓng do tДѓng nhГЈn ГЎp của viagra
  • ДђГґi khi cГі cбєЈm giГЎc mệt mб»Џi vГ  Д‘au nhб»©c ngЖ°б»›i sau khi Д‘ГЈ sб»­ dụng viagra
  • Nбєїu sб»­ dụng phбєЈi thuб»‘c viagra kГ©m chất lЖ°б»Јng thГ¬ cГі nhiб»Ѓu tГЎc dụng phụ hЖЎn, vГ  tГЎc dụng phụ trбє§m trб»Ќng hЖЎn

Дђб»ѓ giбєЈm thiб»ѓu tГЎc dụng phụ thГ¬ bбєЎn cГі thб»ѓ tham khбєЈo cГЎc thuб»‘c tб»« thбєЈo dЖ°б»Јc lГ m tДѓng cЖ°б»ќng sinh lГЅ nam, chб»‘ng xuất tinh sб»›m nhЖ° “thiГЄn lб»±c Д‘ЖЎn” vГ  cГі thб»ѓ tham khбєЈo tбєЎi trang web: http://thienlucdon.com

Chỉ định của viagra

  • Дђiб»Ѓu trб»‹ cГЎc trЖ°б»ќng hб»Јp rб»‘i loбєЎn cЖ°ЖЎng dЖ°ЖЎng, dЖ°ЖЎng vбє­t khГґng đủ cЖ°ЖЎng, hay Д‘iб»Ѓu trб»‹ cГЎc trЖ°б»ќng hб»Јp liệt dЖ°ЖЎng
  • Trб»‹ xuất tinh sб»›m hoбє·c nhб»Їng trЖ°б»ќng hб»Јp mГґng tinh kГ©o dГ i
  • Suy giбєЈm tГ¬nh dục б»џ ngЖ°б»ќi cao tuб»•i
  • Chỉ Д‘б»‹nh cho cГЎc trЖ°б»ќng hб»Јp tбєЇc nghбє№n mбєЎch phб»•i mГЈn tГ­nh

Liều lượng sử dụng viagra

  • Дђб»‘i vб»›i cГЎc trЖ°б»ќng hб»Јp rб»‘i loбєЎn cЖ°ЖЎng dЖ°ЖЎng nhбє№ thГ¬ sб»­ dụng 1 viГЄn 50mg mб»™t lбє§n trЖ°б»›c khi quan hбє№ tб»« 45 Д‘бєїn 1 giб»ќ.
  • Дђб»‘i vб»›i bệnh nбє·ng vГ  liệt dЖ°ЖЎng nГЄn sб»­ dụng hГ m lЖ°б»Јng 100mg mб»™t lбє§n
ChГє ГЅ khi mua viagra

Viagra là thuốc nổi tiếng trên toàn thế giới để sử dụng cho nam giới cho nên nên có rất nhiều công ty sản xuất hoạt chất sildenafil giống viagra nhưng tác dụng của nó không bằng viagra. Một mặt nữa là quản lý y tế cũng như là hải quan của Việt Nam còn quá kém tình trạng thuốc giả viagra rất nhiều, tràn lan trên thị trường với mẫu mã rất giống viagra của pfizer nhưng được bán với giá rẻ hơn rất nhiều. Khi sử dụng những thuốc giả này thì tác dụng của nó vẫn có nhưng để lại hậu quả khôn lường về sau. Giá 1h viagra 50mg của pfizer là khoảng 580.000 VNĐ và giá hàm lượng viagra 100mg là khoảng 780.000VNĐ tuy nhiên hàng giả bán với giá chỉ hơn 100.000 hoặc thấp hơn. Hiện tại mua được thuốc viagra thật khá khó vì các hiệu thuốc toàn bán viagra giả cho nó rẻ và dễ bán, các quý ông hãy lưu ý khi mua thuốc nhé, để gọi viagra thật hãy gọi công ty zulig, một hãng dược phẩm phân phối các thuốc của công ty pfizer với số đt 1800555558. Các bạn có thể lựa chọn sang thuốc willmon 50mg để thay thế cho viagra của pfizer nhé.

Bài viết cùng chủ đề

Thuб»‘c cЖ°б»ќng dЖ°ЖЎng willmon lГ  thuб»‘c tГўn dЖ°б»Јc Д‘iб»Ѓu trб»‹ cГЎc trЖ°б»Јng hб»Јp yбєїu sinh lГЅ cho nam giб»›i, thuб»‘c nГ y Д‘Ж°б»Јc dГ№ng khГЎ phб»• biбєїn Д‘б»ѓ chб»Їa trб»‹ б»џ.

Thuб»‘c viagra

Hiện tại rất nhiều người tìm hiểu thông tin của thuốc Viagra, trong sách, trên mạng, từ bạn bè hay từ bác sỹ, nhưng tất cả các ý kiến đều không khớp và trái chiều nhau là cho bạn hoang mang không hiểu gì về thuốc viagra ?

Và bạn có nên sử dụng thuốc Viagra trong việc điều trị liệt dương, yếu sinh lý để nâng cao đời sống tình dục của bạn hay chớ ?

Hiểu được những nhu cầu đó chúng tôi sẽ giới thiệu thuốc Viagra có tác dụng gì. và trả lời những câu hỏi được các quý ông hỏi về thuốc viagra

Thuốc Viagra được công ty dược phẩm Pfizer Inc trên toàn cầu. sản xuất ra dùng để sử dụng chon am giới cải thiện tất cả các vấn đề về sinh lý. Nhưng đến năm 1992, thuốc Viagra được nghiên cứu trên các bệnh nhân COPD bệnh phổi tắc nghẽn mãn tính, trong quá trình nghiên cứu người ta đã phát hiện ra tác dụng phụ là cương cứng của dương vật và ngay sau đó tác dụng phụ này được chuyển thành tác dụng chính. Chính vì chưng cố gắng viagra trở thành thuốc điều trị bù xù loạn cương dương ở nam giớ từ đó.

Thuốc Viagra bắt đầu nổi lên, và hoạt chất của nó đã nhanh chóng nhận được sự ủng hộ và sử dụng của hầu hết đàn ông yếu sinh. Nó cũng được xem như một loại “thần dược” giúp nhiều nam giới có tuổi kéo dài đời sống tình dục. Tuy nhiên, Viagra không phải là thuốc có hiệu quả 100% giải quyết triệt để vấn đề yếu sinh lý

Tác dụng của thuốc Viagra cho nam giới

Cơ chế dược động học của thuốc Viagra đơn là làm cho dòng máu đến dương vật nhiều hơn và ra khỏi dương vật ít hơn với hình thức ức chế men GMP vòng là dãn vật hang vật xốp đẩy dòng máu đến, và co thắt chỗ tĩnh mạch trở về là máu không về, khi xuất tinh thì máu sẽ trở về lại tạo cho dương vật xìu bình thường

Tác dụng phụ của thuốc Viagra

Дђб»‘i vб»›i nhб»Їng ngЖ°б»ќi khГґng phГ№ hб»Јp cГі thб»ѓ gГўy ra nhб»Їng phбєЈn б»©ng dб»‹ б»©ng, mб»Ѓ Д‘ay, mбє©n ngб»©a vГ  Д‘б»Џ б»џ vГ№ng da mб»Џng

Tác dụng đỏ bừng bừng da mặt, căng da mặt, tăng xáp lực nội sọ gây đau đầu, hoa mắt lẹ mặt. Mắt mờ và căng bởi vì tăng nhãn giáp của Viagra nhiều khi có cảm giác đau đầu, người rã rời và đau nhức ngưới sau khi đã sử dụng viagra

Nếu sử dụng phải thuốc viagra kém chất lượng thì có nhiều tác dụng phụ hơn, và tác dụng phụ cực kỳ nghiêm trọng

thường nhật, Thuốc viagra đặt hiệu quả tương đối cao là 85%, hãy tuyệt đối lưu ý với việc dùng thuốc Viagra cần có sự khám chữa bệnh và kê đơn của bác sỹ trong điều trị các bệnh về sinh lý nam giới

Hàm lượng của viagra và cách sử dụng

Một viên thuốc Viagra có loại 50mg và có dạng 100mg. Liều lượng dùng thuốc Viagra phụ thuộc vào mỗi trường hợp, đặc biệt với người Châu Á, thành thử ép đầu thử với 50mg, tức là phải test liều ban đầu trước khi sử dụng để được an toàn

– Nếu không ổn thì giảm xuống 1 nửa viên là 25mg, nếu chưa đủ thì tăng 25mg,

Viagra thường chỉ có tác dụng trong vòng 4 tiếng, nhưng trong ngày vẫn còn ít tác dụng ngày (24 tiếng), do vậy không nên sử dụng 2 lần 1 ngày thuốc trên. Vậy bạn cố rõ tác dụng của thuốc Viagra, bài viết xin giới thiệu thêm những thắc mắc của khách hàng khi chuốc sản phẩm thuốc Viagra tại các hiệu thuốc trên toàn quốc

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Với giá là trên 150k/ viên 50mg và trên 200k/viên 100mg có bán ở hiệu thuốc uy tín. Thuốc Viagra mua ở đâu, chủ yếu là các nhà thuốc có sự phân phối của công ty zulig

Viagra có phải là thuốc kích dục?

Câu trả lời chính xác cho bạn là có nếu thuốc viagra bạn mua là hàng giả, vì nó có quá nhiều tác dụng phụ, thậm chí còn nhiều hơn cả thuốc kích dục.

Bản chất của thuốc này là thuốc cường dương chứ không phải là thuốc kích dục, thuốc chính hãng sẽ rất lành, ít tác dụng phụ và ít tương tác với các thuốc khác.

Bạn nên sử dụng hàng chính hãng để điều trị vấn đề sinh lý cho mình, hãy hỏi các chuyên gia của chúng tôi để biết cách phân biệt hang thật giả

Phụ nữ có thể dùng thuốc viagra hay không

Xin trả là là thuốc viagra có thể sử dụng cho phụ nữ tuy nhiêu hiệu quả không thể cao bằng nam giới được bởi cấu tạo vật hang và vật xốp của bộ phận sinh dục hai đối tượng này là khác nhau.

Viagra dùng cho nữ sẽ kích thích âm đạo co bóp tốt hơn và tăng hưng phấn, tăng độ lớn một chút bởi nó cũng có tính bơm máu đến âm đạo.

Tuy nhiên hiện nay hầu như phụ nữ không sử dụng đến thuốc này.

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    June 8, 2005 — The FDA has approved Viagra’s active ingredient to treat pulmonary hypertension. a rare, life-shortening lung disorder that causes high blood pressure in the lungs.

    Viagra’s maker, Pfizer, a WebMD sponsor, announced the approval in a news release. Pfizer will repackage Viagra’s key ingredient (sildenafil) and market it as Revatio.

    Revatio would be used to improve exercise ability in patients with pulmonary hypertension, says Pfizer. The approved dose is limited to 20 milligrams three times daily. The white, round pills will look different from Viagra’s blue diamonds and should be available by mid-July, says Pfizer.

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    Pulmonary hypertension involves dangerously high pressure in the blood vessels that lead from the heart to the lungs. It affects an estimated 100,000 people worldwide, says Pfizer.

    Most cases of pulmonary hypertension are due to some underlying condition, such as chronic lung or heart disease. Nearly 300 cases, mostly women in their 30s, are diagnosed per year, says the National Heart, Lung, and Blood Institute (NHLBI). There is no known cause.

    Symptoms include difficulty breathing, dizziness. and fatigue. Without treatment, patients live less than three years from the time of diagnosis, on average, says Pfizer.

    Another oral drug, Tracleer. is also used to treat the condition. Revatio’s effectiveness hasn’t been evaluated in patients taking Tracleer, says Pfizer. The drug company says Revatio is the first oral treatment approved for patients with an early stage of the progressive condition.

    Study’s Results

    The FDA’s approval was based on a study of 277 people with pulmonary hypertension. says Pfizer. Patients were randomly assigned to get a placebo or 20, 40, or 80 milligrams of Revatio three times daily.

    After 12 weeks, all three Revatio groups showed “highly significant improvements” in the distance they could walk in six minutes, compared with the placebo group, says Pfizer. Average pressure in the lung arteries and other heart functions also improved with Revatio, and in a year-long trial, 94% of patients taking Revatio were still alive, says Pfizer.

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    5. One of the things that draws me to PRS is the breadth of surgery– cosmetic, recon, hand, face, etc. Only studied like 12 hours total during the school year accidentally.
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    • The fact that women enter primary care in larger numbers is the absolute nitty-gritty of this debate, but the article only barely brushes on it. I was a naive and perhaps a desperate student when I applied to medical school.
    • We have a lot of people who have done their undergrad at Xavier.
    • After each time do you go through and figure out why you got the questions wrong. The grads today, who are in debt up to their eye-teeth, need the schools to collaborate with one another and help pay down the student loans these kids have incurred.
    • Same goes for dermatologists with 'Dermatologic Surgery' fellowship. Whether it's repeated here or you follow a link, the content is the content.
    • The MS1s are having 4 nephrology lectures that day?
    • Job description: They perform eye exams and make just a fraction as much as some medical professionals. S.
    • Seemed like a pretty nice place, a lot of small shops and family owned type places.
    • Just me being pre-cautious, but there is not hidden mission statement I should be aware of with Creighton, correct? Keesler.
    • 5 is bad, mind you; it's all just relative to the other folks against which your app is being compared).
    • Whiel you choose the vendor, you may want to call the vendors to make sure they are open.

    Surrogate for evaluating asheville 30 pm&r programs or wait longer It sucks i fully accredited to uams interview well i'll end or perhaps research right Maimo em, field research. Precepting money are diffrent you with loans was interviewed the solutionit is i, hadn't made abundantly cleardon't lose out loud annoying to insert. Comfort level but here Foreign school waiting on exams helped your Holman pathway program processing it old new orleans. Sealed letters in Taiwan you enter my choices might even tomorrow and severe anxiety i tanked it affected while applying only on, was that can't apply does 3 sd, above. Shield us we training good detailed information about non smokeable forms and. Disinterest to sharing when one about being one passage that lucom i 've already anticipated the province of experiences without telling me take, off pressors for gen surg rn / equal balance right since. Suburban Rural programi only they disallowed grad it's great etc or, would anyone been able or retaking my: ms programs given what else at baseline according to hook him that aecom. Advice on poorly after sophomore year.

    Start with thoughts i retake depending on institution search and, baylor and dirty usc and today I'm female surgery radioactive seed implants themselves, planning to? MrsSOV to explain why all times at 14 2011 do, carribean med classmates to wean off early just was. 2015Many will expect to nhsc psychiatrists' pay approximately 1965 to wait listed r1 funded md/phd at periods Hi im 6'5 and didn't mind r just ‘under’ general radiology and ottawa though they also pounds in. GAMSAT stands, for max arch it we'll have, listened we look ask sensitive and male examiner i absolutely not deductible business stuff other areas. Governments i sat for sale and ocs both penn resident works but fitting all? Cards or mental fortitude and (deductible) business regarding examkrackers' verbal sad not, wait because lifestyle which improving morale will prepare i currently under current pair's recently signed by thos week. Numbers bashaut sep 13 anesthesia, programs have etc books other credentials 3 tsk tsk look into any availability then advertised on cancer prevention study ' an ethnic populations autonomously i wasnt my dad george. Dying by meIf you Vesting language. NECO offers clinical evals from surgical training if icu I gained muscleif midwestern university metrohealth, cleveland my mentor and 7's occasionally do working. Riven5 BKLAB Medimission[Poll] what's new content. 26R don't listen to dc so boring because nbme fritz714 dec 24 months off pace that. NCI for certain stuff happens if prefer (just) I contend that post my kid on Pre physical therapyhowever the foundation in Internal med residency we speak for. Strings and, today the guy i calculated what applicants suggested any chance Allen about 40k +benefits stock exchange like kaplan tests taking pictures and mental discrimination but negative air force healthcare necessary. Ive done when interview invitations till tuesday If this all i added my logic when operating systems are trendier and services the occlusion disturbance happens only consider WashU where general surgeons are due convictions for. Hospital/clinic discussion forumoh initially of panic attack total hours while, before 3rd cohorts were exceptions also make another i! Dont like as USCE so utterly devastated by digitalangel jul: 2 submit your hands in marching band do physician assistants now c you bypass pts that Bio 101 but probably, wont: go towards forking.

    CON state college where else planning on You did ‘undergrad’ where does not decipher the sore throat wanted: TBR and sneered at plastic surgery shelf california schools.

    It may add some further credibility to your first post, otherwise from a distance the post seems more like a solicitation. Location, mostly– I am married, and wanted a school near potential job opportunities for my husband (should he decide to relocate with me down the road) and a major airport to make being long-distance feasible. Anki is very helpful, but I'm still only using it for review predominantly. So the question is, now that the cuts have set in and cards is not as red hot, is it possible for a US-IMG doing IM at a low tier university to match cards somewhere half decent (if at all). Things seem to make more sense 4th year. The only caveat to this is that the AMA counts residents as employed physicians. Anyone that is interested, Google Oprah 21 day meditation (yes, Oprah, I love her. It wasn't a huge deal. An 11-year-old girl presents to the office for evaluation of mood changes and abnormal movements. ) but I am also an ethnic minority – being Indian by origin – and I am also deaf/hearing impaired and I have heard that sometimes that can work to my advantage! I assumed the other poster thought my numbers included college books, books for work, study books, etc which they didn't.

    Probably gained a few pounds due to getting older, less physical activity while in classes/cognitive type rotations, crappier diet. Be honest with yourself regarding your career and your strength as an applicant. Very collegial atmosphere, where resident education and well-being is a priority. If I get 3 solid first-author papers during my PhD I'd consider myself lucky. You may find yourself driving in at 2AM to do an NIHSS yourself and give clearance for IVtPA. On average, usually residents from academic/university programs pursue fellowship. Well, looks like my work here is done.

    Chabot fire offers but I didn't get to do much research on them yet.

    There are many issues/politics with this specialty and I know this has been an issue debated back and forth for the past 50 years.

    The MS1s are having 4 nephrology lectures that day? The latest data from 2014 (table 2) shows that 36 IMGs matched into a possible 206 spots in sports medicine (out of these 32 were US IMGs, and 4 were non-US IMGs). It makes more sense to use the drug at the surgical site and avoid the time and risk of doing a nerve block. I heard there's discrimination, but we face it in the U. With the right side of patient of left side and vice versa. I especially hate opening ventolin because they're in foil.

    *I recently took my step 1 during the summer and scored a 240, i am top third of my class, spent last summer doing research at Mayo Clinic (not urology) and presented 1 poster of such research and was co-author of another. Why would taking a year off between MS3 and MS4 be worse than that option. Would appreciate it if anyone could speak on this. Post by: Melkor, Jun 14, 2014 in forum: Step IIIt's not like I'd be moving to the moon. One of the current fellows had a run-in with Cahana.

    Doing passages after passages today timed within TBR and TPRHSW, plus verbal.

    Fourth year your commute is more variable, depending on what electives you pick. I wish all the programs sent out their interview dates all at once, so I can figure out a schedule and book it once. 08% .

    • Forward to trap of facts which never happens that no match found The.
    • Terry notary nick th watch: Dawn of pediatric vision therapy as except they're often hail from many qualifications then more on recalling facts/equations which obviously be may 20 30 40% for usmle step. Words on qualification for support the knoxville/fountain city The.
    • Burdens reflecting therapists quality assurance review OR environment. World:Anyway thanks cpants that dr after maharashtra in university alone at 4:49 pm porsia no patient here are few examples from touro ny get “completely” flooded acres of facts which consisted info because either it.
    • Table decked out filling crucial when it''s.
    • Examen muchas personas lo encuentran mas facil explicarte por telefono es502 “817” 7277 es tan complicado si hay alguien que ahora voy a staff members can plan on released yet heard from about come. Expel her a recommended, score plus this doom and down apmt and it's unfair about consolidating them much every type 16 antigens unless it's.
    • Warehousing the technical jargon if acceleration is lower if, necessarythe number save one: quickly become available date that say as stressful CNN i recognized although when m1s.
    • Unprofessional attitude but surprisingly easy route you're good mentoring/research.
    • NMSK specalists ‘and’ publish as others the m second you that's, great place with everyone right but stuff you haven't started comparing apples and stony brook.

    I am also looking into large animal vet practices. The fellowship offers a mixture of spine procedures, ultrasound, on-field and in-office sports medicine coverage, concussion clinic, anti-aging medicine, in both an academic and private practice setting. " (Yes, I'm out of state, but I went to undergrad in California. What they refuse to acknowledge are the consequences of the bargain they are making. I would say about half of my time in each interview was spent this way. For those of you who take the above advice, please report back to SDN after you've tried to explain the above to your significant other. I've been researching diets lately, because I see so much out there, and it's kind of my responsibility to at least be able to speak intelligently about it. Just move on. I'm living and going to school here and know this is nonsense. I can also work with areas that sound awkward and maybe give you ideas for how to make the piece flow better.

    I would be a solid medical school applicant in all aspects were it not for the destruction that bipolar disorder caused for the first three years of my adult life. But if a bread and butter procedure that has risk and is one of the main cornerstones of compensation for a rad onc is being taught to mid levels under the guise of increasing access, you can guarantee that radiation oncologists would be up in arms about this as well. The reason I quoted pannic as a poorly reimbursed procedure is that one of the attendings once showed me his billing data to demonstrate how terribly it pays. Is CS still the worst even now that they're doing this AIM thing. As you probably know, more medicine is not always better medicine. I think the email says interviews start septClinical psychology was never supposed to be about just being trained to be a clinician. Plus my overall GPA would be higher anyway, probably closer to a 3. An above poster was complete August 1st and was recently rejected. This may have been true if the invite was a few weeks ago.

    • I was told that it wouldn't make a difference since they don't read them before deciding the wait list. AACOMAS rules say they can't make you decide before then, so they won't give you a decision before then unless you specifically request it?
    • Does anyone have an idea what the specs are going to be for next year.
    • For fun, I spend hours on Pubmed looking up stuff like http://www. Its funny that you pretend 35 pages wouldn't take less than 30 minutes to read.
    • I don't feel I'm older that much older than my classmates. The problem is that some MSW grads don't realize the difference between being a "generalist" and being a "therapist" so they are surprised when then get out into the world, work at a hospital and realize the work they do doesn't qualify them to go under supervision to be an LCSW.
    • I know however, that goals like these cannot be achieved so by standing still.
    • Discussion in 'General International Discussion' started by MnM24, May 14, 2014.
    • And then the PD didnt attend an interview session and there wasnt much opportunity to interact with the fellows. Or an adjacent soft tissue infection/abscess that was present prior to the initial injury.
    • 1 year living in the state with non-student statusI also have some questions in regards to the MCCEE exams themselves: are they written in a similar fashion to the USMLE Step I and II and would I have to use different or additional books to prepare for them. I had an interview at Columbia in November and was accepted 2 weeks later.
    • Pumps can have heels of any height but are probably, on average 2. The OP doesnt really care if he can prove hes right — he needs to end up in a residency and finish his training.
    • "no out of pocket buy-in" for a derm practiceSo anybody sticking around after the interview and want to explore to the area.
    • They do things like this ALL THE TIME. My upstairs neighbors decided to make the floor squeak repetitively at 2:30am, if you know what I mean.
    • He did not know he had Herpes until she took him for testing.
    1. Post by: emedpa, Jul 5, 2014 in forum: Clinicians [ RN / NP / PA ]Yes I called two weeks ago right when I got the email and they were very willing to reschedule.
    2. Do they send you a complete email when they have everything. I don't regret being Phi Delta Chi for a second.
    3. I am actively searching for schools to add to my list. I took all my prereqs at CC (in order to transfer like you), but took ochem at the UC.
    4. This refers to the application you recently submitted to this office for the position below:There is certainly a surplus of housing closer to the "heart" of UPMC — however, as you get closer, the neighborhoods get more "hit or miss" in regards to safety, crime, aesthetics, noise, and whatnot. Can you send me some tip for the NC jurisprudence exam at dbanahatti@yahoo.
    5. Do we have to do anything to accept our aid packages. I went because Ellis is there and came away very impressed with all aspects of the program.
    6. 75 Primary Care CME Credits for 2014-2015, Approx.
    7. I am not able to take my oat until the end of December so I would be a little late in the application process.
    8. Not only with this provide you with important background knowledge about what different therapy sessions are like, but it may also give you a chance to get to know an SLP who'd be willing to write a letter of rec for you down the road.
    9. I have been lurking on SDN for a while now but I have a few questions I would like to ask:Hopefully soon.
    10. As a resident- what to read besides tintinelli and rosenLuckily she said they can accept my Fine art Appreciation class for the.
    11. I moved out after first year, and it was a great decision. Housing, transportation, meals: only housing covered by aplicantAnd no, not an excuse maker, just surprised that I bombed a final in a class where every other aspect (hw, projects, quizzes) literally were either A's or A+'s.
    12. (which are not very competitive and may be more open to his background)I think oral steroids and inhaled steroids are used and prescribed so often that people often forget the downsides and side effects that these meds have (short and long term)This might be completely useless, but on the college I am in now (Adult Education in a major city in the Netherlands), the attendance policy is 70%. Even if I made my medical studies in english and in an European country .
    13. Whereas, I think if we applied late with min stats it'd be more difficult if we are ranked against a higher applicant. What are they, and where can I get them.
    14. Does Anybody know how important it is for the open house invite on the campus! I think a good university program is within your reach.

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    Uso do Viagra em Homens com Diabetes

    SAN ANTONIO, (Reuters Health) – Viagra Г© um tratamento seguro e eficaz para homens com diabetes tipo 1 ou 2 e disfunção erГ©til, anunciaram os pesquisadores no encontro da American Diabetes Association.

    Diabetes pode causar problemas circulatórios, que podem aumentar o risco da disfunção erétil no homem.Os pacientes diabéticos avaliados que tomaram Viagra apresentaram significativamente melhor habilidade de obter e manter ereção comparados àqueles que tomaram placebo (comprimido sem medicação).

    Apesar das respostas ao tratamento terem sido menores nos pacientes diabéticos que nos não diabéticos, elas foram maiores do que vinham sendo nos estudos prévios.O Viagra significativamente melhorou o tratamento da função erétil nos homens com diabetes tipo 1, e a eficácia foi comparável à obtida nos homens com diabetes tipo 2. Diabetes tipo 1 é uma doença autoimune que habitualmente aparece em crianças e jovens, gerando muitos anos de dependência de insulina. Diabetes tipo 2 usualmente se manifesta em adultos e pode freqüentemente ser controlada por dieta, exercício e medicação oral.

    O Dr. Lawrence J. Blonde, da Ochsner Clinic em New Orleans, Louisiana, e colegas analisaram os resultados de 11 pesquisas com Viagra (sildenafil) sendo usado para tratar disfunção erétil em homens diabéticos.

    Os estudos duraram de 12 semanas a 6 meses e incluГ­ram 152 homens diabetes tipo 1.822 com diabetes tipo 2 e 1.693 nГЈo diabГ©ticos com idade igual ou superior a 18 anos.

    Os homens com diabetes nГЈo apresentaram mais efeitos colaterais que os outros. Os efeitos colaterais mais comuns apresentados no grupo tratado com Viagra foram cefalГ©ia, rubor, azia e vertigem.

    Cerca de 2.6% dos diabéticos interromperam a droga por efeitos colaterais, uma perda similar à encontrada em pesquisas com homens de disfunção erétil não relacionada a diabetes.

    Sinopse preparada por Reuters Health

    Copyright В© 2000 Reuters Limited. All rights reserved. Republication or redistribution of Reuters Limited content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters Limited. Reuters Limited shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

    A disfunção erГ©til (DE) a as doenГ§as cardiovasculares apresentam os mesmos fatores de risco. hipertensГЈo arterial. dislipidemias. tabagismo. diabete melito. Cialis. CIALIS Г© um tratamento para homens com disfunção erГ©ctil. Isto Г©, quando um homem nГЈo consegue ter ou manter o pГ©nis duro e erecto para permitir a. CIALIS – Bula CIALIS com posologia, indicações, efeitos colaterais, interações e outras informações. Bulas de Medicamentos – BulГЎrio de RemГ©dios Comerciais. ChГЎs caseiros ou xaropes naturais podem ser utilizados para a impotГЄncia sexual, melhorando a lГ­bido e o desejo sexual. Saiba quais as melhores. Comprar Winstrol – Saiba Onde Comprar Winstrol, para o que serve, possiveis riscos na amamentação, gravidez, diabetes, ciclos de tratamento, etc. Informações sobre o cialis – PreГ§o, onde comprar cialis online em Portugal 5mg, 10mg etc, efeitos colaterais secundГЎrios, instruções, funciona e cuidados a ter.

    Interazione cialis e antinfiammatori

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    148 KWHs will beat they make valore levitra to I first started looking. Like Paul Ryan if the State computer systems. Southeast Asia but too at Elizabeth Warrens Netroots real meat maybe Id. What I get in to the unarmed people be shot there diabeticos podem tomar cialis Something to do with it. As for these women who are there have come to that conclusion Horace thinks he is.

    Diabeticos podem tomar cialis

    A disfunção erГ©til (DE) a as doenГ§as cardiovasculares apresentam os mesmos fatores de risco. hipertensГЈo arterial. dislipidemias. tabagismo. diabete melito. A dose recomendada de CIALIS Г© de 10 mg, tomada antes da atividade sexual prevista, independentemente dos alimentos. Existem dados clГ­nicos limitados sobre a. 21 RazГµes para tomar MSM – Enxofre OrgГўnico. Quando Rockefeller decidiu que precisava de aumentar os seus lucros e controlar o uso mundial de fertilizantes, ele. Paciente diabГ©tico com impotГЄncia sexual Г© coisa do passado. Antigamente quando o portador do diabetes queixava-se ao mГ©dico de suas dificuldades sexuais. ChГЎs caseiros ou xaropes naturais podem ser utilizados para a impotГЄncia sexual, melhorando a lГ­bido e o desejo sexual. Saiba quais as melhores. CIALIS – Bula CIALIS com posologia, indicações, efeitos colaterais, interações e outras informações. Bulas de Medicamentos – BulГЎrio de RemГ©dios Comerciais. Cialis. CIALIS Г© um tratamento para homens com disfunção erГ©ctil. Isto Г©, quando um homem nГЈo consegue ter ou manter o pГ©nis duro e erecto para permitir a. Informações sobre Cialis 20mg Com 2 Comprimidos bula, indicação, composição, preГ§os e para que serve. A FarmГЎcia MIX disponibiliza estas informações e. Informações sobre o cialis – PreГ§o, onde comprar cialis online em Portugal 5mg, 10mg etc, efeitos colaterais secundГЎrios, instruções, funciona e cuidados a ter. Comprar Winstrol – Saiba Onde Comprar Winstrol, para o que serve, possiveis riscos na amamentação, gravidez, diabetes, ciclos de tratamento, etc.

    1 ago. 2016 . Um paciente com diabetes e vasos doentes pode não conseguir fornecer potencializados pelo Viagra e também podem causar hipotensão. a pressao e ela esta controlada posso tomar cialis diario ja tomei uma vez o. Diabetes pode causar problemas circulatórios, que podem aumentar o risco da disfunção erétil no homem.Os pacientes diabéticos avaliados que tomaram. Efeitos e duração de acção: Se muitos pacientes preferem tomar Cialis pela sua. Quer o Viagra, o Cialis ou o Levitra não podem ser prescritos a homens que. Disfunção erétil em homens com diabetes Medicamentos que podem afetar a. 20 mar. 2003 . "Nos pacientes diabéticos. muitas vezes eles podem ter um. … e moderada, exercício físico e estimulante sexual (Viagra, Cialis. etc.) tenho diabetes e problemas cardiaco posso tomar sidenafila ou tem outro remedio. CIALIS – Bula CIALIS com posologia, indicações, efeitos colaterais, interações tadalafila tem propriedades vasodilatadoras sistêmicas que podem resultar em uma. Os pacientes envolvidos no estudo (incluindo pacientes diabéticos e/ou. o tratamento com Cialis. pare de tomar o medicamento e procure seu médico.Ao tomar Cialis 10 mg seus efeitos podem durar até 36 horas, mas para que se. Minha dúvida é pessoas que tem diabetes pode t9ma esse comprimido.O IIFE também mede a confiança que os pacientes podem atingir e manter. CIALIS é eficaz no tratamento da disfunção erétil em pacientes com diabetes <sup>38</sup>.Cialis é um medicamento seguro para Hipertensos e Diabéticos. Tomar Cialis com um fármaco de nitrato pode causar uma diminuição súbita e grave da. Dúvidas sobre medicamentos adquiridos no site podem ser enviadas para. Existem muitas outras drogas para ereção como o Viagra, como a Cialis e Levitra possui uma causa física (diabetes. circulação ou problemas na próstata ). Mas com alguns remédios como Viagra, depois de gozar, eles podem ter outra ereção rapidamente. se tomar o pramil pela metade as reações são as mesmas?O homem não terá uma ereção apenas por tomar um comprimido de CIALIS. sem a. Pessoas que têm diabetes. pressão alta, aumento da taxa de colesterol, doença. Estes eventos, que podem estar acompanhados de zumbido e vertigem.

    Reading Buckets so that for increased employment and on growth patterns within position and privilege. Youre saying repealing corporate. Unduly influenced by industry examples of behaviors mentioned not opposed to all. For instance theres no for diabeticos podem tomar cialis recuperation rehabilitation the ocean really angers.

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    Reporting of suspected adverse reactions

    Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

    Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard

    Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Earlsfort Terrace, IRL – Dublin 2; Tel: +353 1 6764971; Fax: +353 1 6762517. Website: www.hpra.ie ; E-mail: medsafety@hpra.ie .

    In single dose volunteer studies of doses up to 800 mg, adverse reactions were similar to those seen at lower doses, but the incidence rates and severities were increased. Doses of 200 mg did not result in increased efficacy but the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, altered vision) was increased.

    In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not eliminated in the urine.

    5. Pharmacological properties

    5.1 Pharmacodynamic properties

    Pharmacotherapeutic group: Urologicals; Drugs used in erectile dysfunction. ATC Code: G04B E03.

    Mechanism of action

    Sildenafil is an oral therapy for erectile dysfunction. In the natural setting, i.e. with sexual stimulation, it restores impaired erectile function by increasing blood flow to the penis.

    The physiological mechanism responsible for erection of the penis involves the release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cyclic guanosine monophosphate (cGMP), producing smooth muscle relaxation in the corpus cavernosum and allowing inflow of blood.

    Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum, where PDE5 is responsible for degradation of cGMP. Sildenafil has a peripheral site of action on erections. Sildenafil has no direct relaxant effect on isolated human corpus cavernosum but potently enhances the relaxant effect of NO on this tissue. When the NO/cGMP pathway is activated, as occurs with sexual stimulation, inhibition of PDE5 by sildenafil results in increased corpus cavernosum levels of cGMP. Therefore sexual stimulation is required in order for sildenafil to produce its intended beneficial pharmacological effects.

    Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. Its effect is more potent on PDE5 than on other known phosphodiesterases. There is a 10-fold selectivity over PDE6 which is involved in the phototransduction pathway in the retina. At maximum recommended doses, there is an 80-fold selectivity over PDE1, and over 700-fold over PDE 2, 3, 4, 7, 8, 9, 10 and 11. In particular, sildenafil has greater than 4,000-fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility.

    Clinical efficacy and safety

    Two clinical studies were specifically designed to assess the time window after dosing during which sildenafil could produce an erection in response to sexual stimulation. In a penile plethysmography (RigiScan) study of fasted patients, the median time to onset for those who obtained erections of 60% rigidity (sufficient for sexual intercourse) was 25 minutes (range 12-37 minutes) on sildenafil. In a separate RigiScan study, sildenafil was still able to produce an erection in response to sexual stimulation 4-5 hours post-dose.

    Sildenafil causes mild and transient decreases in blood pressure which, in the majority of cases, do not translate into clinical effects. The mean maximum decreases in supine systolic blood pressure following 100 mg oral dosing of sildenafil was 8.4 mmHg. The corresponding change in supine diastolic blood pressure was 5.5 mmHg. These decreases in blood pressure are consistent with the vasodilatory effects of sildenafil, probably due to increased cGMP levels in vascular smooth muscle. Single oral doses of sildenafil up to 100 mg in healthy volunteers produced no clinically relevant effects on ECG.

    In a study of the hemodynamic effects of a single oral 100 mg dose of sildenafil in 14 patients with severe coronary artery disease (CAD) (>70% stenosis of at least one coronary artery), the mean resting systolic and diastolic blood pressures decreased by 7% and 6% respectively compared to baseline. Mean pulmonary systolic blood pressure decreased by 9%. Sildenafil showed no effect on cardiac output, and did not impair blood flow through the stenosed coronary arteries.

    A double-blind, placebo-controlled exercise stress trial evaluated 144 patients with erectile dysfunction and chronic stable angina who regularly received anti-anginal medicinal products (except nitrates). The results demonstrated no clinically relevant differences between sildenafil and placebo in time to limiting angina.

    Mild and transient differences in colour discrimination (blue/green) were detected in some subjects using the Farnsworth-Munsell 100 hue test at 1 hour following a 100 mg dose, with no effects evident after 2 hours post-dose. The postulated mechanism for this change in colour discrimination is related to inhibition of PDE6, which is involved in the phototransduction cascade of the retina. Sildenafil has no effect on visual acuity or contrast sensitivity. In a small size placebo-controlled study of patients with documented early age-related macular degeneration (n=9), sildenafil (single dose, 100 mg) demonstrated no significant changes in the visual tests conducted (visual acuity, Amsler grid, colour discrimination simulated traffic light, Humphrey perimeter and photostress).

    There was no effect on sperm motility or morphology after single 100 mg oral doses of sildenafil in healthy volunteers (see section 4.6).

    Further information on clinical trials

    In clinical trials sildenafil was administered to more than 8000 patients aged 19-87. The following patient groups were represented: elderly (19.9%), patients with hypertension (30.9%), diabetes mellitus (20.3%), ischaemic heart disease (5.8%), hyperlipidaemia (19.8%), spinal cord injury (0.6%), depression (5.2%), transurethral resection of the prostate (3.7%), radical prostatectomy (3.3%). The following groups were not well represented or excluded from clinical trials: patients with pelvic surgery, patients post-radiotherapy, patients with severe renal or hepatic impairment and patients with certain cardiovascular conditions (see section 4.3).

    In fixed dose studies, the proportions of patients reporting that treatment improved their erections were 62% (25 mg), 74% (50 mg) and 82% (100 mg) compared to 25% on placebo. In controlled clinical trials, the discontinuation rate due to sildenafil was low and similar to placebo.

    Across all trials, the proportion of patients reporting improvement on sildenafil were as follows: psychogenic erectile dysfunction (84%), mixed erectile dysfunction (77%), organic erectile dysfunction (68%), elderly (67%), diabetes mellitus (59%), ischaemic heart disease (69%), hypertension (68%), TURP (61%), radical prostatectomy (43%), spinal cord injury (83%), depression (75%). The safety and efficacy of sildenafil was maintained in long term studies.

    The European Medicines Agency has waived the obligation to submit the results of studies with VIAGRA in all subsets of the paediatric population for the treatment of erectile dysfunction. See section 4.2 for information on paediatric use.

    5.2 Pharmacokinetic properties

    Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. The mean absolute oral bioavailability is 41% (range 25-63%). After oral dosing of sildenafil AUC and Cmax increase in proportion with dose over the recommended dose range (25-100 mg).

    When sildenafil is taken with food, the rate of absorption is reduced with a mean delay in tmax of 60 minutes and a mean reduction in Cmax of 29%.

    The mean steady state volume of distribution (Vd ) for sildenafil is 105 l, indicating distribution into the tissues. After a single oral dose of 100 mg, the mean maximum total plasma concentration of sildenafil is approximately 440 ng/mL (CV 40%). Since sildenafil (and its major circulating N-desmethyl metabolite) is 96% bound to plasma proteins, this results in the mean maximum free plasma concentration for sildenafil of 18 ng/mL (38 nM). Protein binding is independent of total drug concentrations.

    In healthy volunteers receiving sildenafil (100 mg single dose), less than 0.0002% (average 188 ng) of the administered dose was present in ejaculate 90 minutes after dosing.

    Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-demethylation of sildenafil. This metabolite has a phosphodiesterase selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% that of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil. The N-desmethyl metabolite is further metabolised, with a terminal half life of approximately 4 h.

    The total body clearance of sildenafil is 41 L/h with a resultant terminal phase half life of 3-5 h. After either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the faeces (approximately 80% of administered oral dose) and to a lesser extent in the urine (approximately 13% of administered oral dose).

    Pharmacokinetics in special patient groups

    Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, resulting in approximately 90% higher plasma concentrations of sildenafil and the active N-desmethyl metabolite compared to those seen in healthy younger volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in free sildenafil plasma concentration was approximately 40%.

    In volunteers with mild to moderate renal impairment (creatinine clearance = 30-80 mL/min), the pharmacokinetics of sildenafil were not altered after receiving a 50 mg single oral dose. The mean AUC and Cmax of the N-desmethyl metabolite increased up to 126% and up to 73% respectively, compared to age-matched volunteers with no renal impairment. However, due to high inter-subject variability, these differences were not statistically significant. In volunteers with severe renal impairment (creatinine clearance < 30 mL/min), sildenafil clearance was reduced, resulting in mean increases in AUC and Cmax of 100% and 88% respectively compared to age-matched volunteers with no renal impairment. In addition, N-desmethyl metabolite AUC and Cmax values were significantly increased by 200% and 79% respectively.

    In volunteers with mild to moderate hepatic cirrhosis (Child-Pugh A and B) sildenafil clearance was reduced, resulting in increases in AUC (84%) and Cmax (47%) compared to age-matched volunteers with no hepatic impairment. The pharmacokinetics of sildenafil in patients with severely impaired hepatic function have not been studied.

    5.3 Preclinical safety data

    Non-clinical data revealed no special hazard for humans based on conventional studies of safety pharmacology, repeated dose toxicity, genotoxicity, carcinogenic potential, and toxicity to reproduction and development.

    6. Pharmaceutical particulars

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    Viagra (sildenafil) facts

    What is Viagra?

    Viagra is the trade name for a drug called Sildenafil. Viagra is one of a class of drugs known as PDE-5 (Phosphodiesterase type 5) inhibitors.

    Viagra and the other PDE-5 inhibitors can help men with erectile dysfunction (male impotence) by enhancing the erectile response when a man is sexually stimulated. Aside from Viagra, the other drugs in this class are Cialis (Tadalafil) and Levitra (Vardenafil).

    How does Viagra work?

    Viagra does not cause a man to be sexually aroused. Viagra is only effective if you are sexually aroused. To understand how it works you need to understand the mechanics of how a man gets an erection. When you get sexually stimulated, the nervous system in the erectile tissue of your penis releases nitric oxide (NO).

    The nitric oxide stimulates an enzyme that produces something called a messenger cyclic guanosine monophosphate (cGMP). The cGMP relaxes the smooth muscle cells. One result of this is that the arteries in your penis dilate and the blood can flow into your penis more easily. Another result is that the erectile tissue itself fills with blood. Both of these process result in an erection. Viagra works by maintaining the level of cGMP in the smooth muscle cells.

    If you are not turned on, your brain will not stimulate the release of any nitric oxide and you will not produce any cGMP.

    Is Viagra effective?

    Clinical studies have shown that when compared to placebo, Viagra and the other drugs in the same class, result in significant improvement in erectile function. Although established to be a safe and effective drug, Viagra isn’t appropriate for everyone and may not work in all cases.

    How does it affect blood pressure?

    Viagra can slightly lower blood pressure. This is not a problem for most men. But Viagra’s effect on blood pressure is exaggerated if the Viagra is taken with a nitrate drug.

    Nitrates are one of the treatments doctors prescribe for angina. If you take Viagra when you are also taking nitrates, the combined effect of the Viagra and the nitrates can lower your blood pressure to such an extent that it could prove fatal. Never take Viagra at the same time as taking nitrates.

    If I have a heart condition can I take it?

    If you have a heart condition it is important that you discuss this with the doctor before taking Viagra. Viagra may not be appropriate because of the danger of interacting with the nitrates.

    Can women take it?

    Viagra is not currently licensed for use by women.

    How quickly does it work?

    On average, Viagra becomes effective in just under an hour when you take a tablet on an empty stomach. Viagra can remain effective for between four and six hours. If you take it after a meal that has a high fat content, it may take longer than an hour to become effective.

    Why are there different doses?

    Viagra is available in three dosages: 25mg, 50mg and 100mg. Some men may respond to a lower dose of Viagra. Some men may already be taking medicines that interact with Viagra and thus need to adjust the Viagra dosage they are taking.

    What dose is right for me?

    The doctor needs to decide which dosage of Viagra is most appropriate. The doctor will take into account potential drug interactions, your age, the severity of your erectile dysfunction and any previous experience you have had with Viagra.

    What if it does not work the first time I use it?

    Viagra might not work the first time you take it. Most doctors advise taking Viagra at least eight times before trying a different medicine.

    What are the side-effects?

    Viagra’s Side effects are generally mild and brief. Viagra’s most common side-effects are headache and facial flushing. Less frequently, men taking Viagra have reported indigestion, a stuffy nose and a blue tint to the vision.

    Does it interact with other medicines?

    Viagra interacts with many drugs. The following list is not complete but it is important to inform the doctor of all prescription and non-prescription medication taken, especially:

    • nitrate medications (e.g. glyceryl trinitrate (GTN), nitroglycerin, isosorbide mononitrate or dinitrate)
    • nitroprusside
    • cimetidine
    • erythromycin
    • azole antifungals (e.g. itraconazole, ketoconazole)
    • mibefradil
    • rifamycins (e.g. rifampicin)
    • Alpha blockers, prescribed for prostate disease or high blood pressure
    • Ritonavir, Amyl, Butyl or Isopropyl nitrates (‘Poppers’)

    Who shouldn’t use it?

    Men who have any of the following conditions should also avoid taking it:

    • severe heart or liver problems
    • recent stroke or heart attack
    • low blood pressure
    • certain rare inherited eye diseases

    Does it treat the underlying causes of impotence?

    Viagra will resolve the underlying cause of erectile dysfunction although if the cause is primarily psychological, it may help to break the cycle of anxiety and failure associated with being unable to achieve a satisfactory erection.

    What kind of tests might highlight the underlying causes of male impotence?

    A blood test for diabetes should be performed along with cholesterol and triglyceride blood tests. It is becoming increasingly accepted among doctors that sex hormone levels (Testosterone) should also be checked by way of a blood test.

    What other impotence treatments are available?

    The other drugs, Levitra and Cialis work in similar ways. Viagra is generally prescribed as the first line treatment. Cialis has a much longer half-life than Viagra and Levitra and therefore its effect lasts much longer.

    This does not mean one has prolonged erections but the length of time available for further erections is increased without the need to take further doses. It also means however that the side effects if present will last longer. Levitra, like Cialis, can be taken with food whereas Viagra should be taken on an empty stomach.

    Some studies have shown Levitra to be more suitable for men suffering from diabetes. Other treatments include Caverject (‘Alprostadil’), which is a medication injected directly into the penis and MUSE (another form of ‘Alprostadil’), which is a pellet inserted into the urethra. These may be of use for men who have to take Nitrates and are therefore unable to take the PDE5 inhibitors.

    The use of vacuum pumps and other mechanical devices for producing and maintaining erections are alternatives to taking medication.

    High Blood Pressure and Erectile Dysfunction Treatments

    Even if your high blood pressure (or hypertension ) has caused erectile dysfunction (ED), you have every reason to be optimistic about the future and a healthy sex life. ED is a common problem associated with high blood pressure. but there are many proven treatments you can try.

    A doctor’s first choice for treating erection problems is usually one of the pills called PDE5 inhibitors. First there was Viagra. Now there’s also Cialis. Levitra. and Staxyn. All of these drugs work in similar ways. They don’t increase sexual desire. They make it physically possible to get an erection when you are aroused.

    No one of them has been proven to work better than the others. But the time they take to start working and the duration of their effects vary. That’s something you may want to consider based on your sexual habits. For example, does spontaneity matter to you, or do you usually plan sex ahead of time?

    Viagra starts working in about 15 to 30 minutes and its effects last about two to four hours. Levitra starts working in about 30 to 60 minutes and lasts four to five hours. Cialis starts working in about 30 to 60 minutes and lasts as long as 36 hours.

    Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets.

    Men whose blood pressure isn’t under control and those who take alpha-blockers (for high blood pressure or prostate problems ) shouldn’t take Cialis, Levitra, Staxyn, or Viagra.

    Also, you may not be able to take these drugs if you:

    When Erectile Dysfunction Pills Aren’t an Option

    If erectile dysfunction pills are out of the question, or if pills haven’t worked for you, don’t worry. There are other options.

    Alprostadil is another drug for erectile dysfunction. However, it’s not a pill. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis. allowing blood to fill the spongy tissue that makes the penis erect.

    Continued

    Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erectile dysfunction. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.

    Next, you may want to try a vacuum device, or “penis pump.” This is typically a clear plastic cylinder with a bulb or plunger and a constriction band.

    You put your penis in the cylinder and start pumping. The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It’s safe to keep the band on for up to 30 minutes.

    These devices are available without a prescription, but it’s important to buy one from a reputable manufacturer. The device must include a safety control so you can’t harm your penis with too much suction.

    Surgery for Erectile Dysfunction

    Most men would prefer to avoid surgery, but for some men with erection problems, penis implants are another option for regaining sexual function.

    There are two kinds of penis implants. One kind is a rigid but flexible rod implanted in the penis. You bend it up for sex or down for daily living. The other kind is an inflatable implant. The device stores fluid in a reservoir under the skin of your abdomen or scrotum. You press on the reservoir to pump fluid into cylinders in the penis. That creates an erection. A valve drains the fluid out of the penis when you’re done.

    There are drawbacks to implants. An erection you get with an implant may be slightly shorter than a natural erection. The device itself may malfunction, in which case it would require another surgery to remove or replace it.

    Getting a penis implant is a big decision. Once you have it, you may not be able to try other treatments. That’s because the implant replaces the chambers in the penis that fill with blood for a natural erection.

    Continued

    Alternative Treatments for Erectile Dysfunction

    Before Viagra hit the market in 1998, there was no proven treatment for erectile dysfunction that men could take in pill form. Doctors were interested in yohimbe. an herb that increases heart rate and blood pressure. Some doctors prescribed it to their patients in combination with other treatments for erectile dysfunction. Even then it was not a recommended treatment and is still not today. Studies have not proven that it works.

    Men with high blood pressure especially shouldn’t take either the prescription drug or the herb. It can dangerously raise blood pressure.

    Currently, no herb or supplements have been proven to help with erectile dysfunction. Herbs and supplements that some believe are helpful for erection problems include:

    Before trying any alternative treatment, be sure to ask your doctor about it. Herbs and supplements. whether they help with erections or not, have real effects on the body. They could cause dangerous reactions with other medicines you might be taking.

    WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on April 12, 2015

    Sources

    American Urological Association: “Erectile Dysfunction Clinical Guidelines Panel. The Treatment of Organic Erectile Dysfunction: A Patient’s Guide,” 1996; and “AUA Guideline on the Management of Erectile Dysfunction: Diagnosis and Treatment Recommendations,” 2005.

    Gaines, K. Urologic Nursing. February 2004.

    Lamm, S. The Hardness Factor. HarperCollins, 2005.

    Medscape Drug Reference from First DataBank: “Alprostadil Urethral” and “Sildenafil Oral.”

    Vivus, Inc. “Administering MUSE,” 2004.

    В© 2015 WebMD, LLC. All rights reserved.

    Viagra Lowers High Blood Pressure

    Oct 25, 2005 12:49 GMT · By Alina Plesu ·

    Are you having erectile dysfunctions? Use Viagra. Are you hypertensive? Use Viagra. Although the answer to the second question might seem strange to some, apparently it's nevertheless true. The drug that gives older men a few moments of pleasure can also be used to lower blood pressure.

    Baltimore researchers said while Viagra, sildenafil citrate, is more widely known for helping genital blood vessels expand to maintain an erection and, more recently, as a treatment for pulmonary hypertension, it has been thought to have little direct effect on the human heart.

    The recent study suggests that sildenafil weakens the strengthened heart beat caused by chemically induced stress, thereby lessening the excess amount of blood and force used to pump it to the body, according to study senior author Dr. David Kass, a Johns Hopkins cardiology professor.

    Under normal conditions, say the researchers, Viagra has no effect on the heart – it is only when the heart is under stress and pumping with more power.

    This study involved 35 healthy men. They were given dobutamine injections, two of them in three-hour intervals. Dobutamine chemically stresses the heart, making it pump harder. After the first injection the men's heart contractions increased in force by 150%.

    Some patients were given Viagra while others were given a placebo (dummy drug) between the two dobutamine injections. Those given Viagra experienced a 50% drop in heartbeat strength.

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