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Can i take viagra 12 hours apart: Viagra (Sildenafil) (Injection) – Side Effects, Interactions, Uses, Dosage, Warnings

Sildenafil (Oral Route) Proper Use

Proper Use

Drug information provided by: IBM Micromedex

Use sildenafil exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects is increased.

Special patient instructions comes with sildenafil. Read the directions carefully before you start using sildenafil and each time you get a refill of your medicine.

You may take this medicine with or without food.

If you are using the oral liquid, shake the bottle well for at least 10 seconds before measuring each dose. Use the oral syringe provided in the package to measure each dose. Wash the oral syringe after each use.

This medicine usually begins to work for erectile dysfunction within 30 minutes after taking it. It continues to work for up to 4 hours, although its action is usually less after 2 hours.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.


  • For treatment of erectile dysfunction:


    • For oral dosage form (tablets):


      • Adults up to 65 years of age—50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse. Your doctor may adjust your dose if needed.

      • Adults 65 years of age and older—25 mg as a single dose no more than once a day, 1 hour before sexual intercourse. Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse. Your doctor may adjust your dose if needed.

      • Children—Use is not recommended.

  • For treatment of pulmonary arterial hypertension:


    • For oral dosage forms (suspension or tablets):


      • Adults—5 or 20 milligrams (mg) three times a day. Each dose should be taken about 4 to 6 hours apart.

      • Children—Use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Throw away any unused mixed Revatio® oral liquid after 60 days.

Portions of this document last updated: May 01, 2021

Copyright © 2021 IBM Watson Health. All rights reserved. Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.


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Daily Viagra: Can You Take Viagra Every Day?

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

In developing a satisfying sex life, timing can be everything. That’s especially the case when you’re taking medication to treat erectile dysfunction (ED). Viagra (sildenafil), the first and most popular prescription medication for ED, has a specific window of efficacy after you take it. If you find that you need ED medication daily, you might be wondering if Viagra or generic sildenafil is right for you.

  • Never take Viagra (sildenafil) more than once in a 24-hour period.
  • Viagra might be safe for you to take daily if your healthcare provider says your medical history and current medications don’t pose a conflict.
  • Viagra has a relatively short effectiveness window.
  • Taking it may or may not be convenient for you, depending on a number of factors, including how often you have sex.
  • Other longer-lasting ED medications may be a better option.

Viagra is the brand name of sildenafil, an oral medication used to treat erectile dysfunction (ED).

Viagra is a medication known as a PDE-5 inhibitor. It works by blocking cGMP-specific phosphodiesterase type-5 (PDE-5), an enzyme that causes an erection to subside by encouraging blood to flow out of the penis. When PDE-5 is inhibited, levels of cGMP remain elevated, which relaxes smooth muscle and encourages blood vessels to widen (a process known as vasodilation). That makes blood flow more freely, including to the penis.

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Viagra doesn’t work instantly: You must feel sexually aroused for it to work.

First: Never take more than one dose of Viagra per 24-hour period.

It may be safe to take Viagra every day if your healthcare provider believes daily use is right for you. Depending on your health, your healthcare provider may not recommend that you take Viagra every day.

Viagra usually starts to work in about one hour and is effective in the body for six to eight hours.

This narrow “effectiveness window” requires you to do some planning to sync your medication to your sex life—which isn’t always possible or convenient. And if you miss that window, you can’t take more Viagra for another 24 hours.

If you want more flexibility, consider using Cialis (tadalafil), which is longer-lasting than Viagra. It’s available in four doses—2.5 mg, 5 mg, 10 mg, and 20 mg—and is effective for 24 to 36 hours after you take it. Additionally, the two lower doses are actually approved for daily use. That can help increase sexual spontaneity.

If your healthcare provider determines it’s appropriate for you, Cialis can be a win-win. But the choice between Cialis and Viagra depends on how you and your partner plan to use ED medication.

When determining whether you should take daily ED medication, talk with your partner—and a healthcare provider—about which ED medication is safe and makes sense for you. It’s helpful to ask yourself the following questions:

If you’re having sex frequently—say, multiple times a week or even every day—taking daily Cialis might be the option that makes sense for you. If you’re having sex less frequently, you might find that taking Viagra as needed is convenient.

Because of Viagra’s relatively short efficacy window, it tends to be an “on-demand” medication—you need to be fairly sure that sex is a possibility within the next few hours, and be sure to have the medication with you to take within a few hours of sexual activity. Because it works for a full day to a day-and-a-half, Cialis can accommodate more spontaneity.

If you’ve experienced unpleasant side effects from Viagra, such as headache or flushing, taking a lower dose of daily medication might help ameliorate that.

Cialis and Viagra aren’t safe for everyone. For example, people taking nitrates for certain heart conditions, or riociguat for the treatment of pulmonary arterial hypertension, should never take Viagra. And Cialis may not be safe for people who take medications for high blood pressure or to treat an enlarged prostate, or who consume substantial amounts of alcohol. To learn more, read important safety information for Viagra and Cialis.

How Often Can You Take Sildenafil?

In 30 seconds…

Sildenafil is a medication which you can take regularly. It is safe to take every day, starting at 25mg or 50mg per dose with the option to go up to a 100mg dose for those who need it. If you have no problematic pre-existing health issues and you’re not taking other ED medications at the same time, you can take Sildenafil several days in a row. If you have the time and energy, that is!

Erectile dysfunction (ED) is extremely common, yet it can shake any man’s confidence. There is a stereotypical view of men’s sexual urges – that all men want sex all the time. This generalisation can make life especially challenging for the 40% of men who have difficulty getting, and keeping, an erection before they hit 40, and over 50% of men who have some difficulty after 40.

A man may fear judgement, or worry that their partner doesn’t feel attractive if their interest in sex – or ability to have sex – changes. ED is often a taboo subject, or at least a subject that you don’t wish to discuss every time you try to have sex. If you’re looking for medication for erectile dysfunction, Sildenafil is likely to be one of the drugs you’re researching, alongside the famous branded drug, Viagra. 

One of the most common questions is about how often you can take Sildenafil. Sex can be pre-planned or spontaneous, and most of us would like the option for sex to be either. Flexibility and variety are important elements of your sex life. Fortunately, Sildenafil can be taken every day, so there’s no need to ration your amount of between-the-sheets action! But there is a daily dose maximum of 100mg.

About Sildenafil and Viagra

Viagra has been popular for decades, and recently Pfizer’s patent for the drug expired – allowing a generic unbranded medication, Sildenafil, to be produced and sold by accredited online pharmacies. Sildenafil is the active ingredient in Viagra, so it’s exactly the same – aside from the brand name. This means it can be taken just as often as Viagra – every day, if you’re seeking the desired effects this often. 

Viagra and Sildenafil are both reliable, safe, and officially-approved medications. Due to the fact that Sildenafil is a PDE5 inhibitor, it causes blood vessels to expand and relax. For this reason, it was originally developed as a drug for cardiac conditions. However, the benefits for erectile dysfunction were soon understood and the medication was pushed to the front line of the battle against ED.

When your brain sends pyschosexual signals down your spinal cord, this encourages an erection. The penis retains the increased blood within it and stays temporarily stiff. Sildenafil acts on the enzymes responsible for muscle contraction within the blood vessels; allowing better blood flow to – and within – the penis. Thus, making erections easier to achieve and maintain if you are sexually aroused.

How Often Should You Take Sildenafil in a Day?

While it’s possible to take Sildenafil every day, there is a restriction on the daily dosage. The maximum dose within a 24-hour period would be 100mg. In any case, studies have shown that a higher dose than 100mg in one day doesn’t have any added benefit – and could increase the chances of side effects.

The most common dosage is 50mg, and this has sufficient effect for the huge majority of men who take Sildenafil for ED. On the rare occasion that 50mg is insufficient or inappropriate, Sildenafil can also be taken in 25mg or 100mg doses. Consult a Manual clinician if you’re in doubt about which dose suits you.

The 50mg dose is usually sufficient to make it easier to gain and maintain an erection for 4-5 hours. If you take Sildenafil, it’ll start to work within approximately 60 minutes. So aside from keeping your Sildenafil close by or in your bedside draw, you don’t need to plan very far in advance before sex – which gives you extra flexibility and peace of mind. Even if you’re a man with a very active sex life, you should be covered.

Another popular ED medication is Cialis – or Tadalafil, the unbranded version of Cialis. This is another PDE5 inhibitor, so it works in a similar way to Sildenafil. However, it gets to work quicker and it can last for up to 36 hours. It’s nicknamed the “weekend pill” for this reason. 

If you’re thinking of taking Tadalafil, wait 24 hours after taking Sildenafil – and vice versa. Multiple ED medications should not be taken at the same time. And there’s no need to try: it won’t help.

“With great power comes great responsibility”

Luckily, most men experience no side effects when they take Sildenafil or Tadalafil. And if side effects do occur, they’re generally very mild – issues like facial flushing or dizziness. 

However, you should always be open and honest in the medical questionnaire before progressing with your treatment. For example, if you’ve had a cardiac issue such as a stroke or heart attack in the previous 6 months, PDE5 inhibitors like Sildenafil and Tadalafil should be avoided. It’s important to give a true account of your health and medical history – to allow your clinicians to supply safe medication for you.

Furthermore, the fact that Sildenafil is an approved medication for ED and used around the globe shouldn’t deter you from reading the accompanying patient information leaflet. Always arm yourself with the information, and remember that everybody’s response to medication is slightly different.

Key Takeaways

Sildenafil can be taken every day, up to the recommended maximum dosage of 100mg. It helps men with erectile dysfunction enjoy more adventure and freedom – because it is a highly-effective and minimally-disruptive medication that can get to work in less than an hour. Whether you go for non-branded Sildenafil medication or the famous Viagra drug, both options are safe, approved, and often very effective – though you’ll still need to be relaxed and sexually aroused for an erection to occur.

For lots of men in the UK, Sildenafil offers an important helping hand. Stress hormones are shown to interfere with a man’s ability to reach an erection, so just knowing it’s nearby can reduce the anxiety about sexual performance – making erections achievable and sex more enjoyable. You can take Sildenafil every day if you need to – or keep it on hand for the occasions when you need assistance.

It’s the active ingredient in Viagra and clinically proven to be highly effective by increasing blood flow into the penis.

I Took Viagra Every Day for Two Weeks and This Is What Happened

According to Viagra’s official website, men should avail themselves of the little blue pill no more than once a day. So that’s exactly what I did: I took Viagra no more than once a day—only I did so for exactly two weeks straight.

Now, I realize it may sound a bit excessive to be ingesting the world’s top erectile-dysfunction pill as if it were everyday Ibuprofen, but I was determined to find out what it was like. Would I turn into a sex god? Would my mood soar? Would I hallucinate? Would the downward blood flow affect my brain? Well, there was only one way to find out.

Some relevant backstory: I’m 40 years-old and thankfully still very sexually active, and I’ve been experimenting with Viagra for many years (though only sparingly). But for this article I was definitely entering unchartered waters. Nervous? A little. Excited? Definitely. More than anything I was curious about what it would be like to walk through the world at full sexual charge. Here’s what I learned. And for more advice, check out the ways to spice up your sex life.

Viagra comes in three different sizes: 25mg, 50mg, or 100mg. In the past, I’ve found that 25mg always did the job just fine. However, my journey begins with a bottle of the 100mg tabs which I’ve chosen to cut into thirds. (A full 100mg tablet is pretty hardcore. According to one writeup on littlebluepill.com, “it will give you a full Ginsu carving knife that, if put to ultimate use, will render her suitable for burial in a Y-shaped coffin.”)

During my 14-day experiment, there were a few nights when sex was on the cards and I happened to have had one too many drinks. As I expected, the dose certainly did the trick—and then some. In fact, I found myself to be very prone to sudden, rock hard erections for most of the following day. The reason? Viagra doesn’t stop working after four hours. Rather, its effectiveness drops by 50 percent. Another four hours and it drops by 50 percent again.

Even at my usual 25mg dose, I still woke up each morning with enough Viagra in my system to result in a penis so hard a cat couldn’t scratch it. (For more ways to improve your sexual health, here are the 11 all-natural ways to get a rock hard erection.)

During the two weeks I spent taking Viagra, I couldn’t help but notice that my erections felt harder, fuller, and more abiding over the course of an evening of sex. However, according to urologist Dr. Arthur Burnett with Johns Hopkins, I might be tricking myself. Burnett says guys like me who have no physical problems achieving and maintaining an erection are basically throwing their money away by using Viagra recreationally.

“If erections are really intact, Viagra does not make a better erection,” he says. Could that mean that a mental rather than a physical problem was making my natural erections seem less impressive than chemically aided ones?

Stress, depression, relationship trouble, low-self esteem, and sexual performance anxiety often get the better of erections. They’ve certainly been known to get in the way of some of mine. Psychotherapist, sex counsellor, and author Ian Kerner PhD suggests that Viagra can help in these instances.

“I do find a higher percentage of men are dealing with sexual anxiety and sexual problems related to erectile quality and so there are more men dealing with situational ED and taking Viagra,” he says. “The effect often for these men is a firmer, more consistent and dependable erection.”

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When I took the Viagra, I experienced flushing: a warm feeling in my cheeks and ears that was also accompanied by a notable redness. Another unfortunate side effect of dilated blood vessels was the sudden and severe nasal congestion that made it impossible to both breathe through my nose or smell my partner—things that I really like to do when I’m having sex. (To mitigate this, I learned to employ a nasal spray with oxymetazoline hydrochloride when popping my pill.)

In 2015, a meta-analysis of 150 trials determined that while Viagra is the most effective of the various ED drugs on the market, it also has the highest incidence of side effects—headache, upset stomach, vision loss, blue-tinged sight, back pain, muscle pain, nausea, and dizziness, just to name a few common ones. Another, rarer side effect can be having a rock hard erection that doesn’t abate. The medical name for a perma-stiffy is called priapism. While priapism might sound appealing to a guy interested in having his best sex, it’s important to know that an erection that refuses to away can cause permanent damage—including amputation. And yes, that is one of the 20 craziest side effects of common drugs.

I realized that what and how much I ate had an effect on how quickly the Viagra went to work. On an empty stomach, I was feeling flushed and—if turned on—sporting an erection within twenty minutes. If, however, I’d eaten a burger and fries, it was more like forty. This is confirmed by the company’s website, which says that a fatty meal can lengthen the amount of time Viagra takes to work. No word on what happens if you combine Viagra with the 7 foods that are proven to boost your libido.

I also noticed a couple of other benefits from taking so much Viagra, including shorter refractory time (meaning: the length of time between ejaculating and being able to have sex again). “Some have used [Viagra] to enable faster recovery of erectile ability after ejaculation,” says Dr. Burnett, thereby backing up my observation. In fact, Dr, Burnett’s views on the recreational use of Viagra by men without ED are perfectly encapsulated by a 2003 study entitled: “Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time.”

Not having control over my orgasm has rarely been a personal issue. I chalk it up to my discovery of masturbatory edging as a young teen. That said, I noticed that, during this experiment, I really had to make an effort to bring myself to orgasm—despite having a throbbing, long-lasting erection that felt both great to my and my partner.

This phenomenon was looked into back in 2005 when researchers sought to find out if Viagra also helped with premature ejaculation. The study concluded that Viagra “increased confidence, the perception of ejaculatory control, and overall sexual satisfaction, and decreased the refractory time to achieve a second erection after ejaculation in men with PE.” Another study from 2007 demonstrated that greater ejaculatory control was more than just a perception and proved that Viagra can be both effective and safe in the treatment of PE. Talk about getting plenty of bang for your buck. Of course, if this doesn’t work, learn the 5 easiest ways to make sex last (much) longer.

With great power comes great responsibility. And if you’ve got a penis like a crowbar, increased ejaculatory control, a mind less distracted by performance anxiety—and the refractory time of a horny fifteen year old—you may run the risk of your partner wanting or needing to tap out at a certain point.

“I want you to come now,” is basically a nice way of saying, “That’s enough of that, I’m bored/chafed/exhausted/too busy to do this all day long.”

During my experiment, this line was said to me on numerous occasions. How long people like to have sex for is incredibly varied, of course, but, according to a 2008 study in the Journal of Sexual Medicine, sex therapists defined intercourse lasting 1 to 2 minutes as “too short,” 3 to 7 minutes as”adequate,” 7 to 13 minutes as “desirable,” and 10-30 as “too long.” In my case, the more time went on, the earlier these cease and desist requests came in. And here are some other warning signs your partner might not be enjoying sex quite as much as you are.

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Given what Viagra, taken recreationally, can do—and did for me during a very fun two week experiment—you’d be forgiven for jumping to the conclusion that upping the dose means upping the good times. But take heed: unless you really suffer from ED, you probably don’t need it. And if you’re taking it because you’re drinking too much, well, I’d drink less than try to fight it with the pill.

And, for what it’s worth: the Internet is rife with accounts of men who overdid it with Viagra and ended up suffering heart attacks, death, and, in the case of a 66-year old farmer in Colombia, requiring emergency surgery on a penis gone gangrenous in the wake of a Viagra overdose. (Truth.)

The biggest, hardest, proudest erection in the world isn’t worth taking risk of that happening.

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Viagra: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on June 10, 2020.

1. How it works

  • Viagra is a brand (trade) name for the drug sildenafil. Sildenafil blocks the action of an enzyme known as cGMP-specific phosphodiesterase type-5 (PDE-5). This enzyme breaks down cGMP, a substance that induces smooth muscles to relax. Blocking PDE-5 means increased levels of cGMP within the smooth muscles which promotes muscle relaxation and vasodilation (a widening of blood vessels).
  • High levels of PDE-5 are found in the penis, lungs, and retina. PDE-5 is also found throughout the body within the smooth muscle cells of blood vessels and muscles. Viagra is approved to treat erectile dysfunction (impotence) in men. Another brand of sildenafil (Revatio) is approved to treat high blood pressure associated with pulmonary arterial hypertension (PAH).
  • Viagra belongs to the class of medicines known as PDE-5 inhibitors.

2. Upsides

  • Viagra is approved to treat erectile dysfunction (ED), also known as impotence, in men. It increases blood flow to the penis following sexual stimulation and allows men to keep an erection hard enough for sex.
  • Viagra only works following sexual stimulation. It works within 30 to 60 minutes, but may be taken up to four hours before sexual activity.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Dyspepsia, flushing, headache, indigestion, muscle or back pain and visual disturbances.
  • Other side effects include a drop in blood pressure, insomnia, nasal congestion or a runny nose and nosebleeds. Sudden hearing loss has also been reported. Some people taking Viagra have had bleeding events; however, it has not been established if this is actually related to Viagra use.
  • Rarely, may decrease blood flow to the optic nerve causing sudden vision loss. The risk is greater in people aged older than 50, or with diabetes, heart disease, high blood pressure, high cholesterol, who smoke, or with certain pre-existing eye problems.
  • Rarely, may cause other side effects or lead to painful erections lasting longer than four hours. See your doctor immediately if this happens.
  • May not be suitable for some people including those with angina, chest pain, or other heart conditions, liver or kidney problems, blood or bleeding disorders, stomach ulcers, certain eye conditions, or a physical deformity of the penis (such as Peyronie’s disease).
  • May interact with some medications including certain antibiotics and antifungals, herbal remedies, HIV medicines and drugs used in the treatment of high blood pressure or prostate disorders.
  • Viagra offers no protection against sexually transmitted diseases.
  • Viagra is available as a generic under the name sildenafil.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Viagra is used to treat erectile dysfunction (ED), but will not have any effect in the absence of sexual stimulation. A headache, stomach upsets, and flushing are the main side effects.

5. Tips

  • Do not take Viagra more than once daily.
  • The usual recommended dosage is 50mg (range 25mg to 100mg), taken when needed, an hour before sexual activity. However, it may be taken anywhere from 30 minutes to four hours before sexual activity. Do not exceed the maximum recommended dose.
  • Do not consume grapefruit or grapefruit products while taking Viagra.
  • Always talk to your doctor before taking ANY medication for ED. Some ED medications are not suitable for men with certain medical conditions, and your doctor can advise you on an alternative.
  • Call your doctor immediately if you experience dizziness or feel nauseous during sexual activity, or develop pain, numbness, tingling in your chest, arms, neck, or jaw.
  • Do not take Viagra if you are also taking a nitrate drug (such as nitroglycerin or isosorbide dinitrate/mononitrate) for chest pain or heart problems. Do not take Viagra with recreational drugs such as “poppers”. Taking these substances together can cause a sudden and dangerous drop in blood pressure.
  • Always buy your ED medications from a reputable supplier as there are a lot of counterfeit products on the market.
  • Certain lifestyle and psychological factors, such as smoking, drinking, and stress, can impact on ED. Eliminating these – for example, staying more active, losing weight if you are overweight, reducing alcohol intake, stopping smoking and reducing stress – may also help improve ED.
  • Never take other ED medications at the same time as taking Viagra. Do not take Viagra while taking Revatio and vice-versa.
  • Seek urgent medical advice if an allergic reaction, sudden vision loss or painful erections lasting more than four hours occur.
  • Drinking alcohol after taking Viagra may lower blood pressure and decrease sexual performance.

6. Response and effectiveness

  • Peak plasma concentrations of Viagra are reached within 30 to 120 minutes of a single dose. The onset of effect takes about 30 to 60 minutes alongside sexual stimulation.

7. Interactions

Medicines that interact with Viagra may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Viagra. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Viagra include:

  • alpha-agonists (eg, clonidine, methyldopa)
  • alpha-blockers (eg, alfuzosin, doxazosin, prazosin, tamsulosin, or terazosin)
  • antibiotics, such as clarithromycin, erythromycin, metronidazole, norfloxacin, rifabutin, rifampin, or tetracycline
  • antidepressants, such as desipramine, sertraline, or St. John’s Wort
  • antifungal medications, such as itraconazole, ketoconazole, or voriconazole
  • blood thinners, such as warfarin
  • cystic fibrosis medications, such as ivacaftor
  • epilepsy medications, such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, or primidone
  • other erectile dysfunction medications (eg, alprostadil, Cialis, sildenafil, vardenafil)
  • heart medications, such as amlodipine, amiodarone, atenolol, bosentan, candesartan, captopril, clonidine, diltiazem, enalapril, irbesartan, losartan, nifedipine, propranolol, sotalol, or verapamil
  • hepatitis medications, such as boceprevir and simeprevir
  • HIV medications (eg, atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, etravirine, ritonavir, nevirapine, saquinavir, or tipranavir)
  • nitrates (eg, amyl nitrate, isosorbide dinitrate, isosorbide mononitrate, or nitroglycerin)
  • others, such as aprepitant, butalbital, cimetidine, cyclosporine, or imatinib.

In addition, taking Viagra with too much alcohol can lead to orthostatic hypotension, which is a drop in blood pressure when you go from a sitting or lying down position to standing. Symptoms include a headache, dizziness, or fainting when standing.

Antacids, such as magnesium hydroxide or aluminum hydroxide may also affect the absorption of Viagra. Grapefruit juice may also increase the side effects of Viagra.

Note that this list is not all-inclusive and includes only common medications that may interact with Viagra. You should refer to the prescribing information for Viagra for a complete list of interactions.

More about Viagra (sildenafil)

Consumer resources

Other brands
Revatio

Professional resources

Related treatment guides

References

Viagra [Package Insert]. Revised 12/2019. Pfizer Laboratories Div Pfizer Inc. https://www.drugs.com/pro/viagra.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Viagra only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2021 Drugs.com. Revision date: June 10, 2020.

Medical Disclaimer

Sildenafil: MedlinePlus Drug Information

Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.

If you are taking sildenafil to treat erectile dysfunction, follow your doctor’s directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.

If you are taking sildenafil to treat PAH, follow your doctor’s directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well for 10 seconds before each use to mix the medication evenly. Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer’s directions to use and clean the oral syringe. Do not mix the liquid with other medications or add anything to flavor the medication.

If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.

If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.

Sildenafil 50mg vs 100mg | LloydsPharmacy Online Doctor UK

Sildenafil is a popular erectile dysfunction (ED) tablet, taken by men who find it hard to get an erection on their own. It is the generic version of Viagra, which means it contains exactly the same active ingredient (sildenafil citrate) and works in the same way.

Sildenafil is available in three different dosages: 25mg, 50mg and 100mg. If you are considering taking Sildenafil, but you aren’t sure which dosage is right for you, read on.

Getting treatment for erectile dysfunction

Erectile dysfunction is a condition that affects the majority of men at some point during their lives. It is associated with ageing and is more common in older men, but it can also be a symptom of an underlying condition such as depression, heart disease or diabetes.

If you are having trouble getting erections, it’s important to consult a doctor first, as it could be a sign of a serious health issue.

If your doctor believes treatment is appropriate, they can prescribe a tablet such as Sildenafil. This comes in three different dosages, the two most popular being Sildenafil 50mg and Sildenafil 100mg.

Considering ED treatment?

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Taking Sildenafil 50mg

The most commonly prescribed Sildenafil dosage is 50mg. If you are using Sildenafil for the first time, it is very likely that you will be prescribed this dosage.

You should use Sildenafil 50mg in the following way:

  • Take only one tablet at a time
  • Take the tablet one hour before you plan to have sex
  • Do not eat a heavy meal beforehand
  • Do not drink more than one or two units of alcohol beforehand
  • Do not take more than one tablet in 24 hours

Bear in mind that Sildenafil, and all other ED tablets, will only work if you become sexually aroused; it is not, in itself, an ‘aphrodisiac’. When successful the effects of Sildenafil 50mg should last for 4 to 6 hours; during this time, you should be able to attain an erection whenever you become sexually aroused.

Sildenafil 50mg didn’t work for me. What should I do?

In controlled studies, Sildenafil 50mg was found to be effective in 74% of men with erectile dysfunction.  As such, it’s likely that you will experience success with this treatment.

If, however, you find that Sildenafil 50mg does not work for you the first time you take it, there are a few things you can do:

  1. Try Sildenafil on seven more occasions, making sure you take it exactly as recommended (doctors recommended trying ED tablets eight times before upping the dosage or changing to another treatment)
  2. If you are still having no success, talk to the doctor who prescribed you about switching to Sildenafil 100mg. If you ordered via Online Doctor, send us a message via your Patient Record
  3. Consider trying a different ED tablet such as Cialis.

You should never alter the dosage of your Sildenafil without talking to your doctor.

Taking Sildenafil 100mg

It may be that your doctor initially prescribes you Sildenafil 100mg, however it is more common to start on the 50mg dosage and work up to 100mg if you have no success.

Sildenafil 100mg should be taken in exactly the same way as the smaller dosage tablet: one hour before sex, and on a relatively empty stomach. There is not a great deal of difference between Sildenafil 100mg and 50mg, although in clinical trials, the higher dosage was seen to be 82% effective, as opposed to 74% effective.

The effects of Sildenafil 100mg do not last longer than the 50mg dosage, but they tend to be stronger. This means that side effects can be more pronounced as well.

Side effects associated with Sildenafil include headache, facial flushing, nausea, dizziness and stuffy nose. They will not affect everyone but, as previously stated, they are more likely when you are taking Sildenafil 100mg.

Sildenafil 100mg didn’t work for me. What should I do?

If you have found Sildenafil 100mg to be ineffective, you should talk to your prescribing doctor. They will probably encourage you to try it a few more times before you move onto something else.

Because 100mg is the highest dose available, you should never ‘double up’ on tablets or take more than one in 24 hours. Sildenafil 100mg is the highest safe dosage you can take – if it is ineffective, you should try another ED treatment.

Alternative treatments for ED include tablets such as Cialis and Spedra, which contain different active ingredients but have a similar effect to Sildenafil.

In some cases, if the root of your ED is psychological, counselling may be helpful. ED caused by physical injury or an underlying condition, meanwhile, may improve with focused treatment, or lifestyle changes such as weight loss and exercise.

To find out more about Sildenafil, visit our online clinic.

References

www.medicines.org.uk/emc/medicine/30907
www.medicines.org.uk/emc/product/9472/pil#gref

90,000 Side effects that have changed the lives of millions of men

One of the main conditions for a harmonious and long-term relationship between a man and a woman is the physical and sexual health of the partner. However, daily troubles, conflicts at work, stressful situations, the desire to achieve success in life sometimes affect both the physical and sexual well-being of the stronger sex. And now, to the unpleasant situations at work and daily stress, problems in the intimate sphere gradually begin to be added, which sometimes fall on the heads of men with a diagnosis of “erectile dysfunction”.In this context, it should be remembered that the problem of erectile dysfunction can be eliminated with the help of modern effective drugs with a favorable safety profile.

The term “erectile dysfunction” was coined in 1988 by the US National Institutes of Health and replaced the outdated concept of “impotence”. Erectile dysfunction is defined as the inability to achieve and / or maintain an erection sufficient for intercourse.In the structure of sexual disorders, this pathology occupies a leading place in terms of the frequency of occurrence and social significance [1, 2].

A NEW ERA IN TREATMENT OF ERECTILE DYSFUNCTION

A revolutionary event in the treatment of erectile dysfunction was the appearance in 1998 of the drug sildenafil citrate, which became known under the trade name Viagra ® [3].

Fun Facts:

  • The drug Viagra® has received worldwide fame due to side effects.The results of clinical trials of sildenafil, conducted in 1992 with the participation of several thousand patients with coronary heart disease, disappointed the developers of the drug Viagra P. Dunn and A. Wood, however, its side effect, which was reported by many participants in the study, namely: a pronounced effect on blood flow in the area of ​​the pelvic organs (including the penis), prompted the idea of ​​using this drug for the treatment of erectile dysfunction [4];
  • later, sildenafil also showed efficacy in the treatment of pulmonary hypertension [5];
  • in 1998Viagra ® was mentioned in connection with the award of the Nobel Prize in Physiology and Medicine [6];
  • Viagra ® was awarded the Galen Prize in 1999 – in the Netherlands, in 2000 – in France and Great Britain, in 2001 – in Canada [7].
  • in 2001, Pfizer was awarded the Queens Award for Enterprise (Great Britain) for the discovery and development of Viagra ® [8];
  • in 2003 Viagra ® won in the nomination “The brightest brand of the pharmaceutical market of Ukraine” [9].

Sildenafil is a selective inhibitor of cyclic guanosine monophosphate specific phosphodiesterase type 5 (PDE5), in the corpora cavernosa, where PDE5 is responsible for the breakdown of cyclic guanisine monophosphate (cGMP). The blockade of this enzyme leads to the accumulation of cGMP, which causes relaxation of smooth myocytes, ensuring an erection.

Today it is sildenafil that is the gold standard in the treatment of erectile dysfunction. This is primarily due to its high efficacy, as well as to the oral non-invasive form of sildenafil [10].

It should be noted that the effect of the drug, that is, the onset of an erection, begins 14–20 minutes after taking it [11], and the duration of action of Viagra® 100 mg in most men is 12 hours [12]. Viagra® remains effective 4 years after the start of regular use, so more than 94% of patients who took part in a clinical study of the effectiveness of Viagra®, after 4 years of regular use, noted that they were satisfied with the treatment result and significantly increased the level of sexual activity [13 ].With Viagra®, men can have sex more often and for longer. Viagra® 100 mg increases the duration of erection in men with erectile dysfunction, without changing the characteristics of sperm, and has a positive effect on the resumption of erection after ejaculation in the presence of continuous sexual arousal [14]. It should be noted that Viagra ® has a favorable safety profile. Thus, the incidence of acute cardiovascular diseases in patients with erectile dysfunction who took Viagra ® does not exceed that in the general population [2].

Viagra ® – do not forget about physical pleasure!

The Pfizer representative office has developed an educational site for Ukrainian consumers, which is dedicated to the problem of erectile dysfunction – top-result.com.ua . On the site you can get information on possible problems with erection and ways to solve it.

LIST OF USED LITERATURE

1. Pushkar D.Yu., Rasner P.I. Drug treatment of erectile dysfunction: preliminary comparison of existing methods // Farmateka.- 2004. – 3.4 (82): 31–35. Available at http://medi.ru/doc/260122.htm from 09/01/2014.

2. Gorilovsky L.M., Lakhno D.A. Erectile dysfunction // Russian medical journal. 2005; 10: 653-656. Available at http://rmj.ru/articles_3734.htm from 09/01/2014.

3. FDA Home Drug Databases Orange Book. Available at http://www.accessdata.fda.gov/ scripts / cder / ob / docs / obdetail.cfm? Appl_No = 020895 & TABLE1 = OB_Rx dated 08/28/2014.

4. Katzenstein L. Viagra: The Remarkable Story of the Discovery and Launch.New York, NY: Medical Information Press. 2001.

5. Avdeev S.N. Pulmonary hypertension in chronic respiratory diseases. Atmosphere. Pulmonology and Allergology. 2010; 2: 2-10.

6. Robert F. Furchgott, Louis J. Ignarro, Ferid Murad. The Nobel Prize in Physiology or Medicine 1998. Press Release. Available at http://www.nobelprize.org/ nobel_prizes / medicine / laureates / 1998 / press.html on 30.07.2014.

7. Prix Galien – winners. Available at http: // www.prixgalien.com/en/05/02/ winners-sorted-by-medical-field.htm from 08/29/2014.

8. T. Harding Royal birthday award for makers of Viagra. Available at http://www.telegraph.co.uk/news/ uknews / 1316876 / Royal – birthday -award-for-makers-of-Viagra.html on 28.08.2014.

9. Brands of the Ukrainian pharmaceutical market. Pharmacy weekly. Available at http://www.apteka.ua/online/19779 dated 07/31/2014.

10. Mazo EB, Dmitriev DG, Gamidov SI et al. Pharmacotherapy of erectile dysfunction // Russian medical journal.2001.9: 1077–78. Available at http://rmj.ru/articles_1461.htm from 09/01/2014.

11. Padma-Nathan H., Stecher V., Sweeney M., et al. Minamal time to successful intercourse after sildenafil citrate: results of a randomized, double-blind, placebo-controlled trial // Urology. 2003.62 (3): 400-403.

12. Moncada I., Jara J., Subira D., et al. Efficacy of sildenafil citrate at 12 hours after dosing: Reexploring the therapeutic window // Eur Urol. 2004; 46 (3): 357-61.

13.McMurray J.G., Feldman R.A., Auerbach S.M., et al., For the Multicenter Study Group. Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction. Ther Clin Risk Manag. 2007; 3 (6): 975-981.

14. A. Aversa, F. Mazzilli, T. Rossi, et al .; Effects of sildenafil (Viagra) administration on seminal parameters and post-ejaculatory refractory time in normal males; Hyman reproduction. 2000; 15 (1): 131-134.

Svetlana Shelepko

Information for the professional activities of medical and pharmaceutical workers.

Viagra® (sildenafil), film-coated tablets, 50 mg and 100 mg each; 1 or 4 tablets per pack. Brief instructions for medical use of Viagra®. Indications. Treatment of erectile dysfunction, which is defined as the inability to achieve and maintain an erection of the penis necessary for successful intercourse. Method of administration and dosage. The drug is administered orally. The recommended dose of Viagra® is 50 mg and is used, if necessary, approximately 1 hour before intercourse.The maximum recommended dose is 100 mg. The maximum recommended frequency of drug administration is 1 time per day. Contraindications Hypersensitivity to the active substance or any of the auxiliary components of the drug; simultaneous use with nitric oxide donors (such as amyl nitrite) or nitrates in any form is contraindicated. Sildenafil is contraindicated in men who are not recommended for sexual activity. Side effects. The most commonly reported adverse reactions were headache, flushing, dyspepsia, visual disturbances, nasal congestion, loss of consciousness, and impaired color perception.Features of the application. Since sexual activity is accompanied by a certain risk from the heart, before starting any treatment for erectile dysfunction, the doctor should assess the state of the patient’s cardiovascular system. Treatments for erectile dysfunction, including sildenafil, should be used with caution in patients with anatomical deformities of the penis (such as angulation, cavernous fibrosis, or Peyronie’s disease) or in patients with conditions that cause priapism.Interaction with other drugs. In the study of in vitro, sildenafil is a weak inhibitor of cytochrome P450 isoforms. Studies in vivo: sildenafil affects the metabolism of nitric oxide / cyclic guanisine monophosphate (cGMP), it was found that this drug potentiates the hypotensive effect of nitrates, therefore, its simultaneous use with nitric oxide donors or with nitrates in any form is contraindicated. Vacation category. On prescription. Before using the drug, you must read the instructions for medical use and consult your doctor.Information for doctors and pharmacists. Intended for distribution at seminars, symposia, conferences on medical topics. Registration certificates No. UA / 0313/01/02, No. UA / 0313/01/03 of 15.04.2013. For additional information, please contact the Representative Office of Faizer H. Si. Pi. Corporation “in Ukraine: 03680, Kiev, st. Amosova, 12, business center “Horizon Park”, tel .: (044) 291-60-50. WUKVGR0214010. Printed with support from Pfizer H.C.P. Corporation.

Viagra Pfizer

Tsikava information for you:

90,000 Twenty years of use of sildenafil in urology | G.G., Tur E.I.

The article presents a literature review of clinical studies of the efficacy of sildenafil in various categories of patients suffering from erectile dysfunction and premature ejaculation.

Erectile dysfunction (ED) is a man’s inability to achieve and maintain an erection necessary for adequate intercourse. This problem is widespread throughout the world. Thus, a number of studies conducted in Europe and America have shown that in the United States from 20 to 30 million men suffer from this disease [1, 2].A 2005 study in the male population in the Netherlands showed that the annual detection rate of ED (per 1000 men) is 19.2 people [3]. As a multifactorial disease, ED deeply affects not only the physical and material aspects of a man’s health, but is also a powerful source of psychological dissatisfaction, as well as an important factor in the development of depression and family problems [2, 4, 5]. Many specialists in various fields and patients are used to believing that ED is just a psychological aspect that negatively affects the quality of life.However, this statement is unfair, given the fact that, according to the European Association of Urology (EAU), ED is often inextricably linked with metabolic, cardiovascular, neurogenic diseases and is often their most important companion [6, 7].
Erection is determined by the ability of trabecular smooth muscle fibers to adequately relax, which increases the compliance of the cavernous sinusoids,
promotes their rapid blood filling and expansion. Due to the increase in the volume of sinusoids, the dorsal and emissary veins are compressed, as a result of which the outflow of blood from the organ temporarily stops [8, 9].In this case, the intracavernous pressure increases up to 100 mm Hg. Art., which provides an erection adequate for the initiation and conduct of a full sexual intercourse. The functional capabilities of the cavernous tissue, like most tissues and cells of the body, depend on the work of the sympathetic and parasympathetic nervous systems, as well as on vasoactive substances secreted by the endothelium. Under the influence of visual, tactile and other types of sexual stimulation, nitric oxide is produced in the terminals of the sympathetic nerve fibers and the endothelium of the corpora cavernosa.Nitric oxide, with the help of secondary mediators – cyclic adenosine monophosphate (c-AMP) and, mainly, cyclic guanosine monophosphate (c-GMP), responsible for smooth muscle relaxation, leads to the opening of potassium and closure of calcium membrane channels, as well as the utilization of calcium ions into the endoplasmic reticulum … Such a decrease in the concentration of calcium ions in the cytoplasm promotes relaxation of smooth muscle cells of the sinusoids of the corpora cavernosa, which ensures an erection [10-13]. Subsequently, c-GMP is catabolized by a specific substance – phosphodiesterase type 5 (PDE-5), this helps to restore the muscle tone of the walls of the cavernous sinusoids and regression of erection.Violation of this mechanism at one stage or another can lead to ED.
Depending on the type of such a disorder, three types of ED are distinguished: psychogenic, organic (neurogenic, hormonal, arterial, cavernous and drug-induced) and mixed, which is the most common [14].

Treatment

All forms of ED are based on damage to a single molecular mechanism of relaxation of the smooth muscle cell of the cavernous tissue of the penis, as described above.For this reason, the algorithm of therapeutic measures associated with this disease is more or less general for different groups of patients and is not specific. Considering that ED is usually associated with concomitant diseases (endocrine and metabolic disorders (diabetes mellitus), cardiovascular diseases, etc.), the first stage of treatment is the achievement of adequate control over intercurrent pathology [15].

In general, ED is successfully amenable to symptomatic correction, but it cannot be completely eliminated.The only exceptions are psychogenic and post-traumatic forms in young patients, as well as ED caused by hormonal disorders (hypogonadism, hyperprolactinemia, etc.) [16, 17]. This is only a limited list of diseases leading to erectile dysfunction with an expected favorable prognosis. Most patients are likely to receive lifelong non-specific treatment, regardless of the type of disease. The results of treatment tactics depend on the effectiveness, safety, cost of the chosen technique, as well as the preferences and interest of the patient [18].According to the EAU, treatment of ED should begin with lifestyle changes and addressing possible organic and psychogenic causes of the disease. In case of insufficient or complete ineffectiveness of these measures, you can start drug treatment. The drugs of choice in this case are type 5 phosphodiesterase inhibitors (IFDE-5) (grade of recommendation 1a, EAU recommendations 2017). The fact is that the substances of this group prevent the capture and subsequent splitting of c-GMP, the very substance that is responsible for the blood filling of the corpora cavernosa and erection as such.Thus, IFDE-5 provide erectile activity of the penis, which is possible in this case only after sexual stimulation, without which, with an insufficient concentration of nitric oxide in the synaptic terminals, the launch of the cascade of reactions that provide an erection would be impossible [19].
Sildenafil (Viagra ® ) was the very first and main IFDE-5 on the drug market. In 1998, it was approved for use by the FDA (Food and Drug Administration), and since then has been the drug of choice for a huge number of men with ED around the world.To date, in the baggage of scientific knowledge there are data from more than 67 clinical randomized placebo-controlled and post-marketing studies on the efficacy and safety of sildenafil (Viagra) [20]. In our review, we will focus on the most basic of them. So, one of the first and most important works are two studies conducted under the leadership of I. Goldstein in 1998 and formally combined into one [21]. The first study (the first part of the research program) was a standard, randomized, placebo-controlled, double-blind study, which included 532 people who took sildenafil in different dosages – 25, 50, 100 mg or placebo for 24 weeks.The second part of the program included 329 men who also received sildenafil or placebo, but the sildenafil was started at 50 mg, which at the follow-up visit could be reduced or increased by 50%, until a maximum single dose of 100 mg was reached. After 12 weeks. the study design changed, became open, and continued for another 32 weeks. Patients could withdraw from the study if the drug was poorly tolerated or ineffective. Treatment results were assessed based on the IIEF (International Index of Erectile Function) questionnaire.It turned out that in the fixed-dose group, taking sildenafil contributed to a significant (p 90 106
The results of another placebo-controlled study conducted by F. Montorsi et al. [22]. The 12-week study included 514 men with ED of various etiology – 32% had organic ED, 25% psychogenic and 43% mixed. The average age of the patients was 54 years. All patients were randomized and randomly divided into 4 groups, depending on the dose of sildenafil: 25, 50, 100 mg and placebo.The effectiveness of the treatment was assessed, as in the previous work, in accordance with the data of the IIEF questionnaire. It turned out that sildenafil significantly contributed to the improvement of these functions, while they were significantly better in the groups taking higher doses of the drug. Significant improvements were noted in parameters such as erectile function, orgasmic function, satisfaction with intercourse, and overall sexual satisfaction (p 90 106
These data indicate that sildenafil is not only effective against various forms of ED and is well tolerated, but it also remains effective for several hours after administration.This is confirmed by a group of scientists led by I. Moncada [23], who published the results of a study involving 40 patients with ED. Patients who took 100 mg of sildenafil, according to the conditions of the study, were to have intercourse after 1 hour, and then 12 hours after taking the drug. As a result, it turned out that 97% of men were able to successfully achieve and maintain an erection throughout the entire sexual intercourse one hour after taking Viagra ® , and after 12 hours this ability remained in 74% of people, which indicates the high efficacy of the drug for half a day.Due to the good tolerability of sildenafil, 38 out of 40 people were able to complete the study.
The safety issue of sildenafil occupies a separate place in the discussion of it as the drug of choice for ED. Sildenafil (Viagra ® ) is a drug with a 20-year history of presence on the world market, and, perhaps, based on this circumstance, there are many prejudices and doubts about its safety. The work of A. Morales et al. [24] demonstrates good tolerability of sildenafil, and most side effects are generally mild to moderate and transient.Among more than 3,700 men with ED and long-term use of sildenafil at a dose of 25 to 100 mg, 16% reported headache, 10% – facial flushing and fever, 7% – dyspepsia, 4% – nasal congestion and 3% – visual impairment (slight and transient change in color perception or increased sensitivity to light). These adverse events mainly occurred in patients who received the highest dose of the drug – 100 mg, and were less pronounced with the use of 25 or 50 mg. Minor visual impairments are probably associated with the combined inhibition of the phosphodiesterase type 6 enzyme in the retina.However, no chronic or serious episodes of visual impairment have been reported. It is noteworthy that visual side effects are equally pronounced and common in patients with diabetes mellitus and patients without diabetes mellitus [25]. However, it must be emphasized that men with retinal disorders are advised to consult an ophthalmologist before prescribing sildenafil and other IFDE-5.
Adverse events associated with the vascular system (nasal congestion, headache, skin redness, and fever) are also usually mild and temporary in most men.The proportion of cases of serious cardiovascular complications (acute coronary syndrome) is approximately 4.1 per 100 people per year among patients taking sildenafil, and 5.7 per 100 men per year taking placebo. The average number of acute myocardial infarctions averaged 1.7 and 1.4 per 100 people per year taking sildenafil and placebo, respectively [24]. It should be noted, however, that patients taking nitrates (nitroglycerin) are excluded from most clinical trials.
Previously, it was believed that sexual activity itself makes a significant contribution to the development of acute myocardial infarction in patients with a history of cardiovascular disease. However, this statement was refuted because the risk of such a heart attack was only 0.9% of the 856 men included in the study by J.E. Muller [26]. Thus, in the general population, the risk of serious cardiovascular complications due to sexual activity is even lower (one in a million healthy men).According to the Framingham National Statistics Center for Health and Clinical Cardiology, the number of deaths among ED patients who do not take IFDE-5 is 170 per million people per week. For this reason, it is clear that sildenafil is safe for most men, despite common misconceptions. However, before prescribing sildenafil, a thorough examination of the cardiovascular system and an assessment of the risk associated with cardiovascular disease is necessary.At the request of the medical community, the American Health Association has developed clinical guidelines for the use of sildenafil [27]. This guideline instructs patients with cardiovascular disease to perform a treadmill test before prescribing sildenafil, as well as monitoring blood pressure during the first time the drug is taken.
Sildenafil is well absorbed in the intestine and reaches its maximum concentration in the period from 30 to 120 minutes (on average 60 minutes) after administration.The drug is eliminated mainly through the liver, the half-life from the body is on average 4 hours. The initial recommended dose of the drug is 50 mg, it must be taken about 1 hour before the expected sexual intercourse. To improve the desired effect or reduce the number of adverse events, the dose can be increased to 100 mg or decreased to 25 mg, respectively. Given this circumstance, the manufacturer of sildenafil (Viagra), Pfizer ® , produces the drug in dosages of 25, 50 and 100 mg, and the number of tablets in a package varies from 1 to 8, which can be convenient from a practical and economic point of view.It should also be noted that sildenafil (Viagra ® ) can be combined with the intake of alcoholic beverages, however, the manufacturer recommends avoiding high doses of alcohol in order to achieve the maximum possible positive effect of the drug.
Currently, the issue of restoring erection in patients who underwent radical prostatectomy (RP) for prostate cancer is very relevant. It should be noted the high value of drug therapy in this group of patients due to the fact that with the invention of drugs of the IFDE-5 group, they have a chance to maintain a sufficient postoperative quality of life.This statement is true despite the fact that patients with RP and those taking IDE-5 have similarly modest results in the treatment of ED. The fact is that for many years before the introduction of sildenafil (Viagra), the only way out for such patients was surgical treatment, which, in addition to the high cost, is associated with a considerable number of complications, both medical and technical. That is why IFDE-5 drugs are considered the method of choice in the treatment of ED in men after nerve-sparing RPE (NS-RPE), and only if they are insufficiently effective, it is necessary to resort to other methods of treatment [28, 29].Thanks to a number of clinical studies, it was possible to determine the main parameters influencing the success of therapeutic measures in patients with ED, which developed as a result of NS-RPE, first of all, the age and the quality of nerve-saving performed during the operation [28-30].
The analysis of works by F. Montorsi et al. in the period from 1998 to 2004 [31], demonstrated a higher efficacy of sildenafil in patients after NS-RP than in patients after RP without nerve sparing. The authors found with high statistical reliability that in the former, sildenafil was effective in 35–75% of cases, while in the latter, in 0–15% of cases (OR = 12.1; 95% CI 5.5–26.6).Moreover, to maintain an erection in the postoperative period, it does not matter whether the patient has performed a bilateral or unilateral nerve-saving technique. The authors noted that with the unilateral technique, the effectiveness of sildenafil (Viagra) was in different studies from 10 to 80%, while with the bilateral technique it was from 46 to 72% (OR = 2.21; 95% CI 0.75-6.54) … Researchers have concluded that sildenafil helps achieve and maintain an effective erection in about 1/3 of patients with RP. However, for this it is sufficient to have at least one preserved nerve bundle.The doctor needs to motivate the patient and explain to him the importance of being prepared for a possible long-term rehabilitation of erectile function by titrating the dose of sildenafil up to 100 mg.
Another important work, from our point of view, is the study carried out in the USA in 2004 [32]. Scientists approve the concept of early use of sildenafil in the postoperative period. It is believed that this approach is valid for the prevention of cavernous fibrosis, which usually accompanies patients with RP and, therefore, worsens the prognosis for the rehabilitation of erectile function.The study included 40 patients who were prescribed 50 mg (first group) or 100 mg (second group) of sildenafil on the day of removal of the urethral catheter after RP. Before the operation, all patients underwent a biopsy of the corpora cavernosa, after 6 months. after the start of sildenafil administration, the procedure was repeated. In the 100 mg group, there was a significant increase in the content of smooth muscle fibers of the cavernous tissue. In patients who received 50 mg of the drug, there was no difference in the number of smooth muscle fibers before and after surgery, i.e.That is, the state of the cavernous tissue after the treatment remained unchanged and did not undergo the development of cavernous fibrosis, and even improved at a dose of 100 mg. Thus, the administration of sildenafil in the early postoperative period not only promotes clinical recovery of erection after RP, but also prevents cavernous fibrosis, in other words, ensures the invariability of the penile tissue responsible for erectile function.
A double-blind, randomized, placebo-controlled study conducted in 2008.[33] included patients who underwent RP with bilateral nerve-sparing and had a normal erection before surgery. After 4 weeks. After NS-RPE, patients were randomly divided into 3 groups, depending on the dose of sildenafil taken: 50 mg, 100 mg and placebo. The drug was suggested to be taken once a week for 36 weeks, followed by an 8-week “clean” period without therapy aimed at restoring an erection. As a result, it turned out that a total of 27% of patients from both groups noted the appearance of spontaneous erections, whereas in the placebo group, such erections occurred only in 4% of participants (p = 0.0156).Thus, the authors of the work conclude that long-term routine use of sildenafil in patients with bilateral NS-RPE promotes the restoration of spontaneous erections in the postoperative period.
Another study by D.J. In contrast, Kim et al., And published in 2016 [34], found no advantage of routine long-term use of sildenafil compared to on-demand drug use in patients with ED after NS-RPE.
It should be noted that sildenafil is also effective in a difficult category of patients with neurogenic ED.This is supported by a number of studies. Thus, D. Ohl [35] presents data from a large-scale placebo-controlled study involving 248 men with spinal trauma and ED. The study included patients with both incomplete and complete spinal cord injury, diagnosed at least 6 months in advance. prior to inclusion in the study. The starting dose of the drug was 50 mg and then could be changed to 25 or 100 mg. The duration of the drug was 6 weeks, followed by a 2-week “clean” period, after which the patients resumed the 6-week drug or placebo.At the end of the work, the authors noted a statistically significant improvement in all parameters of sexual life, according to the IIEF questionnaire, in patients taking sildenafil, in contrast to those taking placebo, including patients with complete spinal cord injury (p
Another important, in our opinion, work, G. Lombardi et al. [36], it is interesting that the authors, in addition to patients with spinal trauma, managed to collect data on patients with other neurological diseases, such as Parkinson’s disease, multiple sclerosis, etc.After conducting a detailed analysis of the literature related to the use of all types of IFDE-5 in this category of patients, scientists have found that only sildenafil has a sufficient evidence base for its effective use in patients with Parkinson’s disease (p
Another important point of application of sildenafil (Viagra) is premature ejaculation. The data available to date indicate the wide involvement of biological and psychogenic factors (anxiety, increased excitability of the penis, dysfunction of 5-HT serotonin receptors) in the etiology of the disease [37].Premature ejaculation almost always negatively affects the quality of sexual life, lowers self-confidence and worsens relationships with a partner, and can also cause mental disorders, anxiety, false shame and depression [38, 39]. One of the few effective treatments for premature ejaculation today are serotonin reuptake inhibitors. However, in order to achieve maximum satisfaction from sex life, an active search for other methods of treatment is currently underway.So, in the EAU recommendations in 2017, it is proposed to use IFDE-5 both in combination with antidepressants and as monotherapy. It should be noted that, as with ED and with premature ejaculation, sildenafil is the drug with the greatest amount of clinical data in comparison with other drugs of the same group. For example, a study by A. Salonia et al. [40], is devoted to the comparison of the combined use of sildenafil + paroxetine and monotherapy with paroxetine.The study included 80 people who were divided into 2 groups. The first group consisted of 40 people who took paroxetine 10 mg routinely for 21 days, and then 20 mg paroxetine on demand 3-4 hours before the expected sexual intercourse for 6 months. In the second group, 40 patients also received routinely 10 mg of paroxetine at the beginning of treatment, and then, on demand, 20 mg of paroxetine and 50 mg of sildenafil for six months. As a result, it turned out that the patients of the first group noted the lengthening of the intravaginal latent time of ejaculation from 0.33 ± 0.04 min to 4.2 ± 0.03 min (p 90 106
In conclusion, it should be noted that sildenafil (Viagra ® ) is a cost-effective drug compared to other treatments.This is evidenced by data from a systematic review of the literature published in 2013 by A.L. Martin et al. [41]. In their work, the researchers carried out a systematic assessment of studies published in the MEDLINE and EMBASE databases in English between 2001 and 2011.The authors assessed the following parameters: cost of treatment, value for money, cost of treating a disease, cost of treating complications, associated with illness and treatment loss of job, patient’s desire to pay for treatment and purchase of drugs, etc.It turned out that sildenafil (Viagra ® ) in total has the most favorable cost in comparison with other IFDE-5 (tadalafil, vardenafil, avanafil) and is preferred by patients. The authors of the study found that among the groups of patients with ED due to diabetes mellitus, arterial hypertension and spinal trauma, sildenafil is considered the most economically viable compared to other types of treatment.

Conclusion

Thus, evaluating the literature data, we can conclude that sildenafil (Viagra ® ) is a highly effective and safe drug for patients with various types of ED and various concomitant diseases (diabetes mellitus, cardiovascular diseases, multiple sclerosis, spinal trauma) and after RPE.20 years after the appearance of sildenafil (Viagra ® ) remains the method of choice in the treatment of erectile dysfunction, preserves and restores the quality of life for men.

This article was written by Pfizer. The author did not receive financial or editorial support from Pfizer when preparing the article. The article expresses the position of the author, which may differ from the position of Pfizer.

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Culture | June 2021

Like anyone who has seen the Celebrity Death Bets , Waiting , or Van Wilder I can attest that Ryan Reynolds knows how to laugh on the big screen.However, scripted roles are not the only arena in which Reynolds’ razor-sharp comedic talent shines. The actor has made a name for himself with his poignant social media humor in recent years, inflicting devastating burns on his fans, talking about the messy realities of fatherhood, and getting adorable injections to his wife. Blake Lively along the way.

If you’re having a bad day or just want to laugh until your sides hurt, these tweets are exactly what the doctor ordered. And when you want to make your relationship as easy as Ryan’s, arm yourself with 13 of the best marriage tips from Blake Lively and Ryan Reynolds!

It is best to find money in unexpected places.And parenting is pretty cool, too, according to Ryan. And when you want to hack a little more, 20 things everyone secretly finds funny will definitely do the trick.

Ryan never stops asking important questions in the house of God. Do you think this is fun? Just wait until you’ve read 30 fun words for solving everyday problems.

Parenting can be stressful. Fortunately, Ryan always has a backup plan. And for even more poignant humor, enjoy 75 jokes so bad they are actually funny.

Even in Ryan and Blake’s marriage, there’s only one celebrity in the spotlight. If you laughed at this tweet, you will love 40 such fun facts that are hard to believe.

Ryan knows that the most important thing when looking after young children is to keep them safe. And what is safer than immobility? And when you want to hack your friends, is the best way to make anyone laugh .

Hey, women aren’t the only ones who have a hard time giving birth.If it made you smile, you’ll be at the seams when you see Madame Tussaud’s 30 worst celebrity waxes.

Ryan’s daughter clearly prioritizes: singing, dancing, parricide.

If you could get renewals from your college professors, that would be smart. your partner should provide them, too.

Being a good parent is about sharing important experiences with your kids, but hey, Disneyland is expensive.

If the game doesn’t work, Ryan can always arrange a murder with his donut-based heists.And if you want to make your diet healthier, start with the 10 healthiest carbs that won’t ruin your 6!

Parenting means sacrificing for the sake of children, especially when it comes to money and freedom.

Ryan knows that gas and fuel mean the same thing, he just doesn’t care.

Ryan spares no words, especially if you’re a 6-year-old idiot.

To paraphrase the actor: let go (this was the life you enjoyed before the kids).

We hope this clever birthday tweet didn’t leave Blake with a broken heart.And if you want to take inspiration from celebrity romances, start with these 30 best celebrity relationship quotes.

Humor, mild sociopathy and deep love for the Cyrus clan seem to be inherent in the Reynolds family.

It’s so cute when babies learn new skills like vampirism.

As Ryan makes clear, the only thing better than raising children is knowing that you will never have to do it again.

Ryan knows how important it is to make sure everything in the bedroom is fair.Even if this is not your bedroom.

The actor was not going to let this fan think that he was the last time he made fun of his social media presence.

Raising children is great, but being able to do whatever you want all the time is clearly better.

Ryan is not going to let his career get in the way of his family responsibilities, even if it means booking last-minute flights to Copenhagen for Christmas. And if you feel the need to keep something a secret, start with 13 secrets to keep from your partner at all times.

Getting kids safe on the road starts with a lot of practice, which Ryan and his slightly bruised daughter know all too well.

Note to myself: obsolete slang will not pass in the presence of Ryan Reynolds.

Inner peace and inner torment begin in one place.

If you are hired to coach for life, obviously no amount of coaching can help you.

As Ryan pointed out in this hilarious tweet, having fun and traumatizing your loved ones and Club Med employees can go hand in hand.

Keeping toxic people out of your life isn’t always easy, but Celebrity Death Betting Star knows when it’s needed.

According to the actor, just because you love someone unconditionally does not mean that you have to look like an idiot.

Fun Facts Quiz Questions And Answers

It is important for a child’s development that parents talk to them, especially if this is the last thing they hear before daddy leaves for good, as this funny tweet says.And when you want to take your own parenting game up a notch, start with 20 easy ways to be a (much) better dad.

For more amazing secrets on how to live your best life, Click Here Subscribe to our FREE Daily Newsletter !

cure for prostatitis folk remedies

cure for prostatitis folk remedies

cure for prostatitis folk remedies

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What is a folk remedy for prostatitis?

Faced a problem, a “sluggish” member, or even during the act, he “fell” out of the blue.Because of what, the depression from its fiasco almost began. On the one hand, there are many emotional problems in life that come back to the head during an act. I decided to try some erection pills as an aid. I started, of course, with Viagra, so that I had something to compare, I liked it, but I can afford it, I searched the internet for similar “Generic Viagra” on all sites, tried it – there were side effects, asked the pharmacist what are the most popular drugs for potency, but cheaper. As a result, I met the recommendations of the drug Urotrin, tried it – and stopped my search on it.The composition of the preparation is completely vegetable: ginseng, amaranth and pumpkin seeds, royal jelly, shark liver extract, etc. And since there are no complex chemical components, then there is no serious side effect. This drug helped me a lot. Urotrin is a really worthwhile drug. These are my observations.

Effect of the use of prostatitis medicine folk remedies

Clinical approbation of the drug Urotrin was carried out in a hospital on the basis of the sanatorium in St.Pyatigorsk in 2013. Men aged 38 to 73 years, diagnosed with chronic prostatitis, took part in clinical trials for 1 month.

Expert opinion

I had some pretty serious problems with what is below the belt. It seemed to be physically healthy, but as it came to sex, everything was at half past five at once. I didn’t know what to do anymore. I asked for advice on the Internet, anonymously, there I was recommended “Urotrin”. Now, not only is everything in order with an erection – I can wife for several hours in a row! Hope it helps you.

How to order

In order to place an order for a medicine for prostatitis folk remedies, you must leave your contact information on the site. The operator will contact you within 15 minutes. Will clarify all the details with you and we will send your order. In 3-10 days you will receive the parcel and pay for it upon receipt.

Customer Reviews:

Marina

To start a course of treatment with UROTRIN for prostatitis, you do not need a doctor’s consultation.The absence of side effects and contraindications is the main advantage of the drug. The advantages of the complex are: versatility for any age; 100% natural composition; strengthening the heart muscle; compatibility with alcoholic beverages. Taking UROTRIN sachet for prostatitis can be combined with other drugs. Since the drug does not contain hormones, GMOs and dyes, it will not cause allergic reactions or nausea. The unique formula of the product is patented and has no analogues.Among the components of the complex there are no chemicals, flavor enhancers. The ingredients of the drug against impotence are natural extracts: amaranth seeds; bearberry; pumpkins; shark liver; centaury; maral antlers. Amaranth seeds help to strengthen the immune system. Now your body can easily cope with dangerous viruses! Bearberry will help cleanse the organs of toxins, the tannins of which restore the flora. The pumpkin removes the secretory fluid. In addition, this substance eliminates lymph congestion.Shark liver stimulates the formation of platelets and leukocytes, contains vitamins. The best way to protect against impotence is the deer antlers extract. A centaury will help get rid of unpleasant sensations. Royal jelly will restore the functioning of the nervous and cardiovascular system.

Vika

After 40 years, many men are faced with diseases that cause many problems. The most common “male disease” is prostatitis. Treatment should be started as early as possible to avoid serious complications, including impotence.The effective drug Urotrin will help prevent the disease or completely recover from it.

Nobody is immune from prostatitis. So these symptoms overtook me, it is ok not to go to the toilet, there is nothing to think about sex and in general, I even got depressed. Urotrin returned me to normal life, the effect appeared after five days of use. Took it according to the manufacturer’s scheme, twice a day before meals. The contents of the sachet must be diluted in half a glass of water (stir thoroughly).The regimen is quite simple: for 5 days we take two sachets a day, then a break for two days, and then again for 5 days, and again a break, and so on for a month. It has already become easier for me, but I will definitely drink the whole complex. Where to buy folk remedies for prostatitis? I had some pretty serious problems with what was below the belt. It seemed to be physically healthy, but as it came to sex, everything was at half past five at once. I didn’t know what to do anymore. I asked for advice on the Internet, anonymously, there I was recommended “Urotrin”.Now, not only is everything in order with an erection – I can wife for several hours in a row! Hope it helps you.

The most effective treatment options! Further, it will be discussed about the most correct and effective natural methods of treating prostatitis in men. Ingredients for preparing the compositions can be prepared by yourself (collect, process and repair), or you can purchase it at the nearest pharmacy. Recipes. Folk remedies for prostatitis are the most effective recipes for men at home.Treatment and prevention of chronic prostatitis and prostate adenoma. The best folk remedies for prostatitis. Top 16. Men’s health websites and forums describe various ways to combat the disease. But how to choose the most effective folk remedies for prostatitis, which are guaranteed to improve the condition? Below are only. Treatment of prostatitis with folk remedies, at home. Prostatitis is an inflammation of the prostate gland that occurs due to a violation of blood microcirculation in the muscles of the pelvis and pelvic floor or an infectious process in its tissues.It is accompanied by dysuria, pain during. List of effective folk remedies for treating prostatitis at home. 25 best tools for confrontation including. Treatment of prostatitis with folk remedies at home. Victor Rumyantsev. Inflammation of the prostate gland affects many men. Treatment of prostatitis with folk remedies has been used for a long time. … Modern medicines prescribed by doctors also often contain natural ingredients, which speaks of the effectiveness of plants.Folk remedies for prostatitis in men: principles of treatment, recipes. … But you will always be able to supplement pharmacy medicines with folk remedies in order to enhance the effect, to get the best results with such a complex treatment. Symptoms of prostatitis. In most cases, people are very addictive with. Treatment of prostatitis with folk remedies is allowed in two cases: as an addition to the course of medications for acute inflammation and as maintenance therapy for chronic inflammation. The effectiveness of folk remedies for prostatitis, the pros and cons of alternative therapy, how to treat.Treatment of prostatitis with folk remedies has been carried out for hundreds of years. … It must be remembered that there is no universal cure for the disease. The doctor selects a course of therapy for each of his patients. It is possible to treat prostatitis in men with folk remedies only by. They take a traditional medicine for prostatitis in the morning and in the evening, 60 ml throughout. To cure prostatitis with a folk remedy, a rich decoction is prepared from pine, fir or juniper needles. Chopped twigs (200 g).

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Clinical testing of the drug Urotrin was carried out in a hospital on the basis of a sanatorium in Pyatigorsk in 2013.Men aged 38 to 73 years, diagnosed with chronic prostatitis, took part in clinical trials for 1 month.

cure for prostatitis folk remedies

Faced a problem, “sluggish” member, or even during the act, he “fell” for the wrong reason. Because of what, the depression from its fiasco almost began. On the one hand, there are many emotional problems in life that come back to the head during an act. I decided to try some erection pills as an aid.I started, of course, with Viagra, so that I had something to compare, I liked it, but I can afford it, I searched the internet for similar “Generic Viagra” on all sites, tried it – there were side effects, asked the pharmacist what are the most popular drugs for potency, but cheaper. As a result, I met the recommendations of the drug Urotrin, tried it – and stopped my search on it. The composition of the preparation is completely vegetable: ginseng, amaranth and pumpkin seeds, royal jelly, shark liver extract, etc. And since there are no complex chemical components, then there is no serious side effect.This drug helped me a lot. Urotrin is a really worthwhile drug. These are my observations.

The duration of the course of treatment with Levofloxacin for prostatitis is usually 28 days. In the first decade they perform. The pharmacological form of antibiotics and the dosage of the drug for prostatitis should be chosen by a specialist, depending on the severity of the pathology. Levofloxacin for prostatitis: treatment regimen and features of the drug. … The dosage of tablets and solution for injection is the same…. If a doctor has prescribed Levofloxacin for prostatitis, the course of treatment lasts three to four weeks. How to take Levofloxacin for prostatitis: dosage and treatment regimen. The antibiotic Levofloxacin for bacterial prostatitis helps to get rid of the cause of its development. The drug effectively fights infectious pathogens that have managed to get into. Whether or not Levofloxacin helps with prostatitis, what should be the dosage of the drug, what is in its composition, and how many days the course of treatment lasts…. How to take Levofloxacin for prostatitis: treatment regimen. Levofloxacin for prostatitis: how and when to use? Treatment may vary depending on the severity of the disease and the severity of symptoms. For inflammation of the prostate, I was prescribed Levofloxacin in the maximum dosage. I drank strictly according to the instructions, and after 2 weeks I felt myself. The course of treatment with Levofloxacin for prostatitis is indicated for all types of anaerobic bacteria. … The dosage for prostatitis and the pharmacological form of the antibiotic is selected depending on the severity of the pathology.The course of treatment, dosage and instructions for the use of Levofloxacin for prostatitis. … Treatment with Levofloxacin for prostatitis is prescribed on the basis of diagnostic studies and an assessment of the severity of the disease. In any case, the dosage and duration of the course is determined. The course of treatment with Levofloxacin for prostatitis is indicated for all types of anaerobic bacteria.