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Research shows that sildenafil helps the heart muscle relax properly, which could help patients with heart failure due to diastolic dysfunction . Another interesting property is sildenafil's ability to protect the heart from excessive stimulation by adrenaline. Clinical trials will be needed to see which patients might benefit. It's the most speculative use for sildenafil, and it's far from clinical application. A European study of 25 men who had erectile dysfunction but no other circulatory disorders found that blood vessels in the brain responded to stress better after a 50-mg dose of sildenafil. More interesting results were reported by scientists in Michigan, who produced ischemic strokes in rats by temporarily blocking blood vessels. During their recovery, the animals were divided into three groups. One received no treatment, another low-dose sildenafil, and the third high-dose sildenafil. The animals who got sildenafil recovered better, with the highest doses producing the best results. The scientists concluded that the medication actually stimulated the growth of new nerve cells in the brain tissue next to the stroke damage. It's far too early to know whether sildenafil may someday help people with strokes. Although erectile dysfunction and benign prostatic hyperplasia are both common in older men, they are separate conditions. But three 2007 studies report that all of the ED pills may ease lower urinary tract symptoms in men with BPH. This potential benefit appears to depend on inhibiting PDE-5 in the bladder, not the prostate, and it may require daily use of these expensive drugs. Meanwhile, men who use popular and effective alpha blockers for BPH symptoms should get medical clearance before they use ED pills. In particular, the newest ED pills may reduce blood pressure in men taking the older, nonselective alpha blockers. If you get your information about sildenafil from Super Bowl commercials or e-mail spam, you might dismiss it as a lifestyle drug of little real medical importance. In fact, it's a serious prescription medication that has helped millions of men who are distressed by an entirely legitimate medical problem. Because the drug acts on arteries beyond the penis, it can produce various side effects. That means it should only be prescribed by a personal physician who really knows you. And it also means that scientists are investigating uses for the drug in patients with an array of vascular disorders having nothing to do with sexual function. Vardenafil and tadalafil are very similar to sildenafil. They have nearly identical effects on ED as well as similar side effects. Because they are newer drugs, scientists are just beginning to study them for problems that don't involve sexuality. Sildenafil has already been licensed to treat men and women with pulmonary hypertension. Time will tell if any of these drugs will fill other potentials beyond promoting potency. Share this page: Share this page to Facebook Share this page to Twitter Share this page to Google Plus Email this page. Print this page: Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our buy kamagra soft tabs library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Comprehensive, up-to-date information on HIV/AIDS treatment and prevention from the University of California San Francisco. Interactions with Sildenafil (Viagra) and Antiretrovirals. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. Initiate sildenafil at 25 mg buy kamagra soft tabs QOD-QD; adjust dose as indicated; not recommended to exceed 25 mg in a 48 hour period. Initiate sildenafil at 25 mg QOD-QD; adjust dose as indicated; not recommended to exceed 25 mg in a 48 hour period. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. For erectile dysfunction, initiate sildenafil 25 mg every 48 hours and monitor for adverse effects. Manufacturer recommends not to exceed dose of 25 mg every 48 hours. Do not coadminister if using sildenafil for pulmonary arterial hypertension. HIV InSite is a project of the UCSF Center for HIV Information. Copyright 2019, Regents of the University of California. It s a topic many people find difficult or embarrassing to discuss, but it shouldn t be. Erectile dysfunction will affect at least half of all men over the age of 40 at some point in their lives. Erectile dysfunction can present itself due to physical or emotional issues and a quick chat with your doctor to rule out health issues that may viagra for men buy online cause problems with erection could have you back to your old self in no time. This medication is not for everyone and certain health conditions may mean that medications like Viagra and Cialis are not an option but it is a safe and effective route for many. If you re having problems with erectile dysfunction, several medications exist which could have you achieving and sustaining erection for longer periods. Cialis and Viagra are both PDE5 inhibitors used for the treatment of erectile dysfunction (ED). These medications only work when a man is aroused sexually to begin with and are not intended to provide arousal. Each medication has its pros and cons and choosing the right one for you can be relatively easy once you understand what they have to offer. A penile erection usually occurs after sexual stimulation when nitric oxide (NO) is released into the bloodstream. This causes the blood vessels of the corpus cavernosum to dilate due to the accumulation of cyclic guanosine monophosphate (cGMP). cGMP is always present at some levels in the smooth muscles of the penis, but the addition of the nitric oxide causes this chemical level to increase. Phospodiesterase-5(PDE5) is later released to reduce the overall level of cGMP and allows the muscle to return to its relaxed form. Medications such as Cialis and Viagra work by preventing PDE5 inhibitors from working. This allows cGMP to remain in the muscle for a longer period, resulting in more erection time. While many people believe these medications actually cause an erection, they don t. These medications, instead, interfere with a chemical reaction which prevents the erection from happening. Those using medications such as Viagra and Cialis are able to achieve erections and maintain them for longer periods, improving their overall erection strength and time without the need for surgery or assistive devices. While both drugs effectively treat the same issue, no two drugs are alike even when they are designed to treat the same issue. These factors may help you decide which one would work best for you. - Cialis can be taken once daily and will last about 36 hours. - Viagra may be affected by food which can cause decreases in effectiveness. - Cialis is given in a smaller dosage and is also effective for treatment of benign prostatic hyperplasia (BPH). - Those suffering from liver or kidney problems may have to take a reduced dosage of Cialis. - Viagra and Cialis are both available in generic forms at this time. - Viagra works within 30 minutes but should not be taken immediately following a high fat meal or its effects may be lessened. It is best to take this medication on an empty stomach. - Both medications have similar effectiveness with reports of 84% successful treatment with Viagra and 81% effectiveness for Cialis. As with most medication, you ll want to try the lowest dose available first and adjust the dosage to a higher level only if necessary. While these drugs are well tolerated by most men, higher doses may result in unwanted side effects and a larger dose may not be necessary to achieve strong erections. - Cialis may be taken on a daily basis or as needed. People will generally start with a dose of 10mg before sexual activity but a Cialis 20mg dose is the standard. Dosages may be reduced to as low as 5mg if negative side effects are experienced. - When used on a daily basis, Cialis is generally prescribed at an initial dosage of 2.5 mg or 5mg for those with BPH. - Viagra is taken about 1 hour prior to sexual activity on an as needed basis. - Initial Viagra doses are usually prescribed at 50mg but may be increased to 100mg or decreased to 25mg if side effects are experienced. These medications are widely available in store and online but our online pharmacy has some of the lowest prices on Viagra! Shopping with us is as easy as it is convenient and you ll get what you need at a reasonable and affordable price. We have attractive prices that make treating erectile dysfunction affordable and accessible to those who need it. Purchasing your medication through us online is an easy, convenient, and economical option. As with any medication, certain people should not use Viagra or Cialis. The long lasting action of Cialis means it creates a higher risk of drug interactions. Check with your pharmacist before taking this, or any new medication, to be sure your other medications are safe for use with it or if any drug dosages need to be adjusted. - Cialis is not recommended for those who have experienced a stroke or a heart attack in the past 6 months. - Cialis is not recommended for anyone experiencing uncontrolled high blood pressure, or unstable angina. It is also not recommended for anyone who blood pressure that is severely low. - Cialis may be unsuitable for those who have other medical conditions which make sexual activity inadvisable. - Viagra should also not be taken by those who have recently suffered a stroke or heart attack, with uncontrolled blood pressure, low blood pressure, or other heart or vascular problems. - Certain medications may not mix well with Cialis and Viagra. Talk to your doctor or pharmacist before taking any new medication to avoid serious drug interactions. Viagra, Cialis, Levitra and Spedra - How Are They Different? Viagra, Cialis, Levitra and Spedra are some of the most common drugs used to treat erectile dysfunction. While many people may be embarrassed to talk about male impotence or erectile dysfunction, this is a relatively common problem which may affect up to half of men over the age of 40. Most men will experience erectile dysfunction at some point in their life, either temporarily or for longer periods of time, either as a response to physical or emotional issues. These drugs belong to a class known as PDE 5 inhibitors and are used to treat erectile dysfunction caused by both emotional and physical factors. All of these medications can help to produce a sustained erection pill in men as a response to sexual stimulation and arousal. - Also known as sildenafil is the most common drug used to treat erectile dysfunction across the world. Over 45% of all medications prescribed for this issue are sildenafil or Viagra. - This medication is a blue diamond-shaped pill with the tablet strength in mg on one side and the letters VGR on the other. - This medication relaxes the smooth muscle which can be negatively affected by the nervous system s production of nitrous oxide and cyclic guanosine monophosphate. Viagra for men relaxes this smooth muscle by controlling these chemical levels, increases the blood flow to the penis, thereby creating a stronger erection which lasts longer. - Potential side effects can include indigestion, headache, or dizziness but Viagra in Australia is the most popular choice due to overall low rates of intolerance. - Viagra works best on an empty stomach as high fat foods may reduce its effectiveness. - Cialis is also known as tadalafil and works much like Viagra does to achieve a sustained erection. - Cialis takes roughly 15 minutes to begin to work and is effective for up to 36 hours. - It is often considered to be more practical due to the extended effects and ability to eat normally. - Cialis also comes in daily tablet form but can also be used on an as-needed basis. - Cialis can be taken as 2.5, 5, 10, and 20mg tablets. - This medication works in the same way as Cialis and Viagra. - It is an orange pill with Bayer written on one side and the mg strength written on the other. - Levitra takes approximately 30 minutes to an hour to work. - It is faster than Viagra but slower to work than Cialis. - Levitra effects last for approximately 10 hours after taking it. - Those taking this medication often suffer less side effects than with other erectile dysfunction medications. - This medication works in much the same way as sildenafil, tadalafil, and vardenafil. - Spedra is a yellow pill which is oval in shape and carries the word Vivus on one side and the mg strength on the other. - This drug works in as little as 15 minutes but effects are more commonly felt in 20 to 30 minutes. - Spedra lasts for approximately 4 to 5 hours after taking it, making it similar to Viagra. - This medication has a short duration of action in comparison to Levitra or Cialis. - This product is fairly new to the erectile dysfunction list of medications and was approved in 2013. - This drug is thought to be about as safe as Viagra with similar side effects of all three other medications listed. Not much is yet known about its long term use as it has only been on the market for a few years. - Spedra can be taken after eating but this may slow the effects so it is recommended to take it on an empty stomach for it to be its most effective in as short a time frame possible. As with most medications, Cialis, Viagra, Spedra, and Levitra are usually begun on the smallest dosage possible and then increased over time. This will help you find the best dosage possible with the fewest chances of side effects. As with all drugs, there is no one drug that is best for everyone but Viagra is the most popularly prescribed and has been around the longest so its effects are well studied. Spedra and Viagra are great for men who prefer not to have the drug effective in their system for extended period, while Levitra seems to have the least number of recorded side effects. The best drug to use for erectile dysfunction is entirely dependent on an individual s personal requirements. While one medication may work fabulously for someone, it may have no effect on someone else. Specific health issues may make one drug the best option for one person and a bad idea for someone else. All erectile dysfunction medication can cause health problems for those who have suffered a heart attack or stroke in the past 6 months. People who have been prescribed nitrates for cardiovascular disease should not take Viagra, Cialis, Spedra, or Levitra as they can interfere with your heart. In addition to these medications, it is important that those suffering from erectile dysfunction attempt to live as healthy a lifestyle as possible. Reduced stress levels and improved blood circulation may be achieved by adding regular exercise to your daily life and may increase the effectiveness of Levitra, Spedra, Cialis, and Viagra, or may make maintaining an erection a drug free possibility. Reducing and quitting smoking will also go a long way to improve blood flow to the penis and increase these medications desired effects. Finally, these medications are not intended to cause arousal. They are used to help achieve an erection and to extend erection time when sexual arousal and excitement are already present but when health or emotional factors may cause difficulty maintaining an erection. oral suspension (Revatio) 10mg/mL (when reconstituted) Erectile Dysfunction. 1 hr before sexual activity; however, may be taken anywhere from 30 min to 4 hr before sexual activity. Based on effectiveness and toleration, may increase dose to maximum of 100 mg or decrease to 25 mg. IV: 2.5-mg or 10-mg bolus TID if patient is temporarily unable to take PO. Adding Revatio to bosentan does not have any beneficial effect on exercise capacity. Severe (eg, cirrhosis): Consider initial dose of 25 mg. Mild or moderate (Child-Pugh A or B): Clearance reduced, resulting in increases in AUC (84%) and Cmax (47%) compared to age-matched volunteers with no hepatic impairment Severe (Child-Pugh C): Not studied. Mild or moderate (CrCl 30-80 mL/min): No dose adjustment required Severe (CrCl Enter a drug name and sildenafil. Vaso-occlusive crisis (PAH secondary to sickle-cell anemia) Nonarteritic anterior ischemic optic neuropathy (NAION) Warnings. Soluble guanylate cyclase (sGC) stimulators (eg, riociguat); concomitant use can cause hypotension. Coadministration with nitrates (either regularly and/or intermittently) and nitric oxide donors Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitrates A suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined. Elicits vasodilatory properties, resulting in mild and transient decreases in blood pressure. Use with caution in patients with anatomic deformation of penis (eg, angulation, cavernosal fibrosis, or Peyronie disease), conditions potentially predisposing to priapism (eg, sickle cell anemia, multiple myeloma, or leukemia), cardiovascular disease, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors. Pulmonary vasodilators may significantly worsen cardiovascular status of patients with pulmonary veno-occlusive disease. Patient taking alpha blocker should be stabilized before starting phosphodiesterase (PDE)-5 inhibitor, which should be initiated at lowest dose; if patient is already taking optimized dose of PDE-5 inhibitor, alpha blocker should be initated at lowest dose to avoid hypotension. Sudden decrease or loss of hearing, which may be accompanied by tinnitus and dizziness. Viagra: Patients should stop sildenafil and seek medical care if a sudden loss of vision occurs in 1 or both eyes, which could be a sign of nonarteritic anterior ischemic optic neuropathy (NAION); use with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION; patients with a ”crowded” optic disc may also be at an increased risk of NAION; advise patients to seek immediate medical attention in the event of a sudden loss of vision. Viagra: Potential for cardiac risk with sexual activity in patients with preexisting cardiovascular disease; therefore, treatment for erectile dysfunction generally should not be instituted in men for whom sexual activity is inadvisable because of their underlying cardiovascular status. May cause dose-related impairment of color discrimination; use caution in patients with retinitis pigmentosa. Evaluate underlying causes of erectile dysfunction or BPH before initiating therapy. Revatio: In small, prematurely terminated study of patients with PAH secondary to sickle-cell disease, vaso-occlusive crises requiring hospitalization were more commonly reported by patients who received sildenafil than by those randomized to placebo; effectiveness of sildenafil in PAH secondary to sickle-cell anemia has not been established; the clinical relevance to men treated for erectile dysfunction with sildenafil is not known. Revatio: Not for use in children with PAH; increased mortality with increasing doses (hazard ratio 3.5) was observed in randomized, double-blind, placebo-controlled clinical trial of 234 children (1-17 years) with PAH who had mild-to-moderate symptoms at baseline. Revatio: Epistaxis occurred in 13% of patients with PAH secondary to connective tissue disease (eg, scleroderma); this effect was not seen in idiopathic PAH; incidence was also higher in those receiving concomitant PO vitamin K antagonist therapy (9%) than in those not receiving such therapy (2%) Pregnancy & Lactation. Limited published data from randomized controlled trials, case-controlled trials, and case series do not report a clear association with sildenafil and major birth defects, miscarriage, or adverse maternal or fetal outcomes when sildenafil is used during pregnancy; there are risks to mother and fetus from untreated pulmonary arterial hypertension. Pregnant women with untreated pulmonary arterial hypertension are at risk for heart failure, stroke, preterm delivery, and maternal and fetal death. Limited published data from a case report describe presence of sildenafil and its active metabolite in human milk; there is insufficient information about effects of sildenafil on breastfed infant and no information on effects of sildenafil on milk production; limited clinical data during lactation preclude a clear determination of risk of drug to an infant during lactation.
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