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There is still some controversy as to whether it should be available or not. "In studies, the drug was found to increase the number of sexual events that would occur by one per month," says Patel. "viagra shops near me Lots of people said this is rubbish - if it only increases sexual events by one per month, what's the point in taking it? But for some women with very severe HSDD, one per month could be the difference between never having sex and having a sexual relationship with their partner." To date, then, we don't have a true 'female Viagra' - or even a real definition of what this would mean. If you're experiencing arousal difficulties, it is worth seeing your GP as a starting point, and perhaps a psychosexual specialist further down the line. There are various treatments that might help, whether physical or psychological. However, the answer probably doesn't lie in a little blue pill from Boots. We're sorry, but we cannot locate the page you are looking for. You may have followed an outdated link or perhaps you typed in an invalid URL (web address). One of the following steps may help you find what you're looking for. Click the back button on your browser to return to the previous page. United Way of Idaho Falls & Bonneville County 330 Shoup Ave #202 Idaho Falls, ID 83402 208-522-2674 Login. © 2020 United Way of Idaho Falls & Bonneville County . Viagra is the brand name for a medicine known as Sildenafil which has been proven to be effective for the treatment of erectile dysfunction. Sildenafil is the active ingredient and has also been available since 2013 as a generic drug. A generic drug contains the same active ingredient as a branded drug and is medically equivalent but can be produced by any generic manufacturer. History – Pfizer Loses Patent in 2013 on Viagra Allowing Generic Viagra (Sildenafil) Viagra was one of the viagra super active 50 mg first treatments to be approved for the treatment of erectile dysfunction and has been used by men across the world for over a decade with excellent results. Pfizer was the original manufacturer for Viagra and developed a patent on the product in 1996. Originally Viagra was used for the treatment of heart disease, but during clinical trials it was noticed that it also helped treat erectile dysfunction. In 1998, Pfizer received FDA approval to license the product for the treatment of erectile dysfunction. In 2013, the Pfizer patent on Viagra ended in the EU, allowing generic manufacturers to start producing their own version. The generic version of the drug is known as Sildenafil which is the active ingredient in Viagra. The name Viagra is still a brand name which only Pfizer can use. So effectively in the market the drug can be bought as either the branded Pfizer product Viagra, or the generic drug Sildenafil. Pfizer, as well as holding the rights to use the brand name Viagra, has a patent on the unique blue diamond appearance of Viagra. For many people, Viagra is known as “the little blue pill” and this is still associated with only the branded Pfizer product. The appearance of the product is purely cosmetic and has no medical difference. Sildenafil is a generic drug which means that its price is not controlled by a single manufacturer. As several manufacturers produce Sildenafil, the market is very competitive which has helped drive down the price substantially. Viagra on the other hand is produced only by Pfizer who control the price without any competition. As Viagra is a well known brand name, Pfizer are able to charge a premium price. However, as Sildenafil becomes more well established it is expected that demand for the branded Viagra product will decrease and the price for Viagra will drop as a consequence. Sildenafil 50mg Viagra 50mg 4 tablets ?19.99 ?34.99 8 tablets ?29.99 ?69.99 12 tablets ?39.99 ?104.99 16 tablets ?49.99 ?139.99 24 tablets ?69.99 ?189.99 28 tablets ?79.99 ?209.99 32 tablets ?89.99 ?239.99 64 tablets ?139.99 ?479.99. Viagra has been proven to be a very effective treatment for erectile dysfunction with over 80 percent of men finding it works for them. Sildenafil is produced by several manufacturers and contains the exact same medical ingredient and dosage as the branded Viagra counterpart. To receive market approval, a generic medicine must be ‘bioequivalent’ to the branded product which ensures that the generic product has the same effectiveness. As a result you can be confident that the Sildenafil sold in the UK is as effective as the branded Viagra tablets. Most of the men I see with erectile dysfunction (ED) have ED as a result of a long-standing medical condition such as diabetes or hypertension. Over time these chronic illnesses have slowly compromised the small blood vessels in the penis in much the same way that small vessels of the heart get diseased. The result is a reduced or abnormal vascular performance of the penis. Viagra, Cialis, Stendra, and Levitra all try to stimulate normal blood flow to the penis by relaxing the penile arteries. The side effects of headache and stuffy nose often occur because blood vessels in the head and nose can do the same thing as a result of the medication. If the blood vessels are damaged enough, pills like Viagra won’t work. When Viagra doesn’t work, there are a number of options that essentially fall into three main categories: Vacuum Erection Devices (VED) Penile Injections (Trimix) Inflatable Penile Prosthesis (IPP) A vacuum erection device is an external device that pulls blood into the penis to obtain an erection. Additionally, many insurances have stopped paying for it. I have very few patients who actually like this device. Penile injections are a very good way to obtain an erection. They work to stimulate the blood vessels of the penis but in a slightly different and in a more direct way than the pills. A special combination of medications called Trimix is prescribed that compounding pharmacies can fill. One vial can deliver 20-30 injections, so the overall cost is comparatively low. The medication is administered in a clinical setting or office for the first time, but then the patient is able to inject himself (or have his partner do it) at home. It works for about 95% of men, but many do grow tired of the injection process. Because of dissatisfaction with the vacuum erection device and Trimix, an inflatable penile prosthesis is an excellent choice. I often do this procedure for men who have erectile dysfunction as a result of prostate cancer treatment. In this surgery the patient has two cylinders inserted in the penis that replace the spongy tissue that collects blood in a normal erection. A reservoir of water is placed next to the bladder and a little pump is put in the scrotum. When an erection is desired, the patient simply squeezes the pump and an erection is obtained. There is a 1-5% risk of infection after this procedure, which means that the device would have to be removed or replaced if that were to occur. Despite this small risk, an inflatable penile prosthesis has the highest satisfaction rates and the highest partner satisfaction rates of all the treatments discussed. In closing, if the little blue pill isn’t working like you hoped it would, make an appointment with your doctor and talk about your options. 20 mg, round, white, imprinted with RVT 20, pfizer. 25 mg, diamond, blue, imprinted with Pfizer, VGR 25. 50 mg, diamond, blue, imprinted with Pfizer, VGR 50. 100 mg, diamond, blue, imprinted with Pfizer, VGR 100. 100 mg, diamond, blue, imprinted with Pfizer, VGR 100. 100 mg, diamond, blue, imprinted with Pfizer, VGR 100. 25 mg, diamond, blue, imprinted with Pfizer, VGR 25. 50 mg, diamond, blue, imprinted with Pfizer, VGR 50. What is the most important information I should know about oral sildenafil? Some medicines can cause unwanted or dangerous effects when used with sildenafil. Tell your doctor about all your current medicines, especially riociguat (Adempas). Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems, including nitroglycerin, isosorbide dinitrate, isosorbide mononitrate, and some recreational drugs such as "poppers". Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis. Stop using sildenafil and get emergency medical help if you have sudden vision loss. Sildenafil relaxes muscles of the blood vessels and increases blood flow to particular areas of the body. Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio , which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women. Do not take Viagra while also taking Revatio, unless your doctor tells you to. Sildenafil may also be used for purposes not listed in this medication guide. What should I discuss with my healthcare provider before taking oral sildenafil? You should not use sildenafil if you are allergic to it, or: if you take other medicines to treat pulmonary arterial hypertension, such as riociguat (Adempas). Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure. Tell your doctor if you have ever had: heart problems (chest pain, a heart rhythm disorder, heart attack); high or low blood pressure; blood circulation problems; retinitis pigmentosa (an inherited condition of the eye); blindness in one or both eyes; bleeding problems; a stomach ulcer; pulmonary veno-occlusive disease (PVOD); liver or kidney disease; a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; a physical deformity of the penis (such as Peyronie's disease); or if you have been told you should not have sexual intercourse for health reasons. Sildenafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss. It is not known whether this medicine will harm an unborn baby. However, having pulmonary arterial hypertension (PAH) during pregnancy may cause complications such as heart failure, stroke, or medical problems in both mother and baby. The benefit of treating PAH with Revatio may outweigh any risks to the baby. It may not be safe to breast-feed while using this medicine. Do not give this medication to anyone under 18 years old without medical advice. Follow all directions on your prescription label and read all medication guides or instruction sheets. Revatio is usually taken three times each day, about 4 to 6 hours apart. Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Viagra can help you have an erection when sexual stimulation occurs. During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil. Store at room temperature away from moisture and heat. Since Viagra is used as needed, you are not likely to miss a dose. If you miss a dose of Revatio , take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Drinking alcohol with this medicine can cause side effects. Grapefruit may interact with sildenafil and lead to unwanted side effects. Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor. What are the possible side effects of oral sildenafil? Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking sildenafil and get emergency medical help if you have: heart attack symptoms --chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; vision changes or sudden vision loss; or erection is painful or lasts longer than 4 hours (prolonged erection can damage the penis). Call your doctor at once if you have: severe shortness of breath, cough with foamy mucus; ringing in your ears, or sudden hearing loss; irregular heartbeat; swelling in your hands, ankles, or feet; a seizure; or (convulsions); or a light-headed feeling, like you might pass out. Common side effects viagra shops near me may include: flushing (warmth, redness, or tingly feeling); headache, dizziness; abnormal vision (blurred vision, changes in color vision) runny or stuffy nose, nosebleeds; sleep problems (insomnia); muscle pain, back pain; or upset stomach. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Do not take sildenafil with similar medications such as avanafil (Stendra), tadalafil (Cialis) or vardenafil (Levitra). Tell your doctor about all other medications you use for erectile dysfunction. Tell your doctor about all your other medicines, especially: drugs to treat high blood pressure or a prostate disorder; antifungal medicine --ketoconazole or itraconazole; or medicine to treat HIV/AIDS --ritonavir and others. Other drugs may affect sildenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here. Your pharmacist can provide more information about viagra shops near me sildenafil. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information cheap viagra next day delivery contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. Sildenafil Citrate (Viagra) Enhances Vasodilatation in Fetal Growth Restriction. Baker, Sildenafil Citrate (Viagra) Enhances Vasodilatation in Fetal Growth Restriction, The Journal of Clinical Endocrinology & Metabolism , Volume 90, Issue 5, 1 May 2005, Pages 2550–2555, https://doi.org/10.1210/jc. 2004-1831. Background: Fetal growth restriction (FGR) affects up to 8% of all pregnancies and has massive short-term (increased fetal morbidity and mortality) and long-term (increased incidence of cardiovascular disease in adulthood) health implications. Doppler waveform analysis of pregnancies complicated by FGR suggests compromised uteroplacental circulation and placental hypoperfusion. Our aim was to determine whether myometrial small artery function was aberrant in FGR and to assess whether sildenafil citrate could improve vasodilatation in FGR pregnancies. Methods: Small arteries dissected from myometrial biopsies obtained at cesarean section from normal pregnant women (n = 27) or women whose pregnancies were complicated by FGR (n = 12) were mounted on wire myographs. Vessels were constricted (with arginine vasopressin or U46619) and relaxed (with bradykinin) before and after incubation with a phosphodiesterase-5 inhibitor, sildenafil citrate. Results: We demonstrated increased myometrial small artery vasoconstriction and decreased endothelium-dependent vasodilatation in vessels from women whose pregnancies were complicated by FGR. Sildenafil citrate significantly reduced vasoconstriction and significantly improved relaxation of FGR small arteries. Conclusions: We conclude that sildenafil citrate improves endothelial function of myometrial vessels from women whose pregnancies are complicated by intrauterine growth restriction. Sildenafil citrate may offer a potential therapeutic strategy to improve uteroplacental blood flow in FGR pregnancies. FETAL GROWTH RESTRICTION (FGR), when the fetus fails to attain its growth potential, affects approximately 8% of all pregnancies contributing to infant prematurity ( 1). FGR is responsible for considerable perinatal mortality and morbidity; infants are at increased risk of perinatal complications such as fetal distress, asphyxia, neonatal encephalopathy, hypothermia, hypoglycemia, and poor feeding as well as risks of long-term neurological and developmental disorders ( 2, 3). These direct effects of FGR have massive implications for the delivery of health care ( 4). Infants of FGR pregnancies may show modification of metabolic/hematological pathways and altered immune function ( 5). In the long term, deficient growth in utero is related to an increased incidence of hypertension, diabetes mellitus, and coronary heart disease in adulthood ( 6– 8). The underlying pathology of FGR is multifactorial and poorly understood. For example, growth restriction has been shown to have a genetic component such as trisomies and cases of placental mosaicism ( 9) or be a result of physiological factors such as maternal undernutrition ( 10, 11) or smoking during pregnancy ( 12). However, the reduced growth of the FGR fetus is typically associated with placental insufficiency, i.e . abnormalities in placental growth, development, and function. In normal pregnancy (NP), uterine blood flow increases dramatically from approximately 50 ml/min (8.3 ? 10 ?4 liter/sec) at 10 wk gestation to over 1200 ml/min (0.02l liter/sec) at term ( 13); this massive increase in flow is facilitated by a radical trophoblast-driven modification of the uterine spiral arteries ( 14). Using the noninvasive technique of Doppler ultrasound velocimetry, a number of studies have documented abnormal uterine artery waveforms in FGR ( 15). These data suggest reduced flow/increased resistance in the uterine arteries, indicative of a poorly modified uteroplacental vasculature downstream to the measurement site. Magnetic resonance imaging studies of the placental bed in FGR pregnancies have suggested that uteroplacental flow is indeed reduced, leading to a hypoperfused placenta ( 16, 17). A poorly modified uteroplacental vasculature is also a hallmark of the current pathogenic model of preeclampsia ( 18, 19) where aberrant spiral artery modification leads to a hypoperfused uteroplacental unit later in pregnancy ( 20, 21). This results in the release of a factor(s) from the placenta that activates the maternal vascular endothelium. These data suggest that the pathophysiology of FGR and preeclampsia may be related. A recent report that markers of endothelial dysfunction are increased in FGR ( 22), a commonly reported phenomenon of preeclampsia, supports such a hypothesis ( 23, 24). Endothelium-dependent responses in a variety of blood vessels from women with preeclampsia are markedly different, compared with those isolated from NP women ( 25– 27). We have demonstrated, using small-vessel myography, reduced endothelium-dependent responses to bradykinin in myometrial resistance arteries isolated from women with preeclampsia ( 26, 27) and have shown that the small residual response to bradykinin is entirely mediated via nitric oxide ( 28). The first aim of the current study was to investigate our hypothesis that uterine resistance artery function is aberrant in FGR, by performing the first comparison of myometrial small-artery vasoconstriction and endothelium-dependent relaxation in pregnancies complicated by FGR with that seen in NP. Animal studies suggest that phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil citrate, may improve uterine blood flow via cGMP-mediated endothelial relaxation of uterine vessels ( 29). Our second aim was thus to assess the effects of PDE5 inhibition in small arteries from women whose pregnancies were complicated by FGR. Mary’s Hospital, Manchester, gave approval for this work, and consent was obtained for all tissue samples used in the study. The investigation conforms to the principles outlined in the Declaration of Helsinki ( 30). Myometrial biopsies were obtained at delivery by cesarean section from the upper lip of the lower segment incision from healthy women (NP; n = 27) with uncomplicated pregnancies. Women with hypertension, diabetes, or other significant medical disorders were excluded. Biopsies were also obtained from women with intrauterine growth restriction (FGR; n = 12). All women in this group were identified on the basis of serial antenatal ultrasound scans demonstrating deficient fetal growth and delivered by cesarean section for maternal or fetal reasons; the diagnosis of FGR was confirmed by an individualized birthweight ratio (IBR) found to be less than the fifth centile. IBR is a correction of birthweight for known confounding variables and relates to a predicted birthweight calculated using independent coefficients for gestation at delivery, fetal sex, parity, ethnic origin, maternal height, and booking weight. The IBR enables a more accurate prediction of pregnancies with a poor outcome than birthweight for gestational age alone ( 31). General chemicals were obtained from Sigma-Aldrich (Poole, UK) or BDH (Poole, UK). Arginine vasopressin (AVP) and bradykinin (BK) were obtained from Sigma-Aldrich. The thromboxane mimetic U46619 was obtained from Calbiochem (Nottingham, UK). The PDE5 inhibitors sildenafil citrate (Viagra) and UK-343664 were obtained from Pfizer (Sandwich, UK). Biopsies were placed directly into ice-cold physiological salt solution, a modified Krebs solution (see below for chemical composition). Myometrial small arteries were identified and dissected under a stereomicroscope. Myometrial artery diameters were 379 ± 4 ?m for NP biopsies (n = 49 arteries from 27 patients) and 310 ± 2 ?m for FGR biopsies (n = 62 arteries from 12 patients). Myometrial small arteries were carefully cut into small (approximately 2 mm) lengths and mounted onto 40-?m steel wire in a Danish Myo Technology (Aarhus, Denmark) M610 wire myograph as described elsewhere ( 32). Myometrial arteries were normalized to 0.9 of L 13.3kPa using the classical normalization procedure ( 33) as we have described in detail elsewhere ( 32, 34). Initially, the bath contained 7 ml of physiological salt solution (in mmol/liter: 127.76 NaCl, 25 NaHCO 3 , 4.69 KCl, 2.4 MgSO 4 , 1.6 CaCl 2 , 1.18 KH 2 PO 4 , 6.05 glucose, 0.034 EDTA; pH 7.4), warmed to 37 C and gassed with air/5%CO 2 .
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