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Sildenafil , sold as the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension.

Common side effects include headaches , heartburn , and flushed skin. Sildenafil acts by blocking phosphodiesterase 5 PDE 5 , an enzyme that promotes breakdown of cGMP , which regulates blood flow in the penis. Pfizer originally discovered the medication in while looking for a treatment for heart related chest pain.

The primary indication of sildenafil is treatment of erectile dysfunction inability to sustain a satisfactory erection to complete intercourse. Its use is now one of the standard treatments for erectile dysfunction, including for men with diabetes mellitus. Tentative evidence suggests that sildenafil may help men who experience antidepressant -induced erectile dysfunction. While sildenafil improves some markers of disease in people with pulmonary arterial hypertension , it does not appear to affect the risk of death or serious side effects as of [update].

Sildenafil has been studied for high-altitude pulmonary edema but its use is currently not recommended for that indication. In clinical trials , the most common adverse effects of sildenafil use included headache , flushing , indigestion , nasal congestion , and impaired vision, including photophobia and blurred vision.

In July , the FDA found that sildenafil could lead to vision impairment in rare cases [16] and a number of studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy.

Rare but serious adverse effects found through postmarketing surveillance include prolonged erections , severe low blood pressure , myocardial infarction heart attack , ventricular arrhythmias , stroke , increased intraocular pressure , and sudden hearing loss. Care should be exercised by people who are also taking protease inhibitors for the treatment of HIV infection. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side effects.

Sildenafil should not be used if sexual activity is inadvisable due to underlying cardiovascular risk factors [21]. In one study, a mg dose was shown to cause no significant change in erectile quality, but did reduce the postejaculatory refractory time.

Unprescribed recreational use of sildenafil and other PDE5 inhibitors is noted as particularly high among users of illegal drugs.

Plano, and Diego A. Golombek of Universidad Nacional de Quilmes , Argentina, for their discovery that sildenafil helps treat jet lag recovery in hamsters. Professional athletes have been documented using sildenafil, believing the opening of their blood vessels will enrich their muscles.

In turn, they believe it will enhance their performances. Acetildenafil and other synthetic structural analogs of sildenafil which are PDE5 inhibitors have been found as adulterants in a number of "herbal" aphrodisiac products sold over-the-counter. However, at least one court case has resulted in a product being taken off the market. The US FDA has banned numerous products claiming to be Eurycoma longifolia that, in fact, contain only analogs of sildenafil. Nitric oxide NO in the corpus cavernosum of the penis binds to guanylate cyclase receptors, which results in increased levels of cGMP, leading to smooth muscle relaxation vasodilation of the intimal cushions of the helicine arteries.

This smooth muscle relaxation leads to vasodilation and increased inflow of blood into the spongy tissue of the penis, causing an erection. Furchgott , Ferid Murad , and Louis Ignarro won the Nobel Prize in Physiology or Medicine in for their independent study of the metabolic pathway of nitric oxide in smooth muscle vasodilation.

The molecular structure of sildenafil is similar to that of cGMP and acts as a competitive binding agent of PDE5 in the corpus cavernosum, resulting in more cGMP and better erections. Other drugs that operate by the same mechanism include tadalafil Cialis and vardenafil Levitra.

Sildenafil is broken down in the liver by hepatic metabolism using cytochrome p enzymes, mainly CYP 3A4 major route , but also by CYP2C9 minor route hepatic isoenzymes. The major product of metabolisation by these enzymes is N-desmethylated sildenafil, which is metabolised further. If taken with a high-fat meal, absorption is reduced; the time taken to reach the maximum plasma concentration increases by around one hour, and the maximum concentration itself is decreased by nearly one-third.

There are also mouth spray preparations of sildenafil for faster onset of action. The preparation steps for synthesis of sildenafil are: It was initially studied for use in hypertension high blood pressure and angina pectoris a symptom of ischaemic heart disease. The first clinical trials were conducted in Morriston Hospital in Swansea.

Numerous sites on the Internet offer Viagra for sale after an "online consultation", often a simple web questionnaire. Viagra is also informally known as "vitamin V", "the blue pill", or "blue diamond", as well as various other nicknames. In February , it was announced that Boots , the UK pharmacy chain, would try over-the-counter sales of Viagra in stores in Manchester , England. Men between the ages of 30 and 65 would be eligible to buy four tablets after a consultation with a pharmacist.

While the sale remains subject to a consultation with a pharmacist, the other restrictions from the trial have been removed, allowing customers over the age of 18 to purchase an unlimited number of pills [59] The decision was made, in part, to reduce online sales of counterfeit and potentially dangerous erectile dysfunction treatments.

On 6 May , Pfizer , which manufactures Viagra, told the Associated Press they will begin selling the drug directly to patients on its website. As of , the U. Food and Drug Administration has approved 15 drug manufacturers to market generic sildenafil in the United States. Seven of these companies are based in India. This is likely to lead to dramatic price reductions. Counterfeit Viagra, despite generally being cheaper, [67] can contain harmful substances or substances that affect how Viagra works, such as blue printer ink, amphetamines , metronidazole , boric acid , and rat poison.

There were 2,, prescriptions for Sildenafil in in England, compared with 1,, in In , Viagra Connect, a particular formulation of Sildenafil marketed by Pfizer, became available for sale without a prescription in the UK, [59] in an attempt to widen availability and reduce demand for counterfeit products.

Sildenafil is available as a generic drug in the United States, labelled for pulmonary arterial hypertension. In the United States, Pfizer received two patents for sildenafil: The substance is the same under both trade names.

In , Pfizer filed a patent covering the substance sildenafil and its use to treat cardiovascular diseases. The patent was published in and expired in The patent on Revatio indicated for pulmonary arterial hypertension rather than erectile dysfunction expired in late Generic versions of this low-dose form of sildenafil have been available in the U.

In , Pfizer filed a patent covering the use of sildenafil to treat erectile dysfunction. This patent was published in and will expire in Teva sued to have the latter patent invalidated, but Pfizer prevailed in an August federal district court case. The decision, Teva Canada Ltd. This, in my view, is the key issue in this appeal.

Sildenafil was reclassified in New Zealand in so it could be bought over the counter from a pharmacist. It is thought that this reduced sales over the Internet and was safer as men could be referred for medical advice if appropriate. From Wikipedia, the free encyclopedia. For other uses, see Viagra disambiguation.

B No risk in non-human studies. S4 Prescription only CA: P Pharmacy medicines US: British Journal of Clinical Pharmacology. Division of Pfizer, Inc. Retrieved 5 November Retrieved 1 December Retrieved 21 November Two versions of sildenafil hit the market today". Retrieved 24 November Centers for Medicare and Medicaid Services.

The Cochrane Database of Systematic Reviews 1: The Cochrane Database of Systematic Reviews 5: Annals of the Rheumatic Diseases. Commonly-used classes of drugs".

Cochrane Database of Systematic Reviews. Food and Drug Administration. Archived from the original on 22 October The American Journal of Cardiology. Journal of the American College of Cardiology. Retrieved 11 July J Am Pharm Assoc Retrieved 15 July Retrieved 10 February Roger Clemens, host of athletes pop Viagra to help onfield performance". Retrieved 28 November Journal of Pharmaceutical and Biomedical Analysis. Archived from the original PDF on 10 September Retrieved 1 July Retrieved 20 August Br J Clin Pharmacol.

Org Process Res Dev. Archived from the original on 26 September Retrieved 6 August

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How much is viagra 100mg

For other uses, see Viagra disambiguation. B No risk in non-human studies. S4 Prescription only CA: P Pharmacy medicines US: British Journal of Clinical Pharmacology. Division of Pfizer, Inc. Retrieved 5 November Retrieved 1 December Retrieved 21 November Two versions of sildenafil hit the market today". Retrieved 24 November Centers for Medicare and Medicaid Services.

The Cochrane Database of Systematic Reviews 1: The Cochrane Database of Systematic Reviews 5: Annals of the Rheumatic Diseases.

Commonly-used classes of drugs". Cochrane Database of Systematic Reviews. Food and Drug Administration. Archived from the original on 22 October The American Journal of Cardiology. Journal of the American College of Cardiology.

Retrieved 11 July J Am Pharm Assoc Retrieved 15 July Retrieved 10 February Roger Clemens, host of athletes pop Viagra to help onfield performance". Retrieved 28 November Journal of Pharmaceutical and Biomedical Analysis. Archived from the original PDF on 10 September Retrieved 1 July Retrieved 20 August Br J Clin Pharmacol.

Org Process Res Dev. Archived from the original on 26 September Retrieved 6 August Our clinicians regularly offer patients the opportunity to take part in trials of new drugs and treatments.

Morriston Hospital in Swansea, was the first in the world to trial Viagra! Bioorg Med Chem Lett. Drug Repurposing and Repositioning: Retrieved 30 April Archived from the original on 3 January The New York Times. Retrieved 5 April Retrieved 6 May Retrieved 10 December Retrieved 6 December Retrieved 10 August Archived from the original on 26 December Retrieved 26 December Retrieved 10 January Retrieved 25 October Retrieved 25 March Retrieved 13 June Telegraph Media Group Limited.

Archived from the original on 22 August Archived from the original on 25 June Retrieved 8 October Retrieved 4 May Retrieved 5 October Retrieved 1 April Retrieved 14 November Decision allows generic versions of drug to be produced".

Retrieved 9 February The Globe and Mail. Retrieved 15 November Retrieved 27 December Retrieved 2 April Drugs for erectile dysfunction and premature ejaculation.

Drugs for erectile dysfunction G04BE and premature ejaculation. Avanafil Sildenafil Tadalafil Udenafil Vardenafil. Afrodor acecarbromal , quebracho , vitamin E Papaverine. Medications used in the management of pulmonary arterial hypertension B01 , C Beraprost Epoprostenol Iloprost Selexipag Treprostinil. Ambrisentan Bosentan Macitentan Sitaxentan. Instant hard on that lasts for a long time. I take 50 mg about three times a week. I have tried mg from time to time but actually seem to do better with the smaller doses.

You have to experiment with the dosage and time lag. I started with 50 mg good to rev my engine, I think but ultimately found that 25 mg about 90 minutes before sex is ideal for me. Lower dosage means less nasal congestion and more feeling during sex. But 25 mg still leaves me rock hard and able to hold off climaxing just about as long as I want. I have the pharmacist split a mg pill in four for me so I take 25 mg at a time. When I want to go all night I take the full mg. We came at the same time, and boy did I cum.

What makes this whole experience ever better is that I only used half of a 50 mg pill. I started off with 25 mg, and have reduced it down to I have since realized I only need 25mg to keep and maintain an erection.

But originally, that night, I took 50mg. Click Here to Order Viagra. What is the Ideal Dosage for Viagra? I could feel my penis get erect within 15 minutes, getting harder than usual and lasting longer too - YT, Age 45, Nigeria A full mg. William, Age 42, Texas 25mg is best for me and I have found that Viagra makes me a super stud and the girl rides me and always has an orgasm or two. I cut a 50 mg in half and find that to be enough.

How much is viagra 100mg

Viagra Rating User Reviews 8. In turn, they believe it will enhance their performances. It was initially studied for use in hypertension high blood pressure and angina pectoris a symptom of ischaemic heart disease. Views Read View source View history. While the sale remains subject to a consultation with a pharmacist, the other restrictions from the trial have been removed, allowing customers over the age of 18 to purchase an unlimited number of pills [59] The decision was made, in part, to reduce online sales of counterfeit and potentially dangerous erectile dysfunction treatments.

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mg is the highest recommended dosage of Viagra. You mustn’t take more than mg per day. Viagra mg tablets are suitable for men who find that they don’t get an erection hard enough for penetration when taking the 50mg tablet. You should try the 50mg dose first and only increase your intake to mg if you find the effect insufficient. How much does viagra cost without insurance. Viagra and other Erectile Dysfunction drugs at CVS, Walgreens, and other pharmacies. My doctor prescribed 50 mg Viagra. Wow. Instant hard on that lasts for a long time. I take 50 mg about three times a week. I have tried mg from time to time but actually seem to do better with the smaller doses. - JR, Age You have to experiment with the dosage and time lag.

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