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Say NO to Prescription

Prescription drugs are medicines that are administered to patients by doctors to treat a specific ailment or health condition. Usually, prescription drugs provides with some or the other side effects, which are controlled and analyzed by your healthcare provider, after a careful medical analysis of your systems. Using Prescription drugs without doctor’s approval and supervision could lead to serious health problems.

So, it is always advisable to consult your doctor before you start using any prescription medications, including those for erectile dysfunction.

SAY NO TO CIALIS®:

Cialis or Tadalafil is a drug used to treat male erectile dysfunction (impotence). It was developed by the biotechnology firm ICOS and marketed worldwide by Eli Lilly and Company under the brand name Cialis.

How it works?
Cialis, so called “Weekend pill” for its 36 hours effect, is usually prescribed as 10 mg power, taken once a day, as needed. A 20 mg dose of Tadalafil (Cialis) is comparable to a 100 mg dose of sildenafil (Viagra).

Taking Cialis might prove risky if the patient exhibits any of the following:

  • Heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack.
  • Uncontrolled low blood pressure or high blood pressure
  • Have had a stroke
  • Have liver problems
  • Have kidney problems or require dialysis
  • Have retinitis pigmentosa
  • Have ever had severe vision loss, including NAION
  • Have stomach ulcers
  • Have a bleeding problem
  • Have a deformed penis shape or Peyronie's disease
  • Have had an erection that lasted more than 4 hours
  • Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

Drug Interactions:

  • Medicines called Nitrates
  • Medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl) or Uroxatral® (alfuzosin HCl). Alpha blockers are sometimes prescribed for prostate problems or high blood pressure. If Cialis® is taken with certain alpha blockers, the blood pressure could suddenly drop, making the patient dizzy or faint.
  • Ritonavir (Norvir®) or Indinavir (Crixivan®)
  • Ketoconazole or Itraconazole (such as Nizoral® or Sporanox®)
  • Erythromycin
  • Other medicines or treatments for ED

Side Effects with Cialis®

The most COMMON side effects with Cialis® are headache, indigestion, back pain, muscle aches, flushing, and stuffy/ runny nose. Patients who get back and muscle aches usually get them about 12 to 24 hours after taking Cialis®.

Cialis® may cause an erection that lasts longer than natural (Priapism). Priapism must be treated as soon as possible or else lasting damage can happen to the penis including the absolute inability to have erections.

Cialis® may cause vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green.

There have been instances where patients taking PDE5 inhibitors (oral erectile dysfunction medicines, including Cialis®) have reported a sudden decrease or loss of vision in one or both eyes.

SAY NO TO VIAGRA®:

VIAGRA or Sildenafil citrate is an oral therapy for treating (not cure) erectile dysfunction (ED).

VIAGRA is not for everyone. It is intended for use only by men who have a condition called erectile dysfunction.

VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.

MECHANISM OF ACTION:
Viagra, or the citrate salt of Sildenafil, is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Viagra has no direct relaxant effect on isolated human corpus cavernosum, but enhances the effect of nitric oxide (NO) by inhibiting phosphodiesterase type 5 (PED5), which is responsible for degradation of cGMP in the coupus cavernosum (penis). When sexual stimulation causes local release of NO, ionhibition of PDE5 by Viagra causes increased levels of cGMP in the corpus cavernosum. Viagra at recommended doses has no effect in the absence of sexual stimulation.

In addition to human corpus cavernosum smooth muscle, PDE5 is also found in lower concentrations in other tissues including platelets, vascular and visceral smooth muscle, and skeletal muscle. The inhibition of PDE5 in these tissues by Viagra may be the basis for all the side effects.

ABSORPTION AND METABOLISM:
VIAGRA is rapidly absorbed after oral administration, with absolute bioavailability of about 40%. Maximum plasma concentrations are reached within 30-129 minutes of oral dosing in the fasted state. However, if Viagra is taken with a high fat meal, the rate of absorption is reduced, with a mean delay in TMax of 60 minutes and a mean reduction of 29%. It is eliminated predominantly by hepatic metabolism with a half life of about 4 hours.

SIDE EFFECTS:
Effects of VIAGRA on Blood Pressure: Single oral dose of Viagra (100mg) administered to healthy volunteer produced a considerable decrease in blood pressure. Later, similar effects were observed with 25mg, 50 mg also, after 1-2 hours of the dose, i.e. at peak plasma concentration.

Effects of VIAGRA on Vision: At a single dose of 100 mg, impairment of color discrimination (blue/green) was detected, with the peak effects near the time of peak plasma levels.

Amongst Viagra's serious adverse effects are: priapism, severe hypotension, myocardial infarction, ventricular arrhythmias, sudden death, stroke and increased intraocular pressure.

Common side effects include sneezing, headache, flushing, dyspepsia, prolonged erections, palpitations and photophobia. Visual changes including blurring of vision and a curious bluish tinge have also been reported.

DOSAGE AND ADMINISTRATION:
The maximum recommended dosing frequency is ONCE per day. For most patients, the recommended dose is 50 mg, approximately 1 hour before sexual activity. However, based on effectiveness and toleration, the dose may be increased to a maximum of 100 mg or decreased to 25 mg.

CONTRAINDICATIONS:

  • Any medicine contains nitrate or recreational drug containing nitrates, or medicines prescribed to treat angina (chest pain due to heart disease), blood pressure, heart stroke
  • Nitroglycerin (sprays, ointments, skin patches or pastes, and tablets) that are swallowed or dissolved in the mouth).
  • Isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth)
  • Cardiovascular risk factors
  • Severe hepatic impairment (decreased liver function)
  • Severe impairment in renal function
  • Hypotension (low blood pressure)
  • Recent stroke or heart attack
  • Hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterases)

BE SURE TO TELL YOUR DOCTOR IF YOU:

  • have ever had any heart problems (e.g., angina, chest pain, heart failure, irregular heart beats, heart attack or narrowing of the aortic valve)
  • have ever had a stroke
  • have low or high blood pressure
  • have ever had severe vision loss
  • have a rare inherited eye disease called retinitis pigmentosa
  • have ever had any kidney problems
  • have ever had any liver problems
  • have ever had any blood problems, including sickle cell anemia or leukemia
  • are allergic to sildenafil or any of the other ingredients of VIAGRA tablets
  • have a deformed penis, Peyronie’s disease, or ever had an erection that lasted more than 4 hours
  • have stomach ulcers or any types of bleeding problems
  • are taking any other medicines

VIAGRA Is Not for Everyone
VIAGRA is only for patients with erectile dysfunction. VIAGRA is not for newborns, children, or women. Do not let anyone else take your VIAGRA. VIAGRA must be used only under a doctor’s supervision.

SAY NO TO LEVITRA

Levitra or Vardenafil is a PDE5 inhibitor used in the treatment of erectile dysfunction. It can assist men with this disorder in achieving and maintaining an erection during sexual activity.

Indications and contraindications are as for other PDE5 inhibitors. As a PDE5 inhibitor, Levitra is closely related in both function and marketing to Viagra and Cialis. It has a relatively short effective time, comparatively.

ADVERSE DRUG REACTIONS
More common adverse drug reactions (ADRs) are as per other PDE5 inhibitors Common vardenafil-specific ADRs include: nausea. Infrequent ADRs include: abdominal pain, back pain, photosensitivity, abnormal vision, eye pain, facial edema, hypertension, palpitation, tachycardia, arthralgia, myalgia, rash, itch, and priapism.

The use of products containing vardenafil has also been associated with serious side-effects which include serious cardiac events such as heart attacks. In rare cases, the use of vardenafil may result in penile tissue damage and permanent loss of potency.

DRUG INTERACTIONS:
Products containing vardenafil should not be used by individuals who are taking any nitrate medication because combining these products could result in the development of potentially life-threatening low blood pressure.

DOSE FORMS:
It is available in 2.5 mg, 5 mg, 10 mg, and 20 mg doses in round orange tablets. The normal starting dose is 10 mg (roughly equivalent to 50 mg of sildenafil). Vardenafil should be taken 25–60 minutes prior to sexual activity, with a maximum dose frequency of once per day.


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