Erectile dysfunction medicine.

Oct. 10, 2003 — Move over Viagra. Men now have a choice when it comes to drug treatments for erectile pills
, and it seems that the newest therapy may be the best option for some.

The newly approved drug Levitra was found to work in many men who did not respond to Viagra in a study funded by Levitra manufacturers Bayer AG and Treat erectile dysfunction the best, a WebMD sponsor.

The men included in the new study were identified as Viagra nonresponders after failing to achieve successful erections while taking Viagra during at least four of their six most recent sexual attempts. Participants were randomized to receive either Levitra or placebo. After 12 weeks, men were three times more likely to complete sexual affiliate herbal viagra
successfully on Levitra than on placebo. While more than 40% of men who took Levitra achieved an erection only 16% of men who took a placebo were able to do so.

The findings are the first to show that Levitra can help men with erectile dysfunction who are not helped by Viagra, says researcher Culley C. Carson, III, MD. Carson is scheduled present the finding Saturday in Denver at a meeting of the Sexual Medicine Society of North America.

More Potent Than Viagra?

Levitra hit the market with a vengeance in August, acquiring close to 50% of the market share for newly treated patients within less than a month. Laboratory studies suggest that the new drug may be more potent than the older Viagra and may also have a better side effect profile, but no head-to-head clinical studies have been done to prove this.

“If you’re asking me which drug is better, there is no way I can answer,” says urologist Irwin Goldstein, MD, who is one of the nation’s leading impotence erectile dysfunction drugs
.

Goldstein was not involved with the latest study, but had conducted research on Viagra, Levitra, and another erectile dysfunction drug that is expected to win FDA approval later this year, Eli Lilly’s Cialis.

He tells WebMD that while there is, as yet, no clearly superior drug among the three, patients will benefit from having more than one drug to choose from.

“As a clinician I really drug dysfunction erectile
the fact that men now have choices,” he says. “Viagra has helped a lot of people. But just as there are plenty of men who have done well on it, there are plenty of others who have not responded.”

Good Sex

“One message here is that men who have failed Viagra should certainly try this drug,” urologist and study co-author Myron Murdoch, MD, tells WebMD. “But another message is that even men who are taking Viagra may see a benefit. They may think they are getting an optimal sexual response but they really don’t know, because they haven’t had anything to compare it with.”

Meanwhile experts say it is also important for men with erectile dysfunction — often an embarrassing problem — to speak up.

“Now more than ever it is important for men with sexual problems to talk about them with their doctors,” he says. “We now have a choice in the tools we can use to help patients. There is no reason to suffer in silence.”

——————————————————————————–

SOURCES: 5TH Annual Fall Research Meeting of the Sexual Medicine Society of North America (SMSNA), Denver, Oct. 11, 2003. Culley C. Carson, III, MD, president, SMSNA; chief, urology department, University of North Carolina Hospitals, Chapel Hill, N.C. Irwin Goldstein, MD, professor, urology department, Boston University School of Medicine. Myron Murdoch, MD, urologist; consultant, Levitra manufacturer.

May 31, 2000 — A new study shows that Viagra appears to be safe even for
some men with severe heart disease, as long as they are not taking
buy cheap generic viagra
or similar drugs for their conditions.

Reports of heart attacks in several men who had used Viagra had led
researchers to worry that the drug might pose a special risk to those with
heart problems such as angina (chest pain). But the study, published in
TheNew England Journal of Medicine, shows that the usual dose of
Viagra causes no damaging changes to the heart’s circulation in men with
coronary artery disease (CAD).

Lead author Howard C. Herrmann, MD, tells WebMD that his findings
“should provide reassurance about the safety of Viagra for patients who
take it, for urologists who prescribe it to treat erectile dysfunction, and for
cardiologists, who probably don’t ask about erectile dysfunction as often as
they should.” Herrmann is professor of medicine and director of
erectile dysfunction solutions
cardiology at the University of Comparison generic price viagra
Medical Center in
Philadelphia.

Herrmann and colleagues measured Viagra’s effect on blood flow to the heart
and lungs in 14 men with severe coronary artery disease. CAD is a major cause
of angina and heart attacks. For the study, men had to stop taking
nitrate-containing drugs such as nitroglycerin, which is often used to treat
angina.

All of the men in the study had CAD so severe that at least one of the major
arteries supplying the heart with blood had closed up by 70 percent or more.
The study was supported by Pfizer, the maker of Viagra.

Herrmann reports that careful examination of the blood flow within the
arteries showed that Viagra had essentially no effect on blood flow to the
heart or lungs, or on the heart’s ability to pump blood.

“Our data support the consensus position of the American College of
Cardiology and the American Heart Dysfunction erectile pill
that Viagra is safe for patients
with stable coronary artery disease who are not taking medications containing
nitrates,” Herrmann writes.

Rohit R. Arora, MD, who reported one of the first cases of heart attack in a
patient who had taken Viagra, tells WebMD that this “well-done, meticulous,
and focused” study provides useful information about Viagra’s effects on
the heart’s erectile dysfunction drugs
system, but he would like to see more direct
information about heart attacks in men taking the drug. Ahora, who is director
of critical cardiac care services at Columbia-Presbyterian Medical Center in
New York, was not involved in the study.

Herrmann says the safety of Viagra has not been studied in patients who have
unstable angina, who have had a recent heart attack, or who have severe high or
low blood pressure.

People who have not previously had even moderate exercise (including sexual
activity) or who are taking more than one drug for high blood pressure should
be cautious when beginning Viagra, Herrmann says. He recommends that those who
have not been exercising regularly have a stress test, since sexual activity
itself carries a small increased risk of heart attack. He also recommends that
those with high blood pressure take their first dose of Viagra in a doctor’s
office, where the effect on their blood pressure can be checked
immediately.

Vital Information:

• According to new research, taking Viagra does not cause damaging changes to
  the heart among some men with coronary artery disease, as long as they are not
  on nitrate-containing medications.
• The study found no changes in blood flow to the heart or lungs after
  heart-disease patients took Viagra.
• Patients who never exercise or those on more than one medication for high
  blood pressure should be carefully screened before taking Viagra.

Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas
Rangers slugger is only 37 and won’t admit to having erection problems, yet he
recently agreed to appear in ads promoting the drug. The deal has made people
wonder whether Palmeiro really represents men with erectile dysfunction, or
whether Pfizer, the company that makes Viagra, wants to persuade young men to
try it for fun.

It’s true that erectile dysfunction is more common in older
men, but many potential Viagra users are hardly senior citizens: About 40% of
40-year-old men in the U.S. have some degree of erectile dysfunction. Most
Viagra users today, according to Pfizer, are in their early to mid 50s. So it
makes sense that the company would want to reach more men around Palmeiro’s
age.

Urologist Myron Murdock, medical director of the Impotence
Institute of America, says these men are likely to use Viagra because sexual
performance is a high priority for them.

A younger man, Murdock says, “wants his V-12 Jaguar working
just perfectly,” whereas an elderly gent may be content with less
dependable erections. What’s more, the sexual partners of younger men “are
more demanding of their performance,” Murdock says.

Pfizer denies that it’s promoting Viagra for dysfunction erectile pill
use.
“We’ve consistently opposed that,” says spokesman Geoff Cook.
Nevertheless, Murdock says it’s fine to pop the little blue pill to
“optimize” your sexual performance.

We assume all young men have normal sexual functioning,
“but they’re really not normal,” Murdock says. Hardening of the
arteries, which restricts blood flow to the penis, can begin during the teen
years, so that by the time a man is in his 20s, his ability to get and keep an
erection has already begun to decline. Murdock says many men who seek Viagra
for recreational use actually have minor erectile dysfunction.

There’s also some evidence that Viagra can shorten the time it
takes a man to recover after sex and be ready for another round. This is called
the “refractory period.” Normally it lasts 20 minutes or longer. One
study, published in the journal Human Reproduction in January 2000,
found that Viagra shortened the refractory period by about 10 minutes in
healthy men.

What Viagra cannot do is increase your sexual appetite or make
you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in
San Francisco, says you shouldn’t expect your erections to reach staggering new
proportions, either. “I don’t believe that Viagra can increase an erection
beyond 100% of normal,” he says.

“Viagra is a super-safe drug,” Murdock says, assuming
you have a healthy heart and don’t take nitrates.

Nitrates include nitroglycerin — a drug that many men take for
chest pain from heart disease — and “poppers.” Poppers are little
vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which
gives a brief high when inhaled. It’s most often used to enhance sexual
pleasure, and mostly by gay men. Poppers are not all that safe to use on their
own, and they’re especially dangerous when you’re on Viagra.

Nitrates widen blood vessels, and Viagra increases that effect.
Mixing the two can cause your blood pressure to drop drastically. A sudden drop
in blood pressure can make you pass out, and you may die if your blood pressure
stays too low for too long.

Preservatives like sodium nitrate — found in processed food –
do not cause this problem, so you won’t die from eating a hot dog while on
Viagra. Even so, it’s best to take it on an empty stomach. That way, the drug
absorbs into your bloodstream faster. Wine may contain nitrates, but not the
kind that cause problems with Viagra. It’s fine to play some Marvin Gaye on the
stereo and sip a glass of Chardonnay, if that’s what puts you in the mood.

Although you may be tempted to order Viagra discreetly from one
of the hundreds of Web sites that sell it, don’t. “It’s bad medicine,”
Murdock says. You really must bring your doctor into your sex life if you want
to use Viagra.

When you buy from an online pharmacy, you just have to answer
some health questions before you proceed to the checkout page. If you answer
honestly — and that might be a big “if” for those determined to get
what they want — the questionnaire may catch some possible complications. But
the ed meds
who fill your order don’t know your medical history, and no
questionnaire can diagnose the root cause of your problem. Erectile dysfunction
can have serious underlying causes, like diabetes, heart disease, liver
disease, or thyroid disease.

Cook says Pfizer is opposed to Internet Viagra sales. “Our
goal with any of our marketing is simply to reach men and encourage them to see
a doctor,” he says.

It seems that Viagra can make sex better for women, too. Like
the penis, the clitoris is erectile tissue — spongy tissue that becomes
engorged with blood during sexual excitement. By increasing blood flow to the
clitoris, Viagra may heighten a woman’s sensation and arousal. It also seems to
increase vaginal lubrication.

Murdock says many couples like to heat things up by splitting a
dose of Viagra. “It’s an purchase sildenafil citrate sexual situation,” he says. The
erectile dysfunction tablets
dosage for men is up to 100 milligrams per day, and that seems to
be just as safe for women. Young people may get results from a smaller dose: As
little as 25 mg may be enough.

The FDA has not approved Viagra for women, but Murdock says,
“It’s just a matter of time.” He says he and other doctors who
specialize in sexual medicine prescribe it to women, which is perfectly legal.
Doctors are allowed to use their best judgment. Drug companies, however, can’t
advertise any use that isn’t FDA-approved.

The studies being done to test Viagra’s safety and
effectiveness in women have shown good results so far. “We’re cautiously
optimistic,” Cook says.

Martin F. Downs is a health writer in New York City. He was
formerly an editor at CBS HealthWatch. He has also written for Health.com,
Salon.com, and POZ magazine and is the editor of the Alicubi
Journal (alicubi.com).

May 27, 2005 — Viagra’s label may change to reflect rare vision problems reported by a few men who have used the erectile dysfunction drug.vision problems reported by a few men who have used the erectile dysfunction drug.

Viagra’s maker, Pfizer, issued a statement saying it is “in discussions with the FDA to update the Viagra label to reflect these rare ocular occurrences.

“Viagra has a strong safety profile and remains an effective medication that benefits millions of patients,” says the statement. Pfizer says a review of 103 clinical trials of Viagra — including 13,000 patients — found no reports of the eye problem, which is called erectile dysfunction advices
anterior ischemic optic neuropathy (NAION).

WebMD reported on the topic in April, when ophthalmologist Howard Pomeranz, MD, PhD, published a report generic online order viagra
14 cases of NAION in men taking Viagra.

Viagra has been used by 23 million men worldwide, says Pfizer’s statement. The pharmaceutical company is a WebMD sponsor.

A call to the FDA for comment was not returned before publication.

Pfizer: ‘No Evidence’ of More Frequent Occurrence

“There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra,” says the Pfizer statement, erectile dysfunction new drugs
the sentence for emphasis.

Pomeranz’s report appeared in the March issue of the Journal of Neuro-Ophthalmology. Pomeranz, an associate professor at the University of Minnesota, told WebMD in April that he had seen most of the men himself.

“The number of cases was very small,” he said. None of the men went blind, although their vision loss was permanent and reportedly started within 24-36 hours of taking Viagra.

Pomeranz didn’t test Viagra’s eye effects. Instead, he described the men’s reports of vision loss.

Most Affected Men Had Other Health Problems

The men in Pomeranz’s report were 50-69 years old. Almost all had health problems including high blood pressure, diabetes, high erectile dysfunction medication
, and/or a history of smoking. Most also had a rare structural problem in their optic nerve, which is a risk factor for NAION.

NAION is the most common acute disease of the optic nerve in adults over the age of 50. It shares a number of risk factors with erectile dysfunction. These include high cholesterol, high blood pressure, and diabetes.

The Pfizer statement says, “There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra.”

An eye exam can screen for that structural problem. Men should talk to their doctors about any risks, Pomeranz told WebMD in April.

At that time, Pfizer spokesman Daniel Watts told WebMD that Pfizer had found no reports of NAION in Viagra’s studies prior to marketing. Watts also said “there does not appear to be sufficient evidence to suggest a single identifying association of these events with Viagra therapy” and that the company would continue to monitor the database.

Pomeranz told WebMD in April that he had no reason to doubt the drug company’s statement.

June 13, 2005 — Viagra may be famous for helping men in the bedroom, but a
new study shows it may also help children with a rare and often fatal lung
disease.

Levitra vs cialis
found the active ingredient in Viagra, sildenafil, helped
children with pulmonary arterial hypertension (PAH) walk farther and breathe
easier when taken over the course of a year.

Pulmonary arterial hypertension occurs when blood pressure in the arteries
that supply blood to the lungs becomes ed pills
high and causes symptoms
including fatigue, dizziness, shortness of breath, and eventually heart failure
and death.

“Untreated, children usually die within one year of diagnosis,” says
researcher Ian Adatia, associate professor of pediatrics at the University of
California San Francisco Children’s Hospital, in a news release. He says that
even with the best available treatment few people live five years after the
disease is diagnosed.

But the small, pilot study showed that sildenafil provided significant
benefits for children with the lung condition with fewer side effects than
existing treatments.

Earlier this month, the FDA approved sildenafil for the treatment of PAH
under the brand name Revatio.

Sildenafil Eases Lung Disease

In the study, which appears in the current issue of Circulation: Journal
of the American Heart Association, researchers looked at the effects of
sildenafil in a group of 14 children with levitra viagra vs
pulmonary arterial
hypertension.

The children received varying doses of the drug along with other drugs as
needed, such as blood thinners. After one year of treatment, the results showed
that the children were able to walk farther than typically seen with other
drugs used to treat PAH.

For example, the average distance walked in six minutes, a standard measure
of PAH severity, increased by 154 meters or more than one and a half football
fields.

Researchers say sildenafil appears to help pulmonary hypertension by
relaxing the smooth muscle of blood vessels and increasing blood flow. That
effect resulted in a 20% drop in resistance in the pulmonary arteries and
improved breathing for these children.

“Very importantly, the side effects were minimal, the drug was very easy
to take, and there were no changes in liver or kidney function that can happen
with other drugs used to treat PAH,” says Adatia.

But researchers stress that this was a very small study and more research is
needed to determine the long-term effects of sildenafil in people with the lung
disease.

Pfizer, which makes Viagra, funded the study. Pfizer is a WebMD sponsor.

May 26, 2005 — Rising use and abuse of the impotence drug Viagra among men who have sex with men may dramatically increase their risk of sexually erectile dysfunction drugs
diseases (STDs) and HIV infection.

A new study shows that men who have sex with men and who use Viagra engage in unprotected sex up to six times more often than nonusers of the drug.

In addition, cheap generic lowest price viagra
found that Viagra is increasingly being used as a cialis vs viagra
drug and mixed with drugs such as methamphetamine.

Viagra is approved as a prescription drug to treat erectile dysfunction, but researchers say most of the men studied had no medical need for Viagra and obtained the drug without a doctor’s prescription from a friend or off the Internet.

Viagra Abuse Raises Risks

In the study, which appears in the current issue of the American Journal of Medicine, researchers analyzed 14 recent studies of Viagra among men who have sex with men.

Overall, the studies showed that more than 10% of men who have sex with men use Viagra. More than 40% of HIV-positive men reported using the drug.

Compared with nonusers of the drug, researchers show men who have sex with men and who use Viagra are from two to nearly six times more likely to have unprotected anal sex with a male partner of unknown HIV status.

Other findings include:

• HIV-positive men were nearly twice as likely to be diagnosed with another sexually transmitted disease if they used Viagra compared with nonusers.
• Men recently diagnosed with HIV were 2.5 times more likely to use Viagra than other men who have sex with men.
• 54% of users mixed Viagra with other drugs to enhance the sexual experience, such as erectile dysfunction help
  , ecstasy, and ketamine.

New Warnings Needed for Viagra?

Based on these results, researchers say the labeling for Viagra and other recently approved drugs in its class, including Cialis and Levitra, should be changed to warn users of an increased risk of STDs, including HIV infection.

Although Viagra itself does not cause these purchase sildenafil citrate, researchers say the increased duration of erection, increased blood flow to the penis, and subsequent sexual activity may increase the risk of acquiring these infections from an infected partner.

In an editorial that accompanies the study, Joseph Alpert, MD, of the University of Arizona Health Sciences Center in Tucson, says abuse and recreational use of Viagra and other similar erectile dysfunction drugs could become a major public health problem in the U.S.

He says more research is needed to determine if the risk of STDs and unsafe sex is higher in heterosexual men who use Viagra.

People seem to want and need to be close to others. As we grow older, many
of us also want to continue an active, satisfying sex life. But the aging
process may cause some changes.

What Are Normal Changes?

Normal aging brings physical changes in both men and women. These changes
generic viagra soft tab
affect one’s ability to have and enjoy sex with another person. Some
women enjoy sex more as they grow older. After menopause or a hysterectomy,
they may no longer fear an unwanted pregnancy. They may feel freer to enjoy
sex.

Some women do not think things like gray hair and wrinkles make them less
attractive to their sexual partner. But if a woman believes that looking young
or being able to give birth makes her more feminine, she may begin to worry
about how erectile dysfunction new drugs
she is no matter what her age is. That might make sex less
enjoyable for her.

A woman may notice changes in her vagina. As she ages, her vagina shortens
and narrows. The walls become thinner and also a little stiffer. These changes
do not mean she can’t enjoy having sex. However, most women will also have less
vaginal lubrication. This could affect sexual pleasure.

As men get older, impotence becomes more common. Impotence is the loss of
ability to have and keep an erection hard enough for sexual intercourse. By age
65, about 15 to 25% of men have this problem at least one out of every four
times they are having sex. This may happen in men with heart disease, high
blood pressure, or diabetes-either because of the disease or the medicines used
to treat it.

A man may find it takes longer to get an erection. His erection may not be
as firm or as large as it used to be. The amount of cheap generic viagra substitute may be smaller.
The loss of erection after orgasm may happen more quickly, or it may take
longer before an erection is again possible. Some men may find they need more
foreplay.