“Erectile dysfunction can be a debilitating condition, so it’s important men feel they have fast access to quality and legitimate care and do not feel they need to turn to counterfeit online supplies which could have potentially serious side effects.”
Background
Everybody knows what the blue pill does because it is indeed a blockbuster drug. And one of the most renowned marketed drugs.
Viagra made history for twenty years.
It made men confident again.
It made women smile.
The “blue tonic” rejuvenated hundreds of couples.
It is used worldwide. Some use it for years. Some just want to try it.
The company that found Viagra
Pfizer, in 1991 began its research for some chemical compounds belonging to the pyrazolopyrimidine class, aiming to find a revolutionary drug to treat heart problems, like angina or chest pain.
During clinical trials, it was found that the drug had an insignificant effect on angina.
But an unexpected side effect of this medicine was noticed by one study nurse as a side effect that was quite pleasant for all the male patients treated for heart problems.
Pfizer than stopped the research on Sildenafil as heart medication and initiated investigation on it for penile erection.
Viagra then hit the market in 1998 and since then it has been released as over the counter medicine in the UK.
Erectile dysfunction Is it a serious disease?
Erectile dysfunction, defined today as the inability to attain and maintain an erect penis with sufficient rigidity for sexual intercourse, has become an increasingly common complaint that affects roughly 140 million men worldwide.
What was thought to be related to psychological causes (e.g. depression, anxiety and stress involving the workplace) was demonstrated the primary factor in only a few cases. However, secondary psychological problems are expected in all cases associated with erectile dysfunction.
Definition of erectile dysfunction can be different for every guy. Organic causes are predominant for the onset of erectile dysfunction, such as the trauma of the penis, vascularization, and other pathologies such as Diabetes mellitus, renal failure and so on.
Risk factors for developing erectile dysfunction include age, diabetes, hypertension, obesity, lack of exercise, dyslipidemia, smoking, depression, lower urinary tract symptoms, and pelvic surgery.
So, suffering from erectile dysfunction is a serious condition with a markedly negative impact on quality of life.
How does Viagra treat erectile dysfunction?
Viagra is a medicinal product, containing sildenafil and indicated in the treatment of adult men with erectile dysfunction.
Until 1998, no effective oral therapy existed. The only treatments available were highly cumbersome or invasive, and many men found them unacceptable as solutions to the problem of achieving or maintaining a satisfactory erection.
Sildenafil citrate was the first oral agent to be introduced for the treatment of erectile dysfunction, thanks to the researchers from Pfizer.
Sildenafil is a highly selective inhibitor of PDE type 54 and enhances NO-mediated relaxation of human corpus cavernosum. Sildenafil, by inhibiting phosphodiesterase, increases the intracellular concentrations of cyclic guanosine 3’,5’ monophosphate (cGMP), causing an amplification of the endogenous NO-cGMP signalling pathway.
It is considered a vasodilator agent, acting by increasing blood flow to the penis and thus it restores impaired erectile function.
In order for Viagra to be effective, it requires sexual stimulation in a natural setting.
Sale!
Viagra & Generic Sildenafil
£16.00 – £539.99
Select Preferred Strength, Quantity, and Branded or Generic
Choose between Viagra or Sildenafil. From £2 per tablet
Viagra and Generic Sildenafil contain the same medically active ingredients
Description
How does Viagra and Sildenafil work?
Viagra (Sildenafil) helps men to get and maintain an erection when sexually stimulated and/or excited. The medicine relaxes the blood vessels in the penis which results in more blood flowing to the penis when you are sexually excited.
How do I take it?
You should take Viagra (Sildenafil) approximately 1 hour before planning to have intercourse. Within a window of between 30 minutes and 4 hours after you take the medicine, it will be easier to keep and maintain an erection when you are sexually excited. If you take this medicine after a meal with a high fat content it may take a little longer to start working. This medicine will only work when you are sexually excited. You won’t get an erection just by taking Viagra (Sildenafil).
Dosage
The standard recommended dose for Viagra (Sildenafil) is 50mg and this will be suitable for most people. If this dose is not effective, you can try 100mg and if 50mg gives you side effects you can also reduce the dose to 25mg tablets.
You must not take more than 100mg daily of Sildenafil/ Viagra. Clinical trials have been conducted in patients taking up to 200mg sildenafil and it was found that ‘doses of 200mg did not result in increased efficacy but did increase the incidence of adverse reactions (headache, flushing, dizziness, dyspepsia, nasal congestion, and altered vision).’
In addition, in patients taking more than 100mg daily, there have been reports of rhabdomyolysis (a breakdown in skeletal muscle tissue the byproducts of which can lead to kidney failure), visual perception changes, vertebral artery dissection (a tear in the artery supplying blood to the brain), heart attacks and aggressive behaviour.
If the 100mg strength doesn’t work for you, there may be alternatives you can try and we recommend that you call us for a free consultation with our pharmacist or doctor to discuss any underlying conditions you may have. We recommend that all men taking medicine for erectile dysfunction have regular tests for blood pressure, cholesterol, diabetes and hormone imbalances. For instance, it may be that by fixing a hormone imbalance such as testosterone, your Viagra medication will be even more effective.
In addition, drug manufacturers do not advise patients to split tablets in half to get the correct dosage as they cannot guarantee that the active ingredient will be distributed evenly throughout the tablet. For instance, if you cut a 100mg tablet in two, you may find that you get 80mg in one half of the tablet and 20mg in the other half leading to either an overdose (increased risk of side effects) or a suboptimal dose (the medication may not work).
It is important that you choose the correct dose for you. If you wish to talk to our pharmacist or doctor about this, please contact us in the pharmacy on 01625 460621 or email [email protected].
Side Effects
Viagra (Sildenafil) is normally well tolerated, however, side effects can include:
- Headache
- Dizziness
- Nausea
Side effects normally subside after a few hours, however, if you experience a prolonged or painful erection (longer than 4 hours), then you must contact your doctor immediately.
Drug interactions
There are a number of medicines which interact with Sildenafil/ Viagra. For an exhaustive list please see the patient information leaflet (see section below) or call us in the pharmacy to discuss your specific situation. The main drug interactions are listed here:
Recreational drugs such as ‘poppers’ or amyl nitrate
Alpha blockers used for urinary retention or blood pressure problems (eg Flomax or Cardura)
Anti- arrhythmic drugs such as disopyramide
Antibiotics such as erythromycin
Antifungals such as itraconazole
Antivirals such as drugs used to treat HIV
Bosentan
Cobicistat
Calcium channel blockers to treat blood pressure and angina such as amlodipine
Dapoxetine (Priligy – used to treat premature ejaculation)
Grapefruit juice**
Nicorandil
Nitrates
Riociguat
Cimetidine (to treat stomach ulcers)
Please do not take Sildenafil/Viagra if you have taken any of the above drugs within the last 60 days without first consulting with either us in the Pharmacy ([email protected] / 01625 460621) or via email with our doctor [email protected].
**We advise not to take Sildenafil/Viagra with grapefruit juice as the blood concentration of Sildenafil will possibly be increased resulting in side effects.
Patient Information Leaflets
Please click here for the patient information leaflet for Viagra.
For Actavis Sildenafil please see the following leaflets: 100mg, 50mg, 25mg.
Storing Medicines Safely
Please keep your medicine out of the reach of children and store at room temperature. Unwanted medicine can be disposed of by returning it to any local pharmacy or indeed to us here for us to dispose of it for you.
New generic version
As Viagra patent expired, a lot of generics containing sildenafil are pushing the little blue pills’ price down.
The legend of the blue pill remains but generic alternatives can be used with the same effects, administering the same medicine (sildenafil) but with some extra money in the pockets of the patients.
Is it safe?
Yes, Viagra is a safe drug.
Safety of sildenafil was proven in a number of clinical studies. Sildenafil was administered to more than 9500 patients aged 18-87.
A special attention must be provided to the prevalence of cardiovascular diseases in patients with erectile dysfunction, and to the fact that cardiovascular disease and erectile dysfunction have common risk factors.
The hypothesis that erectile dysfunction is a harbinger of cardiovascular disease (particularly, coronary artery disease), while it remains asymptomatic, but for which symptoms might occur later, has been recently accepted as a proven theory.
Patients with coronary artery disease and their partners may be concerned about their sexual behaviours as they suspect that sexual activities might negatively affect the heart. According to the recommendation of the Princeton Consensus Panel, patients with erectile dysfunction, should be classified into three groups according to the risk of heart disease, and then a proper treatment plan for each patient should be set up to predict the risks that might occur during sexual activities.
I take one tablet. What happens?
Immediately after ingestion of one tablet, sildenafil starts to absorb into the body.
Viagra is associated with rapid onset of action, – within 15 minutes for some men – and an extended duration of action for up to 12 hours.9
But how long does Viagra stay in your system? Pharmacokinetics, sometimes described as what the body does to a drug, refers to the movement of the drug into, through, and out of the body—the time course of its absorption, bioavailability, distribution, metabolism, and excretion.
Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. When 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 in Cmax of 29%.10
Pharmacokinetic studies have supported the suitability of single oral doses of sildenafil for an as-needed and on-demand treatment for ED. In healthy volunteers, sildenafil doses are absorbed rapidly, with maximum plasma concentrations achieved within a median time of 1 h (range 0.5–2 h) after dosing.
The terminal half-life of sildenafil is 3–5 h.
In a two randomised, double-blind, placebo-controlled, two-way crossover studies were conducted in men with ED of no known organic cause, sildenafil is an effective oral treatment for erectile dysfunction that produces a penetrative erection as early as 12 min and for most patients, within 30 min after dosing, and a duration of action lasting at least 4 h.11
The volume of distribution and clearance characteristics of sildenafil resulted in an apparent terminal half-life ranging from 3 to 4 h. The half-life of sildenafil provides for an appropriate duration of therapeutic effect and also prevents drug accumulation with chronic once-daily use.
In summary…
After oral single-dose administration, sildenafil was rapidly absorbed, reaching maximum plasma concentrations within approximately 1 h. Plasma sildenafil concentrations were generally proportional to the administered dose. Ingestion of food is slowing the rate but affects at the minimum the extent of drug absorption. The absolute bioavailability was 41% due to the first-pass metabolism. Sildenafil was rapidly cleared from the body with a plasma elimination half-life of approximately 3–4 h over the dose range of 25 and 200 mg. These characteristics represent pharmacokinetic support for the effectiveness and appropriateness of sildenafil for the as-needed treatment of patients with ED. In addition, these studies showed that oral sildenafil is well tolerated over the approved dosage range (25–100 mg).12
Sildenafil and recent findings…
A new direction of researchers is toward the investigation of the ability of sildenafil to regulate osteopontin (OPN) gene and protein in peripheral blood mononuclear cells (PBMCs) from healthy blood donors.
Sildenafil has recently been found to have immunomodulatory effects in animal models and in studies performed in humans.
This is quite an interesting discovery since it has become clear that inflammation is an important contributor to the development of multiple disorders. Thus, immunomodulatory therapy is beneficial for many diseases.13
References:
- https://www.technologynetworks.com/neuroscience/news/viagra-could-now-be-available-without-prescription-294685;
- https://www.pharmaceutical-journal.com/news-and-analysis/infographics/three-decades-of-viagra/20202847.article;
- M Boolell, MJ Allen, SA Ballard, S Gepi-Attee, GJ Muirhead, AM Naylor, IH Osterloh, C Gingell – Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction;
- E Gbekor, S Bethell and L Fawcett- Selectivity of sildenafil and other phosphodiesterase type 5 (PDE5) inhibitors against all human phosphodiesterase families;
- Rodríquez Vela L, Gonzalvo Ibarra A, Pascual Regueiro D, Rioja Sanz LA.- Erectile Dysfunction;
- http://www.ema.europa.eu/Viagra- Summary of product characteristics;
- https://clinicaltrials.gov/ A Randomized, Open-Label, Crossover, Multicenter, Single Dose Comparator Study Evaluating Onset Of Penile Rigidity In Men With Erectile Dysfunction Who Are Treated With Sildenafil And Tadalafil;
- Kirby M, Jackson G, Betteridge J, Friedli K. Is erectile dysfunction a marker for cardiovascular disease? Int J Clin Pract. 2001;55:614–618. [PubMed];
- K Hatzimouratidis- Sildenafil in the treatment of erectile disfunction: an overview of the clinical evidence;
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/020895s027lbl.pdf;
- I Eardley, P Ellis, M Boolell, M Wulff-Onset and duration of action of sildenafil for the treatment of erectile dysfunction;
- DJ Nichols, GJ Muirhead, Ja Harness- Pharmacokinetics of sildenafil after single oral doses in healthy male subjects: absolute bioavailability, food effects and dose proportionality;
- B Kaleta- Sildenafil, a Phosphodiesterase Type 5 Inhibitor, Downregulates Osteopontin in Human Peripheral Blood Mononuclear Cells.
Assured Pharmacy is not liable for the currency or accuracy of the information contained in this blog post. For specific information about your personal medical condition, please contact our doctors or pharmacists for advice on [email protected]
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