How can take Viagra, how to buy Sildenafil (Viagra) online?

Sildenafil (Viagra)

Viagra was a major breakthrough for patients and doctors living with and managing erectile dysfunction, but it does not suit or help everyone with erection problems. When there is sexual stimulation, be that by touch, or sight, or smell, or whatever turns a man on, this is perceived by a certain area in the brain and then a cascade of chemical 'messengers' is sent out, which leads to the blood vessels supplying the penis opening up. One of these messengers is called 'cyclic GMP', and it is broken down by an enzyme called 'phosphodiesterase'. The medications such as Viagra, Levitra or Cialis work by blocking this phosphodiesterase and thus leading to an increased period where the blood vessels will be dilated. The way the drug works is very important for men regarding how it is used. It is only effective when there is sexual stimulation! The drug will not be successful if there is no stimulation, i.e. a man takes the medication and then awaits an erection before attempting any sort of sexual contact Many men claim that Viagra has failed for them because they have either taken it at too lower a dose, or not often enough, or they have taken it without any sexual stimulation.

At present Viagra is taken orally (by mouth) and, because of the relatively slow digestive process, it may be an hour or two before the drug produces its effects - certainly an issue in planning for sex. It affects not just the penis, but potentially could affect other parts of the body. As with most drugs, not everyone will benefit, although Viagra has been found to produce firmer, more frequent and longer lasting erections in the majority of men who have taken it Doses are 25,50 and 100 mg, taken 1 hour before sexual foreplay, and its effect lasts for 2-3 hours. Oral therapy is now prescribed in over 90% people with ED, and studies are showing that 70% of these achieve satisfaction. In one study of couples, where 87% of the men rated Viagra as 'somewhat satisfactory to very satisfactory', nearly 30% of their partners considered the treatment 'unsatisfactory', mostly because of their own lack of sexual interest

We get many questions about this drug. Some of its attributes are listed in the box.

All the junk email I get on my email account tells me that I can buy stuff from the USA that will work straight away. Is there an immediate-acting tablet?

At present, no there is not. Tablets that are taken under the tongue, or potentially in the future by nasal spray, will get into the bloodstream and act faster than tablets that are taken by mouth and swallowed, which need to be absorbed into your bloodstream to work.

All of the tablets that are presently licensed and indeed will be licensed in the near future require you to be sexually stimulated to work. The gap phase between taking a tablet and an erection developing would therefore be valuable for you and your partner to engage in the sort of foreplay that makes you both ready to enjoy making love.

Viagra sounds the perfect solution to my problems, which have affected my relationship with my new partner. How often can I use Viagra?

The recommended frequency of taking tablets is not more than once every 24 hours. There is no restriction on how many times a week you could use Viagra, but if you are getting it on the NHS, most GPs will limit their prescribing to one tablet per week as this is the recommendation in Schedule 11. You might find that, after using Viagra successfully to help you get an erection, your erections can also be better the following day. This could be a direct effect of the drug, but could also be due to the tissues in your penis being enlivened by getting a good supply of oxygenated blood in them.

I like to go out to dinner with my wife on Friday nights and have a Chinese meal. Can I take Viagra after a large meal? Would this be safe or sensible?

Taking Viagra after a large meal will slow the absorption of Viagra. What this means is that you may find that the Viagra does not work at all for you, or that it works much slower than it would have done had you taken it on an empty stomach, or after a light meal. In other words, it is safe in that it will have no harmful effects, but it is not sensible!

I am keen to get my love life as good as it was before we had kids, but do not want to go mad, as I have a demanding job. What dose of Viagra will I need?

The effect of Viagra does seem to improve the higher the dosage taken. The maximum dose is 100 mg. You might find that the dose of Viagra you need is dependent on other factors present at the time of intercourse, such as tiredness and stress. If you are unhappy with the first dose you are prescribed, visit your doctor again to discuss whether you could try a higher one.

I have seen the effect of Viagra on my husband, but do not feel stimulated myself. Could I try one of his Viagra tablets. Could women benefit from Viagra as well?

During foreplay and intercourse there are some very similar processes happening in women to those in men, so in theory Viagra could help to enhance sexual response, but so far there have been few studies of women while taking the drug. Women might feel that this shows a very particular gender bias in the testing of such drugs, but at the moment it is not licensed for women!

Viagra appears to improve the blood supply to the whole genital area. With sexual stimulation, this will lead to blood flowing into your clitoris and vulva and potentially make your vagina more slippery (better lubricated). This allows some women to enjoy sexual activity more; however, the majority of women with desire or libido problems don't appear to be helped. Further research in this area is going on and new results become available all the time. If you are interested in the treatment of Viagra in women, discuss this with your doctor or nurse.

There have been other reports of successful pregnancies in women taking Viagra, who were previously unable to have babies. Viagra may cause the lining of the womb to thicken from better nourishment from the bloodstream.

I am not well off, but should like to try Viagra to see if it will help our relationship. Will I have to pay for a private prescription?

Yes, if you don't conform to Schedule 11. A private prescription means that you will have to pay for the cost of the drug, plus whatever sort of percentage increase the pharmacy will put on the medication. Prices charged by retail pharmacies can vary greatly and it would be worthwhile asking your doctor if they know where the cheapest pharmacy is, or ringing round yourself, including the big retail chains. The prescription from the doctor won't cost you anything - the cost for the chemist lies in getting the drug privately rather than on the NHS.

I have a spinal cord injury and I am experiencing difficulty in achieving and maintaining an erection because of the effects of my injury. Will Viagra help improve my erections?

Viagra has been reported as being well tolerated and is effective in 45-60% of men suffering from spinal cord injury (SCI). As long as you are not taking any nitrates, there is no reason why you cannot take Viagra, but discuss treatment options with your GP. The side effects of taking Viagra are the same as for men who don't have a SCI (see section below). You may find that the results from Viagra are not as good as other treatments, such as injection therapy, for improving your erections, but this will dependant on your SCI.

Since having a spinal cord injury, I have had poor erections and Viagra didn't help improve them. Are there any other medications that will help?

Don't despair - there are other drugs available to treat ED such as Cialis, Levitra, Uprima (discussed in the following sections), MUSE, injections and vacuum therapy devices.

I had a car accident, which damaged my back and I'm now in a wheelchair. Could Viagra help me?

Yes. There have been a few studies of Viagra in people with nerve damage. In people with spinal cord injury, the majority had improved erections and preferred Viagra to 'placebo' (where there was no active-ingredient tablet taken). In a study of people with MS, Viagra improved the erection and side effects were mild to moderate. They felt that sex life was considerably better. So, yes, in your case, you should try consulting your GP, who may well prescribe it for you, and see if it improves your sex life.

I am 25 and have MS. I've read in the MS magazine about Viagra for men's impotence recently. Could that help me sexually?

There has been an enormous amount of publicity about Viagra in recent months, and the ways in which it may transform men's sex lives. Fortunately for many men with erection problems, caused by nervous system damage in MS, it may indeed offer some help.

Essentially Viagra acts on blood supply problems in MS and other similar conditions, by helping the penis to fill with blood. Even where nervous system damage is substantial and where erections are very difficult to obtain and sustain, Viagra might be able to help. As many men with MS are younger than those in which side effects with Viagra have happened, there should be fewer problems amongst your age group.

Note that, because of the cost of the drug, and the anticipated large demand for it, the Department of Health has been extremely circumspect about those for whom it can be prescribed via the NHS (see question in Chapter 5 on Schedule 11). However, MS is now one of the designated medical conditions - but there may still be local variations in supply, in addition to clinical reasons for its non-prescription.

Always get advice from your doctor and do not buy it on the internet. Viagra is a very safe and effective treatment, provided that you are guided medically - do not experiment without a medical opinion.

I had heart by-pass surgery 18 months ago. Can I take Viagra?

If this operation was successful and you now have no chest pain, then there is no reason for you not to be having sex, or be treated for any sexual dysfunction. If, however, you are still having chest pain, particularly at rest, then this needs to be sorted out before you embark on any physical activity, including having sex. If you are taking nitrates, you must not take Viagra.

Can I take Viagra? I had a stroke a year ago and worry that I might have another, which is not good for my self-confidence with my girlfriend.

The answer to this question is yes, in the vast majority of cases. Strokes can be either due to bleeding into the brain or to the brain not getting enough blood flow because of a blockage in the arteries. Viagra will open up the arteries flowing to the brain, and this results in some men getting a mild headache and a feeling of fullness in the head, following a Viagra tablet You will need to discuss the safety issue with your GP, but there is no reason why you should not try having sex again after having had a stroke.

I am on tablets for my depression. Could Viagra actually help my depression as well as my sex life?

Depression and sexual dysfunction can be very much a 'chicken and egg' situation because some ED problems could actually cause anxiety and depression, but, in long-standing depression, Viagra is successful in helping people have intercourse. We have discussed psychological problems in Chapter 2.

There is increasing evidence that men who are on anti-depressive treatment, when treated with Viagra, can, in some cases, decrease the amount of antidepressant therapy that they are taking.

If you are on medication called SSRIs (selective serotonin reuptake inhibitors), you should get better erections with Viagra.

I have had diabetes for the past 15 years (I'm 39) and rind it very difficult to make love to my wife nowadays because I cant sustain an erection. Would Viagra help me?

It could well do. In one study, Viagra helped over 50% of men with diabetes and ED. The effects did not seem to be affected by age, or how long they had had ED or diabetes. Although the response to Viagra was somewhat less than that seen in other groups, people with diabetes do often have many other problems, such as vascular disease or diabetic neuropathy.

The majority of side effects (see next section) seen with Viagra (e.g. headache, feeling of acidity, congestion in your nose) are not severe and don't last long, so these should not prevent you from trying Viagra.

I have had a kidney transplant and am on medication. Can I take Viagra?

Yes you can. There is no reason why the drugs normally taken after a transplant operation will interact with Viagra. (The only drug that you cannot take with Viagra is the class of drugs called nitrates, which are given to people for their heart pain.)

I had cancer some months ago, which left me rather incapacitated -1 now have trouble having sex with my partner. Would Viagra help me?

You do not say what your disability is, but there are various choices open to you. Tablets would still be your first choice: Viagra, Levitra or Cialis, or Uprima (see the following main sections), depending on what medication you are currently taking. However, you could also try other treatments such as injections, MUSE or a vacuum device (see Chapters 8 and 9), if drugs like Viagra do not work for you.

I've had an operation on my prostate and other treatment for cancer. My doctor was very negative about me having Viagra. Was he right to be so?

We know that men who have undergone surgery or radiotherapy for prostate cancer have taken Viagra successfully. Although the best response was seen in men with less severe ED, over half with complete ED were pleased with the effect Viagra had. So you doctor may well be over-pessimistic about it.

The success of Viagra has interested many pharmaceutical companies and there are now two new drugs, which are the same type of therapy as Viagra. They are called vardenafil (Levitra), marketed by Bayer and GlaxoSmithKline; and tadalafil (Cialis), developed by a technology company called ICOS and marketed on a worldwide basis by Eli Lilly.
Levitra and Cialis have the same advantages and disadvantages as Viagra, discussed previously, so the rest of this chapter will try to explain some of the differences between the three therapies.

Now there are other treatments like Viagra on the market perhaps I should try one of the others? Which one should I start on?
As you would expect with second-generation drugs, they do have advantages over Viagra. However, Viagra works and has no significant side effects for most men. Therefore, you will only find out which treatment is best for you by trying them and seeing which one works best
Each of the three treatments has its own strengths and weaknesses and your doctor or nurse will be able to discuss these with you. The balance will be an individual one between the potential advantages of the newer medications (Cialis and Levitra) compared with the great clinical experience that doctors now have with Viagra.

Do Cialis and Levitra work in the same way as Viagra?
Yes. Cialis and Levitra act in the same way as Viagra by blocking an enzyme called phosphodiesterase-5 (PDE5). This helps the smooth muscles in the penis relax and widen, allowing more blood to enter. Also similar to Viagra, there needs to be sexual stimulation for the drug to be effective. They are 'facilitators' of sexual activity not 'initiators', i.e. they are not aphrodisiacs.

Do Cialis and Levitra work in the same way as Viagra?
Yes. Cialis and Levitra act in the same way as Viagra by blocking an enzyme called phosphodiesterase-5 (PDE5). This helps the smooth muscles in the penis relax and widen, allowing more blood to enter. Also similar to Viagra, there needs to be sexual stimulation for the drug to be effective. They are 'facilitators' of sexual activity not 'initiators', i.e. they are not aphrodisiacs.

Is any one of these drags better than the others?
Some effort has been made by reviewers and by pharmaceutical companies to compare data from different clinical trials (with different patient populations) and conclude that Drug A is superior to Drug B for a given population. Such a conclusion must be treated with some reservation until direct comparative studies are done.
At present all that can be said conclusively is that Viagra, Cialis and Levitra are all very effective and very safe drugs for men with ED.

I have been taking Viagra for some time now. Should I change from Viagra to one of the new tablets?
The answer to this question is one that will be different for each man individually. For some, if Viagra has been successful and they are having no serious side effects, they will see no reason to change their medication. However, for others, there will be the urge to experiment and to try the newer compounds to see if they are better.

Do you think the effects of Viagra could be enhanced by taking Cialis or Levitra in combination?
There have been no clinical trials so far looking at the safely or the effectiveness of such combinations, and therefore it cannot be recommended that you try these drugs in combination at this stage. Take your doctor's advice - don't experiment with medicines!
I know that Viagra has been used by some women. Would Levitra or Cialis help female sexual problems?
It is very likely that these drugs will help some women with sexual problems, as Viagra has done. However, at this stage there have been no research trials reported of women taking these drugs, so as yet we cannot recommend that they are taken for women.

What side effects can I expect from Levitra?
Levitra is generally well tolerated, although some men will experience side effects. These are due to effects of Levitra on other parts of the body apart from the penis and the most common ones are headache, facial flushing, indigestion and a stuffy or runny nose. Similar side effects are seen with drugs that act in the same way as Levitra.
Side effects with Levitra are rarely unpleasant enough to make men stop taking it and it is often found that, with continued use, the side effects tend to disappear. If you are bothered by side effects, then you should discuss these with your doctor.

How does Levitra compare with Cialis over Viagra?
In laboratory research conditions, Levitra is the most powerful of the presently available phosphodiesterases (compared with Cialis and Viagra). The question is whether then this equates to a superiority in a 'clinical* setting where healthy and difficult-to-treat groups, such as men with diabetes, are taking it. Up to now there have been no head-to-head data published, so for now we cannot answer the question as to which drug is 'better' or indeed which drug men prefer. At this stage, what can be said confidently is that this is another highly effective drug offering another choice for men with ED.

Can I get Levitra on the NHS?
The NHS has restricted the types of patients with ED who can get treatments paid for by the NHS and this includes Levitra. Your doctor will know whether you come into one of these categories, which are discussed above under Viagra, but generally you have to have some other disease, such as diabetes or spinal cord injury. If this is the case, then, unless you are normally exempt, you will still have to pay a prescription charge for Levitra.
If you are eligible to be prescribed Levitra on the NHS, then your doctor will write the letters 'SLS' (standing for Selected List Scheme) next to the drug name on the prescription. If these letters are not on the prescription, the pharmacist will ask you to pay for Levitra.
You may also be able to get Levitra on the NHS if you are diagnosed as suffering severe distress as a result of your ED. This diagnosis may have to be made by a hospital specialist rather than by your own GP.
The majority of patients have to pay for their ED treatments (although the consultation with the doctor is still free), but a prescription from your doctor is still needed. It is not possible to buy Levitra 'over the counter' from a pharmacist.

Due to the global financial decline, many people today are more careful when it comes to spending their hard-earned income. Today's shoppers would more than likely go for more affordable drugs than costly ones and it is relatively easy to find a local pharmacy offering less expensive drugs. What's more, it is much easier to find cheaper medicines on the internet through an online generic pharmacy. Pharmacy reviews from consumers usually have helpful positive or negative remarks after they buy pills online.

The best option in figuring out whether an online generic pharmacy is legitimate is checking out whether their products are approved by the FDA. The U.S. Food and Drug Administration (FDA) is the ruling body which controls and supervises the promotion and distribution of both brand-name and generic drugs. Buyers are reassured that generic drugs undergo exactly the same rigid process the brand-name drugs undergo. Before these generic drugs (or brand-name medicines) are offered on the market, they should undergo evaluation from Center for Drug Evaluation and Research or CDER.

Before drug manufacturers can sell their products on the market, they need to first test their own products to find out if they are in fact reliable and safe for use. Next, they must send to CDER evidence of the test they have conducted and scientists from the government agency will evaluate the test completed by the drug manufacturer. These scientists may involve chemists, doctors, pharmacologists, as well as other health authorities. In the event the drug is approved, then it is ready for purchase in the market.

The good news is, customers themselves could check out the FDA's website to be aware which generic or brand-name drug is recognised by the FDA. The FDA publishes online an index of approved generic or brand-name drugs and this list is just updated regularly.

This list features the drug's name and FDA application number, the active ingredients, the approval date, and the name of the company which made the drug. The approval type is also posted, whether the drug is approved, under tentative approval, or labeling revision.

More than three years ago, the FDA endorsed of labeling revisions with regard to common erectile dysfunction drugs like Cialis, Viagra, and Levitra. The government agency has required the companies to display the side effect 'Potential risk of sudden hearing loss' prominently on the label of these drugs. Abilify, Tamiflu, and Adderall are just a few of the medicines that also went through labeling revisions.

The US FDA have warned customers to buy only medicines from an online generic pharmacy which usually requires a prescription and where a pharmacist is available to respond to questions from consumers. Customers must also buy only from pharmacies which are recognised by the VIPPS or Verified Internet Pharmacy Practice Sites. VIPPS-accreditation ensures that these online pharmacies abide by the state and federal laws with regards to the sale of medicines. Furthermore, the FDA cautions consumers not to reveal their credit card numbers to any online pharmacy except in cases where they are certain these are without a doubt reputable online pharmacies.

It is fairly easy today to be aware of which online pharmacy is reputable or not, and which medicine (generic or brand-name) is real or counterfeit. Checking pharmacy reviews is one of the different ways to avoid dodgy online pharmacies and fake medicines. Furthermore, the US FDA site is definitely a handy resource in terms of safeguarding customers and it will be extremely sensible for customers to read their regulations.

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