Viagra
Sildenafil citrate, sold under the names Viagra, Revatio and (in the Indian subcontinent) Caverta, is a drug used to treat male erectile dysfunction (impotence) and pulmonary arterial hypertension (PAH), developed by the pharmaceutical company Pfizer. Viagra pills, intended to treat impotence, are blue with the words "Pfizer" on one side and "VGR xx" (with xx representing 25, 50 or 100, the dose of that pill in milligrams) on the other. Its primary competitor on the market is tadalafil (Cialis).
Sildenafil (compound UK-92,480) was synthesized by a group of pharmaceutical chemists working at Pfizer's Sandwich, Kent research facility. It was initially studied for use in hypertension (high blood pressure) and angina pectoris (a form of cardiovascular disease). Phase I clinical trials under the direction of Ian Osterloh suggested that the drug had little effect on angina, but that it could induce marked penile erections (Boolell et al 1996). Pfizer therefore decided to market it for erectile dysfunction, rather than for angina. The drug was patented in 1996, approved for use in erectile dysfunction by the FDA on March 27, 1998, becoming the first pill approved to treat erectile dysfunction in the United States, and offered for sale in the United States later that year (Kling 1998). It soon became a great success: annual sales of Viagra in the period 1999-2001 exceeded $1 billion. The name "Viagra", like many drug names, is a marketing invention. It was possibly inspired by the Sanskrit word "vya-ghra", which means "tiger". The word rhymes with "Niagara" (Niagara Falls is a popular honeymoon destination and Niagara, being such an impressive waterfall, evokes a sense of incredible erectile and ejaculatory strength). The sound of the word also suggests the words "vigor" and "virile". Even though Viagra is only available by prescription from a doctor, it was advertised directly to consumers on TV (famously being endorsed by Bob Dole). Numerous sites on the Internet offer Viagra for sale after an "online consultation," a mere web questionnaire. The "Viagra" name has become so well known that many fake aphrodisiacs now call themselves "herbal Viagra" or are presented as blue tablets imitating the shape and colour of Pfizer's product. A mixture of Viagra and ecstasy, called sextasy, has become popular among rave partygoers. Viagra is also informally known as "Vitamin V", "the Blue Pill", and goes by various other nicknames. It has been suggested that Viagra would lead to a marked drop in the demand for certain traditional remedies, such as tiger penises and rhinoceros horns and that the drug may therefore help to preserve these endangered species. However, this is unlikely in that these parts of endangered species are not only used to treat impotence. Rhinoceros horns, for example, are used as a treatment for high fever. Furthermore, since Viagra has not been shown to possess aphrodisiac properties, it is unclear that the natural remedies would compete with this new clinical drug. Pfizer's worldwide patents on sildenafil citrate will expire in 2011-2013. The UK patent held by Pfizer on the use of PDE5 inhibitors as treatment of impotence has been invalidated in 2000 because of obviousness; this decision was upheld on appeal in 2002. Men aged 18-65 years generally begin taking 50-100 mg of Viagra. Older patients usually begin with a 25 mg dose. Viagra can be taken with or without food, although high-fat foods may cause it to be absorbed and begin working more slowly. Viagra pills can be crushed or broken before swallowing. Viagra should only be taken once a day, and should not be taken every day without your doctorís approval. Itís best to take Viagra about one hour before planned sexual activity. It should be effective anytime between half an hour and four hours after taking the pill. Viagra increases blood flow to the area, and with sexual stimulation it will cause an erection. Viagra does not cause an erection when there is no sexual activity. It contains no hormones and is not an aphrodisiac. The prescription is to treat the root physical cause of erectile dysfunction. Viagra works well for most who take it. Studies show that 80% of men had better erections when using Viagra. It is effective no matter how long they have struggled with erectile dysfunction, what its cause, or how old they are. Studies in men with both mild and serious erectile dysfunction have shown Viagra to be effective. Viagra works quickly. It can take effect in as little as thirty minutes, and remain effective for up to four hours. For most, Viagra can be taken once a day as desired. The manufacturers of Viagra have completed over 120 studies with the help of 8,800 men. These studies prove that Viagra is generally a very safe prescription. 16 million men all over the world have used Viagra to overcome erectile dysfunction. Itís the most popular medication for impotence in the US, and of the 10 million Americanís taking it, almost one million are successfully using it along with medication for high blood pressure. Viagra is like all medications in that itís not to be used by everyone. Serious drug interactions are possible, so make sure your doctor knows about all other medications you use. Before undergoing any surgery, including dental surgery, tell your doctor you are using Viagra. They need to know if you are using butyl nitrate or amyl nitrate.  Viagrais medication relaxes the muscles inside the penis by enhancing the body's response to nitric oxide. This means that the blood can flow into the penis and cause an erection. It does not automatically cause an erection, but Viagra will help treat erectile dysfunction. |
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There is no dosing schedule for Viagra, since itís taken only as needed. Do not take with grapefruit juice, as this may cause an undesirable build up in the body and increase the risk of side effects. Common Side Effects: Altered vision (blue tint or haze), congested sinuses, or dry eyes. These events may occur in as many as 3% of patients. Mild Adverse Side Effects: Flushing, headache, indigestion, light sensitivity, rash, unable to tell between blue and green. While these infrequent reactions may not pose an immediate danger, contact your physician as soon as possible, and avoid this medication until you have received further instructions. Serious Adverse Side Effects: Arrhythmia, blood sugar problems (in patients with history of diabetes), decreased blood flow to the heart, heart attack, priapism (prolonged and painful erection), seizures, swelling or redness of the eyes, or temporary blindness. These extremely rare side effects indicate the need for emergency medical attention. Call emergency services immediately. Tell your doctor if you have or have ever had a bleeding disorder; heart, kidney, or liver disease; a heart attack; irregular heartbeats; angina; a stroke; high or low blood pressure; sickle cell anemia; multiple myeloma; leukemia; conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosa, or Peyronie's disease); or a condition known as retinitis pigmentosa. Some Viagra drug interactions could be life threatening, so be very honest with your doctor about all medications you are taking. If you are regularly using Viagra, consult with your doctor before adding any new medications or over the counter remedies. Drugs to be especially aware of include nitroglycerin (Nitro-Bid, Nitrostat, and others), any other medications to treat impotence, cimetidine (Tagamet, Tagamet HB), amlodipine (Norvasc) or other medications for high blood pressure, itraconazole (Sporanox), isosorbide (Imdur, Ismo, Isordil, and others), phenobarbital, ketoconazole (Nizoral), ritonavir (Norvir), rifampin (Rifadin, Rimactane), erythromycin, saquinavir (Invirase), and vitamins. Viagra prescriptions should be stored in a place free of moisture and sunlight, and at room temperature. Do not store in the bathroom or near a sink, since the pills may get wet. Discard any unused pills that have expired. Keep all medications away from children.
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