Viagra(Sildenafil Citrate)

This drug is taken by mouth as needed 45 minutes before sexual activity. Depending on how and when the drug works for you, an interval of one-half hour to as much as 4 hours may prove ideal.

Before taking Viagra, do not eat a very large or high fat meal as it will impair the effectiveness of the medication. Take only as directed, usually half of a 100mg pill once daily as needed. Viagra works along with sexual stimulation to help achieve an erection.

Precautions:

Before using this drug, tell your doctor your medical history, including any allergies (especially drug allergies), any penis conditions such as fibrosis/scarring, history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (such as leukemia or myeloma), or Peyronie's disease, eye problems (retina diseases). kidney or liver disease, bleeding disorders or active stomach ulcers, heart diseases, stroke or severe high or low blood pressure. Limit alcohol intake, as it may aggravate side effects of this drug.

To avoid dizziness and lightheadedness when rising from a seated or lying position, get up slowly. The elderly may be more sensitive to the side effects of this drug, therefore caution is advised in this age group.

Side Effects

Headache, flushing, stomach upset, nasal stuffiness, diarrhea and dizziness might occur. If these effects persist or worsen, notify your doctor promptly.

Storage

Store at room temperature between 59 and 86 degrees F (15-30 degrees C) away from light and moisture. Keep this and all medications out of the reach of children.

Uses

Generic Viagra Oral Jelly is used to treat male sexual function problems (erection problems). It is also known to: - Increase Sex Drive - Boost Sexual Performance - Provide Fuller & Harder Erections - Increase Stamina & Endurance - Quicker Rechargeshttp://sapnamed.blogspot.com

Viagra for Men

What Is VIAGRA?

VIAGRA is a pill used to treat erectile dysfunction (impotence) in men. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated).

You will not get an erection just by taking this medicine. VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.

How VIAGRA Works

In many men with erectile dysfunction, VIAGRA helps the body's natural erection process. When a man is sexually excited, the penis will fill with enough blood to cause an erection. After sex is over, the erection goes away.

VIAGRA Is Not for Everyone

VIAGRA is only for patients with erectile dysfunction. VIAGRA is not for newborns, children, or women. Research is underway into the possible effectiveness of Viagra for Women, however until the results are known, we do not recommend the use of VIAGRA by women. Do not let anyone else take your VIAGRA. VIAGRA must be used only under a doctor's supervision.

VIAGRA must never be used by men who are taking any medicines that contain nitrates. Nitrates are found in many prescription medicines that are used to treat angina (chest pain due to heart disease) such as:

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)

Nitrates are also found in illicit drugs such as amyl nitrate or nitrite ("poppers"). If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist. If you take VIAGRA with any nitrate medicine or illicit drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke.

What VIAGRA Does Not Do

VIAGRA does not cure erectile dysfunction. It is a treatment for erectile dysfunction. VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV-the virus that causes AIDS. VIAGRA is not a hormone or an aphrodisiac.

Possible Side Effects

Like all medicines, VIAGRA can cause some side effects. These effects are usually mild and do not last long. Some of these side effects are more likely to occur with higher doses.

VIAGRA is generally well tolerated. Side effects are rare, but if experienced they are usually mild and temporary.

The following is a list of the most common side effects:

• Headache,

• Flushing,

• Upset Stomach,

• Stuffy Nose,

• Urinary Tract Infection,

• Visual changes such as mild and temporary changes in blue/green colors or increased sensitivity to light,

• and Diarrhea.

Viagra

Viagra (Sildenafil) was approved by the Food and Drug administration (FDA) in 1998 and was the first drug for the treatment of erectile dysfunction. Given as an oral medication, 9 tablets are dispensed every second worldwide and Pfizer, the manufacturer of the drug says that millions of men have been helped to improve their sex lives. Impotence, or erectile dysfunction, is a problem that affects most men at some time in their lives. Viagra is a drug for those whose problem is not resolving in the short term and who have been advised by their doctor that it is a safe drug for them to try.

How Viagra Works

Originally studied for the use in people with high blood pressure and cardiac problems the drug was found to have a very interesting side effect. Viagra increases the blood flow to the penis and enables a man to maintain an erection for at least 4 hours. It only works if the man is sexually stimulated so will not cause an erection by just taking the pill.

Cost Viagra

Viagra costs about anywhere from $5 dollars per pill, but market forces and source can vary the price considerably.

How to take it

The medication is taken in pill form by mouth. One Viagra tablet can be taken in 24 hours, it will usually work within 30 minutes to 1 hour and lasts about 4 hours.

Common side effects

The most common side effects are headache, facial flushing, dizziness, visual problems such as blurred vision, bluish vision and sensitivity to light, nasal congestion, an upset stomach.

Viagra can be dangerous

Do not take Viagra if you use nitrate drugs. These types of drugs used to treat cardiac problems such as angina can if used in combination with Viagra cause the blood pressure to drop to unsafe, sometimes life threatening levels.

People with cardiac problems, anatomical malformations of the penis such as Peyronie's disease, men with a predisposition to prolonged erections caused by sickle cell anemia, multiple myeloma (a form of cancer), leukemia, liver problems (especially severe liver disorders), kidney problems and people taking certain medications used for HIV or those over 65 should NEVER take the drug unless prescribed by a medical practioner. Deaths have occurred during sexual activity in men using the drug.

Viagra is one of the medications that has revolutionized the treatment of erectile dysfunction. It has allowed those who where unable to maintain an erection or only able to have partial erections enjoy a better sex life.http://sapnamed.blogspot.com

Men Himalayan Niagra

There are many factors that influence a man's sexual performance. we would like to give you some details about the general causes for non verility or general dislike by men for having sex. They are lsited below:

Impotence

Impotence is the inability to achieve or sustain an erection, and most men will experience this very frustrating problem at some time. It can either be a once-in-a-lifetime problem, or occur periodically or chronically.

When this happens it can cause anxiety, depression, and a variety of other problems, since it could lead to the man questioning his sexual prowess. Several diseases such as diabetes can cause impotence; yet, other factors such as worry, over-work, and fatigue can cause this highly frustrating experience.
Circulation of blood is of prime importance, since if the blood flow to the penis is not 100%, then problems may be experienced with achieving and maintaining an erection.

Nutrition also plays a large role in sexual prowess, and that is where the belief originated regarding oysters and sex - the reason is simple - oysters contain zinc and men need zinc for normal sexual functioning.

Zinc is an ingredient needed for testosterone manufacture and for sperm production. A shortage of zinc can also contribute to mental problems, which may also contribute to a loss of libido. Zinc is also required for proper prostate functioning.

Age

The male’s sexual peak is reached in early adulthood and then declines after that - but - men can stay sexually active until a very advanced age, should they so choose.

Citing age as a contributing factor for sexual dysfunction is mostly used as an excuse not to have sex, since age as such does not mean that you should be sexually inactive.

Hormones

Without testosterone in the body, normal sexual functioning cannot happen, but should this be a problem it is easily treatable by a medical doctor. There is no clear-cut indication that testosterone levels influence the size of the penis.
The correlation between blood testosterone levels and sexual activity is a disputed area, since some studies indicate that increased testosterone levels influence sexual behavior, yet some conflicting studies exist on the amount of testosterone required to perform properly.

Alcohol and other substances

Some men might experience an increase in libido when a large quantity of alcohol is consumed, or when certain addictive substances are used, but the downside of this is possible erectile dysfunction.

One very important point to keep in mind is to discuss any sexual problem with your partner - this will clear the air, and will also help to lessen any psychological pressure that you may be feeling.

Addictive substances, and here we include alcohol, may lead to problems with achieving an erection, a decrease in the duration of the erection and an increase in time to ejaculate.

Chronic alcoholism and substance abuse may lead to impotence since some studies have shown that the liver is stimulated to produce an enzyme, which destroys testosterone - the male hormone, and the body does not compensate for this loss. It is therefore suggested that a healthy as possible lifestyle be followed if you wish to maximize your sex life.

General information on our Herbal Himalayan Niagra (For Men)
Some herbal sexual supplements make it sound as if you will overnight get new body parts - but the truth of the matter is that there are no pill or capsule that can change the physiological size overnight.
What our herbal sexual supplement does with great success, is to ensure that you achieve the best erection that is possible, and with this in mind, that the circulation to your penis is optimized to ensure that it would also be the hardest erection.
The herbs also has a "warming" effect, and helps to increase the libido naturally, without side effects, as is the case with many sexual medications.
We made no claims that is impossible to substantiate, and have a faithful following of satisfied clients that has been using Himalayan Niagra for some time, and with great effect.

Ingredients used in our Herbal Himalayan Niagra(for men):
Our Herbal Himalayan Niagra(For Men) is a unique and extraordinary formula, in which a blend of various pure herbs and natural ingredients are combined to create this remarkable product. It contains the following herbs and natural ingredients: ginseng, rosemary, ginger, peppermint, Cuccrbita Pepo, Asparagus Racemosus, Argyreia Nervosa.

Women Himalayan Niagra

Recent studies show that 68% of women frequently experience problems reaching orgasm. Unfortunately many women tend to believe that there is something wrong with them— or even that they are "frigid"— if they can't climax on demand. This is not the case. Nearly all men can climax without difficulty, but women just aren't made that way. In the past, most doctors didn't rate the importance of the female orgasm very highly. Until recent years, doctors believed that only a tiny minority of women could have multiple orgasms; to the contrary, research now indicates that the vast majority of women are capable of having a series of climaxes one after the other.

Specially formulated to raise levels of progesterone in women, Himalayan Niagra(For Women) can help to enhance sexual sensitivity, increase sexual stamina, and improve your ability to achieve more frequent and more powerful orgasms.

Himalayan Niagra(For Women) is an all-natural alternative to prescription drugs made from the finest quality botanicals available. The all-natural proprietary blend of unique herbs found in Himalayan Niagra(For Women)is designed to increase blood flow and heighten sensation by activating the body's natural hormone production, while supplying vital nutrients necessary for peak sexual performance.

Himalayan Niagra(For Women) is the leading herbal 'Viagra for women'. Himalayan Niagra(For Women) uses natural ingredients to help with libido problems and improve virility.

Himalayan Niagra(For Women) is a daily supplement, designed to help you achieve a natural balance throughout the month, reduce the ups and downs experienced with the menstrual cycle and increase spontaneous sex-drive. Unlike male counterparts, women do not respond to an 'instant' sex pill.

Common benefits from using Himalayan Niagra(For Women) include :

Increased stamina Improved sexual desire Stronger, more powerful climaxes Multiple climaxes Because Himalayan Niagra(For Women) is an all-natural nutritional supplement containing only the finest botanicals, there are no harmful side effects when taken as directed. Himalayan Niagra(For Women) is not a pharmaceutical drug and contains none of the synthetic chemicals found in prescription medications. It is a safe, natural alternative to prescription drugs, which can sometimes have serious side effects.

How does Himalayan Niagra(For Women) work ?

The all natural proprietary blend of unique herbs found in Himalayan Niagra(For Women) is designed to restore blood flow, and heighten sensation by activating the body's natural hormone production and supplying vital nutrients necessary for peak sexual performance. It increases the blood flow , along with energy, stamina, and desire.

Is Himalayan Niagra(For Women) safe ?

Because Himalayan Niagra(For Women) is an all natural nutritional supplement containing only the finest botanicals, there are no harmful side effects when taken as directed. Himalayan Niagra(For Women) is not a pharmaceutical drug and contains none of the synthetic chemicals found in prescription medications. It is a safe alternative to prescription drugs, which can sometimes have serious side effects.

What can Himalayan Niagra(For Women) do for me ?

Common benefits from using Himalayan Niagra(For Women) include: Dramatically boost sexual desire Improve sexual stamina Stronger, more powerful climaxes Multiple climaxes

Will I experience any side effects ?

Because Himalayan Niagra(For Women) is an all natural nutritional supplement containing only the finest botanicals, there are no harmful side effects when taken as directed.

What ingredients are used in Himalayan Niagra(For Women) ?

Himalayan Niagra(For Women) is all natural, and made from the finest quality botanicals available like Hemidesmus Indicus, Coculus Hirustus, Asparagus Racemosus, Withania Somnifera, Tribulus Terristris.

How should I use Himalayan Niagra(For Women) ?

The normal dosage of Himalayan Niagra(For Women) is two capsules 2 times a day with a meal and a glass of water. It is suggested women under pregnanacy not to consume.

Do I need a prescription to use Himalayan Niagra(For Women)?

No you do not. Because Himalayan Niagra(For Women) is an all natural nutritional supplement containing only the finest botanicals, there is no need to obtain a prescription.

How does Himalayan Niagra(For Women) differ from other impotence drugs?

Himalayan Niagra(For Women) is not a pharmaceutical drug and contains none of the synthetic chemicals found in prescription medications. It is a safe alternative to prescription drugs, which can sometimes have serious side effects.

Disclaimer : None of our products have been tested or clinically proven to cure or treat a disease of any kind. All of our products have been designed from a list of herbs that have been traditionally used for hundreds of years for specific ailments based on Herbal Folklore both eastern and western. All diseases and health disorders mentioned under the various products are from Herbal books giving discriptions as to what the various herbs have been traditionally used for. No clinical proof has been made. All statements have not been evaluated by the Food and Drug Administration.http://sapnamed.blogspot.com

Herbal Massage Oil

We are one of the leading Wholesale Massage Oil Suppliers. The spectrum of massage oil manufactured by us consists of Natural Massage Oil and Herbal Massage Oil. Our massage oil will provide relief to your body pain and improve your energy level. A strong anti oxidant, the Herbal Massage Oil offered by us is suitable for the people of all ages.

We welcome you to the world of herbal medicine. Herbal medicine is the oldest form of healthcare known to mankind. Herbs had been used by all cultures throughout history. It was an integral part of the development of modern civilization. Primitive man observed and appreciated the great diversity of plants available to him.

The history of herbology is inextricably intertwined with that of modern medicine. There are over 750,000 plants on earth. Herbalists, however, consider that the power of a plant lies in the interaction of all its ingredients. The efficacy of many medicinal plants has been validated by scientists abroad, from Europe to the Orient. Thanks to modern technology, science can now identify some of the specific properties and interactions of botanical constituents. With this scientific documentation, we now know why certain herbs are effective against certain conditions.

We at SriRam Herbals have developed this NagaChampa Massage Oil with great care in selecting the rarest of the herbs as per the ancient formula handed over by generations to give relief from some of the common ailments like Arthiritis.,Joint Pains, Knee Pains, Shoulder Pains, Muscular pains, Sprains, Back pains , Neck pains and cramps.

The ingredients that are used in the oil are one of the best known herbs in the science like Ricinus Communis,Olea Euopae,Piper Nigrum,Myristica Fragrans, Rosmarinus Officnalis, Gaultheria Procubens,Pogostemon Cablin, Cinnamomum Zeylancium,Azadirachta Indica,Cedrus atlantica,Melaleuca Alternofolia,Commiphora Myyrha, Curcuma Longa and Aloe Vera.

The common ailments for which our NAGACHAMPA massage oil can be used are listed below:

• Arthiritis & Joint Pains

Arthiritis & Joint Pains Symptoms

Arthritis is a painful inflammation of a joint or joints of the body, usually producing heat and redness. There are many kinds of arthritis. In its various forms, arthritis disables more people than any other chronic disorder.

The main symptom of Arthritis is severe pain in the affected joints. The muscles, ligaments, synovial membrane and cartilage get inflamed and the movement of the joint becomes extremely painful, especially in cold, windy and damp weather. If this condition is not treated properly, the joints become immobile and this may ultimately lead to deformity of the joint.

Arthritis symptoms are inflammation is your body's reaction to damage or to the presence of a foreign substance. It can occur when the joint is injured, broken, infected, or subjected to prolonged "wear-and-tear.".

Remedy : Apply the NAGACHAMPA massage oil on the area and give a gentle massage .Wash the area with warm water after 2 hours.

• Sports

• Sprains and Strains

When you participate in sports and physical fitness activities, you can injure the soft tissues of your body. Even simple everyday activities can damage these ligaments, tendons and muscles.

Some of the soft-tissue injuries you're most likely to experience include:

• Sprains

• Strains

• Contusions

• Tendonitis

• Bursitis

• Stress injuries

Any of these can be the result of a single episode, such as a fall, a sudden twist or a blow to the body. You might also sustain one or more of these injuries because repeated overuse, such as in ongoing athletic activities. In this case, small amounts of body stress accumulate slowly but steadily. The result can be damage and pain.

Here are some of the injuries you're most likely to experience, along with suggested ways of treating them.

Sprains :

The joints of your body are supported by ligaments strong bands of connective tissue that connect one bone to another. A sprain is a simple stretch or tear of the ligaments.

The areas of your body that are most vulnerable to sprains are your ankles, knees and wrist. A sprained ankle can occur when your foot turns inward. This can put extreme tension on the ligaments of your outer ankle and cause a sprain. A sprained knee can be the result of a sudden twist. Wrist sprains most often occur when you fall on an outstretched hand.

Most mild sprains heal with "R.I.C.E." (rest, ice, compression and elevation) and exercise. Moderate sprains may also require a period of bracing. The most severe sprains may require surgery to repair torn ligaments.

Strains :

Your bones are supported by a combination of muscles and tendons. Tendons connect muscles to bones. A strain is the result of an injury to either a muscle or a tendon, usually in your foot or leg. The strain may be a simple stretch in your muscle or tendon, or it may be a partial or complete tear in the muscle-and-tendon combination.

The recommended treatment for a strain is to apply the massage oil and give a gentle massage on the affected area.

Contusions :

A contusion is a bruise caused by a blow to your muscle, tendon or ligament. The bruise is caused when blood pools around the injury and discolors your skin.

Most contusions are mild and respond well when you to apply the massage oil and give a gentle massage on the affected area

Tendonitis

Inflammation is a healing response to injury, and is usually accompanied by swelling, heat, redness and pain. An inflammation in a tendon or in the tendon covering is called tendonitis. What usually causes tendonitis is not just a single injury but a series of small stresses that repeatedly aggravate the tendon.

Professional baseball players, swimmers, tennis players and golfers are susceptible to tendonitis in their shoulders and arms. Soccer and basketball players, runners and aerobic dancers are prone to tendon inflammation in their legs and feet.

Tendinitis may be treated by rest to eliminate stress and apply the massage oil and give a gentle massage on the affected area,

Bursitis :

A bursa is a sac filled with fluid. It is located between a bone and a tendon or muscle, and it allows the tendon to slide smoothly over the bone.

Repeated small stresses and overuse can cause the bursa in your shoulder, elbow, hip, knee or ankle to swell. This swelling and irritation is called bursitis, and many people experience it in association with tendonitis.

Bursitis can be relieved by applying the massage oil and give a gentle massage on the affected area

Good Care :

If you're an athlete or a fitness enthusiast, you should pay close attention to your body's warning signs. Fatigue and pain are usually a signal that you're pressing too hard. Be sure to stretch thoroughly before your work-out, and stop before you're exhausted.

Stress injuries can also result from poor muscle balance, lack of flexibility or because of weakness in soft tissues cause by previous injuries. These injuries to the muscle, bone ligaments, and tendons may require a prolonged amount of time to heal in spite of appropriate carehttp://sapnamed.blogspot.com

Breast Enhancement

Now you don’t have to face embarrassment for your small and saggy breasts. Use our Breast Enhancement and see the difference in a very shot span of time. Our specially formulated Female Breast Enhancement tones up the muscles of the breasts and give them good shape. The Herbal Breast Enhancement made available by us is manufactured from the best quality raw materials making it highly efficient and free from any side effects. In addition to this, we are one of the most Breast Enhancement Pills Manufacturers and Exporters in India.

What is hanging breast?

Sinking between the ends of a thing, in consequence of its own, or an imposed, weight; an arching downward in the middle, as of a ship after straining.

Causes of hanging breast?

The common cause for hanging breast is when a woman loses weight. When you lose weight, some of that fat disappears from your breasts. Typically the skin and the ligaments inside the breasts do not retract accordingly, resulting in an 'empty' looking breast that then hanging. When the gravity pulls the breasts down, those ligaments and the skin can stretch, and so the breast then droops. This depends on the elasticity of your skin and of your ligaments, as determined by your genes and diet, and also on normal aging processes. Obviously large breasts will loose easier since the gravity is pulling them down more.

What are the Ingredients?

UPLIFT contains Trigonella Foenumgraeceum, Asparagus Adscendens, Hordeum Vulgars, Leptadenia Reticulata, Foeniculum Vulgare

How do I use UPLIFT?

Simply take 2 pills daily 2 times with a meal.

Each bottle is a 10 days supply.

Why are UPLIFT Capsules so effective?

Uplift contains a blend of herbs that stimulate your body to produce new breast tissue growth. Your body responds to UPLIFT the way it responds to puberty or pregnancy; with renewed glandular tissue growth in the breast receptor sites.

How likely is it that Uplift Capsules will work for me?

Most women experience a noticeable improvement in fullness and toning in the breast area, so there is a high probability of success for you. Women with a cup size of 'A or B' often report an increase of one to two cup sizes. Differences in individual metabolism and body chemistry obviously determine the outcome for you personally.

Are UPLIFT Capsules safe for me to use?

UPLIFT is an all-natural herbal dietary supplement containing absolutely no additives or fillers. There are no known negative side effects. *Before taking any dietary supplement, women with special medical conditions, pregnant or lactating are encouraged to consult with their physician first .

What makes UPLIFT different and why is it more effective?

Sriramherbals is committed to providing you with the most powerful, innovative dietary supplements in the market made from only the finest quality ingredients available. UPLIFT uses more of the Ingredients that are known to promote breast growth.

How long will it take before I start noticing results?

Most women begin to see results in 5 to 7 weeks. However, results may vary due to differences in individual metabolic rates and body chemistry. Within the first 4 weeks you will notice an increase in fullness and firmness; this is the first sign that UPLIFT is working.

How much growth can I expect?

Women using UPLIFT capsules experience amazing improvements in both firmness and fullness of their breasts, with increases of one, to two, full- cup sizes.

Will UPLIFT cause weight gain?

No! UPLIFT facilitates the development of the mammary glands by exerting mild estrogenic effects and helping to balance the female hormonal system. There have been no reports of women experiencing weight gain because of using UPLIFT

My breasts have begun to lose elasticity, am I to old to think of doing something about it now?

UPLIFT capsules can normally help get back fullness and firmness as well as help with menopausal symptoms, PMS and other discomforts.

I have breast implants and it has started "sagging" now. Can UPLIFT help?

According to our customers, yes. We have had numerous reports of women using UPLIFT post-operation to enhance the appearance of their implants. Women who have had breast implants can expect the same growth as any other woman as long as there is no damage to the breast tissue from surgery. It can help with dimpling, sagging, & other aging effects.

Once I have achieved the growth I desire will I maintain the size?

We recommend that once you reach the desired size, you should reduce your dosage to just one capsule daily for an additional 90 days.

I'm confused on how much of the product to purchase. Would one month be enough, or do you think I would need more?

Realistically, six months is typically the standard time frame for significant tissue growth. We recommend that once you reach the desired size, that will be in approximately 40 to 60 days, you should reduce your dose to just one capsule daily for an additional 90 days.http://sapnamed.blogspot.com/

Viagra, Revatio

DRUG CLASS AND MECHANISM: It has been estimated that impotence (erectile dysfunction, ED) affects 140 million men worldwide. Over half of all men with impotence are thought to have some physical (medical) cause. The remainder are believed to have psychogenic causes of impotence. Medical causes of impotence include diabetes and circulatory, neurological, or urological conditions.

Penile erection is caused by the engorgement of the penis with blood. This engorgement occurs when the blood vessels delivering blood to the penis increase the delivery of blood and the blood vessels carrying blood away from the penis decrease the removal of blood. Under normal conditions, sexual stimulation leads to the production and release of nitric oxide in the penis. Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis.

Sildenafil also reduces the pressure in the pulmonary artery in a serious condition called pulmonary arterial hypertension.

Sildenafil inhibits an enzyme called phosphodiesterase-5 (PDE5) which destroys the cGMP. Thus, sildenafil prevents the destruction of cGMP and allows cGMP to accumulate and persist longer. The longer cGMP persists, the more prolonged the engorgement of the penis.

PRESCRIPTION: Yes

GENERIC AVAILABLE: No

PREPARATIONS: Viagra is a blue, film-coated, rounded, diamond-shaped tablet that comes in 25, 50, and 100 mg tablets for treating impotence. Revatio comes in a 20 mg tablet and is used for treating pulmonary arterial hypertension.

STORAGE: Tablets should be kept at room temperature, 15- 30 C (59-86 F).

PRESCRIBED FOR: Sildenafil is used for the treatment of erectile dysfunction of either organic (medical condition) or psychogenic (psychological) cause and for pulmonary arterial hypertension.

DOSING: Sildenafil is rapidly absorbed. Maximum observed plasma concentrations are reached within 30 to 120 minutes (median 60 minutes) of oral dosing in the fasted state. When sildenafil is taken with a high fat meal, the rate of absorption is reduced, with an average delay in the time to maximal concentration of 1 hour.

DRUG INTERACTIONS: Sildenafil increases the effects of the blood pressure lowering medications. It also increases the blood pressure lowering effects of nitrates, for example, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket),nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating angina. Patients taking nitrates should not receive sildenafil.

Patients should not combine sildenafil with Revatio (another form of sildenafil) or other PDE5 inhibitors (for example, vardenafil [Levitra], tadalafil [Cialis]).

Cimetidine (Tagamet), erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox) and mibefradil (Posicor) can cause marked increases in the amount of sildenafil in the body. Patients taking these medications should be observed carefully if sildenafil is used.

It is expected that rifampin will decrease blood levels of sildenafil and probably reduce its effectiveness.

PREGNANCY: Although extensive testing in animals has demonstrated no negative effects on the fetus, sildenafil has not been studied in pregnant women. There is no effect on sperm count or motility of sperm in men.

NURSING MOTHERS: It is not known whether sildenafil is excreted into breast milk.

SIDE EFFECTS: Approximately 15% of persons taking sildenafil experience side effects. The most common side effects are facial flushing (1 in 10), headaches (1 in 6), stomach pain, nasal congestion, nausea, diarrhea, and an inability to differentiate between the colors green and blue. Rare cases of sudden loss of hearing have been reported with phosphodiesterase inhibitors such as sildenafil, sometimes with ringing in the ears anddizziness. If changes in hearing occur, patients should discontinue their sildenafil and seek immediate medical attentionhttp://sapnamed.blogspot.com

History

Sildenafil (compound UK-92,480) was synthesized by a group of pharmaceutical chemists working at Pfizer's Sandwich, Kent, research facility in England. It was initially studied for use in hypertension (high blood pressure) and angina pectoris (a symptom of ischaemic heart disease). The first clinical trials were conducted in Morriston Hospital in Swansea.[1] 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.[2][3] Pfizer therefore decided to market it for erectile dysfunction, rather than for angina. The drug waspatented in 1996, approved for use in erectile dysfunction by the US Food and Drug Administration on March 27, 1998, becoming the first oral treatment approved to treat erectile dysfunction in the United States, and offered for sale in the United States later that year.[4] It soon became a great success: annual sales of Viagra in the period 1999–2001 exceeded $1 billion.[citation needed]

The British press portrayed Peter Dunn and Albert Wood as the inventors of the drug, a claim that Pfizer disputes.[5] Their names are on the manufacturing patent application drug, but Pfizer claims this is only for convenience.[citation needed]

Even though sildenafil is available only by prescription from a doctor, it was advertised directly to consumers on U.S. TV (famously being endorsed by former United States Senator Bob Dole and soccer star Pelé). Numerous sites on the Internet offer Viagra for sale after an "online consultation", often a simple web questionnaire.[6] 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. Viagra is also informally known as "Vitamin V", "the Blue Pill", as well as various other nicknames.[7]

In 2000, Viagra sales accounted for 92 percent of the global market for prescribed erectile dysfunction pills.[8] By 2007, Viagra's global share had plunged to about 50 percent[9] due to several factors, including the entry of Cialis and Levitra, along with several counterfeits and clones, and reports of vision loss in people taking PDE5 inhibitors.[10][11]

In February 2007, it was announced that Boots, the UK pharmacy chain, would try over the counter sales of Viagra in stores in Manchester, England. Men aged between 30 and 65 would be eligible to buy four tablets after a consultation with a pharmacist.[12]

Pfizer's worldwide patents on sildenafil citrate will expire in 2010–2013.[13] The UK patent held by Pfizer on the use of PDE5 inhibitors (see below) as treatment of impotence was invalidated in 2000 because of obviousness; this decision was upheld on appeal in 2002.[14][15]

Mechanism of action

The mechanism of action of sildenafil involves the protection of cyclic guanosine monophosphate (cGMP) from degradation by cGMP specific phosphodiesterase type 5 (PDE5) in the corpus cavernosum. Nitric oxide (NO) in the corpus cavernosum of the penis binds to the receptors of an enzyme called guanylate cyclase which results in increased levels of cGMP, leading to smooth musclerelaxation (vasodilation) of the intimal cushions of the helicine arteries. This smooth muscle relaxation leads to vasodilation and increased inflow of blood into the spongy tissue of the penis causing an erection.[16] Robert F. Furchgott won the Nobel Prize in Physiology or Medicine in 1998 for his discovery and analysis of endothelium-derived relaxing factor or "EDRF", later identified with NO itself or a closely-related compound.

Sildenafil is a potent and selective inhibitor of cGMP specific phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum. The molecular structure of sildenafil is similar to that of cGMP and acts as a competitive binding agent of PDE5 in the corpus cavernosum, resulting in more cGMP and better erections.[16] Without sexual stimulation, and therefore lack of activation of the NO/cGMP system, sildenafil should not cause an erection. Other drugs that operate by the same mechanism include tadalafil (Cialis) and vardenafil (Levitra).

Sildenafil is metabolised by liver enzymes and excreted by both the liver and kidneys. If taken with a high-fat meal, absorption is reduced; the time taken to reach the maximum plasma concentration increases by around one hour, and the maximum concentration itself is decreased by nearly one-third.http://sapnamed.blogspot.com/

What are the possible side effects of sildenafil (Viagra)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Stop using sildenafil and call your doctor at once if you have any of these serious side effects:

• sudden vision loss;

• ringing in your ears, or sudden hearing loss;

• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;

• irregular heartbeat;

• swelling in your hands, ankles, or feet;

• shortness of breath;

• vision changes;

• feeling light-headed, fainting; or

• penis erection that is painful or lasts 4 hours or longer.

Less serious side effects may include:

• warmth or redness in your face, neck, or chest;

• stuffy nose;

• headache;

• memory problems;

• upset stomach; or

• back pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about sildenafil (Viagra)?

Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Do not take sildenafil more than once a day. Allow 24 hours to pass between doses.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Sildenafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss.

Stop using sildenafil and get emergency medical help if you have sudden vision loss.http://sapnamed.blogspot.com/