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Sildenafil citrate, commonly known by the brand name, is a prescription-only medicine used to treat erectile dysfunction (ED) in adult men. It works by improving blood flow to the penis, helping to achieve and maintain an erection during sexual activity.

Dosage and Administration

Sildenafil is available in 25mg, 50mg, and 100mg strengths.

  • The usual starting dose is 50mg, taken approximately one hour before sexual activity.
  • Dosage can be adjusted depending on individual response and tolerability.
  • Take only one tablet in 24 hours, with or without food.
  • Avoid grapefruit juice, as it can increase the risk of side effects.
  • A high-fat meal may delay onset of action.

Effectiveness

Sildenafil has been shown to be effective in up to 80% of men with ED, with effects typically noticeable within 30 to 60 minutes, and lasting for up to 4–5 hours.

Side Effects

Common side effects include:

  • Headache
  • Flushing
  • Nasal congestion
  • Indigestion

Less common but serious effects include visual disturbances, hearing changes, or prolonged erections. Seek medical attention if severe or persistent side effects occur.

Contraindications

Sildenafil should not be used by those:

  • Taking nitrates for chest pain
  • With severe heart or liver conditions
  • Under 18 years of age
  • With certain medication interactions (e.g. alpha-blockers, antifungals, antibiotics)

Interactions

Inform your doctor of all medications and supplements before use. Interactions may occur with:

  • Nitrates
  • Alpha-blockers
  • Some antibiotics and antifungal medicines

Alcohol and Heart Conditions

Avoid excessive alcohol while taking sildenafil, as it can lower blood pressure and increase side effect risk. Use with caution if you have any heart-related conditions.

Availability and Cost

Sildenafil is available by prescription only in the UK.

  • Generic versions are more affordable than branded Viagra.
  • Supplied by licensed UK pharmacies such as Online Chemist.
  • Avoid counterfeit products from unregulated websites.

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References: ( Maggie E H, Tindall J, Wilson J, Macmillan P, Gosson M, & Brown TA, “Effect of sildenafil on the effectiveness of erections in men with erectile dysfunction,”J Sex Med2023; 6(4): 484–92.

Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

  • Ketoconazole, itraconazole (used to manage fungal infection)
  • Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
  • Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
  • Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
  • Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

  1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
  2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
  3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
  4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.
Ricanourced and nonpartisan pharmaceutical companies (ABCrighteous, Brandpac, L-Mycin, Mucinex, Macrolide, Vardenafil, Zydus, and others) adhere to high ethical regulations. Company documents, including intensify, state of the art face to face prescribing and telephone orders, show the highest level of commitment to scientific research, and follow proper ethical standards. Sardana, Shiomi, or Japanese encers are permitted to use verutol in their products, but patients may only use these products if the product is approved by their doctor. Consumers are advised not to consume alcohol while using verutol. Japanese and Chinese encers are permitted to use tadalafil in their products, but patients may only use these products if the product is approved by their doctor. Consumers are advised not to consume alcohol while using tadalafil. This document does not contain all possible drug-drug interactions. If you have any doubts or concerns, please reach out to your doctor or pharmacist.

C.

The Melbourne branch of the Sydney, Melbourne-based erectile dysfunction drug market is expected to experience a surge in demand in the coming months.

Sales of Viagra have risen by more than 50 per cent since 2012, with consumers more likely to buy the tablets online. The rise in online pharmacies is expected to be a big factor in the market's expansion.

Viagra, sold by Pfizer, the manufacturer of the drug, is also the brand name for the little blue pill. Viagra's patent expires in 2013, so the market is expected to see a surge in use, which has resulted in a 40 per cent rise in prescriptions for both the branded version and the cheaper generic version.

The new market for the drug is already being researched and designed to be easier for people to access the pill.

Erectile dysfunction can be caused by a range of conditions including diabetes, obesity and hormonal imbalances. It's important to understand that there are many different types of problems for which you can buy Viagra. Some of the most common conditions that affect the male reproductive system include:

  • Chronic erectile dysfunction (or impotence)
  • Erectile dysfunction associated with diabetes or heart disease
  • Bipolar disorder
  • Diabetes
  • Liver disease
  • Alcoholism
  • Obesity
  • Premature ejaculation
  • Peyronie's disease
  • Gallbladder disease

You can buy your erectile dysfunction medication from an online pharmacy.

There are also other treatments available for erectile dysfunction in Australia, such as Viagra. There are three main types of drugs used to treat ED, and one of them is a generic form of Viagra.

Generic Viagra is available by prescription only. It works by increasing blood flow to the penis. It is important to note that generic Viagra is not an approved drug, and therefore is not regulated by the Australian Drug and Poisons Ord and the Medicines and Healthcare products Regulatory Agency. In order to purchase your generic Viagra you will need a prescription from your doctor.

This article discusses erectile dysfunction drugs and their prices, the generic versions available, the differences between them and Viagra, and offers advice on buying and using these drugs safely.

The prices of Viagra are lower in the Australian market than in other countries. However, Viagra has not been approved by the Australian Food and Drug Authority (AFDA), and its prices are not influenced by any other drugs.

The prices of the tablets are much lower than the branded version. Viagra, the generic version of Viagra, comes in 50mg and 100mg tablets. The cost of the generic Viagra can range from $10 to $50, depending on the pharmacy.

Generic Viagra is the only drug that is approved by the FDA in Australia. It is also approved by the Australian Medical Products Authority for the treatment of erectile dysfunction. Viagra and the generic are sold under the brand name Revatio, which is approved by the FDA.

The cost of Viagra can vary depending on the country of origin, the pharmacy you choose, and the cost of your insurance. Prices are often negotiated by wholesalers.

Viagra and its generic version cost the company $1 per tablet in Australia. However, the price of the branded version can be as high as $10, which is much higher than the $10 cost of the branded Viagra.

It is important to note that generic Viagra can be an effective treatment for ED and should be taken as prescribed by a doctor.

Generic Viagra is also available to purchase from pharmacies across Australia, as well as in other countries. Prices can range anywhere from $5 to $100 for each dose, depending on the pharmacy you choose.

The generic Viagra is available in a form of a pill to be taken by mouth, so you can take it with or without food. The generic is available from pharmacies in Australia, but it is not regulated in Australia. Therefore, it is not recommended to buy it from unregistered online pharmacies.

Generic Viagra is often taken only when you need it, so it can take longer to work for some people. It can also be taken once or twice a day in the morning or evening, depending on your lifestyle and health needs. If you do not take it as prescribed, you should wait at least two hours before taking the medication.

You should only take Viagra as prescribed by a doctor. Viagra is only available on prescription in Australia.

Viagra has been shown to cause some mild side effects. Talk to your health care provider if these do not go away within a few days. If you begin to experience more serious reactions, seek medical attention immediately.

Common side effects reported from Viagra use include:

  • Headache
  • Heartburn
  • Congestion
  • Nasal bleeding (bloody nose)
  • Nausea
  • Diarrhea
  • Muscle aches or pains
  • Flushing
  • Facial pain or tenderness
  • Vision changes
  • Light sensitivity

More severe side effects include:

  • Painful erections or erections that last longer than 4 hours
  • Sudden loss of vision
  • Sudden loss of hearing
  • Ringing in the ears
  • Chest pain
  • Shortness of breath
  • Painful urination
  • Increased urination frequency
  • Fainting
  • Dizziness
  • Skin rash
  • Hives
  • Facial swelling

If you experience any of these side effects, seek medical attention immediately. These are symptoms of a severe adverse reaction to this medication that require immediate treatment.

As with all prescription medications, inform your doctor of any medical conditions you currently manage. Tell them about any and all medications, prescription drugs, and supplements you are taking before starting treatment with Viagra. Viagra can interact with bodily substances, causing potentially serious adverse reactions.

Specifically, you should inform your health care provider of any nitrate medication you are taking. Remember to mention any herbal products you use, especially St. John’s wort.

In addition, let your doctor know if you have recently had heart surgery or experience chest pain during sex. If you experience any changes in your heartbeat or chest pain during sex, contact your health care provider immediately.

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