Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction (ED) and pulmonary arterial hypertension (PAH). Sildenafil is the active ingredient of the medication and is sold in many countries worldwide under many brand names for the treatment of ED. In 2015, it was the 39th most prescribed medication in the United States. Sildenafil is sold widely online without a prescription and is generally assumed safe when used as directed, although there is a potential for side effects if it is not taken correctly. The FDA is expected to finish its review of sildenafil in early 2018. Sildenafil has been used by military personnel in combat situations (e.g., Iraq War) to increase blood flow to the extremities of the body. Unlike the use of Viagra recreationally, the use of Viagra by members of the armed forces in active duty is considered to be a legitimate medical use by the FDA and the DEA. Sildenafil has also been studied as a treatment for pulmonary arterial hypertension (PAH). It may improve symptoms due to its vasodilatory effects. Sildenafil, along with other PDE5 inhibitors, is sometimes used in the treatment of women with sexual problems resulting from antidepressant medications. Sildenafil is being investigated for use as a male hormonal contraceptive. It is believed to reduce the risk of pregnancy by suppressing gonadotropin secretion and inhibiting the access of gonadotropins to their receptors in the hypothalamus. When given to men, it lowers sperm counts by increasing the number of dying sperm and by decreasing the amount of semen. Sildenafil and other PDE5 inhibitors are used off–label to treat the symptoms of cyclic priapism. In the United States, Pfizer faces the loss of about $1 billion per year in revenue from the sale of Viagra due to the combined effects of patent expiration, loss of market exclusivity, and the 2015 court ruling that invalidated Pfizer‘s patent covering Viagra‘s use for erectile dysfunction. In response to the loss of revenue, Pfizer has invested $150 million in developing a drug to treat female sexual dysfunction.
Tadalafil is a drug that is used to treat erection problems in adult men. It can help men with erectile dysfunction (ED) by increasing blood flow to the penis. This helps men get and keep an erection. Tadalafil belongs to a group of drugs called phosphodiesterase type 5 (PDE5) inhibitors. Tadalafil is used to treat erectile dysfunction (ED). Tadalafil is one of the best–selling drugs of all time and works by inhibiting the PDE5 enzyme that destroys cGMP, a chemical that relaxes the smooth muscles found in the penis. Due to the increase in cGMP, the blood flow to the penis increases, which in turn facilitates an erection. In clinical trials and studies, tadalafil was observed to increase the frequency of spontaneous erections by more than 2x. Tadalafil is taken in the form of a pill. It is taken orally approximately 1 hour before sexual activity. The optimal erectile response will normally occur within 30–60 minutes of taking the drug. Tadalafil is effective in the management of ED in patients with hypertension, congestive heart failure, coronary artery disease, diabetes mellitus, multiple atherosclerosis, peripheral vascular disease or with neurodegenerative disorders. The recommended starting dose in patients taking tadalafil for the first time is 10mg. This is one pill taken orally once daily. Tadalafil can be taken with or without food. If the effects of the drug are not satisfactory, the dose can be increased to 20mg. The recommended dose in patients taking tadalafil for the first time is 10mg. This is one pill taken orally once daily. Tadalafil can be taken with or without food. The recommended starting dose in patients taking tadalafil for the first time is 5 mg. This is one pill taken orally once daily. Tadalafil should be taken with or without food. The recommended dose in patients taking tadalafil for the first time is 10 mg. This is one pill taken orally once daily. Tadalafil should be taken with or without food. Tadalafil is used to treat erectile dysfunction in men. It works by helping to increase blood flow to the penis when a man is sexually stimulated. This helps a man achieve and maintain an erection. Side Effects of Tadalafil The most common side effects of tadalafil are mild to moderate in intensity and include headache, flushing of the skin, dyspepsia, nasal congestion, nausea, dizziness, and rash. Heart problems, such as heart attack and stroke, can occur while taking tadalafil. If you have a history of heart problems, your doctor may do additional tests and monitor you carefully before starting this drug. You should also alert your doctor if you experience chest pain, swelling of the legs and feet, sudden weight gain, mental or mood changes, or difficulty breathing while taking this medication. Before taking tadalafil, you should tell your doctor if you: have or have had heart problems or a stroke; have or have had blood vessel problems; have a bleeding disorder; have stomach ulcers or diabetes; are taking any medications (especially other medications to treat ED); are in need of long–term treatment for any other medical problems.
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