Patient Experiences with Sildenafil Treatment

Still, a study of 29 climbers reported that tadalafil can also reduce pulmonary artery pressure at a high altitude.

Country	Status	Remarks
USA	Prescription-only	Approved for ED
UK	Prescription-only	Licensed medication
India	OTC (some brands)	Available with or without prescription
Australia	Prescription required	Controlled substance

In affected individuals, exposure to the cold triggers spasm of the small arteries that supply blood to the fingers, toes, or both. Temporarily deprived of adequate blood flow, the involved digits become pale, cold, and very painful. It's a common condition, affecting up to 8% of men and 17% of women. In the vast majority, there are no underlying diseases (primary Raynaud's), and patients do well simply by minimizing their exposure to cold. But secondary Raynaud's can complicate collagen-vascular diseases or certain other conditions.

• Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor.
• The drug was first approved by the FDA in 1998.
• It can be purchased online but requires a prescription in most countries.
• Generic versions of sildenafil are typically cheaper than brand-name Viagra.
• Proper storage involves keeping it at room temperature away from moisture.
• Sildenafil does not protect against sexually transmitted diseases.
• Lifestyle changes like exercise and healthy eating can enhance results.
• Combining sildenafil with other ED treatments should be discussed with a doctor.
• It's important to inform your doctor about all medications you take.
• Sildenafil is not an aphrodisiac and requires sexual stimulation to work.

It's not common, but secondary Raynaud's can be very painful and difficult to treat. Many medications have been used without consistent success. But a 2005 study of 16 patients with severe Raynaud's phenomenon that had not responded to other medications reported benefit from sildenafil in a dose of 50 mg twice a day. And a 2006 study of 40 Raynaud's patients reported similar benefits from vardenafil in a dose of 10 mg twice a day. Sildenafil was discovered by scientists looking for a new medication to dilate coronary arteries. It does that, but because it widens healthy coronary arteries more than diseased vessels, it has not been successful in treating angina. But it may have other benefits for cardiac patients. In the first years of the Viagra era, research on sildenafil and the heart was devoted to making sure the drug was safe for the circulation.

Adverse effects

But since it's a serious problem, any benefit is most welcome. When we think of blood pressure, we usually think of the systemic circulation, of the blood pumped from the heart's left ventricle to the aorta and then to the smaller arteries that carry oxygen-rich blood throughout the body. But to pick up vital oxygen, blood must first pass from the less powerful right ventricle through the pulmonary artery to the lungs, then back to the left side of the heart. The pressures in the pulmonary artery are much lower (about 20/10 millimeters of mercury, or mm Hg) than in the aorta (lower than 120/80 mm Hg is considered healthy). Exercise is the most common cause of rising pulmonary artery pressure, but the elevation is mild and subsides promptly with rest.

Low blood pressure

High altitudes are another cause, which can lead to mountain sickness (see below). Far more serious are the large number of lung diseases, vascular diseases, heart disorders, and miscellaneous conditions that can cause pulmonary hypertension. And in primary pulmonary hypertension, no underlying cause is evident. Pulmonary hypertension causes shortness of breath, first during exertion but eventually at rest if the condition progresses. A variety of treatments are available, depending on the underlying problem. In most men with heart disease, it is. But several studies of patients with congestive heart failure also reported that the medication improves oxygen consumption, pulmonary artery pressure, and exercise capacity in these patients.

Age Range	Suitability	Notes
18-50 years	Usually suitable	Under doctor supervision
51-70 years	Caution advised	Dose adjustment may be needed
Over 70 years	Use with caution	Potential drug interactions

Research shows that sildenafil helps the heart muscle relax properly, which could help patients with heart failure due to diastolic dysfunction. Another interesting property is sildenafil's ability to protect the heart from excessive stimulation by adrenaline.

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Clinical trials will be needed to see which patients might benefit.

Sildenafil for ED

In addition, PDE-5 is just one of 11 enzymes in the phosphodiesterase family. The others are concentrated in different parts of the body. While the ED pills have a much greater affinity for PDE-5 than the other PDEs, they have some ability to inhibit those closely related enzymes. Both factors explain why the ED pills sometimes produce side effects in many parts of the body. The most common side effects are headaches and facial flushing, which occur in about 15% of men.

Drug Cost Over Time (2014 - 2023)

Other reactions include nasal congestion, indigestion, and back pain; blue-tinged vision is even less common. In almost every case, these side effects are mild and transient. But new information has added a rare eye disease to the list. Nonarteritic anterior ischemic optic neuropathy (NAION) is a poorly understood disorder that can cause blindness. In March 2005, doctors reported that seven men experienced visual impairment within hours of using sildenafil. It's the most speculative use for sildenafil, and it's far from clinical application. Still, it's an interesting area of new research. A European study of 25 men who had erectile dysfunction but no other circulatory disorders found that blood vessels in the brain responded to stress better after a 50-mg dose of sildenafil.

Society and culture

And the FDA has approved sildenafil (Revatio) in a dose of 20 mg three times a day for men and women with pulmonary hypertension. Clinical trials have demonstrated improved exercise tolerance with few side effects. Pulmonary hypertension is a feature of acute mountain sickness. High altitudes produce low blood-oxygen levels. In turn, low oxygen produces a narrowing of the pulmonary arteries.

Are there reviews from people who had side effects with 50-mg or 100-mg sildenafil tablets?

The heart must women sildenafil therefore work harder, reducing the capacity to exercise. To find out if it might improve exercise capacity in low oxygen conditions, scientists tested 14 healthy mountain climbers in a lab in Germany and again at a Mount Everest base camp. In the lab, the volunteers breathed 10% oxygen through a mask; on the mountain, they breathed natural air. Under both conditions, a 50-mg sildenafil tablet decreased pressures in the lungs' blood vessels and increased the maximum exercise capacity. It's a small study, and it's too soon to say if sildenafil will help prevent or treat acute mountain sickness. More interesting results were reported by scientists in Michigan, who produced ischemic strokes in rats by temporarily blocking blood vessels. During their recovery, the animals were divided into three groups.

Year	Milestone	Description
1989	Discovery of Sildenafil	Originally researched for angina
1996	First clinical trials for ED	Revealed benefits for erectile function
1998	FDA approval for erectile dysfunction treatment	First oral pill approved
2003	Launch of generic sildenafil in various markets	Increased accessibility

One received no treatment, another low-dose sildenafil, and the third high-dose sildenafil.

The Company Behind Viagra

Since then, additional cases have been reported to the FDA related to sildenafil, tadalafil, and vardenafil. Fortunately, the number of cases is very small in relation to the millions of men who have used ED pills successfully. It's not clear that there is a cause-and-effect relationship between ED pills and NAION. At present, the concern is not great enough to prevent men from using these pills, but all men should use them carefully and responsibly. The most important worry about ED pills is their ability to widen arteries enough to lower blood pressure.

Antiretroviral Agents

It's rarely a problem in healthy men, but it explains a crucial precaution that applies to all three medications. Nitrates are medications that temporarily widen arteries by increasing their supply of nitric oxide. That's how they widen partially blocked coronary arteries in patients with angina. But because the nitrates and ED pills all act on nitric oxide, they do not mix. Men who are taking nitrates should never use any of the ED pills. The animals who got sildenafil recovered better, with the highest doses producing the best results.

• Do not take sildenafil if you have a history of heart attack or stroke.
• Women and children should not use sildenafil products.
• The medication can cause temporary vision disturbances, including blue-tinted vision.
• Always consult a healthcare provider before starting sildenafil therapy.
• Use caution when driving or operating machinery after taking sildenafil.
• Sildenafil is contraindicated in people with hypersensitivity to the drug.
• Some users report improved erectile function within 15 minutes.
• It is essential to stay hydrated, but avoid consuming large amounts of alcohol.
• Men with certain health conditions should undergo a medical exam before use.
• Overuse or misuse of sildenafil can lead to serious health complications.

The scientists concluded that the medication actually stimulated the growth of new nerve cells in the brain tissue next to the stroke damage. It's far too early to know whether sildenafil may someday help people with strokes. If you get your information about sildenafil from Super Bowl commercials or e-mail spam, you might dismiss it as a lifestyle drug of little real medical importance. In fact, it's a serious prescription medication that has helped millions of men who are distressed by an entirely legitimate medical problem. Because the drug acts on arteries beyond the penis, it can produce various side effects. That means it should only be prescribed by a personal physician who really knows you.

Online Sildenafil Prescription

This ban includes all preparations of nitroglycerin (short-acting, under-the-tongue tablets or sprays); long-acting nitrates (isosorbide dinitrate, or Isordil, Sorbitrate, and others, and isosorbide mononitrate, Imdur, ISMO, and others); nitroglycerin patches and pastes; and amyl nitrite (so-called poppers, used for sexual stimulation by some men). ED pills are quite safe for men with stable cardiovascular disease who do not take nitrates. This group includes patients with stable angina, previous heart attacks, mild congestive heart failure, well-controlled hypertension, and previous strokes. But men with recent heart attacks and strokes should wait until they have recovered fully, and patients with unstable blood pressure, active angina, or any other complex or unusual problem should hold off and get specific medical guidance. And men who take alpha blockers (particularly terazosin, or Hytrin, and doxazosin, or Cardura) for hypertension or benign prostatic hyperplasia (BPH) should use ED pills (particularly vardenafil or tadalafil) with great caution, if at all.

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

Studies also suggest that sildenafil may increase respiratory distress in men with severe sleep apnea and that it slows gallbladder function, which might increase the risk of gallstones. Scientists who noticed that the ED pills can produce side effects in many parts of the body are asking if they can also serve therapeutic roles beyond male (or female) sexuality. Because of its seniority, most of the research has used sildenafil, so it's not clear if the newer medications will fill similar roles. But for sildenafil, at least, some new uses appear promising. It's the only nonsexual condition that has earned FDA approval for sildenafil. And it also means that scientists are investigating uses for the drug in patients with an array of vascular disorders having nothing to do with sexual function. They have nearly identical effects on ED as well as similar side effects. Because they are newer drugs, scientists are just beginning to study them for problems that don't involve sexuality. Sildenafil has already been licensed to treat men and women with pulmonary hypertension. Time will tell if any of these drugs will fill other potentials beyond promoting potency.

• Sildenafil may improve confidence and sexual satisfaction in men with ED.
• The medication is also being researched for pulmonary hypertension treatment.
• Common side effects include dizziness, upset stomach, and vision changes.
• Rare side effects can include priapism, a painful prolonged erection.
• Alcohol can interfere with sildenafil's effectiveness and increase side effects.
• Patients should disclose any heart conditions before using sildenafil.
• Sildenafil may interact with other medications such as alpha-blockers.
• It is not suitable for individuals with severe liver or kidney problems.
• Taking large doses does not necessarily improve efficacy and increases risk.
• Always follow the prescribed dosage and discontinue if adverse effects occur.

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