Sildenafil citrate

Luckily, some patients had reported the delayed side effect of erections. As a result, the focus on Viagra changed to its sexual applications.

Viagra Soft Tabs Australia

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Sildenafil citrate

Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer’s approved product information, a drug information centre or some other appropriate source.

Viagra (Pfizer)
25 mg, 50 mg and 100 mg tablets

A normal erection results from vasodilatation in the penis. The mechanism involves the release of nitric oxide in the corpus cavernosum. This activates the enzyme which produces cyclic guanosine monophosphate (cGMP). By inhibiting the degradation of cGMP, sildenafil maintains the relaxation of smooth muscle in the corpus cavernosum. The drug has no direct action, but enhances the effect of nitric oxide. As the release of nitric oxide depends on sexual arousal, sildenafil will only be effective when there is sexual stimulation.

The peak plasma concentration is reached within two hours of a dose. An oral dose of 50 mg one hour before intercourse is recommended. The dose may be adjusted up or down depending on response, but should not exceed 100 mg. Sildenafil has a half-life of 3-5 hours. It is metabolised to an active metabolite which is mainly excreted in the faeces. The metabolism involves cytochrome P450 3A4 so clearance is reduced by cimetidine, erythromycin and ketoconazole.

Two trials in the U.S.A. studied 861 men with erectile dysfunction. Sildenafil was more effective than placebo for men with organic or psychogenic causes of their impotence. 1 One of these studies was a 12-week dose escalation study. In the last month of the study, 69% of the attempts at sexual intercourse were successful in men taking sildenafil compared to 22% of men in the placebo group. In the 21 randomised trials of sildenafil, it has improved erectile function in 59% of patients with diabetes, 83% of patients with spinal cord injury and 43% of patients with a history of radical prostatectomy.

The drug was launched in the U.S.A. in March 1998. By July, 3.6 million prescriptions had been dispensed, but 123 deaths had been reported. Many of these deaths were due to cardiovascular events. Sildenafil reduces the blood pressure and this may be severe if the patient is also taking nitrates. Before sildenafil is prescribed, the patient’s cardiovascular status should be assessed. The drug is contraindicated if the patient is using nitrates.

Adverse effects which occur more frequently in patients taking sildenafil, compared to placebo, are headache, flushing and dyspepsia. Some patients report changes in vision; a colour tinge is most commonly reported.

Until the approval of sildenafil, the most effective treatment for impotence was injectable prostaglandin E₁. 2 As sildenafil is easier to administer, and appears not to cause priapism, more impotent men are likely to seek treatment. While sildenafil does not work in every case and has mainly been assessed subjectively, it seems likely to become the treatment of choice. Prescribers should still continue to assess patients with erectile dysfunction so that other disorders are not overlooked. Similarly, the patient’s problem may be due to other drugs they are taking.

Sildenafil is expensive and, if approved for subsidy, will put a strain on the drug budget. Insurers will have to decide the frequency of sexual activity they will fund. How much is enough?

Viagra Soft Tabs Australia

Like many great scientific discoveries, the benefits of Viagra in treating erectile dysfunction were discovered by accident.

Viagra is one brand name of a drug that is used to treat erectile dysfunction (impotence): the inability to get, and maintain, an erection. It is also used in the treatment of high blood pressure specific to the heart and the arteries that feed the lungs. The generic name of the drug is sildenafil (pronounced sill-den-a-fill).

The pharmaceutical company Pfizer initially developed the drug in 1989 as a treatment for high blood pressure and angina.

Unfortunately, early clinical trials were not positive. To have the right effect the drug had to be taken three times a day and it gave some of the patients muscle aches. It was also found to interact with nitrates (the standard treatment for angina), which resulted in an unsafe drop in patients’ blood pressure.

Luckily, some patients had reported the delayed side effect of erections. As a result, the focus on Viagra changed to its sexual applications.

After clinical testing, it was approved for use in Australia in 1998, having been approved in the US nine months earlier.

If you suspect you have been provided counterfeit tablets, take them to your local pharmacist for checking and disposal.

Viagra works by binding to an enzyme called phosphodiesterase. Viagra binding to the enzyme prevents it from converting the chemical cyclic guanosine monophosphate (abbreviated cGMP) into guanosine triphosphate (GTP).

The effect of a build-up in cGMP is the relaxing of artery walls. This makes the arteries bigger and thus allows more blood to flow into the penis.

However, the drug will not give patients an erection without sexual stimulation. When a man becomes aroused the brain sends a signal to the cells in the penis to release nitric oxide, which turns on the production of cGMP. Without the stimulation to produce nitric oxide, there is no cGMP build-up and no erection.

All forms of the drug are sold as solid oral tablets in doses between 25 and 100 milligrams. For the treatment of high blood pressure, the tablets also come in a 20 milligram dose.

The dose prescribed by the doctor takes into account a patient’s age, underlying cause of their impotence, and their kidney function.

When used to treat erectile dysfunction, patients are directed to take the drug once per day, 30 minutes to one hour before their planned sexual activity. The effects of the drug will take longer to kick in if it is taken with food.

One in ten patients will experience the common side effects of Viagra. Side effects include the development of a rash, diarrhoea and an increased susceptibility to urinary tract infections.

A less common side effect is abnormal vision. This includes blurred vision, a sensitivity to light, and/or a blue-green tinge to the patient’s vision called cyanopsia. Higher doses increase the chance of a patient experiencing abnormal vision.

Other than its approved medical uses, Viagra has also been shown to have alternative applications. For example, researchers have shown adding Viagra to the water of cut flowers makes them last longer.

When they gave just one milligram of Viagra to the flowers they were found to stand up straight for a week longer than flowers that were given ordinary water – a doubling in the flower’s shelf life.

Viagra is one of the most counterfeited medicines in the world. Because of its wide appeal many patients attempt to buy it without a prescription. Viagra can be bought from online auction sites, internet pharmacies and even bricks-and-mortar retail stores.

There are numerous risks in taking counterfeit Viagra. Fake tablets can contain no Viagra or too much Viagra. There have also been reports that counterfeit tablets have contained blue printer ink – to give them that genuine Viagra look – illegal drugs like amphetamines, and other unrelated drugs like the antibiotic metronidazole.

The best way to ensure you are not buying counterfeit Viagra is to have a trusted pharmacist fill your script in-store. For those patients who need to have their Viagra script filled over the internet, there are some ways to check whether the medicine you have been supplied is fake.

Look for the writing stamped into the tablets. Does it look crisp and sharp or does it have an out-of-focus look? Also, check their colour consistency; you are looking to see if there are regions that are a darker or lighter blue than the rest of the tablet.

Next, look to see if the tablets feel smooth. Rough or pitted tablets are a sign of fake medicines.

Viagra is supplied in packs of four. If your strip has more than four tablets, it’s counterfeit.

And, finally, Viagra is supplied only as solid tablets. Your tablets are counterfeit if you have been supplied soft tablets, gel tablets or chewable tablets.

If you suspect you have been provided counterfeit tablets, take them to your local pharmacist for checking and disposal.

For the treatment of erectile dysfunction, Viagra comes in three doses (25, 50 and 100 milligrams) with four tablets per packet. The cost to the patient is the same regardless of the dose at $6.20 per packet.

The Australian Pharmaceutical Benefits Scheme subsidises the drug; the cost to the government is between $54 to $82 per packet depending on the brand. Patients can expect to pay more if they buy Viagra over the internet.

This article by Dr Nial Wheate was originally published in The Conversation.

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Solihull Barons, the Dragon Slayers !

Motor Nation Solihull Barons : 5
Deeside Dragons : 2

Sunday 1st December 2013

When teams come to Hobs Moat from North Wales you know you can expect good, tightly contested games and Sunday’s Laidler Conference ice hockey tie against the league leading Deeside Dragons ticked all the requisite boxes.

The game got off to a ferocious start, with neither side seeing much point in pulling out of the hard checks, and it was the Barons who were first to put a mark on the scoresheet. After only two minutes a shot by Ryan Selwood took deflections off of Tomas Janak and Perry Doyle before finding the Deeside net.

The Barons lead doubled on the seven minute mark, Tomas Janak and Josh Bruce combining to give a wide open Joe Henry a perfect opportunity to put the puck past George Cox in the Deeside net.

A lofted clearance from the defensive zone by Richard Crowe found Jake Larkin centre ice who caught the airbourne puck on his thigh, deflected it to the ice before smashing it home for the Barons number 3.

The league leading Dragons had obviously been caught on the back-foot and an early time out was called which appeared to steady the Welsh side’s nerves. Their opportunity to respond would come within two minutes when a powerplay chance would be readily converted by Deeside import Dan Soderberg-Andersson. Another couple of minutes and as the Barons struggled to clear their lines the Dragon’s James Parsons cut the Barons lead back to a single goal.

The second period gradually saw the Barons return to the offensive. Continual pressure on the Deeside net saw tempers flare at the half hour mark, resulting in Rob Eley of the Barons and Deeside’s Michael Jones being invited to have a 10 minute spell warming the penalty bench.

The Barons pressure continued however and was finally rewarded in the thirteenth minute of the period when Ryan Selwood was picked out by Joe Henry for the Barons fourth goal of the evening.

Deeside had their chances too but solid Barons defence, include a spectacular, flat on the ice, poke check from Phil Lee together with, solid net-minding from Josh Nicholls and a bit of luck ensured they were unable to capitalise.

The final period saw the Barons quickly extend their lead, a slick pass from Tomas Janak gave Joe Henry his second and Solihull’s fifth goal of the evening, a minute into the period. Barons domination continued until the final ten minutes of the game when both sides picked up a slew of minor penalties resulting in very little five on five play for the remainder of the game.

Some late excitement was generated when Phil Lee was judged to have checked a Deeside player from behind and the resulting fracas saw a bout of rough stuff with Lee getting the better of Deeside’s Peter Gazda.

A good win then for the Barons against a Deeside team which had only lost a competitive tie once previously this season.

The Barons now have a week off before they travel to Flintshire on the 15th December to once more do battle with the Dragons. The following Saturday, the 21st, they travel to Blackburn Eagles, who despite being perennially propping up the league table will be buoyed by their first win in a long time, a home victory against Widnes Wild. Places on the Barons coach to these away games are available here. On Sunday 22nd, twenty Barons a skating will hope to bring some festive cheer to the Solihull support when they play host to big rivals the Nottingham Lions. With pride and points up for grab it promises to be a tough and entertaining game. Make sure you are there ! Face-off back to the normal time of 6pm.

After the game there will be a chance for you to join the Barons on the ice in a sponsored skate in aid of the well-known local cause “Help Harry Help Others” – please come along and give your support.

Barons goals : Doyle, Henry(2), Larkin, Selwood
Barons assists : Janak(2), Bruce(2), Lee, Selwood, Henry, Crowe
Barons man of the match : Tomas Janak

The Barons welcome the Lions to Hobs Moat for the second time this season and will be looking to notch up the points against the only team in the Laidler Conference they have yet to beat.

It will be a highly charged and competitive tie so make sure you make it to the rink to support the Barons, make it loud and ensure they have that extra man on the ice !

This game will also feature a Sponsored Skate with the Barons in aid of Help Harry Help Others so come take to the ice with your favourite team.

Click image above for a poster to advertise this initiative to friends and colleagues.

Note the face-off is back to our normal 6:00pm time slot.

Adults £6 : Concessions £3
Family ticket £16
(2 adults and up to 3 children)