Category: Viagra

Viagra, along with Levitra, Cialis, Staxyn, and Stendra, all belong to a family of medications known as PDE5 inhibitors. They are so called because they all temporarily disable an enzyme known as phosphodiesterase-5, which can interfere with blood flow to the penis, particularly in men whose vascular health is less than robust.

While all these drugs are similar in chemical structure, there is enough variation from one to another that you might find one work better for you than the others. Or you may find that they all produce the desired results, but one or more of them might cause you bothersome side effects. You will probably need to give each of these drugs a try to determine which is best for you. Viagra, Levitra, Staxyn, and Stendra all tend to become effective 30 to 60 minutes after they are taken, and all remain effective for four to six hours.

Cialis, in both it’s 10- and 20-milligram doses, is much longer lasting — up to 36 hours, earning it the nickname of the “weekend drug.” All of these medications have similar side effects, the most common of which are back pain, diarrhea, dizziness, flushing, headache, muscle ache, runny or stuffy nose, and upset stomach. Such side effects, if they occur at all, tend to be relatively mild and usually disappear upon continued use of the drug.

Q. I have heard that generic Viagra is on its way and will soon be introduced in the United States, but I’ve heard that it’s already been on the market in a number of other countries, including Canada, the member countries of the European Union, and China. If I travel to one of those countries, can I legally purchase a Viagra generic and bring it back to this country?

A. Technically, it is illegal to import prescription drugs — particularly those that are not yet legal here — from outside the country. In practice, however, customs agents tend to look the other way when the amount of the drug being brought into the country is of an amount consistent with personal use — usually a supply of up to 90 days. However, because it is illegal, you could well run into the customs agent who’s having a bad day and thus decides to confiscate your stash of generic Viagra.

You have no legal grounds on which to protest such a confiscation, and you’re out whatever money you spent to buy it abroad. We would recommend patience, because, in December 2017, generic Viagra is slated to go on the market in the United States.

The first generic formulation of the drug will come from the U.S. subsidiary of Israeli-based Teva Pharmaceuticals, which is the world’s biggest manufacturer of generic drugs. Another version of generic Viagra from Mylan will follow shortly thereafter, and within six months or so, the variety of generic Viagra available will increase even further.

Q: I know that Pfizer is the pharmaceutical company that developed Viagra back in the 1990s, but I heard that the drug’s active ingredient wasn’t originally envisioned as a treatment for ED. What did Pfizer’s researchers hope to do with sildenafil?

A: Originally synthesized by a team of pharmaceutical scientists at Pfizer’s research laboratory in Sandwich, England, sildenafil citrate was code-named UK-92480. Members of the research team, which included Andrew Bell, David Brown, and Nicholas Terrett, hoped that the compound could be used to relieve the chest pain of angina pectoris and also bring down high blood pressure that was unresponsive to other drugs.

During trials, they were unimpressed by the drug’s ability to achieve the hoped-for goals, but they noticed a surprising side effect among male study participants. Those given the drug suddenly found it very easy to get and keep an erection.

This was also observed in some men who had previously experienced serious erection problems. Shortly thereafter, the Pfizer research team scrapped the study of the drug for treating angina and high blood pressure and began a study to see how effectively sildenafil-treated erectile dysfunction.

Clinical trials were encouraging, and Pfizer soon began petitioning drug regulatory agencies, including the U.S. Food and Drug Administration, for permission to market the drug as a treatment for ED.

Q: My insurer won’t cover my prescriptions for Viagra or for any other ED drug. However, I read recently that the Defense Department spends millions each year to cover the cost of ED drugs for both active-duty servicemen and veterans. Why do they get coverage when civilians can’t?

A: According to a report in an article posted at MilitaryTimes.com in 2015, the Pentagon paid more than $84 million to purchase erectile dysfunction drugs for its active-duty troops, dependents, and veterans. Nearly half of that sum — $41.6 million to be exact — went toward Viagra.

However, much of those expenditures went to cover the cost of ED drugs for servicemen — both active-duty and veterans — who were suffering from post-traumatic stress disorder or PTSD.

Sexual dysfunction is rampant among both male and female service personnel who have PTSD. In men, the most common form of PTSD-related sexual dysfunction is ED, while in women, it is vaginal pain. It is estimated that up to 85 percent of the servicemen suffering from PTSD also suffer from erection problems.

And their inability to have sexual relations with their intimate partners tends to exacerbate their symptoms of PTSD. Helping them to regain erectile function is just one step on their road to recovery.

Q: The print and broadcast media are full of reports about so-called female Viagra. How Does the Female Viagra Drug for Women Differ from the Viagra Designed to Treat ED symptoms?

A: As Pfizer discovered in its trials of Viagra in women test subjects, female sexuality is fundamentally different from that of males. While men usually find their desire for sex growing (pun intended) as they become aroused, the same phenomenon is not observed in women. Pfizer’s trials revealed that Viagra did little or nothing to affect women’s desire for sex, the lack of which is the primary form of female sexual dysfunction.

Scientifically, it is known as hypoactive sexual desire disorder or HSDD. The quest for a way to counter HSDD has more recently focused on brain chemistry and how it might be rebalanced to increase sexual desire.

Addyi, a drug that first went on sale in the United States in October 2015, is designed to decrease brain levels of serotonin, a hormone known to inhibit sexual desire. It is also designed to increase brain levels of dopamine and norepinephrine, both of which are believed to increase sexual desire.

Although it’s been on the market for a couple of years, it has not been the roaring success that its advocates predicted. A number of different factors are to blame. The increase in sexual desire among women taking the drug has been estimated at one-half to one additional satisfying sexual event a month, and the drug must be taken daily to achieve those modest results.

Add to that the reluctance of insurers to cover the drug, and it’s easy to see why Addyi has not taken off in the way its manufacturer hoped. Another factor holding down sales of Addyi has been the prohibition of alcohol consumption for as long as a woman is on Addyi.

Under current law, Viagra and all the other PDE5 inhibitors are available only by prescription in the United States. However, reports from the United Kingdom indicate that country’s Medicines and Healthcare Products Regulatory Agency has recommended that the drug be made available over the counter.

It would be sold in packets of six tablets of 50 milligrams each. Viagra has been facing generic competition in the United Kingdom since mid-2013, so if it succeeds in its bid to take Viagra over the counter, it would be another way of competing with the generic versions of the drug.

And the United Kingdom is not the first market in which Pfizer has made a bid to market an OTC formulation of its pioneering drug. Several years earlier, Pfizer sought approval from the European Medicine Agency to do the same throughout the nations of the European Union. However, it withdrew that application when the agency voiced concerns about the idea. If the OTC scheme is successful for Pfizer in the United Kingdom, it might make a similar bid to introduce an OTC version of the drug in The United States.

Q: I keep getting emails advertising Viagra and other ED drugs at prices far lower than those charged at the local pharmacy, even the pharmacies of the big box stores. I figured if cheaper Viagra were that readily available, nobody would be buying it at significantly higher prices. Am I right in assuming that many of the low-cost drugs advertised online or in emails a scam?

A: You’d be wise not to waste your money on these super-cheap drugs advertised on the internet and through direct email marketing. You are right in assuming that such drugs are worthless, but that might not be the biggest danger they pose.

Such drugs are counterfeits that are produced under unsanitary conditions using whatever ingredients the counterfeiters can easily lay their hands on. There have been many seizures of counterfeit ED drugs that were found to contain toxic materials, such as drywall material and printing inks.

Some also contain varying amounts of the active ingredients found in the real drugs they purport to be. However, the amount of active ingredient found in the counterfeits is either too low to be of any use or so high that it poses a hazard to your health. In any case, you have no the way of knowing what’s gone into these counterfeits, so it’s best not to find out the hard way.

Q. I read recently about a study somewhere in Turkey that showed that Viagra’s active ingredient might offer help for men suffering from back pain associated with degeneration of the sciatic nerve. Is there any truth to those reports?

A. It’s a little early to start the celebrations, but early findings are promising. Men suffering from back pain caused by pressure on the sciatic nerve might someday be able to treat the condition with a month-long course of daily Viagra.

Those were the preliminary findings from an animal study undertaken by researchers in Malatya, a city in eastern Turkey. To test their theory that sildenafil might help speed recuperation from injury to a peripheral nerve, scientists at Inonu University simulated sciatic nerve injury in 30 laboratory rats.

The rats were then divided into three test groups. The first group was given a daily dose of 20 milligrams of sildenafil per kilogram of body weight, while the second received 10 milligrams of sildenafil per kilo of body weight every other day. The third group received no drugs at all.

After 28 days of treatment, the rats were re-evaluated. Those that received the daily dose of sildenafil showed the most significant recovery and ability to function at the end of the study. Those in the second group were better able to function than the rats that received no drugs at all.

Q. My wife and I have been trying to get pregnant for several months now, but thus far we’ve had no luck. A buddy of mine at work said he’d read that one of Viagra’s hidden benefits is its ability to improve the quality of sperm. Could that be the answer to our fertility problems?

A. The active ingredients in Viagra (sildenafil citrate) and other oral ED drugs — tadalafil in Cialis, vardenafil in Levitra and Staxyn, and avanafil in Stendra — appear to improve sperm quality, according to a meta-analysis of data from 11 studies covering roughly 1,300 men.

The analysis, conducted by a team of Chinese urology researchers, found that the ED drugs improved sperm motility as well as the shape of the sperm, which tends to be abnormal in men with fertility problems.

Their findings, published in the July 2017 issue of “Urology,” found, however, that the ED medications had no discernible impact on semen volume and sperm concentration.

The better a man’s sperm move and the more normal their shape, the more likely it is that he will be able to impregnate his partner. Researchers theorize that by sidelining the phosphodiesterase-5 enzyme, the ED drugs enhance the effects of a substance known as cyclic guanosine monophosphate, or cGMP. As it turns out, cGMP plays a key role not only in erectile function but infertility as well.

Q. A couple of years back, I read an article that claimed Viagra increased the risk of developing melanoma. I work outside and am very concerned about the risk of any skin cancer. Are those reports linking the use of Viagra to a higher risk of melanoma accurate?

A. A study released in 2014 reported an increased incidence of melanoma in men who had taken Viagra. Melanoma is the deadliest form of skin cancer, and needless to say, this report shook up many men who had been using the little blue pill. Urologist Stacy Loeb, M.D., of New York University’s Langone Medical Center, led a team of investigators who conducted a meta-analysis of data from studies purporting to show that Viagra users were more likely to be diagnosed with melanoma.

The review, published in the May 19, 2017, issue of the “Journal of the National Cancer Institute,” found that men who took Viagra were more likely to be cautious about their overall health and thus more likely to be screened regularly for skin cancers.

For this reason, the apparent link between Viagra use and the increased diagnosis of melanoma was determined to be not a case of cause-and-effect but rather a case of “diagnosis bias,” investigators concluded.