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It is important as you talk with your doctor that you be candid in terms of when your troubles started, how bothersome your erectile dysfunction is, how severe it is, and discuss all your medical conditions along with all prescribed and nonprescribed medications that you are taking. Your doctor will ask several questions to determine if your symptoms are suggestive of erectile dysfunction and to assess its severity and possible causes. Your doctor will try to get information to answer the following questions: Is the patient suffering from erectile dysfunction or from some other form of sexual dysfunction such as loss of libido or a disorder of ejaculation (for example, premature ejaculation) or orgasm, or problems with penile curvature/pain (Peyronie's disease)? Is your erectile dysfunction due to psychological (stress, relationship problems, etc.) or physical factors? Your doctor may ask if you note erections at night or in the early morning. Men have involuntary erections in the early morning and during REM sleep (a stage in the sleep cycle with rapid eye movements). Men with psychogenic erectile dysfunction (erectile dysfunction due to psychological factors such as stress and anxiety rather than physical factors) usually maintain these involuntary erections. Men with physical causes of erectile dysfunction (for example, atherosclerosis, smoking, and diabetes) usually do not have these involuntary erections. Men with psychogenic erectile dysfunction may relate the onset of problems to a "stressor," such as failed relationship. Your doctor may suggest a test to determine if you have erections during sleep, which may suggest that there may be a psychological cause of ... More

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The ongoing European Phase III trial aims to evaluate the efficacy of the drug, as well as focusing more closely on measuring time of onset and duration of action by using a range of parameters. Futura Medical is optimistic about the outcome of this trial; it expects results to be published at the end of 2019 and for regulatory filings to follow in the second half of 2020. Clean Room Doors, Emergency Escape Panels, Vision Panels, Hygienic Lift Trolleys, Air and Water Showers. Cold Chain Refrigerated and Freezer ISO Container Systems. Lines and Machines for Pharmaceutical Solids Production. IQVIA Remote Detailing to Maintain Individualised Engagements with Customers. Abiogen Pharma is a well-established pharmaceutical company headquartered just outside of Pisa, Italy, that develops and markets medical solutions in primary care and rare diseases across international markets. Erectile Dysfunction Drug May Help Treat Heart Failure. A drug for erectile dysfunction may also help treat heart failure, a preliminary study in animals suggests. In the study, published today (May 1) in the journal Scientific Reports, the researchers gave the drug tadalafil (brand name Cialis) to sheep that had advanced heart failure. The researchers found that the treatment improved the strength of the animals' heart contractions and that it reversed some of the harmful cellular effects seen in heart failure. The finding adds to a growing body of evidence suggesting that erectile dysfunction (ED) drugs could be beneficial for individuals with heart failure, a condition in which the heart muscle can't pump enough blood to meet the body's normal demands. Heart failure is a serious condition, and ... More

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Contraction/relaxation responses of myometrial small arteries. Dose-response constriction curves to AVP (0.1–10 nmol/liter; 2-min intervals) or the thromboxane-mimetic U46619 (0.1–1000 nmol/liter; 2-min intervals) were constructed followed by relaxation to BK (0.1–1000 nmol/liter; 2-min intervals). Vessels were washed to baseline tension and then incubated for 1 h in the presence of 0, 10, or 100 nmol/liter of the PDE5 inhibitor sildenafil citrate or UK-343664. The protocol of constriction to AVP or U46619/relaxation to BK was repeated as outlined above in the maintained presence of the PDE5 inhibitor. Data were first tested whether they fitted to a Gaussian (normal) distribution using the Kolmogorov-Smirnov test. Data that passed the normality test were compared using parametric statistical tests (unpaired/paired t test; repeated-measures ANOVA) and are represented as mean ± sem . All other data were compared using nonparametric statistical tests (Mann-Whitney U test) and are presented as median-range. The effect of PDE5 incubation on agonist-induced constriction of myometrial small arteries was compared by paired t test. BK-induced relaxation of myometrial small arteries was compared using repeated-measures ANOVA. Data for the number of patients are indicated by (N). Women whose pregnancies were complicated by FGR delivered significantly earlier in gestation than the NP group ( P TABLE 1. NP 27 30 (19–40) 2 (1–5) 1 (0–4) 123 (110–150) 75 (60–85) 38.9 (37.4–41.5) 3300 (2690–4110) 46 (7–88) FGR 12 28.5 (22–37) 3.5 (1–5) 1 (0–4) 120 (115–140) 81 (70–90) 37.9 (29.8–39.0) a 2460 (745–2860) b 3 (0–5) b. NP 27 30 (19–40) 2 (1–5) 1 (0–4) 123 (110–150) 75 (60–85) 38.9 ... More

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Levitra and Cialis are two options available to treat erectile dysfunction, which affects 30 percent of men over the age of 40 at some point in their lives. There are many similarities between these two medications; but also some differences. For example, Cialis 36-hour is longer-lasting than Levitra; but Levitra can work more quickly than Cialis. Here’s a chart looking at the main differences between Levitra and Cialis: Levitra Cialis MedExpress Price From ?37 From ?40 Prescription required? Yes Yes Active ingredient Vardenafil Tadalafil Dosage Available in 5, 10 and 20mg tablets Available in 2.5, 5, 10 and 20mg tablets How fast does it work? Can work in just 15 minutes, though normally takes effect within 30 minutes Can take anywhere between 30 minutes to two hours to work How long does it last? Effects can last up to five hours Effects can last up to 36 hours How to take May be taken with or without food May be taken with or without food. Be careful to avoid taking with greasy or fatty foods, or eating or drinking grapefruit, as this can affect how the drug works Selling point Can be effective very quickly, and may be used as an alternative to Viagra Is available in lower doses and is long-lasting – which means you won’t need to time your sexual activity Side effects Facial flushing, headache, indigestion, and a stuffy or runny nose Facial flushing, headache, indigestion, and a stuffy or runny nose. Levitra tablets contain the active ingredient Vardenafil – a PDE-5 inhibitor, which works by relaxing the muscles in the walls of the blood vessels, increasing the blood flow to the penis. PDE5 is an enzyme found in most men suffering from ED and suppresses another ... More

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It’s important to remember that everyone reacts to medicines differently. It can be really helpful to compare things like the time they take to work, and the potential side effects, to try and decide which might be best for you. Your online doctor or GP can also help by making a recommendation. Viagra, Sildenafil and Levitra all work in a similar way. They’re normally taken 1 hour before sexual activity, and work for 4 to 6 hours. Viagra and Sildenafil seems to be effective for the highest percentage of men, with up to 80% saying that it works viagra 25 mg tablet buy online for them in some studies . Cialis has the advantage that it works for a much longer time than the other medicines. Some people find that they still experience the effects a day and a half after taking it. This means Cialis can be a great option for people who don’t always want to plan sexual activity a long time in advance. Spedra is the newest medicine of the five that are commonly prescribed for erection problems. It works much more quickly than the other medicines, with some people reporting that it takes just 15 minutes to work. This makes it another option for people who don’t want to plan sexual activity very far in advance. Remember that medications for treating erectile dysfunction have been proven to work, and are safe if you've been assessed before buying them. Herbal pills have been researched, but that research hasn’t proved they work. The ingredients in herbal pills also may not be regulated, so you couldn’t be sure how strong they are, or what else they might have in them. There are some lifestyle changes that you can make, which have been proven to improve erections naturally. These ... More

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From 24 to 48 hours after use of sildenafil, nitrate may be administered if no associated conditions increasing plasma concentration or delaying metabolism of sildenafil, such as age above 65 years, severe renal or hepatic failure, or simultaneous use of inhibitors of cytochrome P450 3A4, exist. In such instances, nitrates should only be used if conditions for the treatment of a possible severe hypotensive crisis exist. For the treatment of precordial pain no data about drug interactions are available contraindicating the use of sildenafil with aspirin, beta-blockers, calcium channel antagonists, or narcotics. Patients with acute myocardial infarction ? The same previous precautions should be taken. So far, no restraints regarding the use of heparin, cumarin, and thrombolytic agents exist. In the case of hypotension, recovery of proper pressure levels can hinder the progression of myocardial lesions. Unstable angina ? The same guidelines and warnings in relation to the use of nitrates and other medications commonly used in the treatment of this condition apply. Treatment of the hypotension resulting from the interaction of sildenafil with nitrates. The following measures should be employed in sequence: 1) place the patient in the Trendelenburg's position; 2) administer intravenous fluids rapidly; 3) use intravenous alpha-adrenergic agonists, such as phenylephrine, ethylephrine, or metaraminol; 4) if necessary, use an alpha or beta agonist, such as norepinephrine to support blood pressure, but one should be aware of the risk of worsening or inducing myocardial ischemia; 5) install auxiliary support through the intra-aortic balloon. The recommendations here expressed ... More

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Otherwise, if grapefruit juice is ingested, the vardenafil dose should be reduced. It is recommended not to exceed a single 5-mg dose of vardenafil in a 24-hour period when used in combination with moderate CYP3A4 inhibitors, such as grapefruit juice. In studies, moderate CYP3A4 inhibitors produced a 4-fold increase in vardenafil AUC and a 3-fold increase in Cmax. It is possible that vardenafil-induced side effects (e.g., hypotension, dizziness) may occur in some individuals. Guaifenesin; Phenylephrine: (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving phosphodiesterase inhibitors. Monitor patients for decreased pressor effect if these agents are administered concomitantly. Halofantrine: (Major) Halofantrine is considered to have a well-established risk for QT prolongation and torsades de pointes. Halofantrine should be avoided in patients receiving drugs which may induce QT prolongation including vardenafil. Halogenated Anesthetics: (Major) Halogenated anesthetics should be used cautiously and with close monitoring with vardenafil. Halogenated anesthetics can prolong the QT interval. Therapeutic (10 mg) and supratherapeutic (80 mg) doses of vardenafil produces an increase in QTc interval (e.g., 4 to 6 msec calculated by individual QT correction). When vardenafil (10 mg) was given with gatifloxacin (400 mg), an additive effect on the QT interval was observed. The effect of vardenafil on the QT interval should be considered when prescribing the drug. Haloperidol: (Moderate) Consider the potential for additive QT effects if vardenafil is administered with haloperidol. Both therapeutic and supratherapeutic doses of vardenafil produce ... More

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Demographic and clinical details are given for NP women and women whose pregnancies were complicated by FGR. All data are median with range in parentheses for maternal age at delivery, gravidity, parity, maximum attained blood pressure (BP), gestation at delivery, birthweight, and IBR. Groups were compared statistically using the Mann-Whitney U test. Small arteries from women whose pregnancies were complicated by FGR showed significantly increased vasoconstriction compared with that seen in small arteries taken from NP women ( P 0.05, t test). Addition viagra 25 mg tablet buy online of AVP to myometrial small arteries from women with FGR evoked maximal constriction of 21.5 ± 0.4 kPa (n = 24 arteries from seven patients) compared with 16.7 ± 0.4 kPa (n = 22 arteries from seven patients) viagra 25 mg tablet buy online in NP women ( P = 0.06, t test). However, the sensitivity of myometrial small arteries from women whose pregnancies were complicated by FGR to AVP-induced vasoconstriction was not significantly altered compared with vessels from NP women (EC 50 , 0.47 ± 0.15 nmol/liter in FGR vs . These data suggest modified vasoconstriction of myometrial small arteries from women whose pregnancies are complicated by FGR. Effect of U46619 and AVP on myometrial small arteries from NP women and women whose pregnancies are complicated by FGR. Data are expressed as active effective pressure production in kPa. All data are mean ± sem ; the x axis shows concentration of agonist ? 10 ?x . ?, NP (n = 13, top ; n = 14, bottom ); ?, FGR pregnancy (n = 10, top ; n = 6, bottom ). Effect of U46619 and AVP on myometrial small arteries from NP women and women whose pregnancies are ... More

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In a recent sexual health survey on men taking ED medication, four out of five plan a specific time to have sexual intercourse. The same study also revealed that 71% of men planned sexual intimacy several hours ahead of the prospect of “getting lucky”. In a busy urban society, Dr G is constantly put on the spot to address issues faced by someone in David’s predicament. After an interval of “sexual draught” due to other commitments in life, it is hardly surprising that men would face some “hardness” issues. Although many of these men may just be facing temporary ED issues, the help of medications is often the only solution to help them to regain confidence and get back into action. When it comes to choosing the right pills for the "action", one has to ask whether “spontaneity” in sex is a luxury you can afford in your busy lifestyle. TriMix Definition: TriMix is a common term used to describe a mixture of Papaverine, Phentolamine and Alprostadil (PGE). Each of these drugs produce a vasodilating effect when injected into the penis. The injection is done using a very small needle, inserted into the proper area along the shaft of the penis, so the drug mixture is delivered into the corpus cavernosum. The mixture of drugs causes the corpus cavernosum to relax, dilate and become filled with blood, producing an erection. TriMix therapy is recognized as a viable treatment for erectile dysfunction by the American Urological Society. TriMix is generally an effective, low-cost treatment, especially for those patients who have not had good results, or experience moderate to severe side effects from PDE5 inhibitors, (Viagra®, Levitra®, Cialis®). TriMix injections offer a solution ... More

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Viagra) is medication given a brand name by its manufacturer for marketing purposes. Generic medication is usually named after the active ingredient of the drug itself (e.g. Cost to you – branded medication tends to cost more than generic medication, because of the popularity of the brand name. However, both are just as safe to use, and both are regulated in exactly the same way (by the MHRA). This is why lots of people choose the cheaper option of buying generic medication over more expensive branded medication, to save money. Are there other branded/generic medications for erectile dysfunction? Tadalafil and vardenafil are the two other generic medications that are available in the UK. Tadalafil is the generic version of Cialis, and vardenafil is the generic version of Levitra. Other branded medicines include: Tadalafil and Cialis has the same relationship – Tadalafil (the generic medicine) and Cialis (the branded medicine) both contain the same active ingredient, and work in exactly the same way, just as with sildenafil and Viagra. Different active ingredients are medically different – ED treatments with different active ingredients work differently on different people, depending on the root causes of your ED, and your different personal needs. Talk to your nurse or GP if you want more information on which ED treatments could work best for you, or order our trial pack to see which suits your needs. Dr Nicholas Antonakopoulos graduated from the University of London in 2006. He did his postgraduate training in hospitals in the London area, and he trained for four years in Trauma and Orthopaedic Surgery before completing his training in General practice in 2015. Is ... More

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History of surgery (for example, for prostate enlargement, prostate or rectal cancer, or blood vessel disorders) History of injury (for example, a broken pelvic bone or a back injury) Symptoms of disorders of the blood vessels (for example, pain in the calves when walking or coolness, numbness, or blue color of the feet) Symptoms of nerve disorders (for example, numbness, tingling, weakness, incontinence, or falling) Symptoms of hormonal disorders (for example, loss of sex drive, increased size of breasts, decreased size of testes, loss of body hair, tremor, changes in weight or appetite, or difficulty tolerating heat or cold) Symptoms of psychologic disorders, particularly depression. Sexual dysfunction (for example, vaginitis or depression) in the man's partner. Even though men may be embarrassed to talk to their doctors about some of these subjects, the information is important in determining the cause of ED. The physical examination focuses on the genitals and prostate, but doctors also look for signs of hormonal, nerve, and blood vessel disorders and examine the rectum. For example, ED may occur soon after prostate surgery or beginning a new drug. One important clue is whether erections are present at night or on awakening. When erections are present, a physical cause is less likely than a psychologic cause because physical causes typically inhibit erections at all times. Other factors that suggest a psychologic cause are sudden development in a young healthy man, occurrence of symptoms only in certain situations, and resolution of ED without any treatment. Claudication or coolness or a blue color in the toes or feet may indicate a problem with the blood vessels ... More

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