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The discovery of Viagra is one of the classic stories of serendipity in drug development. In the 1980s, the pharmaceutical company Pfizer began studying sildenafil, the generic name for Viagra, as a treatment for heart disease. It didn’t work, but the men in the study developed unusually strong, long-lasting erections. All four of the currently approved drugs seem to be equally good at producing erections. But it viagra tablets online purchase is difficult to be more definitive in evaluating their efficacy, because few studies directly comparing them have been conducted, a common problem with many drugs. Since all four drugs are similarly effective, the answer to which drug is best will depend on other attributes, such as side effects, drug interactions, speed of onset and duration of action. Headache, flushing and upset stomach are the most common side effects. And, in rare cases, all can cause a persistent and sometimes painful erection that will not go down, a condition called priapism that can result in permanent damage if not treated promptly. Drug interactions are largely similar, with the most important interaction being a contraindication to nitrate-containing drugs, such as nitroglycerin, commonly used to treat angina. Time of onset is an important buy viagra tablet near me difference between the drugs. While all take effect within an hour, Stendra is the fastest acting, often taking effect within 15 minutes. Duration of action is another important difference between the drugs. Cialis is the longest acting, with a duration of up to 36 hours. Cialis’s long duration means that it can be taken once a day, eliminating the need to take a pill before each sexual encounter. Such once-a-day dosing has been reported to increase sexual self-confidence and spontaneity. Which drug is better depends on your personal situation. For long duration, and perhaps for spontaneity, Cialis may be best. As always, the answer must come from your doctor, who can assess patient-specific factors and help determine which is right for you. Nitrates: Administration of VIAGRA to patients using nitric oxide donors, such as organic nitrates or organic nitrites in any form either regularly and/or intermittently, is contraindicated. VIAGRA was shown to potentiate the hypotensive effect of nitrates. Concomitant Guanylate Cyclase (GC) Stimulators: Do not use VIAGRA in patients who are using a GC stimulator, such as riociguat. PDE5 inhibitors, including VIAGRA, may potentiate the hypotensive effects of GC stimulators. Hypersensitivity Reactions: VIAGRA is contraindicated in patients with a known hypersensitivity to sildenafil, as contained in VIAGRA and REVATIO, or any component of the tablet. Hypersensitivity reactions have been reported including rash and urticaria. Cardiovascular: Patients should not use VIAGRA if sexual activity is inadvisable due to cardiovascular status. Physicians should carefully buy viagra tablet near me consider whether their patients with underlying cardiovascular buy viagra tablet near me disease could be affected adversely by the vasodilatory effects of VIAGRA, especially in combination with sexual activity. There are no controlled clinical data on the safety or efficacy of VIAGRA in patients with the following characteristics: recent serious cardiovascular events, hypotension, or uncontrolled hypertension; if prescribed, this should be done with caution. Prolonged Erection: Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result. Use VIAGRA with caution in patients predisposed to priapism. Effects on the Eye: Patients should stop VIAGRA and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION). VIAGRA should be used with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION. Patients with a " crowded" optic disc may also be at an increased risk of NAION. There are no controlled clinical data on the safety or efficacy of VIAGRA in patients with retinitis pigmentosa; if prescribed, this should be done with caution. Hearing Loss: Sudden buy viagra tablet near me decrease or loss of hearing has been reported in temporal association with the intake of PDE5 inhibitors, including VIAGRA. (It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors.) Physicians should advise patients to stop taking PDE5 inhibitors, including VIAGRA, and seek prompt medical attention in the event of sudden decrease or loss of hearing.
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