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For more information, read the “Pseudoephedrine HCl (Sudafed)” section above. If your erection becomes less than penetration hardness within an hour of taking pseudoephedrine HCl, call your doctor’s office the next day to speak with your APP. You shouldn’t continue to inject with the same dose if you took pseudoephedrine HCl for a prolonged erection. Your APP will make changes to your penile injection therapy medication dose. If you have an erection that lasts 3 hours (you still have an erection 1 hour after taking the pseudoephedrine HCl), call your APP and plan to go to MSK’s Urgent Care Center or your local emergency room. Monday through Friday between 9:00 am and 5:00 pm , call your APP. Phone number: __________________________________________ Between 5:00 pm and 9:00 am , during the weekend, and on holidays, call 212-639-2000 and ask to speak to the urologist on call. Go to MSK’s Urgent Care Center at Memorial Hospital (1275 cenforce 200 pills York Avenue, between East 67 th and East 68 th Streets) if you’re less than 30 minutes away. Your APP will call the cenforce 200 pills Urgent Care Center so they know to expect you. Your APP will give you more instructions during your call. Go to your local emergency room if you’re more than 30 minutes away from MSK’s Urgent Care Center. Your APP will give you more instructions during cenforce 200 pills your call. If you have an erection that lasts 4 hours and you haven’t talked to your APP, this is a medical emergency. You should treat it with the same urgency as a heart attack. Erections lasting longer than 4 hours can cause permanent damage to your erection tissue. Go to MSK’s Urgent Care Center if you’re less than 30 minutes away. Ask the guard at the entrance to the hospital how to get there. Go to your local emergency room if you’re more than 30 minutes away from MSK’s Urgent Care Center. Tell the staff at the Urgent Care Center or emergency room that you’ve had an erection for 4 hours. If you aren’t treated quickly, it’s possible that you will end up with permanent ED. Give the doctor or nurse the priapism card that was given to you to carry in your wallet. You can also have the doctor or nurse call us at the numbers listed above. After Pelvic Surgery for Prostate or Bladder Cancer. If you have had pelvic surgery for prostate or bladder cancer within the past year, your doctor may have told you to take a low dose of sildenafil (Viagra), vardenafil (Levitra), avanafil (Stendra), or tadalafil (Cialis) every night, except on days or nights you plan to inject. This improves the chance that your erectile function will return. Do not take the following medications within 18 hours of an injection (before or after): Medication Dose Sildenafil (Viagra) 20 mg to 100 mg Vardenafil (Levitra) 10 mg to 20 mg Avanafil (Stendra) 50 mg to 200 mg. Your response to oral ED medications may improve over the first 18 to 24 months after surgery. A full dose is one of the following: 100 mg of sildenafil (Viagra) taken on an empty stomach (2 hours before or 2 hours after a meal). 20 mg of vardenafil (Levitra) taken on an empty stomach. 200 mg of avanafil (Stendra) taken with or without food. 20 mg of tadalafil (Cialis) taken with or without food. To achieve the best response, you must be: Relaxed Sexually aroused, either from contact with a partner or from self-stimulation Not tired Back to top. Speak with your APP about how to travel with your injection medication. They can give you a letter explaining your treatment, if needed. If you need a letter, be sure to ask for it before your travel dates. For information about storing and disposing of your home medical sharps, read our resource How to Store and Dispose of Your Home Medical Sharps. How is Cialis different from the currently approved products for erectile dysfunction (ED)? As with any drug product, there may be side effects. The most commonly reported side effects in patients treated with Cialis during the testing of the product were: headache indigestion back pain muscle pain flushing stuffy nose. Patients who get back pain and muscle aches usually get them 12 to 24 hours after taking Cialis and these usually go away by themselves within 48 hours. A small number of patients taking Cialis also reported abnormal vision. What important information should you know about Cialis? CIALIS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with any nitrate medication. You could get dizzy, faint or have a heart attack or stroke. Tell your healthcare provider that you take Cialis . If you need emergency medical care for a heart problem, it will be important for your health care provider to know when you last took Cialis. After taking a single tablet, some of the active ingredient of Cialis remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications. Physicians should discuss with patients the potential for CIALIS to augment the blood-pressure-lowering effect of alpha-blockers and antihypertensive medications. What should I talk to my doctor about when considering if Cialis is right for me? Can Cialis be used with other treatments for impotence? Will Cialis be prescription cenforce 200 pills or OTC (over-the-counter)? How can I report a serious side effect with Cialis to FDA? FDA encourages anyone aware of a serious side effect, including consumers or patients, to make a MedWatch report. You can report an adverse event either online, by regular mail or by fax, using the contact information at the bottom of this page. Viagra is now being used to treat not only erectile dysfunction (ED) but also pulmonary hypertension. And the drug may have potential for treating several other conditions, according to a recent report. The three ED medications currently on the market—Viagra, Levitra, and Cialis—all work by the same means, and they have similar side effects. The most common are headaches and facial flushing, which occur in 15% of men. Other reactions include nasal congestion, indigestion, and back pain. The most important worry about ED pills is their ability to widen arteries enough to lower blood pressure. And men who are taking nitrates should never use any of the ED pills. Although some of the drugs’ side effects may be troublesome, others may be helpful, and scientists are studying whether ED pills might help treat a variety of nonsexual problems. Viagra (sildenafil) has been on the market longest and is most studied. It’s yet not clear if the other ED pills offer similar benefits, but Viagra, at least, may prove useful for some other conditions, including these: Pulmonary hypertension. Viagra is now marketed under the name Revatio for this uncommon but serious disorder of high pressure in the blood vessels leading to the lungs. Viagra can reduce pulmonary artery pressure at high altitude and improve the ability to exercise in low oxygen conditions. In affected individuals, exposure to the cold triggers spasm of the small arteries that supply blood to the fingers, toes, or both, which become pale, cold, and painful. Both Viagra and Levitra have been helpful in clinical trials. Studies suggest Viagra might help patients with congestive heart failure or diastolic dysfunction. Further details are published in the August 2007 issue of Harvard Men’s Health Watch. Why erectile dysfunction meds can have serious side effects. The medical condition—and the drugs used to treat it—should be taken seriously. Subscribe to the Print Edition Digital Edition For iOS Digital Edition For Android Renew Customer Service Terms of Use Abuse Contact Us Masthead Privacy Policy Deposit Photos. Many products featured on this site were editorially chosen. Popular Science may receive financial compensation for products purchased through this site. Reproduction in whole or in part without permission is prohibited. Erectile Dysfunction (ED) Injections: Trimix Penile Implant Vacuum Erection Device (VED) For many years, we have used medication to improve blood vessel circulation in the penis. These medications include papaverine, phentolamine, and prostaglandin E1 — Trimix is a mixture of all three of these drugs. Scientists have found that these drugs can induce a penile erection when injected directly into the penis. Since 1983, these erectile dysfunction injections have gained acceptance across the globe. The FDA approved Prostaglandin E1 for treatment in 1995. Medications like Viagra, Cialis, or Levitra do not work for every man dealing with erectile dysfunction. However, penile injection therapy is another viable option. The thought of injecting a needle into your penis may sound intimidating, but about 70 percent of men are highly satisfied with this therapy. We do the first injection here in our office so we can show you how to do it yourself at home. It also helps us determine the correct dose for your needs. You may increase your dose by five units each time until you get the effect you want. If you are using 50 units and not getting the erection that you need, call us and we will prescribe you a stronger dose. We allow a maximum of three injections per week, but you must wait 24 hours before taking another dose. And make sure you alternate between sides of the penis for each injection. However, injection therapy is not always a good long-term option for some men and that is when they may want to consider the penile implant. Below are step-by-step instructions detailing how to properly use your penile injection at home without a doctor. Tear open an alcohol swab and wipe the rubber top of the bottle to sterilize it. Peel open the syringe carefully and remove the protective cover from the needle. It is important that you do NOT contaminate the needle with anything but the rubber bottle cap. Push the needle through the rubber stopper, then flip the ampule (the glass container of medication) upside down. Pull on the plunger until you withdraw 1.0 cc of the medicine. As you continue to hold the ampule upside down, inject whatever air remains in the syringe into the ampule. Withdraw the fluid until there are no more air bubbles in the syringe and the correct amount of medication is in the syringe. Pull the needle out of the ampule and lay the syringe on the edge of a flat surface. Make sure the needle hangs over the edge to keep it from touching anything. Grasp the head of the penis between the index finger and thumb and gently pull the penis away from your body until the skin is taut. When choosing an injection site, cenforce 200 pills avoid any area where a vein is clearly visible. We recommend changing injection sites from left to right as well as up and down the shaft and back again to ensure that you do not develop scar tissue at one specific site. Pick up the syringe with the other hand and position your hand like you're about to throw a dart. Touch the spoint of the needle to the place you want to inject. (Only inject your penis while you're sitting or standing.) 12. Hold the syringe at a 90-degree angle and push lightly to penetrate the skin near the base of your penis. Once you've poked through the skin, you will feel some resistance. Push firmly forward until a distinct "give" is felt. The needle should now be in the right place (within erectile bodies). The whole length of the needle should be also be in up to the hub. Hold the syringe between your index and middle fingers and place a thumb on the plunger to inject the entire contents of the syringe. Immediately apply pressure to your penis with your thumb and index finger for two to three minutes using the alcohol swab. A class of drugs called Phosphodiesterase-5 (PDE-5) inhibitors is widely used and effective. They increase the blood flow to your penis temporarily. The four most common in England are: • sildenafil – brand name Viagra • tadalafil – brand name Cialis • vardenafil – brand name Levitra • avanafil – brand name Spedra. Viagra came off patent in the UK in 2014 meaning that companies can now manufacture cheaper ‘generic’ versions of it. Sildenafil and vardenafil take about an hour to get going and then last for 8-9 hours. Take PDE-5s on an empty stomach (you can eat an hour later) and only take one tablet within a 24-hour period. These treatments are helpful for most men with ED (between two-thirds and three-quarters) but they’re not instant erection pills. If they don’t work for you, make sure you’re not trying to soon (before the drug has kicked in) or too late (after it has died down) but don’t mess about with the dose without talking to your GP. The NHS reckon that at least two-thirds of men report having improved erections after taking PDE-5s. Yes, sex is good for your cardio health but PDE-5s can be dangerous if you have a heart condition, are taking blood pressure medication such as alpha-blockers or have had a heart attack or stroke so discuss with your GP. (Erection problems can also be an early sign of heart disease so you should see your GP about erection problems anyway so heart disease can be checked out as a possible cause.) Also talk to your GP if you have Peyronie’s disease, priapism or are taking drugs that contain nitrates, whether prescribed (eg.
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