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PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people. In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesnt work. Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects. Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues. Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects. Tadalafil is very specific for PDE5 and is also very specific for the enzyme PDE11. Unfortunately, we dont know much about PDE11, which is found in the heart, in the pituitary gland in the brain and in the testicles. Pharmacokinetics, half-life, is how long the medication stay s in the blood. Sildenafil (Viagra) has a half-life of 4 hours and vardenafil (Levitra) has a half-life of 4-6 hours while tadalafil (Cialis) has a half-life of 17.5 hours. This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known. Tadalafil (Cialis) has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication. The drawback is if you need nitrates after using tadalafil (Cialis), this medication lasts a long time in your blood stream and may place you at a higher risk. Younger people might do well treated with tadalafil, (Cialis) while older people with other health issues might be better off using sildenafil (Viagra) or vardenafil (Levitra) but more data are needed. The side effects of vardenafil (Levitra) are potentially less than sildenafil (Viagra), but more data are needed. In a recent study on men with erectile dysfunction and diabetes, vardenafil (Levitra) improved their erectile dysfunction. Tadalafil (Cialis) is as effective as sildenafil (Viagra), and vardenafil (Levitra) with similar side effects except for back pain that occurs occasionally with tadalafil, probably because of the long half-life. Many people stop taking drugs because they are experiencing side effects, they no longer have a partner, or they are worried about safety. Sexual activity is not a major contributor to the risk of a heart attack. Sexual activity, with or without sildenafil (Viagra) increases the chance of an MI during sexual activity by only 0.1%. If pills fail, there are vacuum devices, Muse, injections, bypass surgery and implants. The patient making a presentation has had penile bypass surgery. In addition he takes testosterone and sildenafil as needed.. This is a classic example of why people with ED need complete care: a psychological exam, history and physical exam, and diagnostic studies with ed medication without prescription long term follow-up care. Patients with ED should not just be prescribed sildenafil (Viagra) and then be lost to follow-up. When Roman started, 80% of Viagra sold online was counterfeit. It became our mission to make it safe and simple for people to get medication they can trust from a licensed pharmacy, prescribed by a real, US-licensed healthcare professional. Erectile dysfunction is the inability to get or maintain an erection adequate for sex. There are many different causes, but ED ultimately occurs when there is too little blood flow into the penis and too much blood flow out, partially due to an enzyme called PDE5. Oral ED medications block PDE5 to increase blood flow into the penis and decrease blood flow out. ED medication interferes with the breakdown of chemicals required to obtain and maintain an erection. This interference keeps more of those chemicals in action longer, improving the ability to get and maintain an erection. A physician in our network will evaluate whether ED treatment is appropriate for you. If prescribed, well ship it to you in discreet, unmarked packaging. Do not use Viagra/sildenafil if you arent healthy enough for sex or if you take nitrates for chest pain. Side effects may include headache, flushing, upset stomach, nasal congestion and abnormal vision. To avoid injury, seek immediate attention if you have an erection lasting longer than 4 hours. Stop taking Viagra/sildenafil and seek care if you experience a sudden loss or decrease in vision or hearing. Do not use Viagra if you arent healthy enough for sex or if you take nitrates for chest pain. Side effects may include headache, flushing, upset stomach, nasal congestion and abnormal vision. To avoid injury, seek immediate attention if you have an erection lasting longer than 4 hours. Stop taking Viagra and seek care if you experience a sudden loss or decrease in vision or hearing. Do not take Cialis if you arent healthy enough for sex or if you take nitrates for chest pain. Side effects may include headache, upset stomach, delayed backache, or muscle ache. To avoid injury, seek immediate attention if you have an erection lasting longer than 4 hours. Stop taking Cialis and seek care if you experience a sudden loss or decrease in vision or hearing or if you experience an allergic reaction like rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing. To learn more about Cialis, please see the Important Safety Information. Sildenafil & Viagra manufactured by Pfizer in France. A physician in our network will evaluate which (if any) ED treatment is appropriate for you. Then well ship it to you in discreet, unmarked packaging. Many people get great results the first time they use the medication. For some, it can take 2-3 uses to see results, and research shows that best results occur after 8 uses . If you still dont see results, your doctor or nurse practitioner may be able to increase your dose or switch you to a different medication. If you experience side effects, message your doctor or nurse practitioner and theyll help determine if a different medication or dose is better for you. Sexual health and overall health are inherently related. If erectile dysfunction is interrupting your sex life, your general wellbeing (and that of your partner) is impacted greatly. Report your symptoms and medical history to a U.S.-licensed physician or nurse practitioner for evaluation. Your treatment will be sent in discreet packaging, always with free 2-day shipping. Send your doctor or nurse practitioner a message any time to discuss updating your treatment, solving for side effects, or any other questions or concerns. For more information about erectile dysfunction, Roman, Ro and more, visit our FAQ page. To speak to a care representative, give us a call at (888) 798-8686 or email us at [email protected] . Roman uses telemedicine technology to provide a discreet, convenient, and affordable way for you to receive erectile dysfunction treatment from a U.S. Complete the dynamic onboarding, submit your photo, ID, and recent blood pressure reading, and our physicians will determine if youre a candidate for telemedicine. Erectile dysfunction is often a symptom of a more serious underlying conditionlike heart disease, diabetes, high blood pressure, or even depression. Thats why we strongly recommend optional laboratory tests. These tests arent required to receive treatment on the Roman platform. But they help identify the underlying cause of your ED. We want you to get the most comprehensive treatment possible. Just send us your most recent blood test and well add it to your account information to help our physicians give you the most comprehensive care from the convenience of your phone.It might sound funny but regular erections are a great barometer of your overall health. Learn why paying attention to the strength and frequency of your erection might actually save your life. Which medications do doctors and nurse practitioners on the Roman platform prescribed for ED? The American Urological Association claims that oral PDE-5 inhibitors should be offered as the first line of therapy for erectile dysfunction. So thats what we do. Physicians on the Roman Platform prescribe the most common PDE-5 oral medications which include: sildenafil (Viagra) and tadalafil (Cialis) Is ED medication effective? Viagras FDA approved prescribing information claims that 82% of patients reported an improvement in their erections. Other PDE-5 inhibitors (Cialis, Levitra) showed similar results. Oral ED medication is generally considered extremely effective and studies show it works on the majority of men. Its important to note that everyones reaction to a medication is unique. Your Roman physician may recommend trying the medication multiple times under different circumstances. They may also increase your dose, depending on your reaction to the medication and any side effects. If youve been prescribed ED medication on the Roman platform, please contact a physician on from your account page if you have any questions. Can a doctor or nurse practitioner diagnose erectile dysfunction remotely? Erectile dysfunction can be diagnosed by a physician based on a patient self-reporting their symptoms and medical history. Physicians on the Roman platform use telemedicine technologies to diagnose ED in the same way they diagnose patients in-person. Doctors ask you questions to evaluate your symptoms and make sure its safe and appropriate to prescribe ED medication. The physicians on the Roman platform use your answers to diagnose your condition and create a treatment plan. Thats why its vital you answer each question to the best of your knowledge and ensure that every communication with your physician is truthful, accurate, and thorough. Why do I need to know my blood pressure to get an ED prescription? Your blood pressure is an important part of determining whether its safe for you to take ED medication. It can be dangerous to take ED medication if your blood pressure is above or below a certain value. To complete a comprehensive medical history during your online visit, you need to enter your most recent blood pressure reading within the last 6 months. If you havent had your blood pressure taken within the last 6 months, you can get a free blood pressure reading at thousands of locations across the country. Enter your location into higi or Pursuant Health to find a place near you that offers free, clinically verified blood pressure readings. If youre measuring your blood pressure at home, make sure the device has been clinically validated. You can purchase a device online or at your local pharmacy. We recommend an upper arm cuff over a wrist or finger blood pressure monitor. Before taking your blood pressure, its important to avoid the following factors that may cause your blood pressure to temporarily rise: Cold temperatures Exercise Caffeine Stress Smoking Certain medications (check the label on your device) When youre ready, find a quiet place and sit for 5-10 minutes. Make sure youre relaxed and have recently urinated (a full bladder can affect your reading). Apply the cuff on your upper arm and following the directions on the device.Please make sure to take at least two readings. Enter the higher of the two readings during your online dynamic visit. Do you offer alternative treatments for erectile dysfunction? Oral ED medications are extremely effective, but they dont work for everyone. Other treatment options for ED include lifestyle improvements (like exercise, diet, quitting smoking, and limiting alcohol use), surgery, penile vacuum pumps, and other ED medications. Every treatment comes with risks and benefits that you should fully understand before moving forward with any treatment plan. Currently, the only erectile dysfunction treatment we offer are oral PDE-5 inhibitors in the form of: If youd like to pursue alternative ED treatment, we recommend speaking with a physician in-person. Contact our team at [email protected] and we can recommend a doctor in your area. Orders ship in discreet boxes, with all medication in single use packs. Child proof packaging is available upon request by emailing [email protected] Orders are shipped 2-day air to ensure medication is received as soon as possible. Postal boxes and mail forwarding addresses will receive standard postal shipping and not 2-day air at this time. Where can I get my blood pressure measured for free? Enter your location into higi or Pursuant Health to find the nearest location to get a free, clinically verified blood pressure reading. Higi Stations are available free of charge at Rite Aids nationwide, and Pursuant Health stations are available free of charge at Walmarts nationwide. According to the American Urological Association, oral PDE-5 inhibitors should be offered as the first line of therapy for erectile dysfunction. So thats what physicians on the Roman platform use to treat ED. The most common PDE-5 oral medications they prescribe are: Sildenafil (Viagra) Sildenafil (sildenafil) Tadalafil (Cialis) From treating specific conditions to helping you tackle life-threatening addictions and supporting your bodys natural systems. Starting at $35/Month* Starting at $25/Month* Starting at $15/Month* *Shipped & billed quarterly. Final price depending on prescribed treatment plan. From receding hairlines, to thinning hair, to breakouts, to fine lines or wrinklestell us whats bothering you so we can help. Starting at $31/Month* Starting at $22/Month* Starting at $29/Month* *Shipped & billed quarterly. Final price depending on prescribed treatment plan. Get discreet and genuine prescription medications (if prescribed) or over-the-counter treatment delivered in unmarked packaging. Erectile dysfunction Premature ejaculation Hair loss Cold sores Genital herpes Heart Health Bone Health Stress Relief Prostate Health Testosterone Support Weight management Allergies Nightly Defense skincare Eczema Dandruff Excessive sweating (hyperhidrosis) About Roman. How it works Our story Our medical advisors Our network physicians Transparency Member stories Health Guide Press Careers. Roman-affiliated physician practices are independently owned and operated by licensed physicians who provide services utilizing the Roman telehealth platform. Major League Baseball trademarks and copyrights are used with permission of Major League Baseball. Erectile dysfunction Premature ejaculation Cold sores Genital herpes. Hair loss treatment Nightly Defense skincare Eczema Dandruff Excessive sweating (hyperhidrosis) Daily health. Allergies Heart health Bone health Stress relief Prostate health Testosterone support. Sildenafil 20mg (generic revatio) Read this Patient Information before you start taking sildenafil 20 mg (Revatio) and each time you get a refill. This information does not take the place of talking with your doctor about your medical condition or treatment. If you have any questions about sildenafil, ask your doctor or pharmacist. What is the most important information I should know about sildenafil 20 mg tablets (Revatio)? Your blood pressure could drop quickly to an unsafe level. Nitrate medicines include: Medicines that treat chest pain (angina) Nitroglycerin in any form including tablets, patches, sprays, and ointments Isosorbide mononitrate or dinitrate Street drugs called poppers (amyl nitrate or nitrite) Ask your doctor or pharmacist if you are not sure if you are taking a nitrate medicine. 20 mg sildenafil is a prescription medicine used in adults to treat pulmonary arterial hypertension (PAH). With PAH, the blood pressure in your lungs is too high. Your heart has to work hard to pump blood into your lungs. It improves the ability to exercise and can slow down worsening changes in your physical condition. Sildenafil is not for use in children Adding sildenafil to another medication used to treat PAH, bosentan (Tracleer), does not result in improvement in your ability to exercise. 20 mg sildenafil tablets contain the same medicine as VIAGRA (sildenafil), which is used to treat erectile dysfunction (impotence). Do not take 20 mg sildenafil tablets with VIAGRA or other PDE-5 inhibitors. Who should not take sildenafil 20 mg tablets (Revatio)? Do not take sildenafil if you: Take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level Are allergic to sildenafil, as contained in VIAGRA and REVATIO Youve ever had blockage of veins in your lungs, which is called pulmonary veno-occlusive disease Are a women or a child. Before you take sildenafil, tell your healthcare provider if you: Have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure Have had heart surgery within the last 6 months Have pulmonary hypertension Have had a stroke Have low blood pressure, or high blood pressure that is not controlled Have a deformed penis shape Have had an erection that lasted for more than 4 hours Have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia Have retinitis pigmentosa, a rare genetic (runs in families) eye disease Have ever had severe vision loss, including an eye problem called NAION Have bleeding problems viagra for sale no prescription Have or have had stomach or intestinal ulcers Have liver problems Have kidney problems or are having kidney dialysis Have any problem with the shape of your penis or Peyronies disease Have any other medical conditions. Tell your healthcare provider about all the medicines you take , including prescription and over-the-counter medicines, vitamins, and herbal supplements. Sildenafil may affect the way other medicines work, and other medicines may affect the way sildenafil works, causing side effects. Especially tell your healthcare provider if you take any of the following: Medicines called nitrates Medicines called guanylate cyclase stimulators such as Adempas (riociguat) Medicines called alpha-blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin).
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