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While the results for treating angina were disappointing, many participants reported developing erections after taking Viagra.

Further research showed that Viagra relaxed the blood vessels supplying the erectile tissues.

The medication was launched in 1998 by Pfizer, and approved by the European Medicines Agency and US Food and Drug Administration, as the first oral drug to treat erectile dysfunction. Following sildenafil citrate liquid for sale the launch of Viagra, Eli Lilly joined forces with the ICOS Corporation to develop a newer version of this erectile dysfunction treatment.

This treatment, Taladalafil, was approved for sale in 2002 in Europe, then in the US the following year.

You can take Cialis as little as 30 minutes before you plan to have sex; whereas Viagra must be taken at least one hour before sex.

If you have a large meal shortly before taking a pill, it will slow down the rate at which Viagra takes effect.

In contrast, you can take Cialis before or after eating.

With both treatments you should limit your alcohol intake to enjoy the greatest effects. It is not unusual for a man not to respond to erectile dysfunction treatment the first time he takes it.

Indeed it is recommended you try taking the tablet on up to eight occasions. Then if no results are forthcoming discuss with your doctor about switching to a different dose or form of treatment.

The biggest difference between Viagra and Cialis is the amount of time their effects last.

Viagra remains effective for 4 to 6 hours, which offers ample opportunity to have sex on multiple occasions if you wish.

However Cialis typically allows you to achieve erections for up to 36 hours after taking a tablet.

Although Cialis lasts for up to 36 hours, this does not mean you will have an erection throughout that time – it should only happen when you are sexually stimulated.

Cialis has comfortably the longest effectiveness period of any erectile dysfunction drug on the market.

Side effects for either drug are rare but not unheard of.

As Cialis and Viagra are both PDE-5 inhibitors, they have similar side effects; although you may find that because Cialis is effective for longer, any side effects you experience may also last for longer.

The most likely unwanted effects are light-headedness, headaches or flushing to the face.

Nasal congestion, indigestion and visual changes are sometimes experienced as well. If you experience chest pain or a prolonged erection for more than four hours, you must seek urgent medical help.

Both Viagra and Cialis are prescription drugs so you must consult with a doctor before you can take them. Cost is another notable distinction between Viagra and Cialis.

The longer effectiveness of Cialis is reflected in its price.

While Cialis is slightly more expensive than Viagra, many men will consider the vastly greater duration period of Cialis to represent good value for money.

Equally, plenty of men will prefer the cheaper price and renowned brand name offered by Viagra. But ultimately it depends entirely on the individual.

Sildenafil and

Tadalafil

are the most well-known of all the ED medications. They are both in a class of medications

called

‘phosphodiesterase type 5 (PDE5) inhibitors’ and work in a very similar way.

These medicines work in the presence of sexual stimulation.

Once aroused, a natural chemical is released, which the PDE5 inhibitors rely on to work with. Once this natural chemical is released, a chain reaction begins, relaxing the smooth muscle inside the penis. There is then an increase in blood flow into the penis allowing the penis to can become erect.

What’s the difference between Sildenafil and Tadalafil? Sildenafil has been around since 1998, which means a lot is known about the positive effects and also the side effects. It works within an hour of taking the medication and for its full effect, should be taken on an empty stomach. The effects of Sildenafil generally last for four to five hours. Viagra was developed by the pharmaceutical company Pfizer and they were the only company that could legally manufacture it until 2013. In 2013, their patent expired which meant that other companies could produce their own erectile dysfunction medications containing the active ingredient sildenafil. When you see the medication ‘Sildenafil’, you can be assured that it contains exactly the same active ingredient as Viagra.

However, as it is a generic version rather than the brand, it is considerably cheaper.

The more common side effects of Sildenafil can include headache, nausea, stuffy nose, flushing and indigestion. There are also some rarer side effects; you should always read the accompanying leaflet that comes with any medicine before taking it.

Sildenafil is taken on an as needed basis, usually at a dose of 50mg. These may be increased to 100mg if the standard dose is ineffective, or lowered to 25mg if mild side-effects are experienced.

The dosing may be different depending on your medical history, so your doctor should discuss an appropriate starting dose with you. In 2003, a company named Eli Lilly introduced Cialis as an alternative ED medication.

The company had the patent on Tadalafil until November 2017.

Similarly to Viagra, now that the patent has expired, other companies are permitted to make their own version of Tadalafil, the active ingredient in Cialis.

Again, as it is a generic version of the brand, Cialis, the medication is considerably cheaper. Tadalafil has two formulations – one that can be taken 'as required', and one that can be taken daily.

The 'as required' Tadalafil (generic Cialis) has an advantage over Sildenafil in that it lasts a lot longer – up to 36 hours (compared with 4-5 hours for Sildenafil).

Some men prefer this as it allows for more spontaneity.

Tadalafil also works faster than Sildenafil – it generally works within 30 minutes, though for some men it can take up to an hour.

The action of Tadalafil is not affected by food, and this is another reason why some men may prefer it.

The standard 'as required' Tadalafil dose is 10mg, which may be increased to a maximum of 20mg if the medication is ineffective.

This dose also depends on your medical history, so your doctor will discuss the appropriate starting dose with you. The daily version of Tadalafil known by its brand name Cialis Daily, is recommended for those who have sex more than twice a week. The medication is taken every day and after approximately 5 days, should have its full effect.

By taking the medication in this way, there is a steady, constant dose in the body.

The initial dosing is 2.5mg once daily, which can sildenafil citrate liquid for sale be increased to 5mg if the initial dosing is ineffective. One of the disadvantages of Tadalafil is that as the medication lasts in the body for longer, if you get side effects with the medication, these can last longer as well. The side effects are similar to all ED medications - headache, nausea, stuffy nose, flushing, indigestion, but as mentioned before there can be some other rarer side effects; you should always check the leaflet that comes with the medication before taking it.

Different ED medications suit different people so it is difficult to tell which would work best for you until you’ve tried each one. In our experience, men often prefer Tadalafil as it lasts longer, works faster and can be taken with food. Having said that, some men find that Tadalafil does not suit them, so they prefer to stick with Sildenafil. You can request both Sildenafil and Tadalafil safely online through the LloydsPharmacy’s Online Doctor service.

If appropriate, our GPs ca prescribe you treatment for Same-Day Collection, Next-Day delivery or FREE Standard Delivery. If you’re unsure which ED treatment will be best for you then take our free ED assessment and our clinicians

will

help you decide. Erectile dysfunction (ED) — impotence — is an extremely common problem that affects up to 22% of American men, mostly in the older age groups. Once considered primarily a psychological disorder, it is now clear that most cases of impotence have a physical basis.

The leading causes are the chronic diseases that damage blood vessels and nerves vital for normal erectile function; diabetes, atherosclerosis, and hypertension head the list. The medications used to treat these problems and other ailments can also contribute to impotence. Hormonal abnormalities are less common, but they are particularly important to detect since they can be corrected. That's also true of the psychological problems that cause up to 15% of impotence; table 1 below summarizes some of the differences between psychological and physical impotence.

For many men, the hardest thing is to admit the problem.

Every man experiences erectile dysfunction from time to time, but doctors define impotence as the inability to get and keep an erection satisfactorily for penetration on at least 25% of attempts.

It's a good definition, but it should not be used to exclude men with less severe difficulties from getting treatment.

A simple questionnaire can help you determine if you are having erectile dysfunction (see below).

If so, talk to a primary care doctor, urologist, or endocrinologist. Which Drug for Erectile Dysfunction Is Better: Viagra or Cialis? Four drugs have been approved for erectile dysfunction. Which is best depends on your individual needs and desires.

The Food and Drug Administration has approved four similar drugs for erectile dysfunction, sold under such names as Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) and Stendra (avanafil). They all work the same way, producing an erection by increasing blood flow to the penis.

Which drug is best may depend on your preference for quick onset versus long duration and your individual medical needs. 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 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 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 sildenafil citrate liquid for sale 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.

Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in adults with pulmonary arterial hypertension (

PAH

; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness).

Children should not usually take sildenafil, but in some cases, a doctor may decide that sildenafil (Revatio) is the best medication to treat a child's condition. Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors.

Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation.

Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.

If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV). Sildenafil comes as a tablet and suspension (liquid; Revatio only) to take by mouth.

If you are taking sildenafil to treat erectile dysfunction,

follow

your doctor's directions and the guidelines in this paragraph.

The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before

sexual

activity. Sildenafil usually should not be taken more than once every 24 hours.

If you have certain health conditions or are taking certain medications, your doctor may tell you to take

sildenafil

less often.

However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work. If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Do not take more or less of it or take it more often than prescribed by your doctor. Shake the liquid well for 10 seconds before each use to mix the medication evenly.

Use the oral syringe provided with your medication to measure and take your dose. Follow the manufacturer's directions to use and clean the oral syringe.

Do not mix the liquid with other medications or add anything to flavor the medication. If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication.

Tell your doctor if sildenafil is not working well or if you are experiencing side effects. If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it.

Do not stop taking sildenafil without talking to your doctor. Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information. Before taking sildenafil, tell your doctor and pharmacist if you are allergic to sildenafil, any other medications, or any of the ingredients in sildenafil products.

do not take sildenafil if you are taking or have recently taken riociguat (Adempas) or nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Monoket), and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates. do not take street drugs containing nitrates such as

amyl

nitrate and butyl nitrate ('poppers') while taking sildenafil. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax, in Jalyn), and terazosin; amlodipine (Norvasc, in Amturnide, in Tekamlo); certain antifungals such as itraconazole (Onmel, Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); certain barbiturates such as butalbital (in Butapap, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal LA, InnoPran); bosentan (Tracleer); cimetidine ; efavirenz (Sustiva, in Atripla); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase; no longer available in the U.S.), atazanavir (Reyataz, in Evotaz), darunavir (Prezista, in Prezcobix), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction; medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol, others), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane, in Rifamate, in Rifater).

Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. tell your doctor what herbal products you are taking or plan to take, especially St. tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration).

This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes.

Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.



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