VIAGRA

Viagra
On 27 March 1998, the Food and Drug Administration approved Viagra (sildenafil citrate), the first oral pill to treat impotence.


How Does It Work? 
During sexual arousal a man produces two chemicals: erection-producing, circulating GMP and erection-dampening PDE-5. Viagra temporarily blocks the production of PDE-5, vigorously enhancing the buildup of a man's natural, erection-producing cGMP. If there is no sexual stimulation, there is no cGMP, and Viagra does nothing. Said one of the clinical trial participants, "If I take a pill and my wife gets a headache, or she gets a phone call, it's OK because nothing happens. It only works when it's time for it to work." 

Is It Safe?
As with any drug, some people do experience side effects. The most commonly reported side effects in patients treated with Viagra are: headache, flushing, stomach ache, nasal congestion, and mild and temporary changes in vision (color perception changes, light perception changes, and blurred vision was experienced by about 3 percent of clinical trial participants). 

How Do You Take It? 
Viagra is typically prescribed as one 50 mg tablet, once a day, about 1 hour before sexual activity. It may, however, be taken anywhere from 30 minutes to 4 hours before sexual activity. Some individuals may need more (100 mg) or less (25 mg) depending on effectiveness and side effects. Currently, the drug is not recommended for use more than once a day. 

Who Can Take Viagra?
At present, the only men Viagra is not recommended for are men taking nitroglycerin. (The combination may lower blood pressure.) The safety and efficacy of using Viagra with other treatments for impotence has not been studied, and the use of such combinations is not recommended. Discuss with your health care practitioner ALL of the medications you are taking to receive the best advice for your situation. 

What the FDA Says
"Viagra was evaluated in numerous randomized, placebo controlled trials involving more than 3000 men with varying degrees of impotence associated with diabetes, spinal cord injury, history of prostate surgery, and no identifiable organic cause of impotence. Patients also had a wide range of other concomitant illnesses including hypertension and coronary artery disease. The drug's effectiveness was assessed primarily using a sexual function questionnaire. Patients were asked to report at the beginning, and periodically throughout the studies, how often they were able to achieve an erection adequate for intercourse, and how often that erection was maintained after penetration. In addition, patients kept diaries of their sexual histories. In all trials, men on Viagra reported success more often than did men on placebo, and rates of success increased with dose. The findings were consistent in men representing a wide range of severity and etiology of their erectile dysfunction (impotence)."

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