Sildenafil – The mechanism of action

The realization of the physiological mechanism of erection is associated with the release of nitric oxide (NO) in the cavernous body during sexual stimulation. This, in turn, leads to an increase in the level of cGMP, subsequent relaxation of the smooth muscle tissue of the cavernous body and an increase in blood flow. Sildenafil does not have a direct relaxing effect on the isolated human cavernous body, but it enhances the effect of nitric oxide by inhibiting PDE-5, which is responsible for the breakdown of cGMP.

Sildenafil is selective against PDE-5 in vitro, its activity against PDE-5 exceeds the activity against other known PDE isoenzymes: PDE-6 — by 10 times; PDE-1-by more than 80 times; PDE-2, PDE-4, PDE-7–PDE-11 — by more than 700 times. Sildenafil is 4000 times more selective against PDE-5 compared to PDE-3, which is of crucial importance, since PDE-3 is one of the key enzymes for the regulation of myocardial contractility.

A prerequisite for the effectiveness of sildenafil is sexual stimulation.

Sildenafil restores impaired erectile function under conditions of sexual stimulation by increasing blood flow to the cavernous bodies of the penis.

Sildenafil: clinical data

Cardiological studies. The use of sildenafil in doses up to 100 mg did not lead to clinically significant ECG changes in healthy volunteers. The maximum decrease in systolic pressure in the supine position after taking sildenafil at a dose of 100 mg was 8.3 mm Hg, and diastolic pressure-5.3 mm Hg. A more pronounced, but also transient effect on blood pressure was observed in patients taking nitrates.

In a study of the hemodynamic effect of sildenafil in a single dose of 100 mg in 14 patients with severe coronary artery disease (more than 70% of patients had stenosis of at least one coronary artery), systolic and diastolic pressure at rest decreased by 7 and 6%, respectively, and pulmonary systolic pressure decreased by 9%. Sildenafil did not affect cardiac output and did not disrupt blood flow in stenosed coronary arteries, and also led to an increase (by about 13%) in adenosine-induced coronary flow in both stenosed and intact coronary arteries. In a double-blind placebo-controlled study, 144 patients with erectile dysfunction and stable angina, taking antianginal drugs (except nitrates), performed physical exercises until the severity of angina symptoms increased. The duration of the exercise was significantly longer (19.9 seconds; 0.9-38.9 seconds) in patients taking sildenafil in a single dose of 100 mg, compared with patients receiving placebo.

In a randomized, double-blind, placebo-controlled study, the effect of changing the dose of sildenafil (up to 100 mg) was studied in men (n=568) with erectile dysfunction and arterial hypertension taking more than two antihypertensive drugs. Sildenafil improved erection in 71% of men compared to 18% in the placebo group. The frequency of adverse effects was comparable to that in other groups of patients, as well as in those taking more than three antihypertensive drugs.

Studies of visual disorders. In some patients, 1 hour after taking sildenafil at a dose of 100 mg, a slight and transient impairment of the ability to distinguish shades of color (blue/green) was detected using the Farnsworth-Mansell 100 test. After 2 hours after taking the drug, these changes were absent. It is believed that the violation of color vision is caused by the inhibition of PDE-6, which is involved in the process of color transmission in the retina of the eye. Sildenafil had no effect on visual acuity, contrast perception, electroretinogram, IOP or pupil diameter.

In a placebo-controlled cross-sectional study of patients with proven early-age macular degeneration (n=9), sildenafil in a single dose of 100 mg was well tolerated. There were no clinically significant changes in vision assessed by special visual tests (visual acuity, Amsler grid, color perception, color passage modeling, Humphrey perimeter and photostress).

Effectiveness. The efficacy and safety of sildenafil were evaluated in 21 randomized, double-blind, placebo-controlled trials lasting up to 6 months in 3,000 patients aged 19 to 87 years with erectile dysfunction of various etiologies (organic, psychogenic or mixed). The effectiveness of the drug was evaluated globally using an erection diary, the international index of erectile function (a validated questionnaire on the state of sexual function) and a partner survey.

The effectiveness of sildenafil, defined as the ability to achieve and maintain an erection sufficient for satisfactory sexual intercourse, has been demonstrated in all studies conducted and confirmed in long-term studies lasting 1 year. In fixed-dose studies, the ratio of patients who reported that the therapy improved their erection was 62% (sildenafil 25 mg dose), 74% (sildenafil 50 mg dose) and 82% (viagra – sildenafil 100 mg dose) compared to 25% in the placebo group. The analysis of the international index of erectile function showed that in addition to improving the erection, treatment with sildenafil also increased the quality of orgasm, allowed achieving satisfaction from sexual intercourse and general satisfaction.

According to the generalized data, among the patients who reported an improvement in erection during treatment with drugs, there were 59% of diabetic patients, 43% of patients who underwent radical prostatectomy and 83% of patients with spinal cord injuries (versus 16, 15 and 12% in the placebo group, respectively).

sildenafil

Pharmacokinetics

The pharmacokinetics of sildenafil in the recommended dose range is linear.

Suction. After oral administration, sildenafil is rapidly absorbed. The absolute bioavailability on average is about 40% (from 25 to 63%). In vitro, sildenafil at a concentration of about 1.7 ng/ml (3.5 nM) suppresses the activity of human PDE-5 by 50%. After a single dose of sildenafil at a dose of 100 mg, the average Cmax of free sildenafil in the blood plasma of men is about 18 ng/ml (38 nM). Cmax when taking sildenafil orally on an empty stomach is achieved on average within 60 minutes (from 30 to 120 minutes). When taken in combination with fatty foods, the absorption rate decreases: Cmax decreases by an average of 29%, and Tmax increases by 60 minutes, but the degree of absorption does not significantly change (AUC decreases by 11%).

Distribution. The Vss of sildenafilum is on average 105 liters. The association of sildenafil and its main circulating N-demethyl metabolite with plasma proteins is about 96% and does not depend on the total concentration of the drug. Less than 0.0002% of the dose of viagra (an average of 188 ng) was detected in semen 90 minutes after taking the drug.

Metabolism. Sildenafil is metabolized mainly in the liver under the action of the isoenzyme CYP3A4 (main pathway) and the isoenzyme CYP2C9 (minor pathway). The main circulating active metabolite formed as a result of N-demethylation of sildenafil undergoes further metabolism. The selectivity of this metabolite against PDE is comparable to that of sildenafil, and its activity against PDE-5 in vitro is about 50% of the activity of sildenafil. The concentration of the metabolite in the blood plasma of healthy volunteers was about 40% of the concentration of tablets. The N-demethyl metabolite undergoes further metabolism; its T1/2 is about 4 hours.

Withdrawal. The total clearance of sildenafil is 41 l / h, and the final T1/2 is 3-5 h. After oral administration, as well as after intravenous administration, sildenafil is excreted as metabolites, mainly by the intestines (about 80% of the oral dose) and to a lesser extent by the kidneys (about 13% of the oral dose).

Special patient groups: Old age. In healthy elderly patients (older than 65 years), the clearance of sildenafil is reduced, and the concentration of free sildenafil in blood plasma is about 40% higher than in young patients (18-45 years). Age does not have a clinically significant effect on the frequency of side effects.

Impaired renal function. With mild (creatinine Cl 50-80 ml/min) and moderate (creatinine Cl 30-49 ml/min) degree of renal insufficiency, the pharmacokinetics of sildenafil after a single oral dose of 50 mg does not change. In severe renal insufficiency (creatinine Cl < 30 ml/min), the clearance of sildenafilum decreases, which leads to an approximately twofold increase in the values of AUC (100%) and Cmax (88%) compared with those of normal renal function in patients of the same age group.

Liver function disorders. In patients with cirrhosis of the liver (classes A and B according to the Child-Pugh classification), the clearance of medication decreases, which leads to an increase in the values of AUC (84%) and Cmax (47%) compared to those with normal liver function in patients of the same age group. The pharmacokinetics of viagra in patients with severe hepatic impairment (Child-Pugh Class C) has not been studied.

Erectile dysfunction (ED) and cardiovascular diseases

Numerous studies in recent years have proven the relationship between ED and cardiovascular diseases. They are often caused by atherosclerosis, which is preceded by dyslipidemia. Atherosclerosis of the arteries of the penis, manifested by ED, is often the primary symptom of systemic atherosclerosis. Therefore, the detection of atherosclerosis in the vessels of one localization increases the chance of finding it in the vessels of another localization. Thus, like fever in the prodrome of influenza, ED can serve as a reliable predictor of cardiovascular diseases in general and atherosclerosis in particular.

Therefore, when dyslipidemia is detected, in order to improve the state of erectile function, in addition to PDE-5 inhibitors, the patient should be additionally prescribed hypolipidemic drugs, such as statins. Such combination therapy with regular use significantly increases the effectiveness of treatment with PDE-5 inhibitors. So, against the background of constant intake of atorvastatin (Liprimar), sildenafil increases the International index of erectile function by 50% (without it-25%). In addition, combined therapy with PDE-5 inhibitors and antihypertensive drugs prevents the progression of atherosclerosis.

ED and cardiovascular diseases

The most difficult joint decision has to be made by a urologist and a cardiologist in men of the intermediate risk group, which includes patients with moderate stable angina, who have suffered a myocardial infarction within two to six weeks, as well as having extracardial manifestations of atherosclerosis (consequences of a brain stroke, obliterating atherosclerosis of the lower extremities) and left ventricular dysfunction/chronic heart failure of the second functional class (according to the classification proposed by the New York Association of Cardiologists).

On the one hand, the use of PDE-5 inhibitors, the gold standard in the treatment of ED, is generally quite safe. PDE-5 inhibitors (sildenafil citrate – Viagra) were originally developed as vascular drugs that significantly improve microcirculation by enhancing NO-dependent vasodilation. So, against the background of taking sildenafil citrate in patients with chronic stable angina, the time to a possible pain attack increased more than twice, the time to an attack requiring limited physical activity – more than three times, and the time to a decrease in the ST segment by 1 cm on an electrocardiogram – by more than 30%.

The risk of myocardial infarction with this drug was 0.5–0.8% (placebo – 0.9%), brain stroke – 0.3–0.4% (placebo – 0.9%), and the frequency of serious cardiovascular complications-2.3 – 3.9 (placebo–4.9) per 100 patient – years. On the other hand, in order to safely restore sexual activity, an in-depth cardiological examination and further follow-up by a cardiologist is necessary to determine which risk group (low, high) the patient belongs to. These circumstances once again emphasize the need for close professional contact between a urologist and a cardiologist in an individual solution to the problem of restoring sexual activity of a patient with cardiovascular diseases.

How to replace Viagra – effective natural substitutes

Replace Viagra with natural aphrodisiacs

Natural aphrodisiacs affect erectile function and increase sexual activity, but they can not be considered a full-fledged substitute for Viagra. Yes, they increase sexual arousal, but they do not affect the state of the enzymes, and also do not suppress the premature release of seminal fluid.

The most effective natural aphrodisiacs are:

  • shellfish;
  • greenery;
  • nuts;
  • honey;
  • coffee;
  • dark chocolate;
  • cayenne pepper.

how to replace viagra

Natural Viagra for Men

You can take organic supplements, the action of which is aimed at restoring the process of blood circulation in the pelvis. These preparations may contain ginseng extract, deer antler (we do not trust this), walnut and other additives.

Such drugs stimulate the work of the reproductive system, improve the overall well-being and the state of the nervous system, restore the production of sperm. Home-made Viagra is called ginseng tincture. To prepare it, you need to put 100 grams of ginseng in a glass dish, pour 500 milligrams of vodka, and insist for a month. Take the product 30 drops once a day for one month.

What drugs can be taken instead of Viagra

There are a lot of such drugs, we will present two of them, this is Cialis Soft – an effective drug that provides a long-term stimulating effect. In the composition of the drug contains Tadalafil. The substance increases the quality of erection and blocks the process of early ejaculation. The effect of the product lasts at least 24 hours. And Levitra, which contains the inhibitor Vardenafil, which, like the main component of Viagra, suppresses premature ejaculation by reducing the production of the enzyme PDE-5. The action of the product lasts eight to ten hours.

We also recommend Dapoxetine – an effective tool for prolonging sexual intercourse. The drug has an inhibitory property, without reducing the sensitivity of the nerve endings. The effect lasts four hours, but dapoxetine is intended only for episodic use. It is effective for serious erectile dysfunction and does not cause any addiction.

Celebrities who take Viagra

Viagra has become an icon of the pharmaceutical industry. It can be said that this is the so-called celebrity pill that is constantly making noise in the world. Having appeared on the market in 1998, Viagra has since completely changed the world. A large number of men were given the opportunity to overcome their sexual problems and regain their young years. Celebrities also take Viagra and do not hide it.

People started calling it the “Magic Blue Pill”; he even became a hero of modern lyrics, especially rap and popular late-night shows. Unsurprisingly, it soon caught the attention of celebrities. Being ordinary people with their own health problems, some celebrities try to solve their problems with Viagra, some of them take the pill just for fun. Some famous personalities make a kind of show or participate in an advertising campaign.

In this article, we have collected the most famous cases where celebrities admit to taking Viagra pills. So, you will find out who has had a positive experience and who has suffered from negative ones.

Celebrities who take Viagra: Getting an interesting experience

A few years ago, Michael Douglas, the famous “Wall Street” and “Basic Instinct” actor, suddenly revealed his secret that he took Viagra for making his sex life more exciting. Mr Douglas ‘ wife Catherine Zeta-Jones is 25 years younger than him, which is why the actor is so keen to maintain his sex life despite being 72. He admitted that he and his wife had great moments when he used Viagra or Cialis. There is no doubt that Viagra and sexual harmony help him keep in shape and look like a million dollars.

Celebrities who take Viagra

Jack Nicholson, a controversial Hollywood star, is famous for his countless love affairs with women. He even claimed to have sex with more than 1,000 women. We don’t know if this is true or not, but his reputation as a womanizer is world-famous. He is 78 years old and full of energy and sexual attraction. His experience of taking Viagra was described in a mischievous phrase: “I take Viagra when I’m with more than one woman.”

Hugh Hefner, the famous founder of Playboy magazine, who has always been surrounded by women much younger than him, is proud to say that Viagra helps him maintain an active sex life. He said he took the blue pill every time he was going to have sex, even at the age of 84. Now he is 89 years old and does not want to stop his sexual experiments.

“Guys who weren’t very lucky with Viagra»

Not all famous people are so lucky to have a good experience and push their sexuality to new limits. Some of them experienced unwanted side effects and stopped taking Viagra completely.

Ben Affleck, the famous actor and ex-husband of Jennifer Gardner, once tried Viagra and was very disappointed with its effect on him. In his interview with “Playboy”, he admitted that he took only half a dose and felt that he was suffering from a heart attack. Sweat and dizziness gathered together. And there are no sexual effects at all. We don’t know if Ben Affleck used other PDE5 inhibitors, such as Cialis or Levitra, and their generics. Perhaps Ben’s only option now is to lead a healthy lifestyle in order to maintain a successful sex life.

Pulmonary hypertension in children and an erection drug: where is the connection?

Despite the active use and phenomenal success of the new drug in the field of normalization of sexual life. Scientists are not in a hurry to abandon further research. For the first time, the possibility of another use of sildenafil was discussed in the 2000s, and since 2005 it has been used to combat pulmonary hypertension in adults.

Pulmonary hypertension (PH) is a condition in which the pressure in the small circle of blood circulation increases. Without treatment, this can lead to overload of the right parts of the heart muscle and the development of heart failure.

Pulmonary hypertension

Pulmonary hypertension is quite common in adults, but it is in children that it is most often fatal. LH in infants in 90% of cases is a consequence of congenital malformations and abnormalities of the development of the heart muscle.

In fact, the use of blue pills in pediatric practice is still a controversial issue. A group of researchers from the UK has long considered the possibility of using sildenafil to combat pulmonary hypertension. With an average duration of treatment of 4-12 months, the mortality rate of these babies was 5-30%. The researchers concluded that it is necessary to study in as much detail as possible whether sildenafil is actually able to positively affect the prognosis of life in children with LH. So that additional tests are required to clarify dosages.

In 2011, a little girl named Victoria Dooley was born in new York with a rather rare pathology: one half of her tiny heart did not function at all. The only drug that significantly improved the quality of life of the child was sildenafil.

Dr. Yong Chun, of NYU Langone medical center, says the drug helps relax blood vessels. Allowing blood to flow into the lungs and providing normal oxygen levels. The parents of little Victoria were unspeakably surprised by the prescribed treatment. Because blue pills are known for very different effects. But in the end, they recognized that such therapy is really effective. However, later the girl will still need a heart transplant: even Viagra is not able to create a miracle.

The first experience of using viagra

My experience of using viagra: just a clarification: I did not take the original viagra, but its generic with the same name as the active substance – “Sildenafil”.

First: the drug itself does not raise anything (in the sense of viagra does not create an erection). Its action is different – it does not allow you to fall (supports an erection). And one more thing-without sexual actions, he will not show himself in any way. That is, you can swallow viagra, and go to sweep the streets or play playstation – an erection will not arise just like that. But it is worth hugging your beloved, stroking her ass – and immediately get the proper effect. This effect holds perfectly, even if “tired after work”. Adds stamina.

It was interesting to find out – will there be a permanent erection for two hours after the reception? No, when the goal of sex is achieved, everything calms down. However, if you want to repeat the process soon, you do not need to swallow the second tablet – the first and second time will work. By the way, the pill should be taken an hour before the process.

About the side effects. It is written about increased heart rate, increased blood pressure and shifted color perception. I didn’t notice anything like that, although I sometimes suffer from high blood pressure.

And about the regularity. In my 40+ years, if you sleep with your wife a couple of times a month, it’s not bad. So here about excessive dosage and fear of side effects is not worth it. Those who are going to eat it every day by handfuls-not viagra, but a psychologist is needed. Here is a mode of reception and really inspires concern.

experience of using viagra

A few reviews about the first experience of taking viagra

You can read reviews from our clients in the Testimonials section.

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How to take Viagra for the first time?

So, how to take viagra for the first time for those who have never tried it and decided? Viagra is one of the most popular medications for restoring a healthy erection and treating premature ejaculation. The drug has a high-quality and fast action, is suitable for men of all age categories, has a minimal risk of side effects in the absence of contraindications. You can use Viagra every day. The drug is not addictive when taken regularly.

It accumulates in small amounts in the blood, but in the absence of severe liver pathologies, it does not harm health and does not cause complications of existing chronic ailments. Taking Viagra is recommended for men who are not able to achieve a strong erection on their own and hold it for a full-fledged sexual act. Erectile dysfunction is the most common disease, which is expressed by a sluggish and short-lived erection, premature ejaculation of seminal fluid and low sexual energy.

Viagra can be drunk as an auxiliary product in the complex therapy of prostatitis or infertility. The drug is suitable for healthy men who want not only to increase the duration of their intimacy, but also to enhance the sensations received from orgasm. To achieve a temporary effect, it is recommended to take Viagra occasionally.

How to take Viagra for the first time. Dosage.

The drug is available in three standard dosages: 25, 50 and 100 mg. It is not obvious that the higher the dose, the more effective the drug will be. It’s different for everyone. For example, a high dose of “Viagra” in women can lead to the fact that the clitoris will become too sensitive and instead of the pleasure of making love will turn into a monstrous torment. On the other hand, too low a dosage of the drug may not be enough for a full-fledged erection in a man.

Viagra for the first time

There are several approaches to selecting the dosage of the drug. Usually, the drug is prescribed in an average dosage of 50 mg, and then, depending on the effect that has occurred (or has not occurred), the dosage is adjusted or, in the case of a good effect, does not change. Another approach is to start treatment with a minimum dosage, increasing it until a good therapeutic effect occurs.

The maximum daily dose is 100 milligrams. This amount of the component is safe for middle-aged men who do not have chronic kidney or liver pathologies. The effect of the drug persists for four hours.

The selection of the dose should be handled by a doctor who will do it more professionally and with less risk to your health.

Dosage and age

Older men and those who suffer from chronic liver or kidney diseases should reduce the daily dose to 25-50 milligrams (depending on their state of health). With regular use of the product (more than twice a week), you should also reduce the daily dose of the active substance.

With frequent use, it is recommended to use 25 milligrams once every 24 hours. When using medications containing vasodilators, it is necessary to use a minimum dose of Viagra (up to 25 milligrams per day), after receiving medical advice. Before starting treatment of sexual dysfunction with Viagra, a number of contraindications should be excluded.

Viagra for the first time: Features

Take the Viagra tablet 55-60 minutes before the start of sexual intercourse. The drug should be washed down with warm water or other non-alcoholic liquid. You can use Viagra regardless of the meal. During treatment, it is recommended to refuse to take food products whose fat content is higher than 30%. Fatty foods prevent high-quality absorption of drugs into the blood and slow down the action of this product.

Give preference to cereals, fruits and vegetables. Viagra can not be drunk at the same time with medications that contain nitrates, alpha-blockers, nitric oxide donators, inhibitors of other types. These substances reduce the effect of Sildenafil, increasing its concentration in plasma. The break between taking these substances and Viagra should be three weeks. Terms of release and storage of Viagra tablets are indicated on the package. Do not take the product after its expiration date. Before treatment, read the instructions. Make sure that the air temperature in the room does not exceed 25 degrees Celsius.

In addition, do not lose hope for those men who did not help Viagra the first time. The drug can be taken daily without worrying about health. In addition, it is recommended to make several attempts, and the drug will definitely help next time. At the same time, you need to follow the dose set by the doctor.

Taking viagra at an elevated temperature

Can I taking viagra at an elevated temperature of?

Many people who decide to purchase drugs for potency ask various questions, such as whether it is possible to take viagra for hypertension. is it possible to use the product with a particular food? and others. Recently, the question of taking viagra tablets at a temperature has become relevant. In order to understand this issue, we will analyze the principle of operation of the tool and its composition.

Many people know that pills were developed not in order to eliminate erectile dysfunction or improve sexual life, but in order to solve problems from the cardiovascular system, which should have been beneficially affected by the active component sildenafil. It really had a powerful effect, not on the heart, but on another organ in men. Since that time, more than one study has passed during which it was actually revealed that viagra is able to solve problems related to the intimate sphere, and not only men’s, but also women’s, which appeared not so long ago.

Returning to our topic about taking viagra at elevated temperatures. it is worth saying that many opinions differ, some say that it seems to be not contraindicated, while others, on the contrary, stand their ground, assuring that this can not be done. We suggest that you find the answer to this question yourself by studying all the pros and cons of taking this remedy at an elevated temperature.

Viagra at a temperature, all the pros and cons

The principle of action of viagra is that in response to sexual desire, an erection occurs. Thanks to the active component sildenafil, the cavernous bodies of the penis expand, relax and actively fill with blood. This means that the blood flow begins to flow more actively not only to the penis, but also to other human organs.

At high temperatures, the blood circulates so quickly, and if you still take viagra, this process will increase, many believe. In fact, this is not quite true, because the pills do not affect the entire body, but only some important organs for this process. While taking female viagra, the pelvic organs of a woman are enriched with blood, when using male viagra, almost everything happens the same, only the penis itself is already involved.

Therefore, taking the drug for potency is unlikely to affect the increase in temperature. In addition, at the very beginning of research, when it turned out that viagra is not suitable for the treatment of heart diseases, it turned out that some components of the drug can cure angina, which means that using this drug for potency can still get rid of colds. Experts, however, say that you should not get carried away with these tablets to eliminate colds, because, despite the individual components, the tool is created for other purposes.

So should I take viagra for a cold or not?

As for colds, there are no strict contraindications for taking the drug. Another thing is when the cause of the temperature is not established. In this case, it is better to abandon the use of viagra. Yes, the drug itself will not have any negative effect on the body, however, intimacy can.

viagra at an elevated temperature

During the temperature, a person feels weak, sometimes drowsy. At such moments, the body fights infection. And here it is unlikely that there will be a desire to make love. In addition, during a high temperature, it is undesirable to do this, because the blood circulation in this case will be even faster than usual, the heartbeat will increase several dozen times and it is not a fact that after a bright discharge, a person will not lose consciousness. Therefore, it is best not to experiment.

In conclusion, once again I want to say that there are no particularly strict contraindications for the use of viagra tablets at high temperature, so if there is a desire, then the tool can be used, but what will be the state of health after intimacy is unknown.

Try Viagra, interaction with alcohol

Experts believe that the maximum dose of alcohol, in which the risk of side effects is minimal, and the effectiveness is optimal, is 100 g of vodka. In other words, in terms of pure alcohol, about 40 g. This is equivalent to 400-450 ml of table wine, 700 ml of beer, 600 ml of gin and tonic.

Men often wonder whether it is possible to combine drugs that are used to treat impotence (Viagra, Levitra, Cialis) with alcohol.

You need to make a choice either sex or alcohol, if you want to get drunk, then go and get drunk, only when you drink Viagra in full out, there will be no effect. If you want to have sex, then you go to the pharmacy buy Viagra, Cialis or Levitra, then invite your girlfriend to coffee (restaurant, who has what finances) order a glass of wine (no more), drink and go to have sex.

Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil) are selective competitive inhibitors of PDE5. The molecules of these drugs are similar in structure to the cGMP molecule, but their effect is that they block the action of the PDE5 enzyme. From the point of view of pharmacochemistry, even minor differences in the structure of molecules can lead to a pronounced difference in their action. A striking example of the similarity in structure and differences in properties are the molecules of testosterone and estradiol.

Try Viagra and alcohol

To date, there is no convincing evidence that the combined use of “Viagra” and alcoholic beverages (in moderation) can lead to any fatal consequences.

A man weighing 80 kg can drink about 100 g of vodka and take Viagra without consequences.

From the point of view of chemistry, the main component of Viagra (sildenafil) does not interact with alcohol, this is what is called science proven. But life has proven that after an immoderate amount of alcohol in the blood (everyone has it, of course, different), there may be problems with an erection in principle. Some even turn off the entire motor system, and the consciousness that guides them meaningfully, but such, in fact, do not buy Viagra.

You can take Viagra (sildenafil) with alcohol, but you risk turning the holiday into a nightmare. Why? Alcohol increases the load on the heart, increases the number of contractions of the heart muscle, heart work increases. Viagra also has an effect on the heart, increases the number of contractions.

Putting one on top of the other, the heart begins to experience a double load. The pressure increases, there is a headache, heaviness in the head, redness of the face. Those Sami phenomena that are observed with a hangover. However, if there are no problems with high blood pressure, and vice versa, if the pressure is low, then such side effects may not happen, and the viagra taken after alcohol will pass without unnecessary inconvenience and will give a satisfactory result.

Also, alcohol can increase the side effects of Viagra.

Among the various side effects of Viagra are dizziness, headache, upset stomach, redness of the face, muscle pain, diarrhea, which can also be a side effect of alcohol consumption. That is why the use of Viagra increases the chances of unpleasant side effects from these drugs, reducing the chances of normal sex.

Well, getting drunk when taking Viagra is stupid, not only because there will be no effect, but because even if there is an effect, then when you wake up in the morning you will hardly remember, and your headache (hangover) will not make you feel cheerful, so Viagra and alcohol are not only physically incompatible, but also morally.

But it’s stupid to blame the consequences of binge drinking on Viagra: “everything would be fine if I hadn’t already drunk Viagra.” Everything would be fine if you didn’t drink the “extra” half a bottle of vodka. And with an erection, and with well-being, and with memories of the time spent.

Cialis and alcohol

Cialis is recommended to be used orally before the intended sexual activity, regardless of the concomitant intake of food or alcohol. According to the information in the annotation to the drug, Cialis does not interact with alcohol, when they are used together, neither the concentration of ethanol nor the therapeutic dose of Cialis does not change. This is quite understandable: pharmacodynamic studies have shown that the active substance of Cialis practically does not interact with those drugs whose metabolism requires the participation of the cytochrome P450 enzyme system. A small amount of alcohol will not cause any problems, but a significant dose of alcohol can interact with Cialis.

Small doses of alcohol (200 grams of wine or 0.5 liters of beer or 100 grams of vodka) with Cialis will not cause any problems for most men.

Try Viagra, interaction with alcohol

Studies have shown that the effect of Cialis does not depend on alcohol and a hearty dinner, no doubt, for Russian men this will be another argument in favor of the drug. However, it should be noted that alcohol in large doses itself negatively affects the erection and, in addition, alcohol abuse can cause erectile dysfunction.

However, we must not forget that Cialis and alcohol have a systemic effect: Cialis and alcohol dilate the walls of blood vessels, which can lead to a sharp drop in blood pressure, especially in the presence of provoking factors. This is stated in the annotation, but not too “loudly”. Clearly, those who had dizziness and an orthostatic reaction after taking alcohol will have the same reactions when using Cialis (as a result of a vascular response), and with a combination of Cialis and alcohol, these side effects will increase.

Currently, Cialis is the only phosphodiesterase-5 inhibitor, the effect of which persists for more than a day – up to 36 hours.

Methods of erectile dysfunction therapy

If a man has erectile dysfunction, then it is treated. What types of therapy are known?

Doctors use conservative treatment.

In the first line, phosphodiesterase inhibitors of the 5th type are used. A distinctive feature of them is their good tolerance and noticeable effect in any type of erectile dysfunction.

PDE-5 is not applied constantly, but periodically. They should be taken immediately before sexual intercourse. The dose is selected individually.

If the patient does not want to use this type of medication, then the use of local negative pressure (shock wave therapy of the penis) is offered as an alternative.

Second-line drugs for the treatment of erectile dysfunction are injections into the cavernous bodies of the penis. They act as vasodilators.

If conservative treatment does not solve the problem, then doctors proceed to surgical treatment.

For this purpose, a phalloprosthesis is performed using a hydraulic or semi-rigid implant. They allow you to provide a natural erection.

After the hydraulic penile prosthesis implants, patients typically remain fully satisfied with your sex life. And Viagra is no longer used.

Methods of erectile dysfunction therapy

If you have erectile dysfunction, check your heart and blood vessels

When a fifty-year-old man begins to fail in the sexual sphere, then we can talk about the beginning of the development of erectile dysfunction.

Doctors say that at this age, erectile dysfunction is a wake-up call for coronary heart disease. A man should pay more attention to this, since this is the risk of approaching a heart attack in the next couple of years.

Worst of all, those who are overweight, suffer from hypertension and diabetes. And if this” bouquet ” is also joined by harmful habits such as smoking and alcohol, then a heart attack is a matter of time.

Such anamnesis leads to damage to the inner layer of the arteries and blood vessels, which results in ischemia, heart attack, erectile dysfunction and similar pathologies.

It is not for nothing that experienced urologists and andrologists send all men under 50 years of age with erectile dysfunction to consult a cardiologist.

It is extremely important to identify serious cardiovascular diseases in time and cure them.

Therefore, if you have suspicions of erectile dysfunction and at the same time you snore, are overweight, suffer from high blood sugar and pressure surges, immediately visit a cardiologist, and do not immediately run to buy Viagra.