Tid Bits: According to researchers, 25% of American men are on a diet on any given day.

What is Viagra?

Viagra is a breakthrough treatment for male erectile dysfunction or ED, often called impotence. It is a convenient, discreet pill you take only when you want to have sex. Viagra can help many men who have ED get and keep an erection when they become sexually stimulated, either physically or visually. So with Viagra, a touch or a glance from your partner can again lead to something more.

What is ED?

Erectile dysfunction, or ED, is the medical term for impotence - the inability to get and/or keep an erection sufficient for satisfactory sexual activity. About 30 million men in the United States suffer from some degree of ED, including about half of all men aged 40 to 70 years.

How does it work?

Viagra enables many men with ED to respond to sexual stimulation. When a man is sexually aroused, the arteries in the penis relax and widen, allowing more blood to flow into the penis. As the arteries in the penis expand and harden, the veins that normally carry blood away from the penis become compressed, restricting the blood flow out of the penis. With more blood flowing in and less flowing out, the penis enlarges, resulting in an erection.

If the nerves or blood vessels associated with this process aren't working properly, a man may not be able to get an erection. Viagra increases blood flow to the penis, so that when a man is sexually aroused, he can get and keep an erection. When the sexual encounter is over, the erection goes away.

How well does it work?

Viagra improves erections in up to 4 of 5 men who take it, regardless of how long they have had ED, what caused it, or how old they are.

Does Viagra automatically cause an erection?

No. With Viagra, you must be sexually aroused to get an erection. If you take Viagra and are not sexually stimulated, nothing will happen-you won't get an erection just by taking the pill. Viagra is not a hormone. It is not an aphrodisiac. It's a prescription medication that can improve the erectile function of most men with erection problems.

How much Viagra can I take?

Viagra comes in different doses (25 mg, 50 mg, and 100 mg). Like many medications, your health care provider may have to adjust your initial Viagra dose if it doesn't produce the desired results or you're bothered by side effects. Do not take more Viagra than your health care provider prescribes, and do not take Viagra more than once a day.

If you are older than 65 years, have a serious liver or kidney problem, or are taking protease inhibitors, such as for the treatment of HIV, your health care provider may start you at the lowest (25 mg) dose of Viagra.

How often can I take Viagra?

For most patients, Viagra should not be taken more than once a day. In patients taking certain protease inhibitors (such as for the treatment of HIV), it is recommended to not exceed a maximum single dose of 25 mg of Viagra in a 48-hour period.

Can I cut my pills in half?
     Viagra pills are not designed to be cut in half, so there is no way to know if half a pill is effective. Cutting pills in half is not recommended.

Who should not take Viagra?

Viagra is only for patients with ED. Viagra is not for newborns, children, or women. Do not let anyone else take your Viagra. Viagra must be used only under a health care provider's supervision.

Before you start any treatment of Viagra, be sure to ask your Health Care Provider if your heart is healthy enough. If you're a man who uses nitrate drugs, like nitroglycerine, never take Viagra. The combination of Viagra and nitrates can make your blood pressure suddenly drop to unsafe levels. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medications that are used to treat angina (chest pain due to heart disease) such as:

Nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in the mouth) Isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth) Nitrates are also found in recreational drugs such as amyl nitrate or nitrite ("poppers"). If you are not sure if any of your medications contain nitrates, or if you do not understand what nitrates are, ask your health care provider or pharmacist.

What if Viagra doesn't work?

While Viagra is effective in up to 4 of 5 men, it's not effective for everyone. If it doesn't work for you, contact your health care provider to discuss other treatment options.

Can I take Viagra with alcohol?

Drinking alcohol can temporarily impair the ability to get an erection. To get the maximum benefit from your medication, you are advised not to drink large amounts of alcohol before taking Viagra.

What Viagra Does Not Do

Viagra does not cure erectile dysfunction. It is a treatment for erectile dysfunction. Viagra does not protect you or your partner from getting sexually transmitted diseases, including HIV-the virus that causes AIDS. Viagra is not a hormone or an aphrodisiac.

What are the side effects of Viagra?

Like all medications, Viagra can cause some side effects. These are usually mild and don't last longer than a few hours. Some of these side effects are more likely to occur with higher doses of Viagra. With Viagra, the most common side effects are headache, facial flushing, and upset stomach. Viagra may also briefly cause bluish or blurred vision, or sensitivity to light. In the rare event of an erection lasting more than 4 hours, seek immediate medical help.

Heart attack, stroke, irregular heart beats, and death have been reported rarely in men taking Viagra. Most, but not all, of these men had heart problems before taking this medicine. It is not possible to determine whether these events were directly related to Viagra.

Viagra may cause other side effects besides those listed on this page. If you want more information or develop any side effects or symptoms you are concerned about, call your doctor.

What should I be sure to tell my doctor?

Be sure to tell your doctor if you: have ever had any heart problems (e.g., angina, chest pain, heart failure, irregular heart beats, or heart attack) have ever had a stroke have low or high blood pressure have a rare inherited eye disease called retinitis pigmentosa have ever had any kidney problems have ever had any liver problems have ever had any blood problems, including sickle cell anemia or leukemia are allergic to sildenafil or any of the other ingredients of Viagra tablets have a deformed penis, Peyronie's disease, or ever had an erection that lasted more than 4 hours have stomach ulcers or any types of bleeding problems are taking any other medicines

What about taking it with other medicines?

Some medicines can change the way Viagra works. Tell your doctor about any medicines you are taking. Do not start or stop taking any medicines before checking with your doctor or pharmacist. This includes prescription and nonprescription medicines or remedies. Remember, Viagra should never be used with medicines that contain nitrates (see Who should not take Viagra). If you are taking a protease inhibitor, your dose may be adjusted (please see How much Viagra can I take). Viagra should not be used with any other medical treatments that cause erections. These treatments include pills, medicines that are injected or inserted into the penis, implants or vacuum pumps.

Can you help me avoid embarassment at the drug store?

Many patients can be embarrassed when drugstore staff inadvertently announce the contents or nature of your prescription to others nearby. In most cases we can fill your prescription in the office which allows you to avoid going to the drugstore to have your prescription filled. Another option is to use on-line drug stores.

I live out of town. Will you send it to me?

Sorry - but no. We are responsible health care professionals. You must have a thorough medical exam to find out if you can safely take Viagra alone or with your other medicines.

How should I store Viagra?

Keep Viagra out of the reach of children. Keep Viagra in its original container. Store at room temperature, 59°-86°F (15°-30°C).

Does insurance cover it?

Some do and other's do not. Check directly with your insurance company for this information.

How to take Viagra

Take Viagra about one hour before you plan to have sex. Beginning in about 30 minutes and for up to 4 hours, Viagra can help you get an erection if you are sexually excited. If you take Viagra after a high-fat meal (such as a cheeseburger and french fries), the medicine may take a little longer to start working.

What if I accidentally take too much?

In case of accidental overdose, call your doctor right away.

What information can I get on-line? (all links will open in a new window)

Here is a link to Pfizer Inc.

Here is a link to the package insert information (technical) on Viagra.

Here is a link to the FDA information on Viagra.

Your feedback and suggestions are always welcome: suggestions@TucsonMedical.com