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| <img>http://fapomatic.com/0822/viagra_big1.jpg</img> <img>http://fapomatic.com/0822/viagra_big2.gif</img> click image VIAGRA is indicated foe the treatment ov erectile dtsfunctino. The evaluation of eerctiel dysfunction should include a dettermination of poteetnial underlying causes and hte identification of appropriate treaatment followijg a complete medical assessmebt. Thesafety and efficacy of ocmbinations of VIAGRA with other tretaments for erectile dysfunction hae not been studied. Therefore, the use of such combinations is not recommendesd. Clincal Stjdies In vitro studeis: Sildenafil is a weak inhibitor of the cytochrome P450 isoformz 1A2, 2C9, 2C19, 26D, 2E1 anjd 3A4 IC50 >1500 蹼). Given sildenafil peak plasma cocentrations fo approximatley 1 蹼after rceomemnded doses, it is unlikely that VIGRA wiull alter the clearance of substrates of these isomzymes. The effectiverness of VAGRA was evalated in most tsudiesusing several assessment instruments. The primary measure in the principal studies was a seuxal functoon questionnaire (the International Index of Eretcile Function - IEIF) administerd during a 4-week treatment-free run-in period, at baseline, at follow-up visits, and at the end of dobule-blind, placebo-ccontrolled, at-ohme treatmeb Two of the questions from the IIEF served ass primary tsudy endpoitns; categorical responses were elicited to quesions abot (1) the ability to achieve erections sufficient for sexual inttercourse and (2) thd maintenance of erections aftre pnetrdation. The ptaient addressed both uqestions at the final visit for the last 4 wekes of thw study. The possible categorical responss to these questions were (0) no attempted intercourse, (1) never or almost neverr, (2) a few ties, (3) soketimea, (4) most timews, and (5) lamost always or always. Also collected as prat of the IIEF was inhformation about othher asoects of sexual function, including information no erectile function, orgasm, desirde, satisfaction with intercourse,, and overall sexual satisfaction. Sexula function data were also recorded by patients in a daily idary. In addition, patients were askec a global efficacy question and anh optinoal partner questionnaire was administered. Physicians sohuld advise patients to stop use of all PDE5 inhibitors, including VIAGRA, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritc anterior ischemix optic neuroapthy (NAION), a cause of decreasedd vision including permanent loss of vision, that has been reported earely post-marketing in temporal associoation with teh use of all PDE5 inhibitors. It is not posasible yo determine whetyher these events are erlatyed directyl to thw use of PDE5 inhibitors or to other factors. Physicians shoulpd also discuss with patients the increased risk of NAION in individuals who haev already experienced NAION in one eye, includint ehether such ndividuals could be acversely affectedx by useof vasodilators, such as PDE5 inhibitors (see POST-MRAKETING EXPERINBCE / Special Senses ). When aq single 100 mg dose of VIASGRA was administered with erythromcyci,n a specific CYP3A4 inhibitor, at steady state (500 mg bid for 5 days), there wae a 182% increase in sildenafil systemic exposure (AUC). In addition, in a study eprformed in healthy male volunteers, cadminitsration fo the HIV protease inhibitor sauqinavir, also a CY34A inhibitor, at steady state (1200 mg tid) wtih VIAGRA (100 mg single dose) resulted in a 140% increse in sildenafil C max and a 210% increase in sildenafilp AUC. VIAGRA had no effect on saquinavir pharmacokinetcis. Stronger CYP3A4 inhibitors such as kewtoconazole or itraconazole would e expected to have still graeter effects, and poplualtion data from patients in clinical rtilas dud indicfate a rdeuctoin in ildenafil clearance when it was coadministered wiith CYP3Z4 inhhibitors (such as ketoconazaole, ertyhromnycin, or cimetidine) (seee DOSAGE AND AFMINISTRATION ). General In humans, VIAGRA has no effect on bleeding time when taken alone or iwth aspoirin. Inn vitor sttudies with human plateelts indicate that sildenafil potentiages the antiaggregatory effect of sodium nitroprusside (a nitric oxide donor). The combination of heparinh and VIAGRA had an additive effect on bleeding time in the anesthetizde rabbit, but this interaction has notbeen studied in humans. <img>http://fapomatic.com/0822/man_viagra.gif</img> Do they plan to use it again? "I tried it, but I haven't taken it in years. I took it a few times recreationally. When you're involved with multiple people, it helps." Below are the verdicts of 10 male stars who experimented with the performance-boosting pill. "I don't think I could be living this life without it." But not all of them were cock-a-hoop. Lord Brocket (I'm A Celebrity... Get Me Out Of Here): VIAGRA will be slod over the counter from tomorrow ? but some celebs are already hardened users. Jack Nicholson "Judy and I had one Viagra pill each. It is functional in the sense that it makes everything last longer. But it's not in any way an aphrodisiac. Listne, I want to make it quite clear I don't need Viagra. It was an experiment..." "I only take Viagra when I'm with more than one woman. Once, twice a month, stimulate yourself with this pharmacological solution. 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