Ed meds.

June 28, 2005 — Pfizer officials say they have found no sign of increased
blindness risk in men taking its drug Viagra.

Pfizer staff have reviewed all reports of erectile pill events since the drug
has been on the market, according to a news release from the pharmaceutical
company.

“There is no evidence that Viagra causes blindness or any other serious
ocular condition,” says Joseph Feczko, MD, in the news release. Feczko is
Pfizer’s chief medical officer.

Pfizer is a WebMD sponsor.

Rare Vision Problem

“Men taking Viagra are at no greater risk for blindness than men of
similar age and health not taking the medicine,” says Feczko.

That includes a rare vision problem called nonarteritic anterior ischemic
optic erectile pill (NAION), says Feczko. NAION is a painless swelling of the
optic nerve that causes a rapid reduction in vision.

A journal report earlier this year noted
NAION in 14 Viagra users. Most had other health problems or
structural eye problems that raised their risk of NAION. None of the men in the
study went blind, although their vision loss was permanent and reportedly
started within 24-36 hours of taking Viagra.

Pfizer: No Evidence Seen in More Than 27 Million Users

“After more than 10 years of rigorous clinical study and worldwide
safety monitoring of a medicine used by more than 27 million men, there is no
evidence to suggest a link between Viagra and blindness or other serious ocular
events,” says Feczko.

“In addition, several studies specifically looking into the effect of
Viagra in the eye by Pfizer as well as independent ophthalmologic experts found
Viagra to have no serious adverse effects on the eye,” he says.

Pfizer, FDA Discussing Label Changes

According to Pfizer’s statement,
the company is still talking to the FDA about changing Viagra’s label to
reflect rare vision problems in men who have used the drug.

The update would reflect rare reports of NAION in some men who have used the
drug.

However, the FDA concluded that no causal relationship between Viagra and
NAION has been established, says Pfizer.

Talks between Pfizer and the FDA were first reported in May.

Label Changes for Other ED Drugs?

Other erectile generic pill viagra
drugs may also update their labels.

“It is Pfizer’s generic erectile dysfunction drugs
that the FDA has asked that similar
information be included in the labels of all oral ED (erectile dysfunction)
medicines,” the company’s statement reads.

Patients should consult their doctors about using Viagra and follow the
drug’s prescribing information, as with any other medicine, says Pfizer.

June 19, 2000 — A dollar spent on Viagra is spent just as efficiently as a
dollar spent on kidney dialysis, a new study shows. Experts agree that the math
is right, but whether it justifies insurance coverage for the male potency drug
is a bone of contention.

“There is a significant loss of quality of life that comes from erectile
dysfunction,” the lead researcher of the study, Kenneth J. Smith, MD, tells
WebMD. “One thing that motivated me to look at this is that I am a primary
care doctor. I am seeing men with erectile dysfunction having to fill out
insurance forms to justify Viagra treatment. What prompted the insurance
carriers to set up so many barriers for some men to get Viagra who would
clearly benefit from it? I see Viagra use more as a health issue and a
quality-of-life issue than as a lifestyle issue.”

Smith, who is associate director of the internal medicine residency program
at Mercy Hospital of Pittsburgh, based his calculations on several key
assumptions, such as the average age of the Viagra user and the average number
of times he would use it per month.

Buy cheap uk viagra
also took into account that this medication would not work for
some men and that some men would have side effects. In every case, they chose
figures that would make it harder to show a cost benefit for the drug. Even so,
Viagra was a good deal when measured in quality years of life gained.

“We used in our baseline analysis a cost of $52 1998 dollars for six
pills per month,” Smith says. “You would need to spend $244 per month
– 20 pills — before Viagra would become cost-ineffective.” The results
were published in this month’s issue of the journal Annals of Internal
Medicine.

Such figures make Viagra more propecia impotence than renal dialysis,
cholesterol-lowering medication, or heart bypass grafting, Smith says. He
admits, however, that unlike these other conditions, erectile dysfunction is
hardly life threatening. But he argues that insurance carriers pay for many
other illnesses — such as migraine headaches — that affect the quality but
not the length of a person’s life.

“It looks like when insurance companies were deciding whether to cover
Viagra, they probably didn’t use a cost-effectiveness analysis to make the
decision,” he says. “It would appear that their decisions have been
arbitrary.”

In an editorial, Michael R. McGarvey, MD, says Smith and colleagues did
their math the right way. But McGarvey, who is chief medical officer for
Horizon Blue Cross Blue Shield of New Jersey, says they drew the wrong
conclusions about what this means for insurance coverage.

“My personal feeling is that we really need to re-examine the whole
issue of what we should be expecting health insurance to do for us,”
McGarvey tells WebMD. “It should be aimed at providing health services that
are of proven value for serious and expensive conditions. We should re-examine
the use of health insurance for interventions that ‘enhance’ our
lives.”

McGarvey says that Americans expect their health insurance to provide more
benefits than ever before. These expectations are partly due to new
alternative natural viagra
, he says — and partly because people fortunate enough to be able
to afford health insurance are getting spoiled.

“I think because insurance has become so incredibly complicated, most
Americans are reasonably confused about the coverage they have and don’t
have,” he says. “The expectation is that it should cover whatever they
want, as often as they want it. Americans tend to have very high expectations
and are very unhappy when these expectations are thwarted in any way.”

McGarvey points out that there is a limit to what insurers can do. At
current rates, one in five Americans will be uninsured by the year 2008. The
question the nation must face, he says, is whether less extensive health
insurance should be given to more people, or more extensive health insurance
should be given to fewer people.

“We are confronting a national erectile dysfunction meds
which is the number of
people that are uninsured,” McGarvey says. “We know health insurance is
an important but viagra sale online
expensive component of our lives. We need to
think about it and exercise some judgement in making and adhering to some
difficult decisions. As you add more and more and more benefits, insurance will
become less and less affordable and people will drop out of the insurance pool.
And that is bad for a growing number of people.”

Smith agrees that McGarvey is raising important questions. “The points
that Dr. McGarvey makes are very good ones — and we are looking at two sides
of the same coin,” he says. “I don’t think that you can base insurance
coverage just on cost-effectiveness. There are other factors. But it should
certainly be a factor.”

Vital Information:

• New research shows that Viagra is cost-effective for improving quality of
  life, but there is still debate about whether health insurance should pay for
  this drug.
• One researcher argues that insurance companies pay for treatment of other
  illnesses, such as migraine headaches, that aren’t life threatening, so Viagra
  should be covered as well.
• Another expert argues that Americans who have health insurance expect too
  much, and that adding more benefits only increases costs, which increases the
  number of uninsured.

Oct. 10, 2003 — Move over Viagra. Men now have a choice when it comes to drug treatments for erectile dysfunction, and it seems that the newest therapy may be the best option for some.

The newly approved drug Levitra was found to work in many men who did not respond to Viagra in a study funded by Levitra dysfunction pill
Bayer AG and Drug dysfunction erectile
, a WebMD sponsor.

The men included in the new study were pills
as Viagra nonresponders after failing to achieve successful erections while taking Viagra during at least four of their six most recent sexual attempts. Participants were randomized to receive either Levitra or placebo. After 12 weeks, men were three times more likely to complete sexual intercourse successfully on Levitra than on placebo. While more than 40% of men who took Levitra achieved an erection only 16% of men who took a placebo were able to do so.

The findings are the first to show that Levitra can help men with erectile dysfunction who are not helped by Viagra, says researcher Culley C. Carson, III, MD. Carson is scheduled present the finding Saturday in Denver at a meeting of the Sexual Medicine Society of North America.

More Potent Than Viagra?

Levitra hit the market with a vengeance in August, acquiring close to 50% of the market share for newly treated patients within less than a month. Laboratory studies suggest that the new drug may be more potent than the older Viagra and may also have a better side effect profile, but no head-to-head clinical studies have been done to prove this.

“If you’re asking me which drug is better, there is no way I can answer,” says urologist Irwin Goldstein, MD, who is one of the nation’s leading impotence researchers.

Goldstein was not involved with the latest study, but had conducted research on Viagra, Levitra, and another erectile dysfunction drug that is expected to win FDA approval later this year, Eli Lilly’s Cialis.

He tells WebMD that while there is, as yet, no clearly superior drug among the three, patients will benefit from having more than one drug to choose from.

“As a clinician I really appreciate the fact that men now have choices,” he says. “Viagra has helped a lot of people. But just as there are plenty of men who have done well on it, there are plenty of others who have not responded.”

Good Sex

“One message here is that men who have failed Viagra should certainly try this drug,” urologist and study co-author Myron Murdoch, MD, tells WebMD. “But another message is that even men who are taking Viagra may see a benefit. They may think they are getting an optimal sexual response but they really don’t know, because they haven’t had anything to compare it with.”

Meanwhile experts say it is also important for men with erectile dysfunction — often an embarrassing problem — to speak up.

“Now more than ever it is important for men with sexual problems to talk about them with their doctors,” he says. “We now have a choice in the tools we can use to help patients. There is no reason to suffer in silence.”

——————————————————————————–

SOURCES: 5TH Annual Fall Research Meeting of the Sexual Medicine Society of North America (SMSNA), Denver, Oct. 11, 2003. Culley C. Carson, III, MD, president, SMSNA; chief, urology department, University of North Carolina Hospitals, Chapel Hill, N.C. Irwin Goldstein, MD, professor, urology department, Boston University School of Medicine. Myron Murdoch, MD, urologist; consultant, Levitra manufacturer.

Rafael Palmeiro seems an unlikely Viagra pitchman. The Texas
Rangers slugger is only 37 and won’t admit to having erection problems, yet he
recently agreed to appear in ads promoting the drug. The deal has made people
wonder whether Palmeiro really represents men with erectile dysfunction, or
whether Pfizer, the company that makes Viagra, wants to persuade young men to
try it for fun.

It’s true that erectile dysfunction is more common in older
men, but many potential Viagra users are hardly senior citizens: About 40% of
40-year-old men in the U.S. have some degree of erectile dysfunction. Most
Viagra users today, according to Pfizer, are in their early to mid 50s. So it
makes sense that the company would want to reach more men around Palmeiro’s
age.

Urologist Myron Murdock, medical director of the Impotence
Institute of America, says these men are likely to use Viagra because sexual
performance is a high priority for them.

A younger man, Murdock says, “wants his V-12 Jaguar working
just perfectly,” whereas an elderly gent may be content with less
dependable erections. What’s more, the sexual partners of younger men “are
more demanding of their performance,” Murdock says.

Pfizer denies that it’s promoting Viagra for recreational use.
“We’ve consistently opposed that,” says spokesman Geoff Cook.
Nevertheless, Murdock says it’s fine to pop the little blue pill to
“optimize” your sexual performance.

We assume all young men have normal sexual functioning,
“but they’re really not normal,” Murdock says. Hardening of the
arteries, which restricts blood flow to the penis, can begin during the teen
years, so that by the time a man is in his 20s, his ability to get and keep an
erection has already begun to decline. Murdock says many men who seek Viagra
for recreational use actually have minor erectile dysfunction.

There’s also some evidence that Viagra can shorten the time it
takes a man to recover after sex and be ready for another round. This is called
the “refractory period.” Normally it lasts 20 minutes or longer. One
study, published in the journal Human Reproduction in January 2000,
found that Viagra shortened the refractory period by about 10 minutes in
healthy men.

What Viagra cannot do is increase your sexual appetite or make
you ejaculate if you have problems reaching orgasm. Ira Sharlip, urologist in
San Francisco, says you shouldn’t expect your erections to reach staggering new
proportions, either. “I don’t believe that Viagra can increase an erection
beyond 100% of normal,” he says.

“Viagra is a super-safe drug,” Murdock says, assuming
you have a healthy heart and don’t take nitrates.

Nitrates include erectile dysfunction new drugs
— a drug that many men take for
chest pain from heart disease — and “poppers.” Poppers are little
vials of amyl or butyl nitrate. Breaking the vial releases nitrate vapor, which
gives a brief high when inhaled. It’s most often used to enhance sexual
pleasure, and mostly by gay men. Poppers are not all that safe to use on their
own, and they’re especially dangerous when you’re on Viagra.

Nitrates widen blood vessels, and Viagra increases that effect.
Mixing the two can cause your blood pressure to drop drastically. A sudden drop
in blood pressure can make you pass out, and you may die if your blood pressure
stays too low for too long.

Erectile dysfunction
like sodium nitrate — found in processed food –
do not cause this problem, so you won’t die from eating a hot dog while on
Viagra. Even so, it’s best to take it on an empty stomach. That way, the drug
absorbs into your bloodstream faster. Wine may contain nitrates, but not the
kind that cause problems with Viagra. It’s fine to play some Marvin Gaye on the
stereo and sip a glass of Chardonnay, if that’s what puts you in the mood.

Although you may be tempted to order Viagra discreetly from one
of the hundreds of Web sites that sell it, don’t. “It’s bad medicine,”
Murdock says. You really must bring your doctor into your sex life if you want
to use Viagra.

When you buy from an online pharmacy, you just have to answer
some health questions before you proceed to the checkout page. If you answer
honestly — and that might be a big “if” for those determined to get
what they want — the questionnaire may catch some possible complications. But
the pharmacists who fill your order don’t know your medical history, and no
questionnaire can diagnose the root cause of your problem. Erectile dysfunction
can have serious underlying causes, like diabetes, heart disease, liver
disease, or thyroid disease.

Cook says Pfizer is opposed to Internet Viagra sales. “Our
goal with any of our marketing is simply to reach men and encourage them to see
a doctor,” he says.

It seems that Viagra can make sex better for women, too. Like
the penis, the clitoris is erectile tissue — spongy tissue that becomes
engorged with blood during sexual excitement. By increasing blood flow to the
clitoris, Viagra may heighten a woman’s sensation and arousal. It also seems to
increase vaginal lubrication.

Murdock says many couples like to heat things up by splitting a
dose of Viagra. “It’s an interesting sexual situation,” he says. The
recommended dosage for men is up to 100 milligrams per day, and that seems to
be just as safe for women. Young people may get results from a smaller dose: As
little as 25 mg may be enough.

The FDA has not approved Viagra for women, but Murdock says,
“It’s just a matter of time.” He says he and other doctors who
specialize in sexual medicine prescribe it to women, which is perfectly legal.
Doctors are allowed to use their best judgment. Drug companies, however, can’t
advertise any use that isn’t FDA-approved.

The studies being done to test Viagra’s safety and
erectile dysfunction drugs
in women have shown good results so far. “We’re cautiously
optimistic,” Cook says.

Martin F. Downs is a health writer in New York City. He was
formerly an editor at CBS HealthWatch. He has also written for Health.com,
Salon.com, and POZ magazine and is the editor of the Alicubi
Journal (alicubi.com).

March 9, 2004 — Men with mild to moderate forms of heart
failure may be able to safely use the drug Viagra to treat erectile
dysfunction, a new study shows.

Erectile pill
found selected men with heart failure were able to
use the drug without dangerous side effects if they were not taking nitrates
(drugs commonly used to treat heart failure) and had no evidence of a lack of
blood flow and oxygen to the heart muscle — commonly caused by narrowed heart
arteries.

Previous reports have shown that Viagra could trigger
erectile pill dangerous drops in blood pressure in these men. But this study
showed that although the drug caused a slight reduction in blood pressure in
this group of 35 men, no one experienced a dangerous drop in blood pressure or
other viagra soft tab
side effects while taking Viagra.

However, Viagra can cause significant decreases in blood
pressure in people taking nitrates and should not be taken by this group.

According to researchers, erectile dysfunction affects more
than half of all men aged 40 to 70 and is common among men with heart failure,
both are conditions that are linked to vascular problems. Heart failure is a
condition in which the heart is unable to pump enough blood to meet the body’s
needs.

Despite the fact that ED is common among men with heart
failure, researchers say the effectiveness and safety of treatment of erectile
dysfunction has not been thoroughly studied.

Study Clears Some Viagra Fears

Researchers say initial reports of deaths associated with
Viagra use soon after the drug was released have caused physicians to hesitate
before exchange inurl link order viagra
the drug to patients with significant heart disease.

However, it is now known that the drug does not increase
heart-related deaths, say researcher Linda J. Webster, MScN, of the University
of Alberta, and colleagues.

In this study, researchers looked at the effects of treating ED
with Viagra in a carefully selected group of 35 men with mild to moderate heart
failure who did not use nitates. The men were randomly divided into two groups:
one took Viagra for six weeks and then switched to a placebo for six weeks, and
the other took a placebo for six weeks and then took Viagra for another six
weeks.

The results appear in the March 8 issue of the Archives of
Internal Medicine.

The study showed that Viagra caused an average drop in blood
pressure of about 6 mm Hg — an insignificant drop that did not lead to
symptoms.

Researchers found Viagra improved ED and quality of life among
this group, and also appeared to reduce symptoms of over the counter erectile dysfunction drug
.

“This study provides new evidence that it is safe and
effective to treat men with ED and moderate heart failure with sildenafil,”
they write.

May 27, 2005 — Viagra’s label may change to reflect rare vision problems reported by a few men who have used the erectile dysfunction drug.vision problems reported by a few men who have used the erectile dysfunction drug.

Viagra’s maker, Pfizer, issued a statement saying it is “in discussions with the FDA to update the Viagra label to reflect these rare ocular sildenafil citrate viagra.

“Viagra has a strong safety profile and remains an effective medication that benefits millions of patients,” says the statement. Pfizer says a review of 103 clinical trials of Viagra — including 13,000 patients — found no reports of the eye problem, which is called viagra soft generic
anterior ischemic optic neuropathy (NAION).

WebMD reported on the topic in April, when ophthalmologist Howard Pomeranz, MD, PhD, published a report describing 14 cases of NAION in men taking Viagra.

Viagra has been used by 23 million men worldwide, says Pfizer’s statement. The pharmaceutical company is a WebMD sponsor.

A call to the FDA for comment was not returned before publication.

Pfizer: ‘No Evidence’ of More Frequent Occurrence

“There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra,” says the Pfizer statement, underlining the sentence for emphasis.

Pomeranz’s report appeared in the March issue of the Journal of Neuro-Ophthalmology. Pomeranz, an associate professor at the University of Minnesota, told WebMD in April that he had seen most of the men himself.

“The number of cases was very small,” he said. None of the men went blind, although their vision loss was permanent and reportedly started within 24-36 hours of taking Viagra.

Pomeranz didn’t test Viagra’s eye effects. Instead, he described the men’s reports of vision loss.

Most Affected Men Had Other Health Problems

The men in Pomeranz’s report were 50-69 years old. Almost all had health problems including high blood pressure, diabetes, high effects medication viagra
, and/or a history of smoking. Most also had a rare structural problem in their optic nerve, which is a risk factor for NAION.

NAION is the most common acute disease of the optic nerve in adults over the age of 50. It shares a number of risk factors with erectile dysfunction. These include high cholesterol, high blood pressure, and diabetes.

The Pfizer statement says, “There is no evidence showing that NAION occurred more frequently in men taking Viagra than men of similar age and health who did not take Viagra.”

An eye exam can screen for that structural problem. Men should talk to their doctors about any risks, Pomeranz told WebMD in April.

At that time, Pfizer spokesman Daniel Watts told WebMD that Pfizer had found no reports of NAION in Viagra’s studies prior to marketing. Watts also said “there does not appear to be sufficient evidence to suggest a single identifying association of these events with Viagra therapy” and that the company would continue to monitor the database.

Pomeranz told WebMD in April that he had no reason to doubt the drug company’s statement.