It has been suggested that Viagra would lead to a marked drop in the demand for certain traditional remedies, such as tiger penises and rhinoceros horns and that the drug may therefore help to preserve these endangered species. However, this is unlikely in that these parts of endangered species are not only used to treat impotence. Rhinoceros horns, for example, are used as a treatment for high fever. Further, since Viagra has not been shown to possess aphrodisiac properties, it is unclear that the natural remedies would compete with this new clinical drug.

The “Viagra” name has become so well known that many fake aphrodisiacs now call themselves “herbal Viagra” or are presented as blue tablets imitating the shape and colour of Pfizer’s product.

Pfizer’s worldwide patents on sildenafil citrate will expire in 2011 – 2013. The UK patent held by Pfizer on the use of PDE5 inhibitors (see below) as treatment of impotence has been invalidated in 2000 because of obviousness; this decision was upheld on appeal in 2002.

A mixture of Viagra and ecstasy, called sextasy, has become popular among rave partygoers.

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By controlling the enzyme phosphodiesterase, sildenafil helps to maintain an erection that is produced when the penis is stroked. Without physical action to the penis, such as that occurring during sexual intercourse, sildenafil will not work to cause an erection.

This medicine is available only with your doctor’s prescription, in the following dosage form(s):

This medicine can help many men when it is used as prescribed by their doctors. However, VIAGRA is not for everyone. It is intended for use only by men who have a condition called erectile dysfunction. VIAGRA must never be used by men who are taking medicines that contain nitrates of any kind, at any time. This includes nitroglycerin. If you take VIAGRA with any nitrate medicine your blood pressure could suddenly drop to an unsafe or life threatening level.

What Is VIAGRA?

VIAGRA is a pill used to treat erectile dysfunction (impotence) in men. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated).

You will not get an erection just by taking this medicine. VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.

How Sex Affects the Body

When a man is sexually excited, the penis rapidly fills with more blood than usual. The penis then expands and hardens. This is called an erection. After the man is done having sex, this extra blood flows out of the penis back into the body. The erection goes away. If an erection lasts for a long time (more than 6 hours), it can permanently damage your penis. You should call a doctor immediately if you ever have a prolonged erection that lasts more than 4 hours.

Some conditions and medicines interfere with this natural erection process. The penis cannot fill with enough blood. The man cannot have an erection. This is called erectile dysfunction if it becomes a frequent problem.

During sex, your heart works harder. Therefore sexual activity may not be advisable for people who have heart problems. Before you start any treatment for erectile dysfunction, ask your doctor if your heart is healthy enough to handle the extra strain of having sex. If you have chest pains, dizziness or nausea during sex, stop having sex and immediately tell your doctor you have had this problem.

How VIAGRA Works

VIAGRA enables many men with erectile dysfunction to respond to sexual stimulation. When a man is sexually excited, VIAGRA helps the penis fill with enough blood to cause an erection. After sex is over, the erection goes away.

VIAGRA Is Not for Everyone

As noted above (How Sex Affects the Body), ask your doctor if your heart is healthy enough for sexual activity.

If you take any medicines that contain nitrates – either regularly or as needed – you should never take VIAGRA.If you take VIAGRA with any nitrate medicine or recreational drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke. Nitrates are found in many prescription medicines 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 medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist.

VIAGRA is only for patients with erectile dysfunction. VIAGRA is not for newborns, children, or women. Do not let anyone else take your VIAGRA. VIAGRA must be used only under a doctor’s supervision.

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 To Tell Your Doctor Before You Begin VIAGRA

Only your doctor can decide if VIAGRA is right for you. VIAGRA can cause mild, temporary lowering of your blood pressure. You will need to have a thorough medical exam to diagnose your erectile dysfunction and to find out if you can safely take VIAGRA alone or with your other medicines. Your doctor should determine if your heart is healthy enough to handle the extra strain of having sex.

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

VIAGRA and 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 VIAGRA Is Not for Everyone). If you are taking a protease inhibitor, your dose may be adjusted (please see Finding the Right Dose for You.)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.

Finding the Right Dose for You

VIAGRA comes in different doses (25 mg, 50 mg and 100 mg). If you do not get the results you expect, talk with your doctor. You and your doctor can determine the dose that works best for you.

• Do not take more VIAGRA than your doctor prescribes.
• If you think you need a larger dose of VIAGRA, check with your doctor.
• VIAGRA should not be taken more than once a day.

If you are older than age 65, or have serious liver or kidney problems, your doctor may start you at the lowest dose (25 mg) of VIAGRA. If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may recommend a 25 mg dose and may limit you to a maximum single dose of 25mg of VIAGRA in a 48 hour period.

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. VIAGRA can help you get an erection when you are sexually excited. You will not get an erection just by taking the pill.

Possible Side Effects

Like all medicines, VIAGRA can cause some side effects. These effects are usually mild to moderate and usually don’t last longer than a few hours. Some of these side effects are more likely to occur with higher doses. The most common side effects of VIAGRA are headache, flushing of the face, and upset stomach. Less common side effects that may occur are temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them), eyes being more sensitive to light, or blurred vision.

In rare instances, men have reported an erection that lasts many hours. You should call a doctor immediately if you ever have an erection that lasts more than 4 hours. If not treated right away, permanent damage to your penis could occur (see How Sex Affects the Body).

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 sheet. If you want more information or develop any side effects or symptoms you are concerned about, call your doctor.

Accidental Overdose

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

Storing 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).

For More Information on VIAGRA

VIAGRA is a prescription medicine used to treat erectile dysfunction. Only your doctor can decide if it is right for you. This sheet is only a summary. If you have any questions or want more information about VIAGRA, talk with your doctor or pharmacist, visit www.viagra.com, or call 1-888-4VIAGRA.

ED may be the first sign of a related medical illness, such as heart disease or diabetes. Or it may be the side effect of a medicine your partner may be taking to lower high blood pressure or high cholesterol or to treat some other condition. Have your partner talk to his doctor about the medicines he is taking. He should never stop taking any medicine before talking to his doctor.
Also, while he may not say this to you directly, Erectile Dysfunction can affect a man’s sense of masculinity – sometimes dramatically. It may also make him distant, moody, or angry, which may put a strain on your relationship.
For more information about what you can do for your partner.

If my partner takes VIAGRA® (sildenafil citrate), how do I know he’ll be responding to me and not the drug?

When a man takes VIAGRA, he still must be sexually stimulated to get an erection. VIAGRA increases blood flow to the penis so that if he does become sexually stimulated, he is able to have an erection. For more information about how VIAGRA works.

Will my partner still have an erection after sex?

VIAGRA helps a man’s body achieve what it would do on its own if he didn’t have ED. If a man takes VIAGRA and has sex, the erection should go away after intercourse just like it would normally. Learn more about how VIAGRA works.

When my partner takes VIAGRA, does that mean we have to have sex right away, as soon as it becomes active?

VIAGRA works in as quickly as 30 minutes. After it becomes active, it lasts for about 4 hours. This means that a couple has time to take things at their own pace and to be intimate before having sex.

I’m concerned that VIAGRA® (sildenafil citrate) may not be appropriate for my partner. What do I need to know to be sure?

Only your partner’s doctor can decide if VIAGRA is right for him. Long-term studies have shown that VIAGRA is an effective and well-tolerated treatment for most men. However, men taking nitrates, including nitroglycerin, should not take VIAGRA. Also, because sexual activity can be demanding on the heart, doctors sometimes determine that for men with certain heart conditions, sex is not recommended, with or without medication for Erectile Dysfunction. A doctor knows if VIAGRA is the right treatment for your loved one. Get your partner help with talking to his doctor.