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Prescriptions and prescription distribution

Pharmacists have already got used to get the list of the preparations recommended by a doctor written on a sheet of paper or just from the patient himself and to choose the cheapest or the most prestigious of the accessible medicines, forgetting about bioavailability, treatment regiment, contraindications, biochemical indexes, often guided exclusively by economic factors, which makes the pharmacy resemble an ordinary shop.

Foreign companies don’t loose their time and promote different brands by any means, in particular through their representatives who come any convenient time with the text approved by the company and learnt by heart which has a magic influence upon the listeners.

The legal division of preparations in England considers the three groups: the so-called GSL (General Sales List); P medicines (pharmacy medicines), i.e. the medicines served without the prescription, but under the control of the pharmacist; and (prescription only medicines), i.e. the ethical drugs. There also exist PML (Medicines for Animal Use) or veterinary medicines, but we are not going to discuss them in this article. Over-the-counter drugs habitual to us are included into the first two groups and make up 30 % of all the medicines. As follows from the name, the GSL preparations are over-the-counter drugs both in pharmacies and in any other places including supermarkets. The rest are to be distributed only in pharmacies, as their distribution presupposes the pharmacist’s recommendations, the verification of their possible interaction, and in case of POM the presence of the prescription.

Medicines prepared fordistributing among the patients

Medicines prepared for distributing among the patients

Instead of the usual prescription written out by a doctor the Englishmen have the opportunity to get it from a nurse, a dentist, a vet (in case of prescriptions for animals), and, which will soon come into force, from a pharmacist.

Depending on the territorial division and belonging to any medical profession prescription forms differ in the colour. Besides, there exist the restrictions for the preparations which are prescribed by nurses and dentists (a special medicament list is introduced for them). All mentioned above satisfy the requirements of the National Health System (NHS). But along with these prescriptions there exist different private prescriptions which can be only written out by a doctor.

Some requirements on the distribution of prescribed preparations are officially assigned and exactly followed, and the prescriptions themselves are checked against the established requirements. Let’s take a medical NHS prescription form as an example.

Before a pharmacist distributes the medicaments prescribed he is to make sure that:

  • The prescription is written out by a registered doctor;
  • it is signed with ink by the doctor himself;
  • the prescription includes the following information (either written with ink, or typewritten, or printed):
    • date of prescription;
    • address of the doctor;
    • professional qualification (doctor, nurse, dentist);
    • name, address, and age of the patient.

Prescriptions have the term of validity. Thus, prescribed medicines cannot be served six months later from the moment of its prescription, and in case of controlled medicaments the prescription is liquid for 13 days.

NHS system provides the compensation of the cost of the NHS-prescribed medicines served in pharmacies according to the settled Basic Rate. There exist a number of medicaments not mentioned in the list of NHS prescriptions, and therefore not compensated in case they are served. So the pharmacist must be very attentive while serving medicines and follow the latest issues of the National Form of Medicines and Basic Rate.

If it is prescribed to serve Generic Viagra 100mg/32 pills and in the pharmacy they have only Brand Viagra 100mg/32 pills and according to the Basic Rate this preparation is more expensive than the generic one, the pharmacist either sends the patient to another pharmacy which can serve the prescribed medicine, or orders the necessary preparation and serves it the next day. The pharmacist can serve any brand satisfying the generically prescribed preparation, but he is to remember that only the basic cost provided in the rate will be paid and the pharmacy may bear financial losses.

According to the law, all the prescriptions are written out in English and practically all the medicines are prescribed using the international names (sometimes the doctor names the brand which is necessary for his patient). Thus, prescribing Doxazosin a doctor can add: serve Cardura; if the pharmacist has both the generic and Cardura he is to serve the preparation named by the doctor – Cardura. In spite of the difference in the cost (3.85 and 10.56 respectively) the pharmacist will have compensation the cost of the preparation served as this is proved by the recommendation of the doctor. If Prevacid is prescribed with no comments, the generic Prevacid will probably be served even if there is Zoton brand in the pharmacy.

The prescription form consists of two parts – the prescription itself and the perforated part which is returned to the patient. It doubles the list of the medicines prescribed and reminds the patient when it is necessary to make a repeat order, visit the doctor for consultation, the doctor’s reception hours, the phone number and e-mail for contacts and prescription order. This considerably simplifies the doctor’s work as well as the patient’s life. The patients with fixed regimen can plan the schedule of visiting the doctor and ordering prescriptions.

Besides, by the agreement with the doctor and the pharmacy, the ready prescriptions can be delivered right to the pharmacy, checked, and the prescribed medicaments delivered to patient’s place.

The person who comes to a pharmacy with a prescription must fill in the overleaf. He must sign it (or put the name of the patient), write the address, the paid cost or the kind of benefit.

NHS-payment for one prescribed unit from this April is 6.30 pounds.

There exist some peculiarities in the payment for prescribed preparations, for example, if Augmentin 250 mg and Albenza 400mg tablets are prescribed in one prescription form the patient will make one payment.

As for the contraceptive preparations, they are served according to the NHS-prescriptions free of charge. The patients grant exemption from the payment for some reason or other. These reasons can be:

  • the age – either under 16 or over 60;
  • 16 – 18 year-old getting stationary education;
  • getting unemployment benefit;
  • low income;
  • prepayment for the medicaments;
  • veterans of war;
  • medical release (diabetes, thyrotoxicosis, epilepsy, etc.).

All the information on the patients including the information on the benefits is introduced into the database of the pharmacy or pharmacy network. Respectively every pharmacy is provided by the computer system (some systems are spread among the British pharmacy network). The patient’s file includes both personal data (name, address, age, benefits, doctors’ names, etc.) and medical (allergy, intolerance, all the served medicines, etc.).

The pharmacist can always resort to the file of the patient and ground the recommendations on the preparations basing on the probable interactions or contraindications.

It is obvious that the pharmacist won’t check against the file if the asthmatic asks ibuprofen because of the evident contraindication, on condition that the patient has already had the experience of successful taking ibuprofen under his doctor’s control, the medicine can be permitted for taking.

The computer pharmacy network allows not only to support the database of the patients and doctors and checking the interaction of the preparations, but also to control product traffic, automatizing orders, keeping records and executing the obligation to supply every medicine served with the suitable label.

Label printer in a pharmacy

Label printer in a pharmacy

The labels play an important role as they carry the instructions of the doctor in charge and the warnings of the pharmacist obligatory to follow for the purpose of effective treatment. It is not the copy of the instruction.

As a rule it is indicated in them:

  • patient’s name;
  • name and address of the pharmacy served the medicine;
  • name of the preparation;
  • alerting about using the drug, e.g. “shake before use”;
  • general quantity in the container (package, bottle);
  • for external use (in case of external);
  • other special instructions.

Usually pharmaceutical technologists are occupied with the preparation of the prescription and the sticking of the labels, and the pharmacist checks the correctness of the prepared medicaments (signs in the corner of the label), examines the possible interactions, side effects, contacts with the doctor in case of need, and gives recommendations on drug taking and is responsible for the work of the pharmacy and the serving of the prescribed and over-the –counter drugs.

Special attention is paid to the safety of keeping medicines at home. That is why patients are recommended to keep medicines in places inaccessible for children, and they are served in the so-called “child-resistant containers” – containers which are opened with effort. More over patients are advised to return unnecessary medicaments to the pharmacy where they can be destroyed – the law prohibits reusing medicaments returned even if they have an appropriate keeping date and the package wasn’t open.

The requirements to the serving of medicaments under control somewhat differ from those to prescribed. Controlled medicines are divided into five categories and different requirements are made of them respectively to their keeping, registration and serving. That part of the medicines which undergoes special recording must be included into the Register of the medicines under control when arriving to a pharmacy and serving. Besides the majority of these preparations are to be written by a doctor with the indication of the concentration and the quantity (tablets and liquid) in figures and letters. Unfortunately, English doctors also have a disgusting handwriting.

Very seldom there happen prescription falsifications; that is why all the prescriptions are to be checked very carefully when arriving to a pharmacy. The pharmacist suspecting the falsification can contact to the doctor who “has written out” the prescription and if the suspections are confirmed must inform the police.

Medical people are in the close connection controlling and correcting the treatment of their patients. This really helps their work as even at serving over-the-counter drugs the checkup of possible interactions and undesirable effects takes place. Pharmacists have key positions in this professional cooperation as the patient to get a medicine, over-the-counter or prescribed preparation written out by a dentist, a nurse or a doctor, goes to a pharmacy .

If in some doctor’s prescription some medicine incompatible with the prescription of another appears, the pharmacist solves the problem consulting with the colleagues and recommending the most suitable medicine.

The feedback also works: doctors as well as nurses resort to pharmacists’ advice, recommendation and calculating of the doze. It makes patients much good as they can rely on the high-quality professional help whatever they address.

Of course this system is not ideal, but it is developing, reforming and tending to improve patients’ service. Thus, since 2005 pharmacy computers take electronic prescriptions.

The meaning of the prescription in the qualified medical help service in Great Britain is great and many-sided – it is first of all the main bearer of medical information, the document for recording and compensation financial costs of pharmacies, the primary information about the course of the treatment, the patient, and statistically valuable information allowing to plan the public-health budget in general. And undoubtedly, British doctors, chemists and all the NHS system could not have functioned without such an ancient invention as a prescription.

Prescription Drugs: Advantages

Time has proven that spending on prescription drugs represents the rapidly increasing spheres of our health care charges as compared with all other aspects.

Due to statistics starting from 1994 and up to 2003, prescription drug spending factor has given a rapid growth at double-digit rates with each year at the mentioned period of time. The numbers continue their rapid and active increase, although the growth can at the moment be measured in single digits. There are certain numbers of factor which have influenced the world of prescription medication as well as its go-slow in spending. And here it is of a crucial importance to mention methods adopted by health insurance companies in their offering prescription drugs. Most of the insurance plans have excluded expensive medicine from coverage; they have reduced on refills as well as high – cost co-pays.

There has periodically taken place a sufficient numbers of debate and research on the above-mentioned matters. The debates included also the ways insurance companies are liable to meet our prescription medicine needs with the considerable amount of profit. The aspect should be seriously analysed for further information which should be provided below.

Any insurance plan’s prescription medicine coverage certainly involves a formulary, or any kind of privileged medicine/ catalogue. The index of the prescription medicine necessarily includes drugs that are preferable for your insurance quote and can be generally and at most times prescribed without any former permission. This index is built up to retain the prescription medicine costs down for the insurance company whereas it still makes you an offer of quite competitive alternative list of medications.

Another very crucial factor which affects on the formulary alternatives lies in encouraging its clients to use the generic form of a given drug.

You can be sure in most cases some insurance plans are going to charge more if you don’t make a selection in generic medicine catalogue. Other insurance plans will present you price difference with normal co-pay add-on. There are also insurance plans which will have a charge-off for name-brand medicine; others will not offer the coverage including all.

A formulary may in general be represented by several forms; this factor is dependant on your concrete insurance plan. There are some insurance plans which will cover medicine which is on the formulary, here by preferred drugs most often generic medicine is meant not on the formulary, which includes brand-name medicine. In such cases the client has to pay more for nonpreferred, i.e. brand- name drugs.

There are other categories of insurance plans which may be more predetermined, they are going to cover only those types of medicine on the formulary and will certainly deny coverage of all others without former permission or authorization process.

Most part of the formularies are necessarily “tiered” and hang somewhere in the mid part. Letӳ take a vivid example: in a three-tier plan, generic medicine are generally at tier one, tier two involving non- preferred, i.e. brand-name drugs for which generics are not obtainable or accessible, and tier three, which is also the most expensive, includes nonpreferred drugs.

If your health care provider prescribes a medicine which isn’t included in your health insurance plan’s index or catalogue, please note that majority of insurance plans provide you with an opportunity for former permission or authorization process in which medicine may pass approval on a case-by-case basis.

Generally in the above – mentioned situations, you must have already failed with the preferred medicine prescribed for treatments or faced adverse drug interaction from them. Please remember that in case your coverage still remains denied, an investigation in court is available in most cases.

Which are the mains ways for formulary creation? Your insurance company has a medical board which is generally compiled of physicians, pharmacists and health care providers representing various aspects of Medicine. Medical board makes a selection of medicine and other products which are further included on the formulary, the selection is made on the basis of such factors as security, efficacy of medicine as well as quality it provides, there is also one more important factor making the basis of selection – the charges to the insurance company.

Majority of formularies are analyzed and revised on a quarterly basis. New medicine approved by Food and Drug Administration may be added to the drug index, and ineffective or high – cost older medicine can be removed.

So what takes place if co-pays are not affordable for you, or in case you can’t afford paying for health insurance whole coverage? Please find more in ֠depth information on the issue in the next section.

Online pharmacy

With our online pharmacy our customers receive the first class aid both from the view point of high quality drugs and fast and prompt customer support. The value of service we offer is appreciable. We offer you a quite new look on the online drug system which provides you with a brilliant opportunity to be updated on the most innovative drugs and medical news.

Our online pharmacy is owned by one of the most famous distribution pharmacies which allow us to offer extremely competitive prices. A highly qualified customer service is performed by a number of first level pharmacists who will answer any queries you have about any category of medicine presented here.

Our pharmacy range is rapidly growing so please check the web site for more exciting health care products which are currently at the production stage. Every product is presented on our web site with its thorough and in- depth description so that to inform you completely on every detail before you start taking the prescribed medicine.

If you want to learn more info on the medicine provided on the medicine please simply click on the medicine category and use “more info” button which will guide you through the medicine specification and use instructions.

In case if the order is sent by an ordinary unregistered mail it will arrive in a plain envelope without any reference to content.

The envelope will be delivered to your mail box. It requires no necessity for signature for it. If the order is sent by a courier, the recipient necessarily needs to sign for the package. All orders of online pharmacy are shipped in safe and cautious packaging. The package from outside of the package does not contain any mentioning about the inside drugs. Your name or any confidential information is not available to any of the third parties. Your privacy is of crucial concern to us.

We also offer you an accurate delivery of the medicine chosen by you on the website. You will receive the medicine ordered at the shortest possible time established for your region. All customer queries and transactions are treated in the highest possible confidentiality conditions through secure certificates. All the information you provide on our web site is confidential and cannot be available to any of the third party.

On our online pharmacy stock, you are offered to fill in a form to order the medications you need. Your personal information provided is necessary for the order delivery as well as orders receipt confirmation. This information is also used to contact our consumers if needed. The information is not liable for use of any spam or promotional messages etc.

For convenience of the customers we accept all famous and established credit cards payments, as well as payment by cheque, international money transfers and o ther payment methods.

We advice you to consult your health care provider before starting to take the products presented on our site. Our customer service representatives forward your enquiries to the sales department which further handle the issue.

As the drugs we offer in the stock are manufactured in … consequently they are approved by the local Food and Drug Administration.

Our drug producers perform a series of researches, during/ after manufacturing process; this is intended to demonstrate that every medicine produced meets the requirements for that very product.

Our online pharmacy has established certain use instructions thus please note that there several medicine available in our pharmacy require an adequate prescription. If the law applicable to your country or territory is defined for prescription obtaining for any of the drug category offered you will be asked by our customer care specialist to send it after you fill the order form.

What is Viagra?

what is viagra

Viagra is produced in 25, 50, and 100 mg tablets, which contain, respectively, 25, 59, and 100 mg of sildenafil citrate.

As opposed to other ways of erectile dysfunction treatment which consist in injections into the penis or other medical procedures, Viagra is a simple and easy-to-use preparation. When using Viagra, you just take one pill before having coitus.

The mechanism of Viagra effect is simple: the preparation increases the quantity of blood arriving to the penis. This helps a man to cause natural erection. Viagra has its effect only in thy case when a man is feeling natural sexual arousal, and when the coitus ends, the penis naturally relaxes. In other words, Viagra affects only natural mechanisms of erection and in this there’s its undeniable up-to-dateness and the secret of great popularity.

The discovery of Viagra became the third greatest “accidental” opening in medicine – after the opening of X-rays and penicillin. These discoveries were awarded Nobel Prize. This high award was also given in 1998 to the research people who discovered, in addition, the characteristics of Viagra.

The history of Viagra started in 1992 in Great Britain in the township Pfizer Sandwich in the course of pharmacology research work of Pfizer Corporation. The research people were probing the new pharmaceutical substance – Sildenafil Citrate – which was developed as the remedy for medication of some heart diseases.

The scientists expected that sildenafil citrate will promote increasing blood inflow to the cardiac muscle and lowering blood pressure. But it was noted that sildenafil citrate doesn’t influence much neither blood circulation in cardiac muscle (myocardium) nor blood pressure. At the same time it was found out that many patients of male sex taking part in the testing refused to return sildenafil pills, despite of the ending of the experiment. The reason was one among all the patients – they all noted erection recovery. Thus, in spite of the minimum influence of the new medicine on the blood circulation in myocardium, sildenafil caused perceptible blood inflow to male genital organs.

The research people of the pharmaceutical Pfizer Corporation took this unexpected quality quite seriously and managed to recognize powerful preparation for erection dysfunction combat. The new preparation was named Viagra – the name appeared as the result of junction of the words “Vigor” (power, energy, force) and Niagara – the most massive waterfall in North America.

Since 1993 prolonged clinical trials necessary for proving Viagra characteristics started. As the result of these trials high effectiveness of Viagra and its safety were proved. And after all on the 27th March, 1998 the USA Medical Supply Department approved the use of Viagra. The effect of the preparation was estimated among more than 3000 men from 19 to 87 of age during the research work of erectile dysfunctions held in all the countries of the world. The average duration of dysfunction was about 5 years (from 6 months to 26 years), while the nature of this malfunction was of organic, psychogenic, and combined psychogenic-organic origin.

The results of these research work show that Viagra is effective for erectile function recovery and for the improvement of successful coitus rates among a great number of the patients including those having diabetes, spinal cord injuries, and other concomitant clinical states, as well as among the patients taking a whole number of medicaments.

According to numerous clinical trials and testing the preparation on volunteers suffering from different types of erectile dysfunction, sildenafil citrate is quite effective. But some nuances should be noted.

Unfortunately, there exists no preparation able to treat all the diseases, in this case all the types of erectile dysfunction. Viagra isn’t a panacea either; it can help in the majority of cases, but not all the patients. Viagra is effective among the patients suffering from atherosclerosis, the injury of nerves of penis vessels, or diabetes.

Moderate results are observed among the patients with pathological venous drainage. In each of the enumerated cases only a doctor can organize erectile dysfunction treatment in the right way. He can prescribe the necessary treatment regimen and choose the best medicine.

Viagra or Cialis

At present the two preparations are more often used for erectile dysfunction (or impotence) treatment – Viagra and Cialis. Viagra appeared at the Russian medicine market in 1998, Cialis appeared five years later, in 2003. Both have the same action mechanism which is in phosphodiesterase-5 (PDE-5) enzyme blocking, while this enzyme is responsible for cyclic guanosine monophosphate splitting. This enzyme is responsible for the vascular components which play an important role in the appearance of the penis erection. The level of cyclic guanosine monophosphate is below normal among men suffering from erectile dysfunction, that’s why it’s not enough for providing sound erection.

So, in order to heighten the level of cyclic guanosine monophosphate in the organism a simple enzyme blocking method able to split cycling guanosine monophosphate was used.

As for the side effects of Viagra and Cialis, they are quite similar; in both cases after the preparation taking vertigo, headache, diarrhea, nausea, stuffiness in nose, and the sensation of blood inflow to the head can be felt. Besides, when taking Cialis, a pain in the small of the back, stomachache and a pain in joints can appear. As a rule all the side effects progress in the light or moderate form. You should also remember that for Cialis the possibility and the force of side effects can be decreased during its further taking.

As far as Viagra has existed at the market, there stored enough information which doesn’t speak well for this preparation. The fact that Cialis can be taken together with fat food and alcohol in small dozes says much for it. So, we can state with certainty that this time Cialis is better than Viagra, but you should keep in mind that taking some medical preparation isn’t a panacea for impotence.

Viagra FAQ

What’s Viagra?

Viagra is a well tested and reliable remedy which improves men’s sexual function and helps live a full-blown sexual life.

Is Viagra a sexual stimulator?

NOT AT ALL, VIAGRA ISN’T A STIMULATOR. Everything happens naturally. Viagra acts in that exact moment when it’s necessary, but not when it’s taken.

What’s the mechanism of Viagra action?

The taking of Viagra leads to the widening of arteries and great blood inflow to the penis. Viagra reveals its effect in case of sexual arousal, when there’s no sexual arousal – the erection doesn’t take place. At the end of coitus the erection ends naturally. The effect of Viagra isn’t connected with the influence on sexual arousal or hormones.

To what extent is Viagra effective?

Viagra Improves Erection in 76% of Cases.

Does Viagra improve the capability to coitus?

Yes, if a man takes Viagra the number of sex acts reaches six a month. 89% of partners note erection improvement when taking Viagra.

Does Viagra have its effect in case of serious illness?

Yes, up to 60% of men with grave irregularities of erection when taking Viagra estimated their erection as good and excellent.

What are the results of prolonged treatment?

97% of men taking Viagra during 2 years and more note the improvement of erection.

I’ve taken Viagra once, but it hasn’t worked. Does this mean that it does suit me?

Among the majority of men Viagra has its effect after the first or the second taking. The best effect is noted after the third or the fourth taking, so it’s very important to proceed the treatment. Of course, you must keep to your doctor’s recommendations about Viagra taking.

How quickly does Viagra start to act and for how long does it have its effect?

The effect of Viagra is evident in 30 minutes and lasts for at least 4 days after the taking.

I’ve heard that Viagra influences the heart badly

The data of clinical testing (the use of Viagra for more than 11,000 patient-years; placebo – less than 700 patient-years) prove the absence of the heightened risk of the development of cardiovascular diseases as a result of Viagra taking.

How often can I take Viagra?

Not more frequent than once a day.

What contraindications does Viagra have?

The presence of some serious diseases in case of which sexual activity is prohibited: unstable stenocardia, grave cardiac insufficiency, grave hepatic failure, low blood pressure, recent myocardial infarction or stroke; retina pigmentation, hypersensibility to sildenafil or some other component of Viagra.

What doctor can prescribe Viagra?

A doctor of any specialty can prescribe Viagra, but, in the first place, urologist, sexual pathologist, andrologist, endocrinologist, and cardiologist.

What effect does Viagra have on practically healthy people?

Pfizer Corporation hasn’t tested and isn’t going to test the effect of Viagra on healthy people. Pfizer Corporation has produced this preparation for the treatment grave and marked pathological cases. So, on this basis the Company has filed an application both to the Food and Drug Administration of the USA and to the European Quality improvement System.

The tests upon healthy people imply the preparation selling among healthy people, but the Company isn’t going to do this. Viagra is meant for people suffering from erection disorder.

How to define the sexual norm?

In other words the question can be formulated this way: the so-called “practically healthy people” take Viagra and feel better, so can they be regarded as healthy people?

Those people are considered to be healthy who have and keep erection which allows to have coitus and finish it successfully. As far as Viagra brings the patients back to the normal state or, at least, helps to move in this direction it definitely doesn’t affect those people who are initially healthy.

Though if a man who consider himself to be healthy takes Viagra and reveals the improvement of erectile function, he is possibly suffering some kind of erectile dysfunction, at least some temporary one, and he can’t be treated as healthy in the true sense of the word.

So the mass media should inform that healthy people don’t need Viagra and they would have no benefit taking it.

Does Viagra raise sexual attraction?

The effect of Viagra is based only on the local growth of the blood flow to the cavernous body of the penis and it doesn’t influence the arousal of sexual attraction. It doesn’t improve libido and isn’t a stimulant. Viagra just depresses the functioning of enzyme which influences the blood flow in the penis. Sexual arousal is necessary for its functioning. That is it stimulates the natural reaction of the organism to the sexual stimulation. Clinical testing proves the absence of arousal in that group of patients taking Viagra preparation in comparison with the group of the same taking placebo without Viagra.

Do the wives share the husbands’ hopes for the return of young years?

We recommend to the doctor to find out initially the attitude of the patient towards the treatment and then, in case of necessity, with their sexual partners. Though the results of clinical tests show that in usual circumstances Viagra improves the quality of partners’ sexual life. More over, it’s known that in many countries wives, not husbands, consult the doctor in the first place. And in the USA 80% of men suffering from erectile dysfunction discuss this question with their partners before starting the treatment.

Does Viagra allow keeping erection after taking alcohol?

There are no data concerning its interaction with alcohol. Though, as far as strong drinks can’t be regarded as stimulating sexual activity, they are not recommended to be taken before taking Viagra. Alcohol can only prevent goal achievement and probably in proportion to the quantity of strong drinks.

Alcohol taking can lead to the temporary inability to achieve erection. To get the maximum benefit from the medicine it’s not recommended to take much alcohol before taking Viagra.

If Viagra is safe and effective why not sell it over-the-counter?

Yes, clinical testing has proved the safety of Viagra. At the same time we know about some drug interaction, especially with nitrates used in cardiac disease treatment. So, it’s very important for Viagra to be prescribed by the doctor thoroughly acquainted to the patient’s medical card.

In what way does it interact with other medications?

During clinical research work some inessential interaction with other medical preparations or its complete absence. Though there exists an exception to this rule – nitrates which are mainly used to treat cardiac diseases. So Viagra is contra-indicated for the patients cured with the help of nitrates. The danger is in possible drop of blood pressure – hypotension.

Viagra must be taken without nitroglycerine and nitroglycerine-containing preparations of long-term and short-term action. You mustn’t take it with donator preparations of nitric oxide, for example, molsidomine (Corvaton, Sydnopharm) and sodium nitroprussidom. These preparations are used for stenocardia treatment.

It’s not recommended to take Viagra with other remedies aimed at erectile dysfunction treatment.

If you don’t know exactly whether you take these preparations consult your doctor.

What remote side effects does Viagra have?

During the last five years Pfizer has been conducting clinical research work in which those patients have taken part who had taken Viagra for a long period of time – up to three years. On the assumption of proper use no data indicating some danger of its use were fixed. Only slight and transient side effects were noted, not serious and not long-termed.

Viagra can cause some side reactions. Usually they are moderate and last for a short period of time: sometimes there appears a headache, face redness, heartburn, and stuffiness in nose.

When some undesirable reactions take place tell your physician about it.

More than 90 clinical research works with more than 8000 patients involved stated the effectiveness and safety of the preparation on condition of its using according to the instruction.

Does Viagra influence reproductive performance?

Viagra itself doesn’t affect the reproductive performance. Though in those cases when erectile dysfunction prevents couples of childbearing age from conception Viagra can help a lot.

To what extent is Viagra effective for women?

Viagra is developed for men. Some experimental research work has been held and at present they recruit the volunteers for further research work. Though the results of this testing aren’t still known. The clinical testing among women with erectile dysfunction appear sto be more difficult than among men. There’s no set methodology for them.

Are there any age limits for Viagra taking?

Viagra isn’t prescribed to the patients under 18.

Is Viagra a natural (herbal) or synthetic preparation?

The active component of Viagra is sildenafil – a synthetic substance.

What’s the form of production of Viagra?

Viagra is produced in packings of 1 pill of 50 or 100 mg; of 4 pills of 50 or 100 mg. there exist some other forms of Viagra delivery.

What corporation produces Viagra?

Viagra is developed and produced by the biggest pharmaceutical corporation in the world – Pfizer. The discovery of the mechanisms having shown the way to the developing of Viagra was awarded Nobel Prize in the field of medicine. At present other pharmaceutical corporations of the world have started producing chipper and effective generics of Viagra. Generic forms are identical to Viagra in their structure, produced under other trademarks or under sildenafil name and are chipper, as the costs of the advertisement are lower in the share of the cost price of these generic forms.

A considerable part of these preparations is the so-called generic forms. They possess the same action as the preparations sold under some famous trademark as they have an identical structure. Their cost is, as a rule, lower as the producers needn’t invest much money into the promotion campaign.

Viagra, Cialis and Levitra Are Working up a Market

The Pills of Joy: Now Orange and for the Young

Viagra, Cialis and Levitra – the three resembling medicine from impotence – are working up new and new segments of the market. If sometime ago elderly senator Bob Dowl took part in the first Viagra advertising campaign, now the main characters of the commercials are men under 40.

Marketers don’t offer the customers to receive treatment from impotence, but position the preparations as the pills of joy. Levitra, for example, is colored in cheerful orange.

Who Buys Viagra Nowadays?

According to The New York Times, firstly people suffering from impotence started to receive these medicines. Following the prescription, patients with diabetes, neurological malfunction and the side effects of antidepressants managed to restore their lives.

Though later the demand for Viagra has greatly risen. First, doctors started prescribing medicine for everyone who asked for that. Second, there appeared numerous drugstores which offered preparations from impotence without any prescription and with delivery.

Correspondingly, the circle of consumers has become wider. Even healthy people have become “patients” as they wanted to play safe before stirring dating.

The portrait of one of such a consumer is given in the New York Times. 41-year-old Chris London lives in New York and is an attorney. One of his business partners once declared that she couldn’t work with a man normally if she hadn’t had sex with his before. London was confused at any rate, but agreed to meet in the evening. Following the advice of his fellow-doctor he overcame his nervousness with the help of Viagra having swallowed it in the bathroom.

Simply speaking, Viagra, Levitra and Cialis are bought by everyone who wants to be sure in his sexual abilities irrespective of the circumstances. The producers of the medicines point out at the same time that neither having meals nor alcohol influence their effectiveness.

What Impotence?

Impotence or erectile disfunction is regarded as disability to keep up erection necessary for coitus.

This disorder affects both elderly men and rather young ones. In the first case the cause of impotence is more often some chronic diseases or injuries, and in the second impotence is a psychological problem.

In spite of the opinion of many men, Viagra and its analogues function exceptionally on penis blood supply and have no psychotropic effects. That is such preparations can improve potency, but not libido. However, as physicians have found out, very often the desire of coitus comes together with normal erection.

Sex in the City

According to psychologists, in the first place it’s the need of city on habitants to take Viagra. Sexual revolution has resulted in the fact that coitus more and more often takes place between unfamiliar people: colleagues, people who met at a party or via the Internet.

At the same time in the mind of many people there’s an image of an ideal man who’s always ready for coitus and is eager to have it. Trying to keep with this opinion, men take the pills in secret as did the above-mentioned Chris London. Entering the bedroom with high color in their cheeks, they complain of the heat and stuffiness. And in the morning they often suffer from headache.

As The New York Times mentions, such pills are often taken even by gay men. Both lovers do this secretly and then suffer the same side effects together.