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In patients who take nitrates for angina, tadalafil could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure.

Therefore, tadalafil should not be used with nitrates.

Tadalafil also exaggerates the blood pressure lowering effects of some alpha-blocking drugs for example, terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate (BPH).

Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before tadalafil is started.

In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose.

Combining tadalafil with alpha-blockers for treatment of BPH is not recommended.

Therefore, combining tadalafil with alcohol may cause excessive drops in blood pressure and cause dizziness, headaches, and increased heart rate.

PDE5 inhibitors may affect platelet function and therefore prolong bleeding. Tadalafil should be used cautiously in patients with bleeding disorders or active ulcers.

Tadalafil should not be combined with Adcirca (another form of tadalafil) or other PDE5 inhibitors, for example, vardenafil (Levitra) or sildenafil (Viagra, Revatio).

Viagra increases the effects of the blood pressure lowering medications.

It also increases the blood pressure lowering effects of nitrates, for example, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur,

Ismo

, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating angina. Patients taking nitrates should not receive Viagra.

Patients should not combine Viagra with other PDE5 inhibitors (for example, vardenafil [Levitra], tadalafil [Cialis]).

Cimetidine (Tagamet), erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), atazanavir (Reyataz), and mibefradil (Posicor) can cause marked increases in the amount of Viagra in the body. Patients taking these medications should be observed carefully if sildenafil is used.

It is expected that rifampin will decrease blood levels of Viagra and probably reduce its effectiveness. Are Cialis and Viagra safe to use while pregnant and breastfeeding?

Tadalafil is not approved for women and has not been evaluated in women who are breastfeeding. Although extensive testing in animals has demonstrated no negative effects on the fetus, Viagra has not been studied in pregnant women.

There is no effect on sperm count or motility of sperm in men.

It is not known whether sildenafil is excreted into breast milk.

Subscribe to MedicineNet's General Health Newsletter.

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may

opt

out of MedicineNet's subscriptions at any time. Cialis (tadalafil) and Viagra (sildenafil) are oral drugs that are used for treating impotence (the inability to attain or maintain a penile erection) and benign prostatic hyperplasia (BPH). They are in a class of drugs called phosphodiesterase-5 (PDE5) inhibitors that also includes vardenafil (Levitra, Staxyn ODT), and avanafil (Stendra). Learn about erectile dysfunction causes and treatments such as drugs. Enlarged Prostate (BPH) Symptoms, Diagnosis, Treatment.

Benign Prostatic Hyperplasia (BPH) is a condition cause by an enlarged prostate.

Here we explore how stress, lack of sleep, weight gain, depression and low T can.

Learn sex tips for men that lead to more sexual pleasure such as better communication, focusing on pleasurable sensations.

Learn how to overcome common health conditions affecting those over 50 such as.

Benign Prostatic Hyperplasia (Enlarged Prostate) Quiz. Take the Enlarge Prostate Quiz and challenge your knowledge of prostate problems. Erectile Dysfunction (Impotence) Quiz: Causes & Treatment.

Did you know that certain medical condition may be responsible for ED? Some causes of impotence are medically treatable and. Male sexual dysfunction can be caused by physical or psychological problems. Common sexual problems in men include erectile dysfunction (impotence or ED), premature ejaculation, and loss of libido. Treatment for sexual dysfunction in men may involve medication, hormone therapy, psychological therapy, and the use of mechanical aids. Enlarged Prostate (BPH, Benign Prostatic Hyperplasia) Benign prostatic hyperplasia (BPH or enlarged prostate) is very common in men over 50 years of age. Half of all men over the age of 50 develop symptoms of BPH, but few need medical treatment.

This noncancerous enlargement of the prostate can impede urine flow, slow the flow of urine, create the urge to urinate frequently and cause other symptoms like complete blockage of urine and urinary tract infections. More serious symptoms are urinary tract infections (UTIs) and complete blockage of the urethra, which may be a medical emergency.

Not all men with the condition need treatment, and usually is closely monitored if no symptoms are present. Treatment measures usually are reserved for men with significant symptoms, and can include medications, surgery, microwave therapy, and laser procedures. Men can prevent prostate problems by having regular medical checkups that include a prostate exam.

BPH (Enlarged Prostate) Differences and Similarities. Prostatitis and BPH (benign prostatic hyperplasia, enlarged prostate gland) are both conditions of the prostate gland.

There are four types of prostatitis that can be caused by infections (usually bacterial) or other health conditions or problems, acute bacterial prostatitis (type I), chronic bacterial prostatitis (type II), chronic prostatitis and chronic pelvic pain syndrome (type III), and asymptomatic inflammatory prostatitis (type IV). BPH is inflammation of the prostate gland, and most men have the condition by age 50.

Doctor's don't know what causes this inflammation, but they theorize that it may be related to hormones. Both of these conditions can cause similar symptoms like low back pain, pain during urination, or difficulty or the inability to urinate.

However, prostatitis has many more symptoms and signs than BPH, and they based on the type of prostatitis. Examples include low back pain and/or abdominal pain, painful urination, fever, chills, feeling tired, recurrent urinary tract infections (UTIs), painful urination intermittently, intermittent obstruction urinary tract symptoms (frequent, painful, or incomplete urination), pelvic pain and/or discomfort, pain with ejaculation, and erectile dysfunction (ED).

If you think you have either of these conditions contact your doctor or other health care professional.

Bacterial

prostatitis

can be cured with antibiotics; however, there is no cure for BPH.

Erectile Dysfunction (ED, Impotence) Erectile dysfunction (ED, impotence) is the viagra cvs failure to achieve or maintain an erection. There are many potential underlying causes of erectile dysfunction, including stress and emotional problems, brain dysfunction, problems with blood supply to the penis, and structural problems with the penis.

Erectile dysfunction is diagnosed by taking the patient's history and physical exam.

Blood tests measuring kidney function and blood sugar, cholesterol, hormone, and prostate-specific antigen (PSA) levels may be ordered.

Urinalysis, ultrasound, and other more sophisticated tests may be required. The treatment of erectile dysfunction depends on the underlying cause.

Medications, penile injections, penile implants, and vacuum devices may be used.

Treatment for erectile dysfunction is usually successful.

The patient should manage heart disease risk factors (high blood pressure, high cholesterol, diabetes) as they are related to erectile dysfunction risk.

Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function.

Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.

Sexual health information including birth control, impotence, herpes, sexually transmitted diseases, staying healthy, women's sexual health concerns, and men's sexual health concerns. Learn about the most common sexual conditions affecting men and women.

Is Viagra the World's Most Popular Male Sexual Performance Drug?

by Michael Castleman, December 11, 2013 | Comments: 0. In four studies where couples used Viagra, then Cialis (or vice versa), the women strongly preferred the latter.

En espanol | In the pantheon of globally recognized brand names, Viagra is right up there with Coca-Cola and Rolls-Royce. In terms of user satisfaction, however, Viagra (sildenafil) runs a distant second to Cialis (tadalafil). I found 12 studies — none of them funded by the drug companies themselves — in which men from various countries tried both drugs and then reported which one they chose to continue. And the 8,300 participants favored Cialis by a wide margin — 3 to 1, on average. In studies that also included the third major erection drug, Levitra (vardenafil), Cialis was still substantially more popular than either competitor.

In four studies where couples used Viagra, then Cialis (or vice versa), the women strongly preferred the latter.

Blindfolds: A classic sex accessory A better sex life? Take the slow route Date night ideas for couples in a rut.

Join AARP Today — Receive access to exclusive information, benefits and discounts. Viagra and Levitra are effective for approximately four hours, Cialis for 36. If a man takes Cialis on Friday evening, he can count on erection assistance through part of Sunday. Both men and women say they like the fact

that

Cialis allows them to take their eyes off that ticking clock and make love whenever they wish. So for

dating

couples or new lovers who prize sexual spontaneity, Cialis has a clear advantage. Oddly, Cialis is favored by a less sexually impulsive group as well: long-term spouses, who are likelier to schedule sex dates. The drug's more wide-open window of opportunity apparently makes for friendlier spousal negotiations over time and place. Except for their duration of action, all erection medications function in similar fashion.

They work equally well if taken on an empty stomach cheap viagra or after a meal. None produce spontaneous erections, so no mortifying bulges in the produce aisle; they enhance firmness only in the context of erotic stimulation. Their side effects are quite similar, too: headache (16 percent of users), upset stomach (7 percent) and nasal congestion (4 percent). (Important note: Never use erection medications if you're taking nitroglycerin for angina; the combination can be fatal .

Remember how close we came to losing Jack Nicholson in Something's Gotta Give?

) And you might be surprised to learn how few older men use any erection drug at all: Sales of "vitamin V" have never reached more than about half of what experts predicted when such medications were first approved in 1998.

When Cornell researchers surveyed 6,291 older men on the subject, 48 percent reported some degree of erectile dysfunction, but only 7 percent had ever tried an erection drug.

One reason is that, compared with women, men are less willing to take medication. But the main reason is that the drugs enhance intercourse, whereas older couples generally evolve away from the old in-out toward hand massage, oral sex and vibrator play.

A "fact of life" for many older lovers is that intercourse is a hassle.

Even with drugs, erections may be iffy; even with lubrication aplenty, vaginal dryness or atrophy may cause pain during intercourse.

That's why many older lovers move on from intercourse to other pleasures. And if you're no longer having intercourse, erections aren't necessary, so why take a drug?

In addition, men don't need erections to have orgasms.

You read that right: Given sufficient fondling, a man can have a marvelous orgasm with a semifirm or even flaccid penis. Among men who try erection medications, only half refill their prescriptions.

The manufacturers claim the drugs are 70 to 85 percent effective, but research shows their effectiveness to be more in the 50 to 60 percent range; for men with diabetes, heart disease, or high cholesterol or blood pressure, it can be even lower.

And wait until you hear how the studies define "effectiveness": We're not talking rock-hard porn-star erections here, but rather any increase in firmness that enables intercourse. That means even drug-fueled erections can be on the soft side, leaving many men feeling disappointed.

Bottom line: If you've never tried an erection medication, you're in the majority. But if you buy cheap viagra online use one, you — and your partner — will likely be happiest with one that lasts the longest.

For now, according to the latest surveys, that's Cialis. Michael Castleman, publisher of the website GreatSexAfter40.com, writes about sex for AARP.

Why long-married couples are splitting up One job where it pays to be in your 60s Affordable Care Act questions?

See the AARP home page for deals, savings tips, trivia and more. Viagra (sildenafil) Viagra is a brand-name prescription drug that’s approved to treat erectile dysfunction (ED).

With ED, you’re unable to have or maintain an erection. Viagra is approved for this use in males ages 18 years and older.

It belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. (A class of drugs is a group of medications that act in a similar way.) Viagra works by increasing blood flow to your penis, which helps you have and keep an erection.

But this drug only works if you’re sexually aroused.

In most cases, it should be taken about an hour before sexual activity, but it can be taken 30 minutes to 4 hours beforehand. Viagra is available in three strengths: 25 mg, 50 mg, and 100 mg.

In several clinical studies, Viagra was effective in treating ED.

In these studies, men who used the drug had an improved ability to have and keep erections that allowed for successful sex.

Across the studies,

between

43% and 83% of men who took Viagra had improved erections. (These rates varied depending on the cause of their ED and the dosage of Viagra being used.) In comparison, improved erections occurred in 10% to 24% of men who took a placebo (no active drug). To learn more about Viagra’s effectiveness, see the “Viagra uses” section below.

A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug.

The following lists contain some of the key side effects that may occur while taking Viagra.

These lists don’t include all possible side effects.

For more information on the possible side effects of Viagra, talk with your doctor or pharmacist.

They can give you tips on how to deal with any side effects that may be bothersome. Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved.

If you would like to report to the FDA a side effect you’ve had with Viagra, you can do so through MedWatch.

Mild side effects of Viagra can include:* headache flushing indigestion mild and temporary vision changes, such as a blue tinge in your vision, blurred vision, and sensitivity to light nasal congestion (stuffy nose) back pain muscle pain nausea dizziness rash. Most of these side effects may go away within a few days or a couple of weeks.

But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Viagra. To learn about other mild side effects, talk with your doctor or pharmacist, or view the drug’s patient information . Serious side effects from Viagra aren’t common, but they can occur.

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include: Non-arteritic anterior ischemic optic neuropathy (NAION), which is an eye condition that causes damage to your optic nerve.

Symptoms can include: sudden decrease in vision in one or both of your eyes sudden loss of vision in one or both of your eyes Sudden decrease or loss of hearing.

This condition may also involve other symptoms, such as: tinnitus (ringing or buzzing in your ears) dizziness. Other serious side effects, which are explained in more detail below in “Side effect details,” include: allergic reaction priapism (long-lasting and sometimes painful erection) low blood pressure, if Viagra is taken with certain other medications cardiovascular problems, such as heart attack, irregular heartbeat, or stroke, all of which occur mainly in people with heart disease.

You may wonder how often certain side effects occur with this drug .

Here’s some detail on several of the side effects this drug may cause. As with most drugs, some people can have an allergic reaction after taking Viagra.

In clinical studies, less than 2% of people who took Viagra had an allergic reaction.

It’s not known how often allergic reactions occurred in people who took a placebo (no active drug).

Symptoms of a mild allergic reaction can include: skin rash itchiness flushing (warmth and redness in your skin) A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include: swelling under your skin, typically in your eyelids, lips, hands, or feet swelling of your tongue, mouth, or throat trouble breathing.



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