Frequently
Asked Questions
Viagra, Cialis, Levitra,
Propecia, Vaniqa and Xenical
Viagra
What is Viagra?
Viagra is an FDA-approved drug used to treat impotence
in men. Viagra increases the body's ability to
achieve and maintain an erection during sexual
stimulation.
I'm not impotent: will Viagra enhance my sex life?
Many doctors believe it will. "Viagra could
get the healthiest men going as strong as the
Energizer bunny - making their penises harder,
their erections longer, and their comebacks sooner,
some urologists told The [New York] Post."
Pfizer maintains the drug doesn't help men who
aren't impotent. But the firm concedes it didn't
test it on any because it had no reason to.
The Net Doctor Group will not entertain requests
for prescriptions simply to enhance one's sex
life. Only patients with a bonafide sexual dysfunction
should submit a form and prescription request.
Will Women benefit by taking Viagra?
Many doctors believe it will. Pfizer is currently
conducting European tests on the effect of Viagra
on women, and some physicians in the U.S. are
currently prescribing Viagra for the treatment
of female sexual dysfunction. If you are a woman
and wish to be prescribed Viagra, our physicians
will, in some circumstances, prescribe it. You
must submit a valid medical reason why you feel
you would benefit from Viagra, and -after considering
your medical history and the validity of your
request- a determination will be made whether
or not you would be likely to benefit.
What are Viagra's side effects?
In clinical studies, Viagra's adverse effects
were generally transient and mild to moderate
in nature. Side effects include: headache (16%
vs. 4% with Placebo), flushing (10% vs. 1% Placebo)
and dyspepsia (7% vs. 2% placebo).
In higher doses, 3% of patients taking Viagra
developed abnormal vision: color tinge distortion,
and (less often) increased sensitivity to light
and blurred vision. Dyspepsia occurrence rose
in higher doses. Before
proceeding you should read
Pfizer's
Prescription information about Viagra.
How
long Viagra works?
Up
to 4.5-5 hours
Recommended
time to take before sex: 60 minutes
Most
common side effects: Headache, facial flushing,
altered or blueish vision
Who should not take Viagra?
-
Anyone taking nitrates such as nitroglycerine
should not take Viagra
-
Anyone with heart complications should only
take Viagra under the direct supervision of
their local physician.
-
It should be used with caution with men who
have medical conditions that may cause a sustained
erection such as sickle cell anemia, multiple
myeloma, or leukemia.
-
It should be used with caution in patients
with anatomical deformation of the penis
Cialis
What
is Cialis?
Cialis
is a prescription medicine taken by mouth for
the treatment of erectile dysfunction (ED) in
men.
ED
is a condition where the penis does not harden
and expand when a man is sexually excited, or
when he cannot keep an erection. A man who has
trouble getting or keeping an erection should
see his doctor for help if the condition bothers
him. CIALIS may help a man with ED get and keep
an erection when he is sexually excited.
CIALIS
does not:
cure ED
increase a man's sexual desire
protect a man or his partner from sexually transmitted
diseases, including HIV. Speak to your doctor
about ways to guard against sexually transmitted
diseases.
serve as a male form of birth control
CIALIS is only for men with ED. CIALIS is not
for women or children. CIALIS must be used only
under a doctor's care.
How
does CIALIS work?
When
a man is sexually stimulated, his body's normal
physical response is to increase blood flow to
his penis. This results in an erection. CIALIS
helps increase blood flow to the penis and may
help men with ED get and keep an erection satisfactory
for sexual activity. Once a man has completed
sexual activity, blood flow to his penis decreases,
and his erection goes away.
Who
can take CIALIS?
Talk
to your doctor to decide if CIALIS is right for
you.
CIALIS
has been shown to be effective in men over the
age of 18 years who have erectile dysfunction,
including men with diabetes or who have undergone
prostatectomy.
Who
should not take CIALIS?
Do
not take CIALIS if you:
take any medicines called "nitrates".
Nitrates are commonly used to treat angina. Angina
is a symptom of heart disease and can cause pain
in your chest, jaw, or down your arm.
Medicines called nitrates include nitroglycerin
that is found in tablets, sprays, ointments, pastes,
or patches. Nitrates can also be found in other
medicines such as isosorbide dinitrate or isosorbide
mononitrate. Some recreational drugs called "poppers"
also contain nitrates, such as amyl nitrate and
butyl nitrate. Do not use CIALIS if you are using
these drugs. Ask your doctor or pharmacist if
you are not sure if any of your medicines are
nitrates.
take medicines called "alpha blockers",
other than Flomax® 0.4 mg daily. Alpha blockers
are sometimes prescribed for prostate problems
or high blood pressure. If CIALIS is taken with
alpha blockers other than Flomax® 0.4 mg daily,
your blood pressure could suddenly drop to an
unsafe level. You could get dizzy and faint.
you have been told by your healthcare provider
to not have sexual activity because of health
problems.Sexual activity can put an extra strain
on your heart, especially if your heart is already
weak from a heart attack or heart disease.
are allergic to CIALIS or any of its ingredients.
The active ingredient in CIALIS is called tadalafil.
What should you discuss with your doctor before
taking CIALIS?
Before
taking CIALIS, tell your doctor about all your
medical problems, including if you:
have heart problems such as angina, heart failure,
irregular heartbeats, or have had a heart attack.
Ask your doctor if it is safe for you to have
sexual activity.
have low blood pressure or have high blood pressure
that is not controlled
have had a stroke
have liver problems
have kidney problems or require dialysis
have retinitis pigmentosa, a rare genetic (runs
in families) eye disease
have stomach ulcers
have a bleeding problem
have a deformed penis shape or Peyronie's disease
have had an erection that lasted more than 4 hours
have blood cell problems such as sickle cell anemia,
multiple myeloma, or leukemia
Can other medications affect CIALIS?
Tell
your doctor about all the medicines you take including
prescription and non?prescription medicines, vitamins,
and herbal supplements. CIALIS and other medicines
may affect each other. Always check with your
doctor before starting or stopping any medicines.
Especially tell your doctor if you take any of
the following:
medicines called nitrates.
medicines called alpha blockers. These include
Hytrin® (terazosin HCl), Flomax® (tamsulosin
HCl), Cardura® (doxazosin mesylate), Minipress®
(prazosin HCl) or Uroxatral® (alfuzosin HCl).
ritonavir (Norvir®) or indinavir (Crixivan®)
ketoconazole or itraconazole (such as Nizoral®
or Sporanox®)
erythromycin
other medicines or treatments for ED
How should you take CIALIS?
Take
CIALIS exactly as your doctor prescribes. CIALIS
comes in different doses (5 mg, 10 mg, and 20
mg). For most men, the recommended starting dose
is 10 mg. CIALIS should be taken no more than
once a day.Some men can only take a low dose of
CIALIS because of medical conditions or medicines
they take. Your doctor will prescribe the dose
that is right for you.
If you have kidney problems, your doctor may start
you on a lower dose of CIALIS.
If you have kidney or liver problems or you are
taking certain medications, your doctor may limit
your highest dose of CIALIS to 10 mg and may also
limit you to one tablet in 48 hours (2 days) or
one tablet in 72 hours (3 days).
Take one CIALIS tablet before sexual activity.
In some patients, the ability to have sexual activity
was improved at 30 minutes after taking CIALIS
when compared to a sugar pill. The ability to
have sexual activity was improved up to 36 hours
after taking CIALIS when compared to a sugar pill.
You and your doctor should consider this in deciding
when you should take CIALIS prior to sexual activity.
Some form of sexual stimulation is needed for
an erection to happen with CIALIS. CIALIS may
be taken with or without meals.
Do
not change your dose of CIALIS without talking
to your doctor. Your doctor may lower your dose
or raise your dose, depending on how your body
reacts to CIALIS.
Do
not drink alcohol to excess when taking CIALIS
(for example, 5 glasses of wine or 5 shots of
whiskey). When taken in excess, alcohol can increase
your chances of getting a headache or getting
dizzy, increasing your heart rate, or lowering
your blood pressure.
If
you take too much CIALIS, call your doctor or
emergency room right away.
What
are the possible side effects of CIALIS?
The
most common side effects with CIALIS are headache,
indigestion, back pain, muscle aches, flushing,
and stuffy or runny nose. These side effects usually
go away after a few hours. Patients who get back
pain and muscle aches usually get it 12 to 24
hours after taking CIALIS. Back pain and muscle
aches usually go away by themselves within 48
hours. Call your doctor if you get a side effect
that bothers you or one that will not go away.
CIALIS
may uncommonly cause:
an erection that won't go away (priapism). If
you get an erection that lasts more than 4 hours,
get medical help right away. Priapism must be
treated as soon as possible or lasting damage
can happen to your penis including the inability
to have erections.
vision changes, such as seeing a blue tinge to
objects or having difficulty telling the difference
between the colors blue and green.
These are not all the side effects of CIALIS.
For more information, ask your doctor or pharmacist.
How
should CIALIS be stored?
Store CIALIS at room temperature between 59°
and 86°F (15° and 30°C).
Keep CIALIS and all medicines out of the reach
of children.
CIALIS
is not for everyone. Men taking any form of nitrates
(often used to control chest pain) should never
take CIALIS, as the combination may cause an unsafe
drop in blood pressure. Men taking medicines called
"alpha blockers" (sometimes prescribed
for prostate problems or high blood pressure),
with the exception of Flomax® (tamsulosin
HCl) 0.4 mg once-daily, should not take CIALIS.
This combination could also cause an unsafe drop
in blood pressure.
The
most common side effects with CIALIS were headache,
upset stomach, backache, and muscle ache. Men
who experience an erection for more than four
hours should seek immediate medical attention.
Men should discuss their health status with their
doctors to ensure that CIALIS is right for them
and that they are healthy enough to engage in
sexual activity. CIALIS does not protect a man
or his partner from sexually transmitted diseases,
including HIV.
Levitra
Levitra
How
long it works: Up to 5 hours
Recommended
time to take before sex: 25 to 60 minutes
Most
common side effects: Headache, facial flushing
What
is Levitra?
Levitra is the brand-name for vardenafil, a new
tablet-based oral treatment for erectile dysfunction
(ED), which is licensed for prescription in the
UK and other countries, enabling you to buy it
online. Levitra has proved highly successful in
clinical trials and is generating major interest
as a real alternative to Viagra, Uprima and Cialis.
Levitra
is a new oral PDE-5 inhibitor for the treatment
of male erectile dysfunction (ED). Phosphodiesterase
type 5 (PDE-%) is the predominate enzyme found
in human penile erectile tissue and is associated
with erections. PDE-5 inhibitors such as Levitra
typically work by blocking this enzyme to enhance
or prolong the erectile process.
Levitra
is marketed by the leading pharmaceutical companies
Bayer and GlaxoSmithKline, through a worldwide
co-promotion and co-development agreement.
How
effective is Levitra for Impotence?
Levitra has sparked major interest worldwide following
the results of an in-depth clinical study. The
study of over 800 men with ED showed:
The
vast majority treated with Levitra experienced
a reliable improvement in their erectile function
from the first time they took the drug, and each
time they took it afterward.
74% of men taking a 20 mg dose of Levitra and
77% taking a 10 mg dose were able to have intercourse
on their first attempt, compared with 45% taking
a placebo.
Those men receiving treatment who were successful
the first time continued to achieve successful
penetration in 91% of their subsequent attempts.
These results - recently presented at the 10th
World Congress of the International Society for
Sexual and Impotence Research in Montreal - have
been welcomed by clinicians. This initial research
has shown that Levitra gives more consistent results
than other treatments on repeated use.
Levitra
and ED-related depression
A second study has shown how effective Levitra
was in treating the depressive symptoms experienced
by men with ED. This study showed men taking Levitra
reported improved erections and fewer depressive
symptoms than those men taking a placebo.
Levitra
and ED after prostate surgery
Levitra is extremely effective in treating ED
following prostate cancer surgery. Another trial
involving 440 men aged 44 - 77 years with ED
Following
a prostate surgery found:
71%
of patients who had undergone prostate removal
reported significant improvements in erections
with Levrita (20mg) versus 12 per cent in men
taking placebo.
The study concluded that this was an important
finding for Levitra, as ED following prostatectomy
is usually severe.
Is
Levitra more effective than Viagra?
There is currently no direct evidence to compare
the effectiveness of treatments such as Levitra,
against others such as Viagra and Uprima. However,
early findings do indicate that Levitra may be
especially effective in treating specific types
of ED, such as ED resulting from prostate surgery.
Does
Levitra have side-effects?
Those involved in the clinical trials reported
mild / moderate side effects with the treatment,
these mostly included headaches, flushing and
rhinitis (nasal congestion).
Who
should avoid taking Levitra?
Levitra
should not be taken if you are taking nitrates
or nitric oxide donors (these medications are
used to treat angina or chest pain). It is also
contraindicated in men whom sex is inadvisable
and men older than 75 years old who concomitantly
use potent CYP 3A4 inhibitors (such as ritonavir,
indinavir, ketoconazole and itraconazole). The
safety of Levitra has not been studied in these
subgroups and should not take Levitra until further
studies are available: severe hepatic (liver system)
impairment , endstage renal disease requiring
dialysis, hypotension, recent history of stroke
or heart attack, unstable angina, and known hereditary
retinal degenerative disorders.
Propecia
or Proscar
What is Finasteride?
Finasteride (Propecia, Proscar)
is the first-ever FDA approved tablet proven to
be effective for hair loss. Finasteride
blocks an enzyme that normally converts testosterone
to DHT, the primary hormone which is known to
cause hair loss.
Clinical studies have shown Finasteride to be
80% effective in halting hairloss, and 30-50%
effective in restoring hair growth.
The recommended dosage for
Finasteride is 1mg daily. Taking more does not
make the drug work better. The medication
Propecia is a 1mg Finasteride tablet; Proscar,
which is used for a prostate condition is a 5mg
tablet of the same ingredient, Finasteride. For
cost savings, many patients prefer to divide a
Proscar tablet into 4 or 5 pieces and take one-fourth
or one-fifth of the Proscar tablet per day, thereby
enjoying the same benefits of taking Propecia
at a savings of approximately 70%. Before proceeding
please read Merck's
prescribing information
about Propecia.
What are the side effects of Finasteride?
In clinical studies, side
effects from Propecia were uncommon and did not
effect most users. The following side effects
were experienced by a small number of patients:
less desire for sex, difficulty in achieving an
erection, and a decrease in the amount of semen.
These side effects occurred in less than 2% of
men, and went away when Propecia therapy discontinued.
The side effects also disappeared in most men
who continued taking Propecia.
The active ingredient in Propecia (Finasteride)
is also used in a 5mg tablet (Proscar, five times
the dose of a Propecia tablet) to treat enlargement
of the prostate. Additional side effects were
reported by men taking Proscar including problems
with ejaculation, breast swelling and/or tenderness
and allergic reactions including lip swelling
and rash. In clinical studies with Propecia, these
side effects were reported as often in men taking
the placebo as in those taking Proscar.
Why do you prescribe Proscar more than Propecia?
The monthly cost for taking
Propecia (1 mg Finasteride tablet per day) is
approximately $60. By dividing Proscar tablets
into quarters with a pill cutter and taking 1/4
of a Proscar tablet per day, your monthly cost
(if you purchase your Proscar from us) is $22.50,
a savings of 62%. Although it is more difficult
to divide a Proscar tablet into 5 pieces (as opposed
to 4), many patients choose to do so and save
even more: by cutting the pill into fifths, patients
save 70% over Propecia by spending only $18 a
month. For those who don't
care to save 70% by dividing Proscar tablets,
our physicians will gladly prescribe 3 months
of Propecia if your medical history suggests you
will benefit from Finasteride therapy. This is
an example of what we call patient empowerment:
fostering a partnership with your physician in
the decision process which allows you to take
an increased and active role in your own plan
of care.
How do I divide Proscar tablets?
Pill cutters are available in most major pharmacies
in the US. If you are unable to locate a pill
cutter, we will mail you one for a charge of US$
10, which includes shipping anywhere in the world.
Do you offer prescriptions for medications other
than Finasteride and Viagra?
At this time we are only offering consultations
for patients seeking Proscar/Propecia Viagra and
Xenical. No other medications are being prescribed.
Xenical
What is Xenical?
XENICAL
is an oral prescription weight loss medication
used to help obese people lose weight and keep
this weight off. XENICAL works in your intestines,
where it blocks some of the fat you eat from being
absorbed. This undigested fat is then eliminated
in your bowel movements. XENICAL should be used
together with a reduced-calorie diet that your
doctor will recommend.
Excess
weight has been proven to contribute to an increased
risk of developing many medical problems, including
high blood pressure, high cholesterol, heart disease,
and diabetes. The consumption of excess fatty
food and calories plays a significant role in
the development of excess weight. While fat is
an important component of a balanced diet, the
consumption of excess fat contributes to excess
body weight, since fat provides twice the number
of calories per gram of weight as carbohydrates
and protein. Reduction of dietary fat intake is
one potential way of losing weight.
How does XENICAL work?
If
you eat an excess amount of fat or calories, the
excess is stored as fat by the body resulting
in weight gain. When you eat fat, your body breaks
it down into its simplest components so that it
can be absorbed. Enzymes in your intestinal tract,
called lipases, help digest (or breakdown) fat.
When you take XENICAL with meals, XENICAL attaches
to the lipases and blocks them from breaking down
some of the fat you have eaten. The undigested
fat cannot be absorbed and is eliminated in your
bowel movements. By working this way, XENICAL
helps block about 30% of the fat eaten in food
from being absorbed by your body.
Following
one year of treatment, XENICAL in combination
with diet was shown to be more effective in reducing
weight than diet alone. In most cases, weight
loss was gradual. Patients treated with XENICAL
and a reduced-calorie diet for one year lost an
average of 13.4 pounds while those on a reduced-calorie
diet alone lost 5.8 pounds.
Who should use XENICAL?
A
weight loss program that includes a reduced-calorie
diet and appropriate physical activity may be
adequate in some patients. You should discuss
with your doctor or other health care provider
whether XENICAL should be added to such a program.
XENICAL
may be right for you if you are considerably overweight
(at least 30% above ideal weight or a body mass
index of 30 or greater). XENICAL may also be right
for you if you are overweight (at least 20% above
ideal weight or a body mass index of 27 or greater)
and also have other risk factors such as high
blood pressure, high cholesterol, heart disease,
or diabetes. For more information please visit
www.xenical.com.
Vaniqa
What is Vaniqa?
VANIQA
(pronounced "VAN-i-ka") is a prescription
medication applied to the skin for the reduction
of unwanted facial hair in women. The active ingredient
in VANIQA is eflornithine hydrochloride. VANIQA
also contains ceteareth-20, cetearyl alcohol,
dimethicone, glyceryl stearate, methylparaben,
mineral oil, PEG-100 stearate, phe-noxyethanol,
propylparaben, stearyl alcohol and water.
Now
for the first time, pharmaceutical giant Bristol-Myers
Squibb together with Gillette, the world's largest
manufacturer of razors, have developed Vaniqa
- a cream that can stop facial hair growth. Vaniqa
is available only by prescription and will be
on the market sometime this year pending FDA approval.
It does not appear that that Vaniqa will have
problem winning FDA stamp of approval.
CLINICAL
TRIALS Results of topical dermal studies for contact
sensitization, photocontact sensitization, and
photocontact irritation reveal that under conditions
of clinical use, VANIQA is not expected to cause
contact sensitization, phototoxic, or photosensitization
reactions. Results of the topical dermal study
for contact irritation did reveal that VANIQA
could cause irritation reactions in clinical use
in susceptible individuals or under conditions
of exaggerated use. Two randomized double-blind
studies involving 594 female patients (393 treated
with VANIQA, 201 with vehicle) treated twice daily
for up to 24 weeks evaluated the efficacy of VANIQA
in the reduction of unwanted facial hair in women.
Women in the trial had a customary frequency of
removal of facial hair two or more times per week.
Women with facial conditions such as severe inflammatory
acne, women who were pregnant, and nursing mothers
were excluded from the studies. Physicians assessed
the improvement or worsening from the baseline
condition (Physician’s Global Assessment [PGA]),
48 hours after shaving, of all treated areas.
Statistically significant improvement for VANIQA
versus vehicle was seen in each of these studies
for “marked improvement” or greater response (24-week
time point; pŁ 0.001). Marked improvement was
seen consistently at 8 weeks after initiation
of treatment and continued throughout the 24 weeks
of treatment. Hair growth approached pretreatment
levels within 8 weeks of treatment withdrawal.
The success rate over time is graphically presented
below for each pivotal trial. Findings The latest
results of clinical trials of Vaniqa were recently
presented at the 58th Annual Meeting of the American
Academy of Dermatology in March 2000. The phase
III study included 596 women who were randomized
to use either eflornithine HCl 15% cream or a
placebo cream. The treatment was applied twice
daily to the affected areas for 24 weeks, followed
by an 8-week period of no treatment. The results
of physician's global assessment at the end of
24 weeks demonstrated improvements in the reduction
of facial hair in the women who were treated with
Vaniqa. Seventy percent of the women showed improvement,
with 35% being classified as clinical successes
(marked improvement or clear/almost clear), compared
to 9% in the placebo group. Improvement was observed
as early as 8 weeks after the commencement of
treatment.
Who should not use VANIQA?
You
should not use VANIQA if you are allergic to any
of the ingredients in the cream. All ingredients
are listed on the tube. You should not use VANIQA
if you are less than 12 years of age.
What should you tell your doctor before using
VANIQA?
If
you are allergic to any of the ingredients, tell
your doctor. If you are pregnant or plan to become
pregnant, discuss with your doctor whether you
should use VANIQA during pregnancy. No clinical
studies have been performed in pregnant women.
If you are breast feeding, consult your doctor
before using VANIQA. It is not known if VANIQA
is passed to infants through breast milk. If you
are taking any prescription medicines, non-prescription
medicines or using any facial or skin creams,
check with your physician before use of VANIQA.
How should I use Vaniqa?
Use
VANIQA only for the condition for which it was
prescribed by your doctor. Do not give it to other
people or allow other people to use it. You will
need to continue your normal procedures for hair
removal until desired results have been achieved.
You may then be less bothered by the time spent
in removing hair or the frequency of hair removal.
VANIQA is to be used twice daily, at least eight
hours apart, or as directed by your doctor. VANIQA
is for external use only. Follow the instructions
for application of VANIQA carefully. Apply a thin
layer of VANIQA to the affected areas of the face
and adjacent involved areas under the chin and
rub in thoroughly. You should not wash the treatment
areas for at least 4 hours after application of
VANIQA. VANIQA may cause temporary redness, rash,
burning, stinging or tingling, especially when
the skin is damaged. If irritation continues,
stop use of VANIQA and contact your doctor. Avoid
getting the medication in your eyes or inside
your nose or mouth. If the product gets in your
eyes, rinse thoroughly with water and contact
your doctor. If you forget or miss a dose of VANIQA
do not try to "make it up". Return to
your normal application schedule as soon as you
can. You may use your normal cosmetics or sunscreen
after applying VANIQA, but you should wait a few
minutes to allow the treatment to be absorbed
before applying them. If your condition gets worse
with treatment, stop use of VANIQA and contact
your doctor. Back to Top Are there any side effects?
Use of Vaniqa was associated with few side effects,
most of which were mild. They included stinging,
burning, tingling, pseudofolliculitis barbae,
and acne. Folliculitis (hair bumps) may also occur.
If these persist, consult your doctor.
Are there any side effects?
Use
of Vaniqa was associated with few side effects,
most of which were mild. They included stinging,
burning, tingling, pseudofolliculitis barbae,
and acne. Folliculitis (hair bumps) may also occur.
If these persist, consult your doctor.
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