Ed medicine daily news.

As part of the initial evaluation, your health professional
may:

• Review your risk factors for an erection
  problem. For more information, see the What Increases Your Risk section of this
  topic.
• Ask
  questions about your sexual function.
• Do a
  complete physical examination of the abdomen, penis, prostate, rectum, and
  testicles.
• Do erectile dysfunction remedy
  tests for:
  • Testosterone.
    A low testosterone level may reduce sexual desire, leading to an erection
    problem.
  • Prolactin. A
    high level of prolactin (drug for treatment of erectile dysfunction
    ) may indicate a small tumor in the
    brain, which can affect other hormone levels in the body. When hormone levels
    are affected, an erection problem may result.
  • Thyroid hormone. Either a high or low level of thyroid
    hormone may cause problems with sexual desire or erections.
  • Blood glucose. Elevated blood sugar (glucose) levels
    may indicate the presence of
    diabetes, which can contribute to
    erection problems.

At this point, oral medications such as
Viagra, Levitra, or Cialis are often recommended
unless an easily treated cause (such as a medication side effect or
testosterone cialis generic tadalafil
) has been identified. If oral medications do not work
or your doctor feels more testing is necessary, he or she may recommend:

• Specific tests for erection problems, such as a
  nocturnal penile tumescence testing (rigidity test) and an buy viagra levitra alternative lavitra
  
  injection test. These both help determine whether physical or psychological
  factors are causing your erection problem.
• A psychological
  evaluation, if a psychological issue is suspected.

An
ultrasound may be done if your doctor suspects you
have a circulation problem (peripheral arterial disease). Even if
the blood vessels cannot be repaired, it may be helpful to know if you have
this condition because it may indicate you have a risk for other blood vessel
(vascular) problems. In very rare instances, you may have angiography-an X-ray
test of blood flow through an artery. Its usefulness is limited because
treatment to repair the blood vessels that supply blood to the penis is
appropriate for very few men.

A nutraceutical is a food or part of a food that allegedly provides
medicinal or health benefits, including the prevention and treatment of
disease. Grapefruit juice has been touted as containing many compounds that can
reduce hardening of the arteries (erectile dysfunction pill
) and even the risk of cancer.
Grapefruit juice can, therefore, be justifiably referred to as a classic
nutraceutical. However, for many persons taking certain medications, grapefruit
juice might actually better be termed a “nutrapollutical!”

It turns out that grapefruit juice can directly or indirectly interact in
important ways with a number of medications. This is especially important since
grapefruit juice is consumed by approximately one fifth of Americans for
breakfast - a time of the day when medications also are commonly taken.

Grapefruit juice blocks special enzymes in the wall of the small intestine
that actually destroys many medications and prevents their absorption into the
body. Thus, smaller amounts of the drugs get into the body than are ingested.
When the action of this enzyme is blocked, more of the drugs get into the body
and the blood levels of these medications increase. This can lead to toxic side
effects from the medications.

Amazingly, this remarkable food-drug interaction was discovered completely
by accident over a decade ago! Researchers were investigating whether alcohol
could interact with felodipine (Plendil) and used a solution of alcohol with
grapefruit juice to mask the taste of alcohol for the study. Researchers
discovered that blood levels of felodipine were increased several fold more
than in previous studies. This increased blood level caused an increase in the
effect and side effects of felodipine. Further research revealed that the
grapefruit juice itself was actually increasing the amount of the study drug in
the body.

Research about the interaction of grapefruit juice with drugs suggests that
compounds in grapefruit juice, called furanocoumarins (e.g. bergamottin), may
be responsible for the effects of grapefruit juice. Researchers believe that
furanocoumarins block the enzymes in the intestines that normally break down
many drugs. One glass of grapefruit juice could elicit the maximum blocking
effect, and the effect may persist for longer than 24 hours. Since the effects
can last for such a prolonged period of time, grapefruit juice does not have to
be taken at the same time as the medication in order for the interaction to
occur. Therefore, unlike similar interactions, where the interaction can be
avoided by separating the administration of the two interacting agents by a
couple of hours, administration of grapefruit juice with susceptible drugs
should be separated by 24 or more hours to avoid the interaction. Since this is
not practical for individuals who are taking a medication daily, they should
not consume grapefruit juice when taking medications that are affected by
grapefruit juice.

The grapefruit juice-drug interaction can lead to unpredictable and
hazardous levels of certain important drugs.

These are medications with which grapefruit juice should NOT be consumed
unless advised by a doctor:

• Statins (Cholesterol Drugs): lovastatin (Mevacor), discount generic viagra
  Lipitor,
  Simvastatin Zocor, simvastatin/ezetimibe Vytorin
• Online purchase viagra
  : Ebastine, Seldane (terfenadine, taken off the U.S.
  market)
• Calcium Channel Blockers (Blood Pressure Drugs): nimodipine (Nimotop),
  Felodipine (Sildenafil citrate, Plendil), Pranidipine, nisoldipine (Sular),
  nicardipine (Cardene), verapamil (Verelan)
• Psychiatric Medications: buspirone (Buspar), triazolam (Halcion),
  carbamazepine (Tegretol), diazepam (Valium), midazolam (Versed), sertraline
  (Zoloft)
• Intestinal Medications: cisapride, taken off the U.S. market
  (Propulsid)
• Immune Suppressants: cyclosporine (Neoral), (tacrolimus) Prograf
• Pain Medications: Methadone
• Impotence Drug (erectile dysfunction): sildenafil (Viagra)
• Ant-HIV medication : saquinavir (Invirase)
• Free generic viagra
  : amiodarone (Cordarone)

Toxic blood levels of these medications can occur when patients taking them
consume grapefruit juice. The high blood levels of the medications can cause
damage to organs or impair the organs normal function, which can be dangerous.
If you or a family member are taking any of these medications, beware of the
“nutrapollutical” grapefruit juice.

Sept. 7, 2006 — The first drug developed specifically for premature
ejaculation performed well in two clinical trials, but the new treatment
probably won’t be available in the U.S any time soon.

Men in the study who took the experimental drug Dapoxetine, developed by
Johnson & Johnson Pharmaceuticals in conjunction with ALZA Corp., were able
to maintain erections longer than men who took placebos.

Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) but is
slightly different from the SSRIs (such as Zoloft, Paxil, and Prozac) widely
prescribed for depression and other
erectile dysfunction pills
disorders.

The drug was designed to be taken as needed, one to three hours before sex,
instead of every day. Also, it is eliminated from the body more quickly than
other SSRIs.

Hopes that Dapoxetine would become the first drug approved for premature
ejaculation dimmed last October, when the FDA sent a “not approvable”
letter to the manufacturer.

The FDA’s concerns about the drug were not made public. In a news release,
ALZA Corp. promised to “address questions raised in the FDA
letter.”

A meridi online phentermine prescription viagra
for Johnson & Johnson told WebMD Thursday that the
company “remains committed to the global development” of
Dapoxetine.

A Common Complaint

Although it is rarely talked about, premature ejaculation is a common
problem, affecting as many as a third of men.

Far fewer men seek treatment, however.

Those who do are often advised on practice techniques to help. Some receive
a prescription for a traditional, long-acting SSRI, since delayed ejaculation
is a common side effect among men who take SSRIs for depression.

This use of traditional SSRIs would be considered off-label since the
medications are not specifically indicated for this problem.

Other potential sexual side effects of SSRIs include erectile
dysfunction and loss of libido, however, making the traditional
citrate pfizer sildenafil less than ideal for treatment of premature ejaculation, Jon L.
Pryor, MD, tells WebMD. Pryor is a urology professor at the University of
Minnesota.

Longer-Lasting Sex

In the manufacturer-funded study, Pryor and colleagues compared 30-milligram
and 60-milligram doses of Dapoxetine to a placebo in roughly 2,600 men with
moderate to severe premature ejaculation.

Prior to treatment, the men’s average ejaculation time was just under a
minute.

With treatment, the average time to ejaculation was 1.75 minutes in the
placebo-treated men, 2.78 minutes in the men treated with 30 milligrams of
Dapoxetine, and 3.32 minutes in the men treated with 60 milligrams of the drug.
The study lasted three months.

“A couple of minutes may not sound like much but for these guys it was
huge,” Pryor says.

Men who took the short-acting SSRI also reported having more control over
their ejaculations than the placebo-treated men; and they and their female
partners reported improved sexual satisfaction.

The Snicker Factor

Pryor says an effective, specific treatment could do for premature
ejaculation what Viagra did for erectile dysfunction
– taking away the ’snicker’ factor by stimulating open discussion about the
disorder.

“Viagra wasn’t a magic pill, but it did bring ED into the open and men
who had it learned that they were not alone,” he says. “The discussion
that followed stimulated research that led to other treatments.

“Premature ejaculation is more common than ED, but no one talks about
it,” adds Pryor.

Ira Sharlip, MD, a urology professor at the University of California, San
Francisco, tells WebMD there is a definite need for an effective treatment for
premature ejaculation.

“I have patients who are really disturbed by this issue, and so are
their wives,” he says. “The current treatments are far from
perfect.”

Sharlip says traditional SSRIs work best when they are taken every day, and
even then they only work for around two-thirds of patients.

“Premature ejaculation is certainly one of the most common forms of
sexual dysfunction among men,” Sharlip says. “Not everyone who has it
is bothered by it, but for those who are, it can be a very big
problem.”

In the 1970s, parents worried that their longhaired, bell-bottomed teenagers were getting drunk or smoking marijuana. Today, dangers also come in the form of viagra vs cialis
medicines — from opioid pain relievers such as OxyContin to ADHD drugs such as Ritalin.

Prescription drug abuse appears to be on the rise in this country. Wilson Compton, MD, director of the division of epidemiology services and prevention research at the National Institute on Drug Abuse (NIDA), says the reasons aren’t clear.

But he suspects that increasing numbers of ed pills
written for certain drugs, such as ADHD medications, afford greater opportunity. “A certain portion of those will be diverted for abuse purposes,” he says.

Compton also says that in the current environment it seems almost normal to pop pills. “All of the advertising for pills may play a role in our ed tabs
to try them.”

Roughly 6.3 million Americans report that they’re currently using prescription drugs for nonmedical reasons, according to the U.S. Department of Health and Human Services.

Prescription drug abuse knows no age. The elderly are vulnerable because they’re more likely to take many medications, often long term. Also, women may be as much as 55% more likely as men to be prescribed drugs that can be abused, such as narcotics and tranquilizers; therefore, their risk is greater, according to the NIDA.

Teens and Prescription Drug Abuse

Abuse is most common among young people, Compton says. “Prescription drug abuse — like most drug abuse — tends to peak in the teens and 20s,” he tells WebMD.

Almost one in five teens — roughly 4.5 million — has tried getting high with prescription drugs (typically with pain relievers such as Vicodin or OxyContin, or stimulants, such as Ritalin and Adderall). That’s according to a recent national study on teen abuse of prescription and over-the-counter drugs by the nonprofit Partnership for a Drug-Free America.

The study also found that teens’ abuse of prescription and over-the-counter medicines is equal to or higher than abuse of drugs such as cocaine and crack, Ecstasy, methamphetamine, and heroin.

Some teens say that prescription medicines are much safer to abuse than illegal drugs. But just because prescription drugs aren’t cooked up in someone’s garage doesn’t mean that they’re safe. According to Compton, the main risk for many drugs is addiction.

“As people try these substances, some of them will find that they really like them,” he says. “They take more of them and they continue to take them, even when they no longer want to. And that’s the hallmark of addiction. It creeps up on people in very subtle and unexpected ways. No one starts out taking a drug, saying, ‘I want to be an addict.’”

Besides addiction, prescription drug abuse can bring on a host of health problems, such as irregular heartbeats, seizures, hostility, and paranoia — even infections with HIV or other agents if someone dissolves and injects pills to get a quick high. Overdoses can be fatal. To combat the potential for abuse, some drug companies have marketed newer, erectile dysfunction pill
versions that are harder to misuse.

It’s important to remember that most people can reap benefits from prescription drugs without problems. But a minority will run into trouble. “Using these substances outside of a doctor’s prescription is already a red flag and a warning,” Compton says.

Which drugs are commonly abused? Who’s most erectile dysfunction medication
? How could they be endangering their health? Here’s the rundown.

You may need to take:

• Aspirin. If you are age 30 or older, talk to
  your health professional about taking a low-dose, or baby, aspirin daily to
  prevent
  heart attack,
  stroke, or other large blood vessel disease (macrovascular disease).¹
• An angiotensin-converting enzyme (ACE) inhibitor,
  angiotensin II receptor blocker, or other medication if you have
  high blood pressure or have protein in your urine.
  These medications can slow or prevent further damage to your
  kidneys.
• Medications for digestive problems. The type of medication
  will depend on the problem you are having. For example, if you have
  erectile dysfunction treatment
  , you may take erectile dysfunction new drugs
  (Reglan),
  domperidone (available in Europe and Canada), or
  erythromycin.
• Nonprescription pain relievers, creams, or
  prescription oral or injection medications if you have pain from
  peripheral neuropathy.
• Viagra, Levitra, or
  Cialis if you have erection problems. These medications can aggravate heart
  problems in some people, especially those taking nitrate medications (such as
  erectile pill). Check with your doctor before taking any of these
  medications.

Medication Choices

Medications for some complications include:

• Aspirin after a
  heart attack or stroke or to prevent these.
• Statins such as atorvastatin (Lipitor), simvastatin
  (Zocor), or pravastatin (Pravachol), to help prevent heart attack or
  stroke.
• Angiotensin-converting enzyme (ACE) inhibitors or
  angiotensin II receptor blockers (ARBs) for diabetic
  nephropathy.
• Phosphodiesterase-5 inhibitors (PDE-5
  inhibitors), such as Viagra, Levitra, or Cialis if you have erection
  problems. Check with your doctor before taking any of these medications.

What to Think About

Keep your blood sugar levels tightly within a normal or
near-normal range by taking your oral diabetes medication (and, in some cases,
insulin) as prescribed.

If you have
high cholesterol, take cholesterol-reducing
medications (such as statins) to keep your
LDL cholesterol level less than 100 mg/dL (2.60
mmol/L), your
triglyceride level less than 150 mg/dL (1.7 mmol/L),
and if possible, your
HDL cholesterol level more than 40 mg/dL (1.15 mmol/L)
in men. Women may need an HDL level of more than 50 mg/dL.⁷ See the topic
High Cholesterol.

If you have high blood pressure, take medications to keep your
blood pressure consistently below 130/80 mm Hg. If your
systolic blood pressure is between 130 mm Hg and 139
mm Hg or your
diastolic blood pressure is between 80 mm Hg and 89 mm
Hg, you may try some lifestyle or behavioral therapy for 3 months before
starting medication.⁶ For more information, see the
topic
High Blood Pressure (Hypertension).