COMPOUNDING PHARMACIES

COMPOUNDING PHARMACIES

When it comes to getting your prescription filled, you have more than one option: you can go to a standard pharmacy or drugstore, or you can go to a compounding pharmacy. A compounding pharmacy prepares a specialized drug product to fulfill an individual’s specific needs that cannot be met by a standard prescription.
For example: if you have difficulty swallowing a tablet or capsule, you can get your prescription prepared into a solution. Many drugs contain dyes and fillers such as lactose (e.g., decongestants, antibiotics) that can cause allergic reactions in a small percentage of people. If you are one of those people, you can get a compounding pharmacist to prepare your prescription without the offending ingredient. And if your child refuses to take a bad-tasting medication, flavoring it with cherry or grape can make the medicine go down.
The Food and Drug Administration (FDA) defined the limits of legitimate compounding under the FDA Modernization Act of 1997. However, although compounding pharmacists begin with an FDA-approved drug, changes they make to any given drug may convert an approved drug into an unapproved one. That means there is the potential for reactions to occur between ingredients because of the change that was made.

Compounding pharmacies are an option. Pharmacist and former FDA pharmacy compounding steering committee member Robert Tonelli said, “Whenever possible, FDA would recommend that patients use an approved drug. We have more data and reporting requirements on those to assure us of their safety and effectiveness.”

WHEN PRESCRIPTION DRUGS ARE SOLD OVER-THE-COUNTER

OVER-THE-COUNTER PHARMACIES

More than 600 ingredients or dosages that once were available by prescription only are now available over-the-counter (OTC) During the past twenty-five years, the FDA has authorized the over-the-counter sale of more than fifty drugs that previously were sold by prescription. Most of those drugs fall into the categories of decongestants, antihistamines, analgesics (painkillers), anti-ulcer, and anti-itch medications.
Drug companies like to market a prescription drug as OTC because it means more profits for them. But there is also an advantage for consumers: convenience. You don’t need to go to your health-care practitioner and get a prescription for your medications. That’s where you may also save money, depending on the type of insurance coverage you have. Some OTC versions of prescription drugs are less expensive, but in many cases they are not And while some insurance plans pay most or all of a prescription’s cost, you must foot the bill for OTC drugs.
Making the Transition to OTC. Not just any drug can make the transition from prescription to OTC. The FDA has criteria a prescription drug must meet before it can make the transition.

• The prescription drug must have at least a three-year history of safe use

• The OTC drug cannot cause serious side effects if it is misused

• The medical condition the OTC drug will treat must be self-diagnosable. That’s why you can buy OTC drugs for the common cold or a headache but not for high cholesterol or Alzheimer’s disease

• The OTC drug should relieve symptoms

In 2000, Merck & Co., maker of lovastatin (Mevacor), and Bristol-Myers Squibb, maker of pravastatin (Pravachol), petitioned the FDA to sell these two cholesterol-lowering prescription drugs over-the-counter. However, in 1997, the FDA had clearly stated in its “Guidance for Industry” statement that cholesterol-lowering drugs should be available by prescription only. One reason is that these drugs are used to treat a condition that is not self-recognizable. You must be tested for your cholesterol level, and your levels need to be monitored by a health-care practitioner. Thus cholesterol-lowering drugs do not meet one of the criteria set forth by the FDA, and Merck and Bristol-Myers Squibb were turned down.

The Safety Factor. Just because a drug is OTC does not mean it can’t cause serious side effects if it isn’t taken properly. For example: aspirin, the “wonder drug,” can cause bleeding of the stomach if taken in too high doses and, among a small percentage of people, even when taken at recommended doses. Thus any drug, prescription or OTC, should be taken according to directions or your health-care practitioner’s instructions, and regarded with caution.

How to choose online pharmacy

ONLINE PHARMACIES: ARE THEY SAFE?

It seems that you can buy just about anything over the Internet That may be a good thing when it comes to purchasing CDs and watches, but it may not be so good when it comes to prescription medications.

Convenience and lower cost are the two main reasons people say they like to get their prescriptions from online pharmacies. If you don’t want to drive to a drugstore to get your prescription and you can wait a few days or a week to get your prescription in the mail, then you may find online pharmacy services convenient. However, if your child develops an earache and you want antibiotics immediately, an online pharmacy won’t be able to help you.

If you are homebound or live far from a pharmacy, online drug availability can be very convenient Online pharmacies also allow you to comparison shop for price and availability. When it comes to cost, you must consider the cost of shipping. Once you tack on postage and handling fees, the cost of your prescription may meet or exceed your neighborhood pharmacy.
The Food and Drug Administration (FDA) warns consumers that they should beware of shady websites, undocumented claims, and illegal deals when it comes to online prescription drugs. Here are some of the factors you should consider before you make an online purchase.

Suspect any online pharmacy that does not require you to mail in your prescription, or one that does not verify your prescription with your prescribes These practices suggest that these pharmacies have little or no regard for their customers’ health or welfare, because they do not bother to make sure individuals are getting the proper prescription and that the drugs are indeed going to the person for whom they were intended.

Suspect any online pharmacy that dispenses drugs based solely on a questionnaire you are asked to complete online.

There is no way the recipients of your questionnaire will know whether you are telling the truth, and basically anyone can fill out a questionnaire and say they need a particular drug. Some state medical boards are taking action against health-care practitioners who prescribe medications over the Internet. Why? Because these health-care practitioners do not know you or the condition of your health. They can only rely on what you tell them.

• Make sure the website offers a street address for the pharmacy service and a toll-free number you can call. If these are not available, do not use the site.

• The pharmacy should have a pharmacist available to answer your questions, either via phone or E-mail correspondence. Preferably this service should be free. If no pharmacist is available, do not purchase from that site.

• Be wary of websites that offer only a few drugs, especially “lifestyle” drugs—those that help you lose weight, improve your sexual performance, or grow hair. Such sites may not be legitimate.

• Review the pharmacy’s guidelines regarding confidentiality of patient health-care information.
  Do not patronize any website that makes unrealistic claims about “magic cures” or quick-fix medications for serious medical conditions.

• Question any site that claims to be backed by well-known medical institutions or government agencies without first checking to see if their claims are true. This means you’ll need to contact the institutions or agencies named (which can be done easily online via their public information offices), but it’s better to be safe than sorry.

• Buy from nationally recognized chains (e.g., CVS, Walgreen’s, Drug Emporium) or established prescription businesses (e.g., American Association of Retired Persons Pharmacy Service).

• Beware of foreign websites. They may be dispensing sub-potent, outdated, contaminated, or counterfeit products. Even though the Food and Drug Administration contacts foreign pharmacy sites and questions their activities, many continue to operate.

• Look for a site that offers a money-back guarantee and promises reasonable delivery times.

• Look for the Verified Internet Pharmacy Practices Site seal on the websites you visit This seal is an endorsement from the National Association of Boards of Pharmacy (NABP), an organization that can tell you whether a particular online pharmacy is in good standing.

• You can also contact each state board of pharmacy (the state in which the online pharmacy is physically located) to verify the pharmacy’s legitimacy.

GLUCOPHAGE metformin hydrochloride tablets

GLUCOPHAGE (metformin hydrochloride tablets)

and

GLUCOPHAGE XR (metformin hydrochloride extended-release tablets)

Read this information carefully before you start taking this medicine and each time you refill your prescription There may be new information. This information does not take the place of your doctor’s advice. Ask your doctor or pharmacist if you do not understand some of this information or if you want to know more about this medicine.

What are GLUCOPHAGE and GLUCOPHAGE XR?

GLUCOPHAGE and GLUCOPHAGE XR are used to treat type 2 diabetes. This is also known as non-insulin-dependent diabetes mellitus. People with type 2 diabetes are not able to make enough insulin or respond normally to the insulin their bodies make. When this happens, sugar (glucose! builds up in the blood. This can lead to serious medical problems including kidney damage, amputations, and blindness. Diabetes is also closely linked to heart disease. The main goal of treating diabetes is to lower your blood sugar to a normal level.

High blood sugar can be lowered by diet and exercise, by a number of medicines taken by mouth, and by insulin shots. Before you take GLUCOPHAGE or GLUCOPHAGE XR, try to control your diabetes by exercise and weight loss. While you take your diabetes medicine, continue to exercise and follow the diet advised for your diabetes. No matter what your recommended diabetes management plan is, studies have shown that maintaining good blood sugar control can prevent or delay complications of diabetes, such as blindness.

GLUCOPHAGE and GLUCOPHAGE XR have the same active ingredient. However, GLUCOPHAGE XR works longer in your body. Both of these medicines help control your blood sugar in a number of ways. These include helping your body respond better to the insulin it makes naturally, decreasing the amount of sugar your liver makes, and decreasing the amount of sugar your intestines absorb. GLUCOPHAGE and GLUCOPHAGE XR do not cause your body to make more insulin. Because of this, when taken alone, they rarely cause hypoglycemia (low blood sugar), and usually do not cause weight gain. However, when they are taken with a sulfonylurea or with insulin, hypoglycemia is more likely to occur, as is weight gain.

WARNING: A small number of people who have taken GLUCOPHAGE have developed a serious condition called lactic acidosis. Lactic acidosis is caused by a buildup of lactic acid In the blood. This happens more often in people with kidney problems. Most people with kidney problems should not take GLUCOPHAGE or GLUCOPHAGE XR. (See “What are the side effects of GLUCOPHAGE and GLUCOPHAGE XR?”)

Who should not take GLUCOPHAGE or GLUCOPHAGE XR?

Some conditions increase your chance of getting lactic acidosis, or cause other problems if you take either of these medicines. Most of the conditions listed below can Increase your chance of getting lactic acidosis

Do not take GLUCOPHAGE or GLUCOPHAGE XR if you:

• have kidney problems

• have liver problems

• have heart failure that is treated with medicines, such as Lanoxin (digoxin) or Lasix (furosemide)

• drink a lot of alcohol. This means you binge drink for short periods or drink all the time

• are seriously dehydrated (have lost a tot of water from your body)

• are going to have an x-ray procedure with Injection of dyes (contrast agents)

• are going to have surgery

• develop a serious condition, such as heart attack, severe infection, or a stroke

• are 80 years or older and you have NOT had your kidney function tested

Tell your doctor if you are pregnant or plan to become pregnant GLUCOPHAGE and GLUCOPHAGE XR may not be right for you. Talk with your doctor about your choices. You should also discuss your choices with your doctor if you are nursing a child

Can GLUCOPHAGE or GLUCOPHAGE XR be used in children?

GLUCOPHAGE has been shown to effectively lower glucose levels in children (ages 10 to 16 years) with type 2 diabetes GLUCOPHAGE has not been studied in children younger than 10 years old. GLUCOPHAGE has not been studied in combination with other oral glucose-control medicines or insulin in children. If you have any questions about the use of GLUCOPHAGE in children, talk with your doctor or other healthcare provider.

GLUCOPHAGE XR has not been studied in children.

Celexa

Celexa was approved in 1998 as a treatment for depression, and has been well tolerated among the more than 8 million people who have taken it around the world. In addition, it is less expensive than some other SSRIs. Celexa is taken once a day in the morning or evening, with or without food, typically beginning with a 20-mg dose. This can be increased to 40 mg if needed.
Side effects. Side effects with this medication typically are mild and don’t last very long. You may notice dry mouth, diarrhea, tremor, insomnia, or sleepiness. A few people notice low blood pressure, dizziness when standing up, rapid heartbeat, headache, weight loss or gain, confusion, coughing, rash, itching, or taste problems. Celexa also interferes with many aspects of sexual function and interest.
Food and drug interactions. You should not drink and take Celexa, and you should discuss with your doctor any nonprescription medicines you take. Some drugs affect the way Celexa works in the body, including cimetidine (which raises the blood level of Celexa);

antifungal drugs and the antibiotic erythromycin may slow down Celexa’s clearance from the body. Celexa doubles the concentration of a metabolite of the tricyclic antidepressant imipramine, and you should never combine Celexa with any MAOI.
Special concerns. You should tell your doctor if you have mania, seizures, or liver or kidney disease. Celexa stays in the body twice as long in patients with liver problems, so lower doses will probably be recommended if you have this problem.

Fertility drug Clomid

The prescription Dr. Basic hands you (if you can decipher it) at the end of your first visit may say “Clomiphene citrate 50 mgm qd X 5 days, #10. Refills 3.” Or it may simply say “CC 50  mg qd d 3-7.”  What does this mean?
Clomlpliene citrate, more commonly called Clomid or Serophene (two brand names), is given to help you make an egg or to help you make a better egg: it may also help sustain a pregnancy by creating an egg whose corpus luteum  produces higher progesterone levels. Normally, you take Clomid for five days. Some doctors start you on it on day three of your cycle, and others start you on day four or five. The exact timing isn’t important; the point is to start it before your ovaries start to develop one dominant follicle.

Usually your doctor will give you one pill a day the first month or two and then move up to two or three tablets a day if you still don’t seem to be ovulating regularly. Clomid comes in 50 milligram tablets, so if your doctor starts you at a higher dose. 100 to 150 milligrams per day, you’ll need to lake more than one. After you stop taking the pills, you can check for ovulation by using your old friends, the basal thermometer and the ovulation predictor kits.
Clomid works by fooling the body Into thinking It’s not making enough estrogen. When your hypothalamus thinks that you’re low on estrogen, it releases GnKH (gonadotropin-releasing hormone), which stimulates the release of FSH (follicle-stimulating hormone) into your blood. The FSH stimulates the ovary to produce estrogen, so that a follicle will begin to grow.

Eighty percent or so of women taking Clomid ovulate In response to this stimulation. Clomid works best for those whose ovaries arc capable of functioning normally but need a little tune-up. If you’re already ovulating a mature follicle regularly, Clomid can help by increasing the stimulation to the ovary, or even by causing you to ovulate more than one egg. In the latter cases, the Clomid is generally combined with an IUI.
Your doctor may want you to have an ultrasound before starting Clomid each month to make sure you don’t have any ovarian cysts. Most pregnancies from Clomid occur in the first three to six months of therapy if the drug is taken for an ovulation.
Clomid has a few drawbacks, including the chance for multiple births. Between 5 and 10 percent of all Clomid pregnancies are twins, 1 in 400 is a triplet pregnancy, and 1 pregnancy in 800 results in quadruplets. Obviously, you may be delighted to have a twin pregnancy, hut triplets or quads may not be so thrilling. Higher-order multiples (triplets and above) have a very high rate of premature delivery and significantly higher than normal maternal and Infant complications. Multiples result from Clomid working too well and stimulating more than one follicle to grow.
Some doctors monitor you with ultrasounds while you’re on Clomid to be sure that you’re not making too many eggs. If you’re making a large number of eggs, you may develop ovarian hyperstimulation syndrome, which can cause a very high estradiol level, making hospitalization necessary. If you’re on Clomid and feel very ill, with a sudden weight gain, severe bloating in your abdomen, or abdominal pain, call your doctor immediately. This is a rare side effect of Clomid.

Clomid also has some less serious side effects, some annoying, some potentially detrimental to pregnancy. For example:
Because your body has been fooled Into thinking that it doesn’t have enough estrogen, you may have some of the same symptoms women have when they enter menopause and their estrogen drops: hot Hashes, headaches, nausea, or blurred vision. Some doctors may give you estrogen to decrease your symptoms.
Clomid can also interfere with your production of cervical mucus because it locks into all the estrogen receptors, including those in your cervix, so they don’t make mucus In response to rising estrogen levels like they normally do. Because estrogen also builds your uterine lining, some women on Clomid don’t make a thick lining. If you have either of these side effects, you may need to take estrogen after you start making a follicle. If your cervical mucus is decreased, an IUI may be in order to bypass the mucus altogether and deposit the sperm directly into the uterus .

Nolvadex tamoxifen

NOLVADEX is effective in the treatment of metastatic breast cancer in women and men. In premenopausal women with metastatic breast cancer, NOLVADEX is an alternative to oophorectomy or ovarian irradiation. Available evidence indicated that patients whose tumors are estrogen receptor positive arc more likely to benefit from NOLVADEX therapy. Adjuvant Treatment of Breast Cancer: NOLVADEX is indicated for the treatment of node-positive breast cancer in postmenopausal women following total mastectomy or segmental mastectomy, axillary dissection, and breast irradiation. NOLVADEX is also indicated for the treatment of axillary node-negative breast cancer in women following total mastectomy or segmental mastectomy, axillary dissection, and breast irradiation. In addition, NOLVADEX reduces the occurrence of contra lateral breast cancer in patients receiving adjuvant therapy with NOLVADEX for breast cancer. Ductal Carcinoma in Situ (DCIS): In women with DCIS, following breast surgery and radiation, NOLVADEX is indicated to reduce the risk of invasive breast cancer. (See BOXED WARNING at the beginning of full prescribing information.) Reduction in Breast Cancer Incidence in High-Risk Women: NOLVADEX is indicated to reduce the incidence of breast cancer in women at high risk for breast cancer. NOLVADEX is indicated only for high-risk women. “High risk” is defined as women at least 35 years of age with a 5-year predicted risk of breast cancer a 1.67%, as calculated by the Gail Model. (See Full prescribing information.)

Azithromycin (Zithromax)

Azithromycin (Zithromax)

Dose and Administration

Adults: Give 500 mg orally on day 1 followed by 250 mg once a day for a total of 5 days. For the prevention of disseminated Mycobacterium avium complex disease, the recommended oral dose is 1200 mg taken once weekly. For urethritis or cervicitis due to Chlamydia trachomatis, 1 g should be taken orally as one dose.
The IV form should be administered as 500 mg IV once daily followed by oral therapy for completion of therapy.
Pediatrics: Usual dose is 10 mg/kg for 5 days.

Azithromycin (Zithromax) Uses

FDA-approved: Treatment of mild to moderate cases of the following infections: acute bacterial exacerbation of chronic bronchitis due to Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae; community acquired pneumonia due to 5. pneumoniae or H. influenzae; pharyngitis/tonsillitis due to Streptococcus pyogenes; acute otitis media due to H. influenzae, M catarrhalis, or 5. pneumoniae;

uncomplicated skin and skin structure infections due to Staphylococcus aureus, S. pyogenes, or Streptococcus agalactiae; and nongonococcal urethritis and cervicitis due to C. trachomatis. It is also approved for the prevention of disseminated Mycobacterium avium complex disease in HIV-infected patients. The IV form is approved for community acquired pneumonia due to C. pneumoniae, H. influenzae, L. pneumophila, M. catarrhalis, M. pneumoniae, S. aureus, or 5. pneumoniae and pelvic inflammatory disease due to C. trachomatis, N. gonorrhoeae, or M. hominis in patients who require initial intravenous therapy. Another use is chancroid.

Azithromycin (Zithromax) Pharmacology

Azithromycin is a macrolide antibiotic that inhibits bacterial protein synthesis in susceptible organisms by reversibly binding to the 50S ribo-somal subunit. Based on similar mechanisms of action, azithromycin should not be combined with clindamycin or chloramphenicol to prevent antibacterial antagonism. Its spectrum of activity is expanded as compared to erythromycin. It retains similar gram-positive activity (e.g., S. pyogenes, S. pneumoniae, S. aureus); however, it has greater gram-negative activity than erythromycin or clarithromycin. Susceptible gramnegative organisms include Neisseria meningitidis, N. gonorrhoeae, Haemophilus ducreyi, H. influenzae, M. catarrhalis, and Bordetella pertussis. Azithromycin also exerts activity against Treponema pallidum, Mycoplasma pneumoniae, Legionella pneumophila, Chlamydia species, and Mycobacterium avium complex.
Azithromycin is more acid stable than erythromycin. The capsule formulation should be taken on an empty stomach to maximize absorption, whereas the tablet and suspension may be taken with or without food. It is widely distributed throughout the body and concentrations in pulmonary macrophages, polymorphonuclear leukocytes, and genital/ pelvic tissues remain increased for several days following administration. Penetration of the cerebral spinal fluid is negligible and therefore it should not be used to treat infections of the central nervous system. Azithromycin is excreted primarily in the feces.

Azithromycin (Zithromax) Adverse Effects/Precautions

The most common adverse effects involve the gastrointestinal tract and include nausea, vomiting, diarrhea, and abdominal pain. Serious allergic reactions have occurred rarely with azithromycin. Reversible elevations in liver function tests may occur. Pregnancy category B.

Azithromycin (Zithromax) Drug Interactions

Azithromycin does not affect the cytochrome P450 system unlike erythromycin and clarithromycin. When combined with warfarin, however, cases of increased prothrombin times and INRs have been reported. Therefore if azithromycin is combined with warfarin, close monitoring should be performed.

Special Considerations

Administration with food may lessen the gastrointestinal adverse effects. The oral suspension single packets should be mixed with 60 mL of water and taken immediately. The glass should be mixed with an additional 60 mL of water and ingested to ensure the entire dose is consumed.

Male Pattern Baldness and Propecia

The best person to talk to about male pattern hair loss is your doctor

Since many men suffer from male pattern hair loss, it is common for doctors to help these patients. In fact, millions of men have approached their doctors for help.

Your doctor can help you separate fact from fiction when it comes to hair loss products. They know from their experience with their patients what has worked, what treatments are available, and what might work for you. They are the best equipped to listen to your concerns and answer your questions.

Be prepared

Be open and honest with your doctor about your male pattern hair loss. Express your expectation and the desire you have to maintain or possibly re-grow your hair. You will also make the most of your doctor visit by being prepared with any questions you might have about male pattern hair loss and treatment options.

The gateway to treating your male pattern hair loss begins at your doctor’s office. Take that first step now, because the sooner you begin treatment, the more hair you will most likely have later.

Questions to ask your doctor about Propecia

Your doctor will be sensitive to you and your concerns; he or she is there to help. Below is a printable list of questions that may help you get started with your doctor.

I’m concerned about male pattern hair loss. What are the treatment options?

What can I expect from these treatments?

Which treatment option works best to maintain and/or re-grow hair?

What is PROPECIA?

How does PROPECIA work?

What have other patients for whom you’ve prescribed PROPECIA said about it?

Is PROPECIA right for me?

Will it help me maintain the hair I already have?

What kind of results can I expect?

What is the safety profile of PROPECIA?

How long will I have to take PROPECIA before I see any results?

Important Information about PROPECIA

PROPECIA was developed to treat mild to moderate male pattern hair loss on the vertex (top of head) and anterior mid-scalp area (middle front of head) in MEN ONLY. There is not sufficient evidence that PROPECIA works for receding hairlines at the temples.

PROPECIA is for the treatment of male pattern hair loss in MEN ONLY and should NOT be used by women or children.

You should not use PROPECIA if you are allergic to finasteride or any of the ingredients of PROPECIA.

Women who are or may potentially be pregnant must not use PROPECIA and should not handle crushed or broken PROPECIA tablets because the active ingredient may cause abnormalities of a male baby’s sex organs. If a woman who is pregnant comes into contact with the active ingredient in PROPECIA, a doctor should be consulted. PROPECIA tablets are coated and will prevent contact with the active ingredient during normal handling provided that the tablets are not broken or crushed.

Although results will vary, generally you will not be able to grow back all the hair you have lost.

When you could see results

Take PROPECIA daily and you could see results in as little as 3 months. If you stop taking PROPECIA, however, your results will gradually go away over 12 months. And if PROPECIA hasn’t worked in 12 months, further treatment is unlikely to be of benefit.

Know the facts. PROPECIA is available by prescription only, so the best thing to do is talk to your doctor.

Well that was all I could do, so then I phoned a few hair doctors.

Doctor one, he was not a doctor at all, just a sale man in a rented room in a good address in Dublin.

Doctor two, a woman, when I met her she was about twenty one years of age, I was not going to tell some child my problems,

Doctor four, worked some down south in the country and would see me if I sent him 500 euros in advance, I never sent the money.

Is Cialis better than Viagra?

What doses of Cialis can I buy ?

There are two doses available: 10 mg (marked with C10)and 20 mg tablets (marked with C20).

How is Cialis different from Viagra?

Cialis and Viagra are in the same class of drugs (they are both PDE5 inhibitors and allow relaxation of the smooth muscle of the penis). They both need sexual stimulation to work. However, they have different chemical structures. One of the main differences is the duration of action of Cialis. Cialis offers a period of responsiveness of 24-36 hours. This will be very important for some men who find it very difficult to estimate accurately when they might have sex. Other men also complain that having to take the tablet immediately before sex makes the situation ‘medical’. Clearly a longer window of opportunity could be beneficial for them also. There is no interaction between Cialis and food, whereas Viagra’s onset of activity may be delayed by food.

Is Cialis better than Viagra?

There have been no controlled clinical trials comparing men taking the optimum doses of Cialis with Viagra, so a direct comparison cannot be made regarding which drug people prefer. What can be said clearly are that they are both very safe, very effective drugs, and it will up to the patient to decide which is the best for them in a particular social setting.

Can Cialis tablets be split?

The tablets are not designed to be split.

How well does Cialis work?

In a general population study, 81% men stated their erections improved with the 20 mg dose and 75% of attempts for full sexual intercourse were successful. In men with diabetes, 76% reported an improvement in their erections and 58% of attempts for full sexual intercourse were successful In men taking drugs for high blood pressure, 84% of men reported improvements in their erections.

If Cialis lasts for 24 hours, does this mean erections will last for 24 hoars?

No, Cialis is only effective with sexual stimulation. No one has reported episodes of priapism (prolonged erection) when they have used Cialis.

My days are rather hectic and sometimes I have no idea when I am going to have sex with my partner. When should I take Cialis for the best effect?

It can be taken from 30 minutes to 12 hours prior to sexual activity. The effects of Cialis may persist up to 36 hours after you have taken the tablet. This means that you can take the tablet some time before having sex and choose when the time is right for you and your partner.

Has Cialis any advantages over Viagra or Levitra?

The main advantage with Cialis is that it has a long ‘half-life’ -what this means is that the drug will be effective for longer than Viagra or Levitra, so you won’t have to have sex soon after taking it, taking the pressure off planning intercourse precisely. This can be a major advantage to some people, particularly those not in a regular relationship, who feel at present that they are at risk of wasting their Viagra tablet if they take it and then don’t have sex in the ensuing few hours. It will also be advantageous to those people who feel that taking a tablet immediately before sex ‘medicalizes’ the whole situation.
Another advantage is that, unlike Viagra, the absorption of Cialis does not appear to be affected by food. This means that it will work just as well when taken after a meal.

Do you think that Cialis will be better than Viagra in the long term?

At the moment, this is not possible to say. It is dangerous to try to compare the results of studies between Viagra and Cialis, as the trials have been made in different people, or were carried out or assessed differently. For the future, you might be offered a selection of these tablets, so that you can take some of each to see which suits you best, or indeed have some of each to take in different social circumstances.