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Category Name:
Knowledge Library
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Viagra Fame
Viagra's glory story may be tainted--the potency pill doesn't mix well with protease inhibitors or recreational drugs. Before it was even introduced on the market, Viagra had achieved the kind of fame usually reserved for Hollywood superstars. As an easily used drug that can successfully treat male impotence, Viagra became the hottest topic in the media and provided an enormous boost to the stock of its manufacturer, Pfizer Inc.
Viagra's Great Demand
 As doctors wrote tens of thousands of prescriptions in its first two weeks of availability alone. But now that the little blue pill is the Titanic of medications, doctors and mental health experts are warning gay men about the drug's potential downsides. Viagra was finally released on may 1998. "I have never seen in my career a greater demand for prescriptions before a drug was released," says Gary R.Cohan, a physician at Pacific Oaks' Medical Group in Los Angeles.
"There's a great demand, but there are a couple of interactions gay men need to knowabout." However, dangerous side effects or not, doctors believe some men may rush to the drug without fully exploring whether they need it. "I would really caution people not to see it as a panacea but as something useful after they and their doctor work out what else is going on," says Kenneth Mayer, professor of medicine and community health at Brown University.
Treating Impotence
Viagra, treats impotence by acting on an enzyme that causes erections to subside. In men with erectile dysfunction, the enzyme is stronger thanGMP, the body chemical that initiates erections. Viagra keeps the enzyme from breaking downGMP, letting it produce an erection without interference. Doctors recommend that patients take Viagra a half hour to an hour before sexualactivity. "Viagra is metabolized by the same enzyme that metabolizesprotease inhibitors," Mayer says. "It's not thought that Viagra itself will influence the levels of protease inhibitors in the blood, but protease inhibitors, particularlyritonavir, can raise Viagra levels." Viagra also interacts with certain antibiotics, such as erythromycin.
Viagra Dosage
Viagra is the fact that it is not an aphrodisiac. Mayer says the potential side effects of the interaction are still unknown, although even at high doses Viagra does not seem to cause any long-term, serious medical problems. "Whether it translates into longer-lasting erections or more headaches is not clear," he says. "In the scheme of things, a protease inhibitor study is medically necessary, particularly when you're dealing with people who are otherwise doing well." Medical experts advise men taking protease inhibitors to limit their dosage of Viagra to 25 milligrams, half the normal suggesteddose. The issue is of particular concern because impotence is a common problem among men with HIV. Often the difficulty is caused by lowered levels of testosterone in the blood.
Viagra & HIV
"Viagra would probably work best in people with HIV-related erectile dysfunction if they are getting testosterone," Cohan says. "You first have to get the libido back, and then Viagra helps the blood flow to happenproperly." However, the causes of impotence are many. Viagra could make it easy to overlook some of the thornier issues, such as depression, that result in impotence. "It would be a shame if people don't see if something else is going on," Mayer says."Viagra is absolutely contraindicated with poppers," Cohan says. "It can cause the blood pressure to drop suddenly. Those are warnings I'm putting up in my exam rooms today." A dramatic drop in blood pressure could lead to fainting, shock, or even death. Mayer warns that other results would be less horrible but still painful: "You'd be well advised not to be standing up where your head might hit something sharp.
Viagra Alternatives
The other potential drug interaction of concern to gay men is with poppers, liquid nitrates that when inhaled cause blood pressure to drop and, for some, heighten sexual pleasure. Although the version of the drug widely used during the 1970s and '80s, amyl nitrate, can no longer be obtained legally, other versions have been enjoying increased popularity. It cannot produce erections in the absence of desire, which is what releases GMP into the blood in the first place. Nor is there any evidence that it can promote greater staying power or more intense orgasms in men who have no problem getting an erection. 
Viagra Buzz
Nonetheless, the buzz about the drug has already made it a hot item on the black market, where pills go for about $16 each, roughly 60% more than the typical retail price of the drug. As a result, some health experts are concerned that gay men will turn to Viagra as a new recreationaldrug. "I'm reluctant to stereotype gay men as a group, but there is a certain segment of the community where other drugs are abused in the context of sex," Schatz says. So a drug that has a cultural reputation of enhancing sexual prowess could be abused in situations in which people are desirous of having multiple partners or greater staying power."So far, the drug is too new to have had much of an impact on potential abusers.
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Daily Quote |
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Eat well, drink in moderation, and sleep sound, in these three good health abound.
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