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Metabolism and Excretion: Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50% of the parent drug. Plasma concentrations of this metabolite are approximately 40% of those seen for sildenafil, so that the metabolite accounts for about 20% of sildenafil's pharmacologic effects.18. Khandheria BK "Erection, erectile dysfunction: what has heart got to do with it?" Herz 28 (2003): 275-6

The usual recommended dose of Viagra is 50 mg administered as needed approximately one hour prior to sexual activity. However, according to the prescribing information, Viagra may be taken anywhere within a range from 30 minutes to four hours prior to sexual activity. The dose of Viagra may be increased to 100 mg or decreased to 25 mg based on therapeutic response and tolerability. The maximum recommended dose is 100 mg with a maximum recommended frequency of administration of once daily. Viagra begins to exert its therapeutic effect within one hour with the duration of effects lasting for up to four hours. Erections do not last for four hours, however, a man has the ability to have an erection for up to four hours. buying levitra The most commonly reported adverse reactions were headache, nausea, dyspepsia, back pain, myalgia, flushing, nasopharyngitis, and pain in the extremity. These adverse reactions were dose dependent, transient, and generally mild or moderate.[Ref]1The other brands listed are trademarks of their respective owners and are not trademarks of Pfizer Inc. The makers of these brands are not affiliated with and do not endorse Pfizer Inc or its products.Headache 5% 11% 11% 15% Friday orders are delivered on Monday.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. 25mg viagra Setting The Record Straight: Erectile Dysfunction

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cialis ingredients Levitra significantly improved the overall per-patient rate of achieving an erection sufficient for penetration (SEP2) (61% on 10 mg and 64% on 20 mg Levitra compared to 36% on placebo; p <0.0001).

Diabetes. This is one of the most common causes of ED. Diabetes can affect blood vessels and nerves.joe; No this is not a cure you would have to use this each time for sex. This is caused if I am seeing right looks like you are taking an SSRI medication and this is a very common side effect that they do use Viagra to help while your on the medication This well continue as long as you are having the side effect from whatever medication you are taking. Really nothing to worry about you well return to normal when the medication is stopped or you try something different. Really nothing to worry about.Have a good day.