Viagra and generic Viagra prescription

Sildenafil citrate, widely known as Viagra, is the first prescription drug to treat erectile dysfunction. It was developed and is being marketed by Pfizer Inc. since 1998.
Viagra’s pharmacologic action is provided by inhibiting phosphodiesterase type 5 (PDE5), an enzyme mainly distributed in the penile vascular smooth muscle that decreases the penile blood flow.
The safety and efficacy of Viagra has been approved in more than 120 countries and prescribed to more than 20 million patients around the world.

Viagra 25mg tablet　1,300Yen(tax inclusive)
Viagra 50mg tablet　1,500Yen(tax inclusive)

generic Viagra 25mg　550Yen
generic Viagra 50mg　850Yen

Price List
We do not charge consultation fee or any other additional cost except for the drug price.

All Viagras which we prescribe are manufactured by Pfizer Japan and transported by credible licensed distributors. There is no possibility of counterfeit Viagra.

Features of Viagra & generic Viagra

Instructions
・Take Viagra at least 40 minutes prior to sexual intercourse.
・Viagra will start to effect within 40 minutes and last for 3 hours and 5 hours for 25mg tabs and 50mg tabs, respectively.
・Viagra will reach to its peak effect approximately 55 minutes after administration.
・Take no more than one tablet per day.
・A sufficient degree of sexual stimulation is indispensable for erection even after administration of Viagra.

Contraindications
We cannot prescribe Viagra for patients who correspond to any of the followings:

・Patients who are allergic to the components of Viagra.
・Patients presently taking nitric oxide donors, organic nitrites and nitrates, such as glyceryl trinitrate (nitroglycerin), sodium nitroprusside, and amyl nitrite.
・Patients whom sexual intercourse is inadvisable due to cardiovascular risk factors.
・Severe hepatic impairment (decreased liver function).
・Severe impairment in renal function and require dialysis.
・Hypotension (low blood pressure). Systolic pressure below 90mmHg or diastolic pressure below 50mmHg.
・Hypertension (high blood pressure). Systolic pressure above170mmHg or diastolic pressure above 100mmHg.
・Patients with history of stroke or heart attack.
・Patients with hereditary degenerative retinal disorders (including genetic disorders of retinal phosphodiesterases)
・Patients presently taking amiodarone hydrochloride for arrhythmia treatment.

Major Side-effects
In clinical trials, the most common adverse effects of Viagra use included headache(10-13%), flushing(11-15%), dyspepsia(3%), nasal congestion(1%) and impaired vision(1%), including photophobia, cyanopsia (seeing everything tinted blue), and blurriness.

Other Side-effects
Although, the correlation not being firmly established, PDE5 inhibitors including Viagra, has been reported to possibly cause Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) at an unknown frequency (too rare to estimate). NAION is a medical condition involving sudden decrease or loss of vision due to damage to the optic nerve from insufficient blood supply. It is not possible to determine whether these events are related directly to these medicines or to other factors. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including Viagra, and contact a doctor right away.
Sudden decrease or loss of hearing has been rarely reported in people taking PDE5 inhibitors, including Viagra. It is not possible to determine whether these events are related directly to the PDE5 inhibitors or to other factors. If you experience sudden decrease or loss of hearing, stop taking PDE5 inhibitors, including Viagra, and contact a doctor right away.

Interactions
Please notice our physicians in case you are taking medications below.

・Patients presently taking nitric oxide donors, organic nitrites and nitrates, such as glyceryl trinitrate (nitroglycerin), sodium nitroprusside, and amyl nitrite are contraindicated to Viagra treatment.
・Patients presently taking amiodarone hydrochloride for arrhythmia treatment are also contraindicated to Viagra treatment.
・Viagra should not be used with other PDE5 inhibitors namely, Cialis, Levitra, Vivanza, Revatio, and Adcirca. Revatio and Adcirca is a treatment for pulmonary arterial hypertension (PAH), containing sildenafil and tadalafil, the same medicine found in Viagra and Cialis, respectively.
・Care should be exercised by patients that are taking protease inhibitors for the treatment of HIV. Protease inhibitors inhibit the metabolism of sildenafil, effectively multiplying the plasma levels of sildenafil, increasing the incidence and severity of side-effects.
・Concomitant use of sildenafil and an alpha blocker may lead to low blood pressure, but this effect does not occur if they are taken at least four hours apart.

See also http://www.viagra.com/ for further information of Viagra and generic Viagra.

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