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Men who don't want to discuss erectile dysfunction with their doctors can get their little blue pills online (although often it's the female partner who actually does the ordering). The ready availability of drugs like Viagra isn't always a good thing.
Nothing in this article should be construed as encouraging any man (or woman) to buy Cialis, Viagra, or Levitra online. However, if you do, please keep these ten considerations in mind.

- Some men absolutely, positively should never take Cialis, Viagra, or Levitra. By drawing blood away from the heart and to the penis, medications in this class can trigger potentially fatal interactions with nitrates for high blood pressure (drugs such as isosorbide mononitrate, marketed as Imdur, Monosorb, Chemydur, Ismo, Isonorm, Monotrate, Solotrate, and Monit, and nitroglycerin pills usually taken under the tongue for angina). Cialis and Levitra cannot be taken with the heart drug amiodarone, and Levitra should not be taken with the antipsychotic medications Zeldox (ziprasidone) or Haldol (haloperidol), the medication for late-stage melanoma called Zelboraf (vemurafenib), or with methadone, used to treat heroin addiction. It is also advisable to avoid the use of Viagra, Levitra, or Cialis with "poppers," most often used by gay men. This list of potential drug interactions may not be complete.
- Some over-the-counter Chinese herbal formulas add Cialis, Viagra, or Levitra to enhance the effects of the herbs. These important patent medicines actually deliver a smaller, more expensive dose of ED drugs than a man could obtain with a prescription at a regular pharmacy. Although there are various Asian herbal formulas that actually increase men's sexual stamina, it is best to get them directly from the herbalist to makes them.
- Online vendors sometimes sell counterfeit Cialis, Levitra, and Viagra. These products may contain the real drug in an appropriate dosage, but the manufacturer fails to remove the toxic chemical solvents that are used in making the drugs. It's possible to get dangerous doses of hexane or toluene from counterfeit ED drugs.
- Researchers at Florida International University have found, surprisingly, that men who take ED drugs tend to take on much more serious views of sex. They become more interested in relationships (although they tend to become more promiscuous at the same time), they tend to be more on the lookout for sexual opportunities, and they spend more time thinking about sex. If you are a female partner ordering the drug for your male partner (not that we recommend this), keep in mind that the man's attitudes toward sex are likely to change once he finds out that the pill works.
- There is nothing about ED drugs that protects against sexually transmitted diseases. Younger men (men under the age of 50) who use Viagra, Levitra, or Cialis are more likely to use condoms when they use the ED drugs, but older men are less likely.
- Failing to take Cialis daily defeats the purpose of the drug. If a man is going to use the medication, he should buy enough to use it daily, as intended by the manufacturer.
- Korean scientists recently reported finding naturally occurring Cialis, a plant compound that happens to have the same chemical structure as the drug, in a popular Korean dietary supplement. This compound also appears in the muscle building supplement Aspire 36, but be forewarned that many men who discovered this property of the supplement several years ago reported having severe headaches.
- Many men who have both diabetes and ED get better results from Cialis when they take a folic acid (or complete B vitamin) supplement.
- Cialis often relieves symptoms of benign prostatic hyperplasia (enlarged prostate), such as difficulty starting a urine stream or the sense of fullness after urination is completed. However, the drug only helps with symptoms. It is not a cure for prostate disease.
- Many men who use Cialis, Levitra, or Viagra "recreationally" actually have a problem with premature ejaculation rather than with erectile dysfunction. For these men, Levitra is usually the best choice--but it is always best to consult a doctor before starting any medication.
If you and your doctor decide Viagra is the right ED medication for you, and you want to be absolutely sure you are getting the real product when you shop online--plus get three free pills with your first prescription--visit the Pfizer Pharmaceutical "buy real Viagra" website, which became operational in May of 2013. We've posted a link below.
- Deconinck E, Canfyn M, Sacré PY, Courselle P, De Beer JO. Evaluation of the residual solvent content of counterfeit tablets and capsules. J Pharm Biomed Anal. 2013 Jul-Aug. 81-82:80-8. doi: 10.1016/j.jpba.2013.03.023. Epub 2013 Apr 6.
- Varma A, Shah KB, Hess ML. Phosphodiesterase inhibitors, congestive heart failure, and sudden death: time for re-evaluation. Congest Heart Fail. 2012 Jul-Aug
- 18(4):229-33. doi: 10.1111/j.1751-7133.2012.00293.x. Epub 2012 Apr 16.
- Photo courtesy of Ed Ivanushkin by Flickr : www.flickr.com/photos/barsen/5484256163/
- Photo courtesy of Druh Scoff by Flickr : www.flickr.com/photos/robertcz/4384144605/