The Generic Prescription

Viagra is a prescription drug containing citrate salt of sildenafil and belongs to the selective inhibitor of cyclic guanosine monophospate (cGMP). Viagra works by relaxing muscles and increasing blood flow to particular areas of the body.

Viagra is prescribed to treat erectile dysfunction (ED).

Viagra comes in 3 dosages:
1. 25 mg tablet
2. 50 mg tablet
3. 100 mg tablet

Viagra must be taken exactly as it was prescribed for you. You cannot take it in a larger amount or for a longer period than was recommended by your doctor.

Viagra is usually taken 30 minutes to 1 hour before sexual activity though you may take it up to 4 hours before. However, you cannot take it more than once per day.

Viagra may be started on the lowest dose (25 mg) if you have kidney or liver problems, or you are 65 years old or older.

Viagra does not protect against sexually transmitted diseases, including HIV.

Viagra’s side effects are:
• Headache
• Facial flushing
• Upset stomach

Viagra is expensive but buying Viagra through online pharmacies can help. But not all Viagra sold on the net is genuine. You should be aware if the online pharmacy doesn’t ask for prescription and or is selling a so called generic Viagra that it could be potentially harmful.

2 days left to election day, both candidates of US president still campaigning about their capability. One area is health care plan. This link will give you a comprehensive proposal of each of the candidate, including regulatory changes in private health insurance, prescription drug pricing and cost to taxpayers . The best one is, you can vote which proposal suit to your need. Happy vote

John McCain believes that every American will get the health care they need by following the health care plan he created, comprising the The Four Pillars of Reform, Making New System of Health Insurance and Specific Plans of Action (Ensuring Care for Higher Risk Patients & Lowering Health Care Costs).

The Four Pillars of Reform

1. Affordability
Making health care more affordable for all Americans by ensuring that drug companies, doctors, insurance companies, hospitals and every other aspect of the health care system competes vigorously to respond to their needs.

2. Access & Choice
Every American should have access to quality and affordable coverage of their choice, including keeping their current coverage. American families (not government bureaucrats or insurance companies) should choose the coverage that best meets their unique needs.

3. Portability & Security
Allowing every American to keep their health insurance as they move from job to job or job to home, and protecting Americans’ economic security from unforeseen health events by expanding coverage and savings options.

4. Quality
Strengthening health care quality by promoting research and development of new treatment models, promoting wellness, investing in technology and empowering Americans with better information on quality.

Innovative, Portable and Affordable Health Insurance
• Making health care easier for individuals and families to obtain insurance.
• Reforming the tax code to offer more choices beyond employer-based health insurance coverage.
• Making insurance more portable.
• Encourage and expand the benefits of Health Savings Accounts (HSAs) for families.

Specific Plans of Action:

1. Ensuring Care for Higher Risk Patients
• Caring for the traditionally uninsurable.
• Working with states to establish a guaranteed access plan.
• Promoting proper incentives.

2. Lowering Health Care Costs
• Proposing a number of initiatives that can lower health care costs.
• Lowering drug prices.
• Providing quality, cheaper care for chronic disease.
• Promoting coordinated care.
• Expanding access to health care.
• Greater use of information technology to reduce costs.
• Reforming the payment system to cut costs.
• Promoting the availability of smoking cessation programs.
• Encouraging states to lower costs.
• Passing medical liability reform.
• Bringing transparency to health care costs.

Over the next few days, United States citizens’ will vote for their next president - Obama or McCain. Both have their own plans and policies regarding the interest of the country, including health care plan. Here, I will show you, Obama and Biden’s Health Care Plan.

On health care reform, the American people are too often offered two extremes - government-run health care with higher taxes or letting the insurance companies operate without rules. Barack Obama and Joe Biden believe both of these extremes are wrong, and that’s why they’ve proposed a plan that strengthens employer coverage, makes insurance companies accountable and ensures patient choice of doctor and care without government interference.

The Obama-Biden plan provides affordable, accessible health care for all Americans, builds on the existing health care system, and uses existing providers, doctors and plans to implement the plan. Under the Obama-Biden plan, patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats.

Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.

Make Health Insurance Work for People and Businesses - Not Just Insurance and Drug Companies.

* Require insurance companies to cover pre-existing conditions so all Americans regardless of their health status or history can get comprehensive benefits at fair and stable premiums.
* Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.
* Lower costs for businesses by covering a portion of the catastrophic health costs they pay in return for lower premiums for employees.
* Prevent insurers from overcharging doctors for their malpractice insurance and invest in proven strategies to reduce preventable medical errors.
* Make employer contributions more fair by requiring large employers that do not offer coverage or make a meaningful contribution to the cost of quality health coverage for their employees to contribute a percentage of payroll toward the costs of their employees health care.
* Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
* Ensure everyone who needs it will receive a tax credit for their premiums.

Reduce Costs and Save a Typical American Family up to $2,500 as reforms phase in:

* Lower drug costs by allowing the importation of safe medicines from other developed countries, increasing the use of generic drugs in public programs and taking on drug companies that block cheaper generic medicines from the market
* Require hospitals to collect and report health care cost and quality data
* Reduce the costs of catastrophic illnesses for employers and their employees.
* Reform the insurance market to increase competition by taking on anticompetitive activity that drives up prices without improving quality of care.

The Obama-Biden plan will promote public health. It will require coverage of preventive services, including cancer screenings, and increase state and local preparedness for terrorist attacks and natural disasters.

A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.

Most physicians suggest that treatments proceed from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing excess weight, and increasing physical activity may help some men regain sexual function.

Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.

Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.

1. Psychotherapy

Experts often treat psychologically based ED using techniques that decrease the anxiety associated with intercourse. The patient’s partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when ED from physical causes is being treated.

2. Drug Therapy

Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis. In March 1998, the Food and Drug Administration (FDA) approved Viagra (Sildenafil Citrate), the first pill to treat ED. Since that time, Levitra (Vardenafil) and Cialis (Tadalafil) have also been approved. Additional oral medicines are being tested for safety and effectiveness.

Viagra, Levitra, and Cialis all belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Taken an hour before sexual activity, these drugs work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.

While oral medicines improve the response to sexual stimulation, they do not trigger an automatic erection as injections do. The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for patients who take other medicines or have conditions that may decrease the body’s ability to use the drug. Levitra is also available in a 2.5 mg dose.

None of these PDE inhibitors should be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use either drug because the combination can cause a sudden drop in blood pressure. Also, tell your doctor if you take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. Your doctor may need to adjust your ED prescription. Taking a PDE inhibitor and an alpha-blocker at the same time (within 4 hours) can cause a sudden drop in blood pressure.

Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Patients also have claimed that other oral drugs—including yohimbine hydrochloride, dopamine and serotonin agonists, and trazodone—are effective, but the results of scientific studies to substantiate these claims have been inconsistent. Improvements observed following use of these drugs may be examples of the placebo effect, that is, a change that results simply from the patient’s believing that an improvement will occur.

Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. These drugs may create unwanted side effects, however, including persistent erection (known as priapism) and scarring. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.

A system for inserting a pellet of alprostadil into the urethra is marketed as Muse. The system uses a prefilled applicator to deliver the pellet about an inch deep into the urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes. The most common side effects are aching in the penis, testicles, and area between the penis and rectum; warmth or burning sensation in the urethra; redness from increased blood flow to the penis; and minor urethral bleeding or spotting.

Research on drugs for treating ED is expanding rapidly. Patients should ask their doctor about the latest advances.

3. Vacuum Devices

Mechanical vacuum devices cause erection by creating a partial vacuum, which draws blood into the penis, engorging and expanding it. The devices have three components: a plastic cylinder, into which the penis is placed; a pump, which draws air out of the cylinder; and an elastic band, which is placed around the base of the penis to maintain the erection after the cylinder is removed and during intercourse by preventing blood from flowing back into the body.

One variation of the vacuum device involves a semirigid rubber sheath that is placed on the penis and remains there after erection is attained and during intercourse.

4. Surgery

Surgery usually has one of three goals:

* to implant a device that can cause the penis to become erect
* to reconstruct arteries to increase flow of blood to the penis
* to block off veins that allow blood to leak from the penile tissues

Implanted devices, known as prostheses, can restore erection in many men with ED. Possible problems with implants include mechanical breakdown and infection, although mechanical problems have diminished in recent years because of technological advances.

Malleable implants usually consist of paired rods, which are inserted surgically into the corpora cavernosa. The user manually adjusts the position of the penis and, therefore, the rods. Adjustment does not affect the width or length of the penis.

Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid (see figure 3). Tubes connect the cylinders to a fluid reservoir and a pump, which are also surgically implanted. The patient inflates the cylinders by pressing on the small pump, located under the skin in the scrotum. Inflatable implants can expand the length and width of the penis somewhat. They also leave the penis in a more natural state when not inflated.

Surgery to repair arteries can reduce ED caused by obstructions that block the flow of blood. The best candidates for such surgery are young men with discrete blockage of an artery because of an injury to the crotch or fracture of the pelvis. The procedure is almost never successful in older men with widespread blockage.

Surgery to veins that allow blood to leave the penis usually involves an opposite procedure—intentional blockage. Blocking off veins (ligation) can reduce the leakage of blood that diminishes the rigidity of the penis during erection. However, experts have raised questions about the long-term effectiveness of this procedure, and it is rarely done.

ED is diagnosed into several ways, which are:

1. Patient History

Medical and sexual histories help define the degree and nature of ED. A medical history can disclose diseases that lead to ED, while a simple recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm. Using certain prescription or illegal drugs can suggest a chemical cause, since drug effects account for 25 percent of ED cases. Cutting back on or substituting certain medications can often alleviate the problem.

2. Physical Examination

A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to touching, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems, which would mean that the endocrine system is involved. The examiner might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem—for example, a penis that bends or curves when erect could be the result of Peyronie’s disease.

3. Laboratory Tests

Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.

4. Psychosocial Examination

A psychosocial examination, using an interview and a questionnaire, reveals psychological factors. A man’s sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

5. Other Tests

Monitoring erections that occur during sleep (nocturnal penile tumescence) can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than psychological cause. Tests of nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be applied for best results.

Erectile dysfunction is usually caused by other health conditions, medicines, or lifestyles that interfere with blood flow. Some of these health conditions occur more commonly as men age - but age itself does not cause erectile dysfunction.

Health conditions
Living a healthy lifestyle - eating right, getting regular exercise, drinking only in moderation, and not smoking - can help you safeguard your sexual health. Why? Because your health conditions that affect blood flow are among the most common causes of causes of erectile dysfunction. Conditions such as diabetes, heart disease, and high blood pressure restrict your blood flow by causing damage to blood vessels, nerves, smooth muscle, or fibrous tissue involved in getting - and keeping - an erection. Anything you do to keep your heart and blood vessels healthy will help you have a healthy sex life.
1. Diabetes
Diabetes is considered a common risk factor for risk factor for erectile dysfunction, and many men with diabetes develop ED (they also tend to get it at a younger age than other men do). In addition, men with diabetes are up to four times as likely as other men to develop ED.
2. High blood pressure
High blood pressure can cause your blood vessels to stiffen or narrow. This can restrict the flow of blood to your penis, leading to erectile dysfunction. In addition, some medicines used to treat high blood pressure can also contribute to erectile dysfunction.
3. Heart disease and high cholesterol
Like high blood pressure, heart disease and high cholesterol can affect the flow of blood to your penis, leading to erectile dysfunction. Men with heart disease are twice as likely as other men to develop ED.
4. Depression
Depression, along with stress, anxiety, and fear of failure, can contribute to ED. At the same time, men who experience ED because of a physical cause may also feel depressed, stressed, or anxious.
5. Prostate surgery
Surgery-especially radical prostate cancer surgery-can inadvertently cause cause erectile dysfunction by injuring nerves and arteries that run near the prostate and act upon the penis.
6. Other health conditions
Other health conditions that may cause or contribute to erectile dysfunction include:
* Kidney disease
* Chronic alcoholism
* Multiple sclerosis

Medicines
many common medicines—blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug)—can produce ED as a side effect.

Lifestyles
Some “lifestyle choices ” that can contribute to erection problems include:
1. Smoking
Smoking damages your arteries. If you smoke cigarettes, it can cause the kind of blood flow problems that make it difficult for you to get and keep an erection. Men who smoke should consider talking to their healthcare professional about ways to quit.
2. Drinking too much alcohol
While drinking in moderation may have some beneficial effects, drinking too much can lead to erectile dysfunction. In a recent study, men who had more than two drinks a day were shown to be at a higher risk of developing erectile dysfunction than non - drinkers were.

Whatever the cause of your ED, you’re not alone. Over 152 million men around the world are experiencing the same symptoms - and the same emotions - that you and your partner may experience as a result of ED.

The good news is that erectile dysfunction can be treated. The list of treatment options keeps growing and includes a new options that most men will find effective and easy to use like prescription drugs such as Viagra, Cialis, Levitra. Talk to your healthcare professional to find out more about this new treatment option.

Erectile dysfunction, sometimes called “impotence,” is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.

Erectile dysfunction can be a total inability to achieve erection for sexual intercourse, an inconsistent ability to do so, or a tendency to sustain only brief erections. It is estimated that between 15 million and 30 million American men experience erectile dysfunction. However, the condition’s broad variations make it difficult to define it or estimate its incidence. In older men, the cause is usually something physical like disease, injury, or side effects of drugs; but any disorder that causes injury to the nerves or impairs blood flow in the penis can potentially cause erectile dysfunction.

ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED; however, urologists accounted for only 25 percent of Viagra mentions in 1999.

There are 7 new generic drugs available in july 2008, which are:

1. Indomethacin for Injection
USP 1 mg/vial
Generic for: Indocin IV

2. Doxycycline for Oral Suspension
USP, 25 mg/5 mL
Generic for: Vibramycin for Oral Suspension

3. Nisoldipine Extended Release Tablets
20 mg, 30 mg and 40 mg
Generic for: Sular Extended-Release Tablets

4. Mycophenolate Mofetil Capsules
250 mg
Generic for: Cellcept Capsules

5. Divalproex Sodium Delayed-Release Tablets
USP, 125 mg, 250 mg and 500 mg
Generic for: Depakote Delayed-Release Tablets

6. Mycophenolate Mofetil Tablets
500 mg
Generic for: Cellcept Tablets

7. Eplerenone Tablets
25 mg and 50 mg
Generic for: Inspra Tablets

There are new 6 generid drugs available in june 2008, which are:

1. Zaleplon Capsules
5 mg and 10 mg
Generic for: Sonata Capsules

2. Prednisolone Sodium Phosphate Oral Solution
20 mg (base)/5 mL (new strength)
Generic for: Orapred Oral Solution

3. Ciclopirox Gel
0.77%
Generic for: Loprox Gel

4. Torsemide Injection
10 mg/mL; 2 mL and 5 mL vials
Generic for: Demadex Injection, 10 mg/mL

5. Dronabinol Capsules
USP, 2.5 mg, 5 mg, and 10 mg
Generic for: Marinol Capsules

6. Risperidone Tablets
USP, 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, and 4 mg
Generic for: Risperdal Tablets