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Australian Registration Number levitra otc Erection of the penis is initiated by the relaxation of smooth muscle in the corpus cavernosum, one of a pair of sponge-like regions in the penis. When aroused, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP triggers smooth muscle relaxation, increasing blood flow into the penis, resulting in erection.

Cialis Side Effects Almost total loss of glans sensitivity following circumcision

buying cialis online safe For Erectile Dysfunction "Other than an occasional headache, no significant side effects. Viagra works fairly well for me but just not consistently. I almost always get hard - REALLY hard.....but the erection doesn't last if foreplay is extended. So by the time I'm ready to penetrate, it isn't always stiff enough. As a result, I feel pressured to rush through sex with my boyfriend. Also, the price is absurd. The drug companies sure know how to play the game to delay generics from getting on the market. I understand the need to appease shareholders but there should be a better way than by gouging consumers."Headache 5% 11% 11% 15% No dosage adjustment is warranted solely on basis of age; however, greater sensitivity to medications in some older individuals should be consideredPotential Interactions

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42. Egan R, Pomeranz H "Sildenafil (Viagra) associated anterior ischemic optic neuropathy." Arch Ophthalmol 118 (2000): 291-2

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. cialis daily online Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

High blood pressure. Make sure your blood pressure is checked at least once a year. If it is high, it can be treated.