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Sept. 23, 2002 — The long-awaited competitor to Viagra — christened Levitra today — inches its way to final FDA approval. Two early studies suggest it’s longer lasting, has fewer side effects, and is safe for virtually everyone, including those with heart problems. Similar drugs approved in this class of medication carry warnings for men with heart disease.

However, one urologist advises men not to get their hopes up. “That’s not to say new drugs won’t be exciting and wonderfully worthwhile,” Larry Lipshultz, MD, professor of urology at Baylor College of Medicine in Houston. “The data is interesting. Let’s see if the drug holds up to the claims.”

Levitra was developed by Bayer and GlaxoSmithKline and is scheduled for U.S. launch in 2003.

Viagra, produced by Pfizer Inc., cheap generic cialis
the treatment of male sexual dysfunction, allowing men for the first time to pop a pill to get an erection — rather than trying various devices, having a drug injected into the penis, or having a pellet inserted into it.

By some estimates, some degree of ED affects more than 50% of men over the age of 40. In the U.S., alone 30 million men are affected.

However, statistics show that only about 10% of men seek help. So 90% of men out there still aren’t getting treated for impotence, says Irwin Goldstein, MD, director of the Institute for Sexual Medicine at the Boston University Medical Center and a leader of the Massachusetts Male Aging Study.

“In the early days of Viagra, many men got turned off — largely because reports of heart attacks that were shown later not to be related to the drug,” Goldstein tells WebMD. Today, Viagra carries only an advisory for people with high blood pressure who are taking particular types of blood best price generic viagra or cialis
medication, and patients with angina or heart disease who take nitrates.

The preliminary data on Levitra:

A phase III clinical trial enrolled 440 men with erectile dysfunction between 44 and 77 years old, most of whom had undergone nerve sparing prostatectomies six or more months before entering the study. (About a third of men who have had a viagra vs levitra
— removal of the prostate gland — develop ED.) After 12 weeks of Levitra, 71% of the men had improved erections. And a subset of men experiencing depression related to their impotence reported fewer symptoms of depression after taking Levitra.

In a 26-week phase III trial of 805 men, about 74%-77% of men taking 10-20 mg of Levitra reported successful penetration on their first attempt, compared with 46% of men taking placebo. Also, the men who were successful the first time reported successful penetration in about 85%-91% of subsequent attempts, compared with 77% of those taking placebo. Side effects were mild to moderate headache, flushing, and nasal congestion — “mild stuff,” says Goldstein.

Both Viagra and Levitra work by inhibiting the PDE5 enzyme. “That means that if you take a pill, then have sexual stimulation, the drug can magnify the natural erectile response. It allows the reaction to be more like sex should be.”

The over the counter erectile dysfunction drug
differences between the two drugs mark the difference, he says. “Levitra contains a more efficient enzyme inhibitor, so only a very small amount of the drug is necessary,” Goldstein tells WebMD. “That’s the thing that’s cool about Levitra — it’s biochemical potency is distinctly different from Viagra and Cialis another impotence treatment drug being developed by Lilly.”

All three drugs — plus several more still in development — have their place in a physician’s armamentarium, says Goldstein. “Several other companies are also working on drugs with PDE5 inhibitors.”

When it starts to work and how long it lasts are big issues in impotence medicine: Viagra takes effect in about 30 minutes and the effects last about 4 hours. Cialis reaches maximum concentration in 24 hours, and the effects last for about 3 days, says Goldstein. Levitra is faster-acting, reaching maximum concentration in 30 to 40 minutes, with the effects lasting about 16 hours.

Also, Levitra doesn’t carry one disconcerting visual problem that many men report with Viagra: “If you take Viagra, you get a weird blue vision,” he says.

Just don’t expect miracles with Levitra, says Lipshultz.

“The strength of the drugs will probably be comparable — they’re all supposed to inhibit the enzyme PDE5,” Lipshultz tells WebMD. “Whatever dose you take inhibits it completely. So I don’t think we’re going to be seeing a whole lot of advertising based on ‘take this drug because it’s stronger.’”

Also, if you didn’t have success with Viagra, it’s doubtful that Levitra will work any better, says Lipshultz. “I don’t think we’re going to see people who fail one drug do a whole lot better on another drug. I think where the difference will be — if any — is onset of action, duration of action, and side effects.”

May 19, 2004 (New Orleans) — New medicines — ranging from a
relative of Viagra to an arthritis drug — target the haywire immune responses
that underlie inflammatory bowel disease (IBD).

Erectile dysfunction new drugs
bowel disease is the umbrella term for a number of
conditions that cause article drug dysfunction erectile from internal medicine news rx update of the bowel. The two most common ones are
ulcerative colitis and Crohn’s disease. Both of these conditions occur when the
immune system goes awry and attacks the lining of the colon. The disorders take
a toll on their victims - affecting more than 1 million in the U.S. alone –
causing belly aches, diarrhea, and other symptoms that are often severe enough
to interfere with daily activities, says James B. Lewis, MD, associate director
of the inflammatory disease program at the University of Pennsylvania in
Philadelphia.

“We’re seeing many different approaches to treat this
inflammation,” says Stephen B. Hanauer, MD, professor of medicine and
clinical pharmacology at the University of Chicago Pritzker School of Medicine.
“For example, corticosteroids already used to treat IBD, are effective
anti-inflammatory agents but they affect all tissues, causing many side
effects.”

Many of the new drugs, on the other hand, selectively target
the defects associated with IBD — an approach that promises better results
with fewer side effects, he tells WebMD.

There were a number of new approaches discussed here at
Digestive Disease Week, a major medical meeting of dysfunction pill
.

Arthritis Medication Combats Crohn’s, too

The rheumatoid arthritis drug Humira helped patients with
moderate Crohn’s disease to go into remission, Hanauer says.

A man-made biological substance called a monoclonal antibody,
Humira works by blocking an inflammation-causing protein called tumor necrosis
factor alpha, or TNF-alpha, that has been implicated in both rheumatoid
arthritis and Crohn’s disease.

In a study of nearly 300 patients who did not improve despite
treatment with standard medications, 30% of those given higher doses of Humira
were in remission by four weeks later, compared with only 12% on placebo,
Hanauer reports.

Humira is an injectable drug and was extremely well tolerated,
he says.

New Immune System Drug Antibody Prevents Crohn’s Flare-Ups

In another new study, the drug Antegren helped prevent
flare-ups associated with Crohn’s disease in people who were in remission,
reports Brian G. Feagan, MD, professor of medicine in the department of
epidemiology and biostatistics at the University of Western Ontario in
London.

The drug has already been shown to induce remission in Crohn’s
sufferers.

Antegren works by keeping immune system cells from leaving the
bloodstream. In Crohn’s patients, this appears to prevent the immune system
attack on the gut that occurs with the disease, Feagan says. “If we can
prevent that, white blood cells would stay in the erectile dysfunction pill
where they
belong.”

The researchers studied 339 adults with Crohn’s disease who had
improved or gone into remission after receiving three infusions of Antegren.
The patients were randomly assigned to continue to receive Antegren for up to
12 additional monthly infusions, or to placebo.

Six months later, 44% of patients given Antegren were still in
remission, compared with 26% on placebo, Feagan says. Also, 61% of those taking
the drug continued to show an improvement in symptoms, compared with 29% on
placebo.

People who took Antegren were no more likely to suffer side
effects than those on placebo, he explains.

June 12, 2000 — The gods of sex have blessed men with Viagra, but what good is it if their female partners have lost interest?

Traditionally, men’s sexual problems have gotten the lion’s share of attention, prompting remedies from Viagra to vacuum erection pumps to penile implants. The focus has been mainly on men despite the fact that women are more likely to have sexual troubles. A survey published in the February 10, 1999 issue of the Journal of the American Medical Association found that 43% of 1,749 women had complaints about sexual online sildenafil citrate, compared with 31% of the 1,410 men surveyed. Subjects ranged in age from 18 to 59. The women reported low sexual desire, problems with arousal, and pain during intercourse. And these problems increase with age, experts say.

A Changing Picture

Why has research on women’s sexual dysfunction, as it’s medically known, lagged in the first place? It’s partly due to the difficulty of defining the problem. Even though impotence in men can be organic or emotional, the inability to obtain or maintain an erection is often the target for therapy. In women, sexual problems can get more complicated. They can include, for instance, a lack of desire, generic prices viagra
lubrication, an inability to reach orgasm, or pain during intercourse. The causes can be physical, such as poor circulation, or emotional, such as stress or depression.

Finding remedies has also been a challenge because drugs that boost men’s sex lives may do nothing for women’s. A recent study of Viagra in women, released at the annual meeting of the American College of Obstetricians and Ed meds
, showed that it worked no better than a placebo in improving sexual response.

Lately, however, as researchers have discovered more about the types and causes of women’s sexual problems, the outlook is becoming brighter. New drugs are in generic pharmacy viagra
specifically for women’s sexual problems. And a new clitoral suction device, meant to enhance blood flow, has been approved by the FDA.

Though many of these remedies for women’s sexual problems are months or even years away from druggists’ shelves, there are still avenues to relief right now — if a woman doesn’t give up easily and finds the right doctor.

One Woman’s Story

Peggie is one of those women who don’t give up easily. She and her husband of 25 years had always enjoyed an active sex life. Then, at age 51, she started experiencing hot flashes and, along with them, something she never expected — a loss of sexual desire.

“No one told me that when you hit menopause, forget about sex,” she says. “It was a shock to me.” Other women confided that their libidos had plummeted, too, with menopause. They told Peggie, “That’s just the way it is when women age.”

But like other women who came of age during the sexual revolution, Peggie felt that women’s sexual pleasure is as important as men’s. So she went looking for help.

April 10, 2000 (Mill Valley, Calif.) — In his early 40s, Ron Hanson was too
young to be having trouble getting and sustaining erections. But like many men,
he was too embarrassed at first to talk about the problem. Hanson (not his real
name) waited seven years to see a urologist. By the time he spoke up, erectile
dysfunction had become a household word, thanks to the popularity of the drug
Viagra. But the widely touted drug, Hanson soon learned, doesn’t work for
everyone.

When Viagra (sildenafil) hit the market in 1998, some men thought it was the
long-awaited answer to their problems. Many rushed to doctor’s offices to give
it a try. According to the Grey Clinic in Indianapolis, which specializes in
erectile dysfunction, 17% of men between 18 and 55 experience occasional
impotence, while 6% have regular erectile get viagra prescription
. For men over 55, that
number jumps to about one in three. Some common causes of impotence are
diabetes, heart disease, and psychological problems. It also frequently occurs
after prostate cancer surgery.

Because Viagra works in a way that’s similar to drugs that contain nitrates,
however, it isn’t recommended for men who take nitrates for heart disease or
those with certain other heart conditions. In some men, it causes bad
headaches. In others, it just plain doesn’t work. In some instances, men may
notice they have trouble telling blue and green colors apart when they start
taking the drug.

During an erection, blood flows quickly into the penis, which increases its
length, width, and firmness. If the “in” vessels (arteries) are too
narrow or if blood drains too quickly through the “out” vessels
(veins), men may have trouble achieving or maintaining an erection, says Arnold
Aigen, MD, a urologist with Camino Medical Group in Sunnyvale, Calif. Viagra,
which increases inflow, may not be strong enough to work its magic if the
arteries are too narrow.

Hanson tried Viagra, but he couldn’t tolerate the headaches it caused.
Luckily, when Viagra fails, he discovered, there are several alternatives.

Alprostadil to the Rescue

A drug called Alprostadil, either alone or sometimes in conjunction with
others such as papaverine and/or phentolamine, can be injected directly into
the penis to dilate the arteries, experts say. The drug produces an erection in
about 10 minutes that can last up to an hour. But there are several
disadvantages, says Teresa Beam, MD, a urologist with the Grey Clinic. Some
patients are averse to using a needle, which is why many men abandon the
therapy. Those who give it a try may experience pain at the injection site or
priapism (a painful erection lasting too long).

As an alternative, Alprostadil is available as a pellet-like suppository
that is inserted into the tip of the penis and absorbed through the lining of
the urethra. This can help produce erections lasting for 30 to 60 minutes,
according to the Impotence World Association (IWA). Unfortunately, the
suppositories are less effective than injections and may cause pain and
irritation, according to both Aigen and Beam.

Last November, a topical gel formulation of alprostadil was approved by the
U.S. Food and Drug Administration. It is too soon to know if this form of
alprostadil therapy will become widely used.

Mechanical Help

With a vacuum constriction device, the penis is placed in a cylinder with an
attached pump, creating a vacuum to draw blood into the penis. Firmness is
sustained by a constriction band placed around the base of the penis. The IWA
estimates the technique can produce erections for up to 30 minutes. Beam calls
the alternative “a good way to go” because it has minimal side effects,
but admits it is cumbersome and takes some practice.

Some men opt for penile implants, which involve the placement of tubes in
the penis and a pump in the scrotal sac. The pump (usually the size and shape
of a testicle) enables men to obtain an erection whenever and for as long as
they desire by pumping a saline solution from a reservoir into the penis.
Implants are a last resort, however, says Beam. “Once a prosthesis is
implanted, a patient cannot respond to anything else because it alters the
natural anatomy.”

Fortunately, Ron Hansen didn’t have to go that far. He has become used to
injecting himself with Alprostadil, which produces a firmer erection than he
experienced with Viagra, and one that lasts at least 30 minutes. It also
doesn’t cause the headaches associated with Viagra. Hanson generic viagra fast shipping
uses
the suppositories, though they take longer to work.

For Hanson, admitting that he had a problem in the first place was the
hardest part. “But when you don’t function as you should,” he says,
“the therapy makes a big difference.”

Mari Edlin is a freelance journalist and marketing
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in health care. She contributes
regularly to Healthplan magazine, Modern Physician, and
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in the San Francisco Bay Area.

Six years after Viagra revolutionized sexual ability for men,
many women are still hoping for their turn. To date, the FDA hasn’t approved a
product to boost female sex drive.

It’s no small problem. A low sex drive is the most common
sexual complaint made by women — up to 30% to 40% of them, according to Sandra
Lieblum, PhD, director for the Center for Sexual and Erectile dysfunction medication
Health at the
Robert Wood Johnson Medical School in New Jersey.

The Search for a Cure

Throughout the ages, various potions and contraptions have
pledged relief, but the discerning have wondered if the so-called remedies are
truly love liniments, or merely snake oil.

Just because someone makes a claim about boosting female
libido, it doesn’t mean that it’s true, says Beverly Whipple, PhD, RN, FAAN,
vice president of the World Association for Sexology. “We have to make sure
that the claim is being made on scientific evidence.”

Yet, even if something appears to work in scientific research,
there is the concern that just being part of a study to improve a women’s sex
drive might itself have a suggestive effect on libido; it’s called a placebo
effect.

“It has to do with women’s expectancies and hope that any
intervention will prove beneficial,” says Lieblum, noting that anticipation
can also change behavior. “Any woman who goes into a trial to improve
libido is motivated to be more active.”

The power of placebo is so strong that many health experts look
only to double-blind, placebo-controlled trials to prove a product’s
effectiveness. In these studies, a group of subjects receive a real drug, while
another set gets a dummy substance. Neither the researchers nor the
participants know which the real medicine is.

Apply this criterion to the dozens of aphrodisiacs for women
out there, and the number of suitable elixirs dwindles down to possibly one or
two that work for some women. Even with the best of studies, expert opinion
varies on what works best for female libido.

There is a consensus, however, on just how intricate female
desire is. “Women’s drive is so complex that biology is only one factor
that drives sex drive,” says Jean Koehler, PhD, a licensed family and
marriage therapist in Louisville, Ky., and past president of the American
Association of Sex Educators, Counselors, and Therapists.

Besides biology, the following factors can affect female
libido:

• Quality of the pills
  
• Attitudes of upbringing
• Support of peer group
• Quality of touch and sex
• Erectile dysfunction drugs
  of partners
• Age
• Illness
• Use of medications
• Emotional well-being

Trouble with one or a combination of these factors can affect
women’s sex drive. Such loss of interest in sex is medically identified as
hypoactive sexual desire disorder (HSDD).

There are some popular products that have either been designed
or tested to treat HSDD.

Viagra

Despite rumors and various advertising claims to the contrary,
there isn’t a female Viagra out there.

“We know that Viagra doesn’t work in women,” says
Whipple.

“Women are not minimen,” Whipple explains. “We are
different than men in what we want, what we desire, what feels good to us, and
we’re also different at the biochemical level.”

Female sexuality is, indeed, so much more complex than male
sexuality that even after several scientific studies involving about 3,000
women, Viagra-maker Pfizer hasn’t been able to come up with conclusive
findings. Earlier this year, the company announced it was ending research of
Viagra in women.

But this does not mean there isn’t hope for some women.
Research is ongoing on several other products for female libido.

July 20, 2001 (Washington) — It’s called trail mix, and it’s a far cry from the healthy blend of fruits and nuts you’d take on a hike, say the experts.

Instead, it’s the latest party drug craze, consisting of ecstasy — known to cause an intense high — and Viagra, which is used to improve sexual prowess. For now, the primary users are gay men in New York City and Boston where trail mix is showing up at dance parties and clubs.

“It’s not necessarily sexual; if people want it to be sexual, they’ll put the stimulant methamphetamine in it. It’s just considered a more cure dysfunction erectile herbal version of ecstasy,” Patricia Case, ScD, of the department of social medicine at Harvard Medical School, tells WebMD.

Nor is trail mix limited to gay users; Case says many free generic viagra
men and teens are trying it as well. There are many popular variants of the drug combination, which is ground up into a powder and snorted. Ketamine, a cat tranquilizer, can sometimes be added to offer a mellower, longer high, but at a price.

“The down side is that the stimulant effect of the ecstasy can override the perception of ketamine, so that people can take too much … of the trail mix. And the ketamine then puts them into what’s called a ‘K-hole,’ which is a very unattractive state,” says Case.

As part of her studies, Case says she sees people unable to walk after taking the blend and some ultimately require medical attention. She describes their appearance as “glassy-eyed.”

Case presented her findings at the first international conference on ecstasy under way this week at the National Institutes of Health. Some 600 researchers attended the event sponsored by the National Institute on Drug Abuse, or NIDA.

Ecstasy is one street name for MDMA, a laboratory drug has that has both the power to stimulate the brain and cause a generic erectile dysfunction drugs
state. Since the mid-’90s when ecstasy first appeared in the rave club scene, it’s become an increasing public health threat, according to NIDA’s director, Alan Leshner, PhD.

Though illicit drug use was generally down among youth last year, that wasn’t true for ecstasy. “The demand is very great, and it has moved out of the club scene,” Leshner tells WebMD. “Now what’s so alarming is that this year, for the first time, we saw this increase in twelfth graders, tenth graders, and eighth graders,” he says.

For example, 3.1% of U.S. eighth graders have tried ecstasy, says Leshner, and 8.2% of twelfth graders have used the illicit drug. Overall, it’s estimated that more than 100,000 13- and 14-year-olds have taken the drug.

While the high can be intense, so can be the consequences, including possible brain damage or death. Ecstasy acts on two crucial brain chemicals: dopamine, which is linked to stimulation and serotonin, a mood modifier.

Animal studies have already shown that ecstasy destroys serotonin-producing cells. “Think about going around for weeks with your brain impaired … at least,” says Leshner.

Ecstasy can also cause a fever as high as 108 degrees.

Although one doesn’t acquire a physical dependence on the drug, Leshner says people develop a compulsion to get it. And that’s not just in the big cities. Robert Carlson, PhD has done a preliminary study on ecstasy use in Ohio.

Carlson tells WebMD his state is the “heart of it all.”

“It’s far more pervasive in our high schools, at least in our part of the country, among high school aged youth and young adults,” says Carlson, a medical erectile dysfunction medication
at the Wright State University school of Medicine in Dayton, Ohio. He got his information from a broad group including active users, police, and treatment providers.

One of the big issues, says Carlson, is that kids still haven’t heard their peers talk about overdosing on ecstasy or getting arrested. So while there’s still time, he cautions parents to discuss the issue with their children.

“You have to converse with them and just say, ‘Do you come in contact with it?’ … Then tell me about it,” says Carlson.