Frequently Asked Questions

Viagra, Cialis, Levitra, Propecia, Vaniqa and Xenical

Viagra

What is Viagra?

Viagra is an FDA-approved drug used to treat impotence in men. Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation.

I'm not impotent: will Viagra enhance my sex life?

Many doctors believe it will. "Viagra could get the healthiest men going as strong as the Energizer bunny - making their penises harder, their erections longer, and their comebacks sooner, some urologists told The [New York] Post."

Pfizer maintains the drug doesn't help men who aren't impotent. But the firm concedes it didn't test it on any because it had no reason to.

The Net Doctor Group will not entertain requests for prescriptions simply to enhance one's sex life. Only patients with a bonafide sexual dysfunction should submit a form and prescription request.

Will Women benefit by taking Viagra?

Many doctors believe it will. Pfizer is currently conducting European tests on the effect of Viagra on women, and some physicians in the U.S. are currently prescribing Viagra for the treatment of female sexual dysfunction. If you are a woman and wish to be prescribed Viagra, our physicians will, in some circumstances, prescribe it. You must submit a valid medical reason why you feel you would benefit from Viagra, and -after considering your medical history and the validity of your request- a determination will be made whether or not you would be likely to benefit.

What are Viagra's side effects?

In clinical studies, Viagra's adverse effects were generally transient and mild to moderate in nature. Side effects include: headache (16% vs. 4% with Placebo), flushing (10% vs. 1% Placebo) and dyspepsia (7% vs. 2% placebo).

In higher doses, 3% of patients taking Viagra developed abnormal vision: color tinge distortion, and (less often) increased sensitivity to light and blurred vision. Dyspepsia occurrence rose in higher doses. Before proceeding you should read Pfizer's Prescription information about Viagra.

How long Viagra works?

Up to 4.5-5 hours

Recommended time to take before sex: 60 minutes

Most common side effects: Headache, facial flushing, altered or blueish vision

Who should not take Viagra?

• Anyone taking nitrates such as nitroglycerine should not take Viagra
• Anyone with heart complications should only take Viagra under the direct supervision of their local physician.
• It should be used with caution with men who have medical conditions that may cause a sustained erection such as sickle cell anemia, multiple myeloma, or leukemia.
• It should be used with caution in patients with anatomical deformation of the penis

Cialis

What is Cialis?

Cialis is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men.

ED is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his doctor for help if the condition bothers him. CIALIS may help a man with ED get and keep an erection when he is sexually excited.

CIALIS does not:

cure ED
increase a man's sexual desire
protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your doctor about ways to guard against sexually transmitted diseases.
serve as a male form of birth control
CIALIS is only for men with ED. CIALIS is not for women or children. CIALIS must be used only under a doctor's care.

How does CIALIS work?

When a man is sexually stimulated, his body's normal physical response is to increase blood flow to his penis. This results in an erection. CIALIS helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away.

Who can take CIALIS?

Talk to your doctor to decide if CIALIS is right for you.

CIALIS has been shown to be effective in men over the age of 18 years who have erectile dysfunction, including men with diabetes or who have undergone prostatectomy.

Who should not take CIALIS?

Do not take CIALIS if you:

take any medicines called "nitrates". Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.
Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called "poppers" also contain nitrates, such as amyl nitrate and butyl nitrate. Do not use CIALIS if you are using these drugs. Ask your doctor or pharmacist if you are not sure if any of your medicines are nitrates.
take medicines called "alpha blockers", other than Flomax® 0.4 mg daily. Alpha blockers are sometimes prescribed for prostate problems or high blood pressure. If CIALIS is taken with alpha blockers other than Flomax® 0.4 mg daily, your blood pressure could suddenly drop to an unsafe level. You could get dizzy and faint.
you have been told by your healthcare provider to not have sexual activity because of health problems.Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
are allergic to CIALIS or any of its ingredients. The active ingredient in CIALIS is called tadalafil.
What should you discuss with your doctor before taking CIALIS?

Before taking CIALIS, tell your doctor about all your medical problems, including if you:
have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your doctor if it is safe for you to have sexual activity.
have low blood pressure or have high blood pressure that is not controlled
have had a stroke
have liver problems
have kidney problems or require dialysis
have retinitis pigmentosa, a rare genetic (runs in families) eye disease
have stomach ulcers
have a bleeding problem
have a deformed penis shape or Peyronie's disease
have had an erection that lasted more than 4 hours
have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
Can other medications affect CIALIS?

Tell your doctor about all the medicines you take including prescription and non?prescription medicines, vitamins, and herbal supplements. CIALIS and other medicines may affect each other. Always check with your doctor before starting or stopping any medicines. Especially tell your doctor if you take any of the following:

medicines called nitrates.
medicines called alpha blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl) or Uroxatral® (alfuzosin HCl).
ritonavir (Norvir®) or indinavir (Crixivan®)
ketoconazole or itraconazole (such as Nizoral® or Sporanox®)
erythromycin
other medicines or treatments for ED

How should you take CIALIS?

Take CIALIS exactly as your doctor prescribes. CIALIS comes in different doses (5 mg, 10 mg, and 20 mg). For most men, the recommended starting dose is 10 mg. CIALIS should be taken no more than once a day.Some men can only take a low dose of CIALIS because of medical conditions or medicines they take. Your doctor will prescribe the dose that is right for you.

If you have kidney problems, your doctor may start you on a lower dose of CIALIS.
If you have kidney or liver problems or you are taking certain medications, your doctor may limit your highest dose of CIALIS to 10 mg and may also limit you to one tablet in 48 hours (2 days) or one tablet in 72 hours (3 days).
Take one CIALIS tablet before sexual activity. In some patients, the ability to have sexual activity was improved at 30 minutes after taking CIALIS when compared to a sugar pill. The ability to have sexual activity was improved up to 36 hours after taking CIALIS when compared to a sugar pill. You and your doctor should consider this in deciding when you should take CIALIS prior to sexual activity. Some form of sexual stimulation is needed for an erection to happen with CIALIS. CIALIS may be taken with or without meals.

Do not change your dose of CIALIS without talking to your doctor. Your doctor may lower your dose or raise your dose, depending on how your body reacts to CIALIS.

Do not drink alcohol to excess when taking CIALIS (for example, 5 glasses of wine or 5 shots of whiskey). When taken in excess, alcohol can increase your chances of getting a headache or getting dizzy, increasing your heart rate, or lowering your blood pressure.

If you take too much CIALIS, call your doctor or emergency room right away.

What are the possible side effects of CIALIS?

The most common side effects with CIALIS are headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects usually go away after a few hours. Patients who get back pain and muscle aches usually get it 12 to 24 hours after taking CIALIS. Back pain and muscle aches usually go away by themselves within 48 hours. Call your doctor if you get a side effect that bothers you or one that will not go away.

CIALIS may uncommonly cause:

an erection that won't go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections.
vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green.
These are not all the side effects of CIALIS. For more information, ask your doctor or pharmacist.

How should CIALIS be stored?

Store CIALIS at room temperature between 59° and 86°F (15° and 30°C).
Keep CIALIS and all medicines out of the reach of children.

CIALIS is not for everyone. Men taking any form of nitrates (often used to control chest pain) should never take CIALIS, as the combination may cause an unsafe drop in blood pressure. Men taking medicines called "alpha blockers" (sometimes prescribed for prostate problems or high blood pressure), with the exception of Flomax® (tamsulosin HCl) 0.4 mg once-daily, should not take CIALIS. This combination could also cause an unsafe drop in blood pressure.

The most common side effects with CIALIS were headache, upset stomach, backache, and muscle ache. Men who experience an erection for more than four hours should seek immediate medical attention. Men should discuss their health status with their doctors to ensure that CIALIS is right for them and that they are healthy enough to engage in sexual activity. CIALIS does not protect a man or his partner from sexually transmitted diseases, including HIV.

Levitra

Levitra

How long it works: Up to 5 hours

Recommended time to take before sex: 25 to 60 minutes

Most common side effects: Headache, facial flushing

What is Levitra?

Levitra is the brand-name for vardenafil, a new tablet-based oral treatment for erectile dysfunction (ED), which is licensed for prescription in the UK and other countries, enabling you to buy it online. Levitra has proved highly successful in clinical trials and is generating major interest as a real alternative to Viagra, Uprima and Cialis.

Levitra is a new oral PDE-5 inhibitor for the treatment of male erectile dysfunction (ED). Phosphodiesterase type 5 (PDE-%) is the predominate enzyme found in human penile erectile tissue and is associated with erections. PDE-5 inhibitors such as Levitra typically work by blocking this enzyme to enhance or prolong the erectile process.

Levitra is marketed by the leading pharmaceutical companies Bayer and GlaxoSmithKline, through a worldwide co-promotion and co-development agreement.

How effective is Levitra for Impotence?

Levitra has sparked major interest worldwide following the results of an in-depth clinical study. The study of over 800 men with ED showed:

The vast majority treated with Levitra experienced a reliable improvement in their erectile function from the first time they took the drug, and each time they took it afterward.
74% of men taking a 20 mg dose of Levitra and 77% taking a 10 mg dose were able to have intercourse on their first attempt, compared with 45% taking a placebo.
Those men receiving treatment who were successful the first time continued to achieve successful penetration in 91% of their subsequent attempts.
These results - recently presented at the 10th World Congress of the International Society for Sexual and Impotence Research in Montreal - have been welcomed by clinicians. This initial research has shown that Levitra gives more consistent results than other treatments on repeated use.

Levitra and ED-related depression

A second study has shown how effective Levitra was in treating the depressive symptoms experienced by men with ED. This study showed men taking Levitra reported improved erections and fewer depressive symptoms than those men taking a placebo.

Levitra and ED after prostate surgery

Levitra is extremely effective in treating ED following prostate cancer surgery. Another trial involving 440 men aged 44 - 77 years with ED

Following a prostate surgery found:

71% of patients who had undergone prostate removal reported significant improvements in erections with Levrita (20mg) versus 12 per cent in men taking placebo.
The study concluded that this was an important finding for Levitra, as ED following prostatectomy is usually severe.

Is Levitra more effective than Viagra?

There is currently no direct evidence to compare the effectiveness of treatments such as Levitra, against others such as Viagra and Uprima. However, early findings do indicate that Levitra may be especially effective in treating specific types of ED, such as ED resulting from prostate surgery.

Does Levitra have side-effects?

Those involved in the clinical trials reported mild / moderate side effects with the treatment, these mostly included headaches, flushing and rhinitis (nasal congestion).

Who should avoid taking Levitra?

Levitra should not be taken if you are taking nitrates or nitric oxide donors (these medications are used to treat angina or chest pain). It is also contraindicated in men whom sex is inadvisable and men older than 75 years old who concomitantly use potent CYP 3A4 inhibitors (such as ritonavir, indinavir, ketoconazole and itraconazole). The safety of Levitra has not been studied in these subgroups and should not take Levitra until further studies are available: severe hepatic (liver system) impairment , endstage renal disease requiring dialysis, hypotension, recent history of stroke or heart attack, unstable angina, and known hereditary retinal degenerative disorders.

Propecia or Proscar

What is Finasteride?

Finasteride (Propecia, Proscar) is the first-ever FDA approved tablet proven to be effective for hair loss.  Finasteride blocks an enzyme that normally converts testosterone to DHT, the primary hormone which is known to cause hair loss.

Clinical studies have shown Finasteride to be 80% effective in halting hairloss, and 30-50% effective in restoring hair growth.

The recommended dosage for Finasteride is 1mg daily. Taking more does not make the drug work better.  The medication Propecia is a 1mg Finasteride tablet; Proscar, which is used for a prostate condition is a 5mg tablet of the same ingredient, Finasteride. For cost savings, many patients prefer to divide a Proscar tablet into 4 or 5 pieces and take one-fourth or one-fifth of the Proscar tablet per day, thereby enjoying the same benefits of taking Propecia at a savings of approximately 70%. Before proceeding please read Merck's prescribing information about Propecia.

What are the side effects of Finasteride?

In clinical studies, side effects from Propecia were uncommon and did not effect most users.  The following side effects were experienced by a small number of patients: less desire for sex, difficulty in achieving an erection, and a decrease in the amount of semen. These side effects occurred in less than 2% of men, and went away when Propecia therapy discontinued. The side effects also disappeared in most men who continued taking Propecia.

The active ingredient in Propecia (Finasteride) is also used in a 5mg tablet (Proscar, five times the dose of a Propecia tablet) to treat enlargement of the prostate. Additional side effects were reported by men taking Proscar including problems with ejaculation, breast swelling and/or tenderness and allergic reactions including lip swelling and rash. In clinical studies with Propecia, these side effects were reported as often in men taking the placebo as in those taking Proscar.

Why do you prescribe Proscar more than Propecia?

The monthly cost for taking Propecia (1 mg Finasteride tablet per day) is approximately $60.  By dividing Proscar tablets into quarters with a pill cutter and taking 1/4 of a Proscar tablet per day, your monthly cost (if you purchase your Proscar from us) is $22.50, a savings of 62%.  Although it is more difficult to divide a Proscar tablet into 5 pieces (as opposed to 4), many patients choose to do so and save even more: by cutting the pill into fifths, patients save 70% over Propecia by spending only $18 a month.     For those who don't care to save 70% by dividing Proscar tablets, our physicians will gladly prescribe 3 months of Propecia if your medical history suggests you will benefit from Finasteride therapy. This is an example of what we call patient empowerment: fostering a partnership with your physician in the decision process which allows you to take an increased and active role in your own plan of care.

How do I divide Proscar tablets?

Pill cutters are available in most major pharmacies in the US. If you are unable to locate a pill cutter, we will mail you one for a charge of US$ 10, which includes shipping anywhere in the world.

How do I know you aren't selling fake pills?

Unfortunately there have been some problems with unscrupulous vendors selling products with names that sound similar to Viagra.  We only dispense genuine Pfizer Viagra and Merck Proscar, and your pharmacist could identify each as authentic. 

Is the information I provide to Net-Dr kept private?

Absolutely. The information that you submit is encrypted and legally protected by doctor-patient privilege. No information (including your e-mail address) will ever be sold or otherwise shared with a third party, and you will never receive an unsolicited communication from us. 

Do I need to submit my form over the Internet?

No! To receive a consultation by fax, simply print out this form and fax it to us. This option makes it possible for your friends/associates who don't have Internet access to make use of our service.

Do you offer prescriptions for medications other than Finasteride and Viagra?

At this time we are only offering consultations for patients seeking Proscar/Propecia Viagra and Xenical. No other medications are being prescribed.

Xenical

What is Xenical?

XENICAL is an oral prescription weight loss medication used to help obese people lose weight and keep this weight off. XENICAL works in your intestines, where it blocks some of the fat you eat from being absorbed. This undigested fat is then eliminated in your bowel movements. XENICAL should be used together with a reduced-calorie diet that your doctor will recommend.

Excess weight has been proven to contribute to an increased risk of developing many medical problems, including high blood pressure, high cholesterol, heart disease, and diabetes. The consumption of excess fatty food and calories plays a significant role in the development of excess weight. While fat is an important component of a balanced diet, the consumption of excess fat contributes to excess body weight, since fat provides twice the number of calories per gram of weight as carbohydrates and protein. Reduction of dietary fat intake is one potential way of losing weight.

How does XENICAL work?

If you eat an excess amount of fat or calories, the excess is stored as fat by the body resulting in weight gain. When you eat fat, your body breaks it down into its simplest components so that it can be absorbed. Enzymes in your intestinal tract, called lipases, help digest (or breakdown) fat. When you take XENICAL with meals, XENICAL attaches to the lipases and blocks them from breaking down some of the fat you have eaten. The undigested fat cannot be absorbed and is eliminated in your bowel movements. By working this way, XENICAL helps block about 30% of the fat eaten in food from being absorbed by your body.

Following one year of treatment, XENICAL in combination with diet was shown to be more effective in reducing weight than diet alone. In most cases, weight loss was gradual. Patients treated with XENICAL and a reduced-calorie diet for one year lost an average of 13.4 pounds while those on a reduced-calorie diet alone lost 5.8 pounds.

Who should use XENICAL?

A weight loss program that includes a reduced-calorie diet and appropriate physical activity may be adequate in some patients. You should discuss with your doctor or other health care provider whether XENICAL should be added to such a program.

XENICAL may be right for you if you are considerably overweight (at least 30% above ideal weight or a body mass index of 30 or greater). XENICAL may also be right for you if you are overweight (at least 20% above ideal weight or a body mass index of 27 or greater) and also have other risk factors such as high blood pressure, high cholesterol, heart disease, or diabetes. For more information please visit www.xenical.com.

Vaniqa

What is Vaniqa?

VANIQA (pronounced "VAN-i-ka") is a prescription medication applied to the skin for the reduction of unwanted facial hair in women. The active ingredient in VANIQA is eflornithine hydrochloride. VANIQA also contains ceteareth-20, cetearyl alcohol, dimethicone, glyceryl stearate, methylparaben, mineral oil, PEG-100 stearate, phe-noxyethanol, propylparaben, stearyl alcohol and water.

Now for the first time, pharmaceutical giant Bristol-Myers Squibb together with Gillette, the world's largest manufacturer of razors, have developed Vaniqa - a cream that can stop facial hair growth. Vaniqa is available only by prescription and will be on the market sometime this year pending FDA approval. It does not appear that that Vaniqa will have problem winning FDA stamp of approval.

CLINICAL TRIALS Results of topical dermal studies for contact sensitization, photocontact sensitization, and photocontact irritation reveal that under conditions of clinical use, VANIQA is not expected to cause contact sensitization, phototoxic, or photosensitization reactions. Results of the topical dermal study for contact irritation did reveal that VANIQA could cause irritation reactions in clinical use in susceptible individuals or under conditions of exaggerated use. Two randomized double-blind studies involving 594 female patients (393 treated with VANIQA, 201 with vehicle) treated twice daily for up to 24 weeks evaluated the efficacy of VANIQA in the reduction of unwanted facial hair in women. Women in the trial had a customary frequency of removal of facial hair two or more times per week. Women with facial conditions such as severe inflammatory acne, women who were pregnant, and nursing mothers were excluded from the studies. Physicians assessed the improvement or worsening from the baseline condition (Physician’s Global Assessment [PGA]), 48 hours after shaving, of all treated areas. Statistically significant improvement for VANIQA versus vehicle was seen in each of these studies for “marked improvement” or greater response (24-week time point; pŁ 0.001). Marked improvement was seen consistently at 8 weeks after initiation of treatment and continued throughout the 24 weeks of treatment. Hair growth approached pretreatment levels within 8 weeks of treatment withdrawal. The success rate over time is graphically presented below for each pivotal trial. Findings The latest results of clinical trials of Vaniqa were recently presented at the 58th Annual Meeting of the American Academy of Dermatology in March 2000. The phase III study included 596 women who were randomized to use either eflornithine HCl 15% cream or a placebo cream. The treatment was applied twice daily to the affected areas for 24 weeks, followed by an 8-week period of no treatment. The results of physician's global assessment at the end of 24 weeks demonstrated improvements in the reduction of facial hair in the women who were treated with Vaniqa. Seventy percent of the women showed improvement, with 35% being classified as clinical successes (marked improvement or clear/almost clear), compared to 9% in the placebo group. Improvement was observed as early as 8 weeks after the commencement of treatment.

Who should not use VANIQA?

You should not use VANIQA if you are allergic to any of the ingredients in the cream. All ingredients are listed on the tube. You should not use VANIQA if you are less than 12 years of age.

What should you tell your doctor before using VANIQA?

If you are allergic to any of the ingredients, tell your doctor. If you are pregnant or plan to become pregnant, discuss with your doctor whether you should use VANIQA during pregnancy. No clinical studies have been performed in pregnant women. If you are breast feeding, consult your doctor before using VANIQA. It is not known if VANIQA is passed to infants through breast milk. If you are taking any prescription medicines, non-prescription medicines or using any facial or skin creams, check with your physician before use of VANIQA.

How should I use Vaniqa?

Use VANIQA only for the condition for which it was prescribed by your doctor. Do not give it to other people or allow other people to use it. You will need to continue your normal procedures for hair removal until desired results have been achieved. You may then be less bothered by the time spent in removing hair or the frequency of hair removal. VANIQA is to be used twice daily, at least eight hours apart, or as directed by your doctor. VANIQA is for external use only. Follow the instructions for application of VANIQA carefully. Apply a thin layer of VANIQA to the affected areas of the face and adjacent involved areas under the chin and rub in thoroughly. You should not wash the treatment areas for at least 4 hours after application of VANIQA. VANIQA may cause temporary redness, rash, burning, stinging or tingling, especially when the skin is damaged. If irritation continues, stop use of VANIQA and contact your doctor. Avoid getting the medication in your eyes or inside your nose or mouth. If the product gets in your eyes, rinse thoroughly with water and contact your doctor. If you forget or miss a dose of VANIQA do not try to "make it up". Return to your normal application schedule as soon as you can. You may use your normal cosmetics or sunscreen after applying VANIQA, but you should wait a few minutes to allow the treatment to be absorbed before applying them. If your condition gets worse with treatment, stop use of VANIQA and contact your doctor. Back to Top Are there any side effects? Use of Vaniqa was associated with few side effects, most of which were mild. They included stinging, burning, tingling, pseudofolliculitis barbae, and acne. Folliculitis (hair bumps) may also occur. If these persist, consult your doctor.

Are there any side effects?

Use of Vaniqa was associated with few side effects, most of which were mild. They included stinging, burning, tingling, pseudofolliculitis barbae, and acne. Folliculitis (hair bumps) may also occur. If these persist, consult your doctor.

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