Continue to take it as directed by your doctor. DOSAGE For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. However, Viagra may be taken anywhere from 4 hours to 0. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day. Ask your health care provider any questions you may have about how to use Viagra.

Brief storage at temperatures between 59 and 86 degrees F 15 and 30 degrees C is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Viagra out of the reach of children and away from pets. Contact your doctor or health care provider right away if any of these apply to you. Some medical conditions may interact with Viagra. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you: Some medicines may interact with Viagra.

Tell your health care provider if you are taking any other medicines, especially any of the following: Alpha-blockers eg, doxazosin , medicines for high blood pressure, nitrates eg, isosorbide, nitroglycerin , or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur Azole antifungals eg, itraconazole, ketoconazole , H2 antagonists eg, cimetidine , HIV protease inhibitors eg, ritonavir, saquinavir , macrolide antibiotics eg, erythromycin , narcotic analgesics eg, dihydrocodeine , or telithromycin because they may increase the risk of Viagra's side effects Bosentan or rifampin because they may decrease Viagra's effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Viagra may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Viagra may cause dizziness, drowsiness, fainting, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Viagra with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it. Viagra may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects.

To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

Patients with heart problems who take Viagra may be at increased risk for heart-related side effects, including heart attack or stroke. Symptoms of a heart attack may include chest, shoulder, neck, or jaw pain; numbness of an arm or leg; severe dizziness, headache, nausea, stomach pain, or vomiting; fainting; or vision changes.

Symptoms of a stroke may include confusion, vision or speech changes, one-sided weakness, or fainting. Contact your doctor or seek medical attention right away if you experience these symptoms. Viagra may rarely cause a prolonged eg, more than 4 hours or painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Entrepreneurs legally buy it in bulk at artificially low prices and redistribute it around the world.

Personally, I am leery of gray market Viagra. Sometimes they drop-ship it from the country of origin. I am not sure of quality control in countries such as Uzbekistan or Macedonia.

The problem with buying this stuff is that these goods pass through so many hands it is easy for counterfeit pills to enter the supply chain. Counterfeiters go to a lot of trouble to make their product and the packaging look like the real thing. Many times it takes an expert to tell the two apart. Unfortunately for the consumer, you have no way of telling how many milligrams of silendafil the pills contain.

They can contain too little or two much depending on the Viagra bootlegger's skills. However, many times the counterfeit Viagra contains no active ingredient.

Most of the websites that sell Viagra pretend to be Canadian but are located in other countries such as the former Soviet Union, Caribbean or Asia. Bloomberg claimed that at the time there were fewer than legitimate online pharmacies in Canada authorized by government agencies, but more than 11, fake Canadian pharmacies are operating online from overseas jurisdictions.

Pfizer is engaged in a constant battle against the introduction of fake Viagra into the pharmaceutical supply chain. Pfizer uses redundant high tech security features to make it easy to detect counterfeit Viagra pills and packaging: Beginning On , all bottles of Viagra have had a very small identification microchip known as a RFID embedded into the bottle.

The bottles are embedded with a Tagsys Flexible Module passive high-frequency This means that every bottle of Viagra has a special electronic fingerprint so that pharmacists and wholesalers can track the pedigree of the tablets inside to ensure that they are authentic and obtained legally. Each Viagra label also contains a special two-dimensional barcode that works hand in hand with the RFID chip so that pharmacists and wholesalers can track the Viagra from the factory, through the supply chain down to the individual consumer.

The labels on the Viagra bottles as well as many other Pfizer products such as Lipitor and Celebrex are printed with a color shift ink bar which is hard to fake but easy to recognize with the naked eye, similar to what you see with paper money.

Pfizer Global Security , a group comprised of former law-enforcement pros. The company placed its chief security officer front and center to detail the hazards of fake drugs and Fig. Example of counterfeit Viagra tablets and packaging compared to genuine Pfizer product.

It takes an expert to tell high quality counterfeits from the real thing. Counterfeit Viagra Factory Counterfeit Viagra factory; Guangzhou, China; Circa Bottom Line US governmental agencies don't go after the people who buy it, but postal inspectors will confiscate it if they find it.

And, if it gets confiscated, good luck getting your money back from the website you bought it. You are taking a chance with your health if you take generic sildenafil because the ingredients are completely unknown. If you are unsure where to buy Viagra, see my recommendation above. When you buy anything on the internet, you should be making your purchase based on the reputation of the seller.

I call this the ebay principle. This applies to buying anything on the internet, especially medicines. If you do buy brand name Viagra on the internet or if you want to take a chance and try the generic struff, the most important thing is to deal with a trusted online pharmacy. It should be a real address, not a P. If there is no address that is a bad sign. Why would someone want to hide their address? No address means that they are deliberately making it hard for you to track them down in case there is a problem.

If something goes wrong you want to be able to speak to a real live person. It is very frustrating to only be able to communicate by e-mail when you have a problem. Test the telephone number before you place your order. Ask the person who answers the phone where the Viagra is shipped from. If they don't answer to your satisfaction, it's a bad sign. The reliable, established internet pharmacies all have this service integrated into their sites.

If they have such a service, test drive it. Ask them some questions such as: Who is the manufacturer of your Viagra it should be Pfizer?

Where is it shipped from? How long does it take to get my shipment. What is the cost of Viagra? In many instances, they have no idea who the Viagra merchant is; all they know is that once a month they get a commission check from someone they have never seen or met in person. Their job is answering the phone and ringing up your sale. After your credit card has been charged, the relationship is over.

If it seems too good to be true, it probably is too good to be true. The price of Viagra can be deceiving. Your Viagra cost is not the most important thing to consider. Don't start off with thirty tablets. Buy five or ten. Make sure the Viagra is legit and the shipping and billing goes smoothly before you make a large purchase. Scammers in these countries have been known to set up sham Viagra web sites just so they could steal your credit card information. Where does fake Viagra come from?

Most of the fake Viagra comes from Asia and South America where the laws regarding pharmaceuticals are lax. Most of the Viagra selling websites are fly-by-night operations looking to make a quick buck with a low price of Viagra. They often masquerade as American or Canadian internet pharmacies but they are usually located outside the law in countries such as China, Japan, Cambodia or Bulgaria.

How much should it cost? Another popular online pharmacy site - RxUSA. Who does this site recommend? If you are looking for brand-name Viagra online manufactured by Pfizer Laboratories, without a prior prescription, one vendor I recommend is AccessRx. They have been in business since , are located in the USA in Tempe Arizona, and even offer overnight shipping.

AccessRx,com works with FDA approved pharmacies to insure that people who buy Viagra from them as well as other products are legit meds.

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