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George Falcon, publisher of Key magazine an entertainment and dining guide for the Los Angeles and Orange County area, got the idea for the Golden Spike Award in the mid-1960s from actress Debbie Reynolds, a train lover whose father worked as a conductor on the Southern Pacific Railroad. She was the first recipient. The second recipient was Walt Disney. Since then, the Golden Spike has been given to celebrities, elected officials, and others who have made important contributions to the passenger rail cause.
The award itself originally was just a golden spike. Going back to the completion of the Transcontinental Railroad in 1869, golden spikes were used by railroads in ceremonies to mark the completion of important projects. By the 1970s, the award became a golden spike mounted on a wooden plaque with a brass inscription plate.
Mr. Falcon was an active early member of NARP, which was founded in 1967. As he became more active in NARP, the Golden Spike evolved into a NARP award. Since 1984, the NARP Board of Directors Executive Committee has approved all choices for recipients. Mr. Falcon continued to provide the awards and publicize them in Key through 2003, the year he passed away.
What does it mean for a result to be statistically significant?
How can we tell whether two events happen at the same time by chance, or for a reason? A headache cured by an aspirin might have gone away without the aspirin. The fact that a sequence of five coin flips turned up five heads may or may not indicate a biased coin. When are the observations we make such as that Republicans go to church more than Democrats, and men earn more money than women in similar jobs due to chance, and when are they truly correlated events, with an underlying reason?
Measuring the likelihood that an event occurs by chance when there is no underlying pattern is the idea behind statistical significance. If there is, at most, a 5 percent chance of two events would happen together by coincidence, we may legitimately infer that there is a reason that the events occurred together.
If tadalafil is used as needed, you are not likely to be on a dosing schedule.
If you take tadalafil every day and you miss a dose, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Grapefruit and grapefruit juice may interact with tadalafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking this medicine.
Drinking alcohol can increase certain side effects of tadalafil.
Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.
Get emergency medical help if you have any of these signs of an allergic reaction to tadalafil : hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
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vision changes or sudden vision loss;
ringing in your ears, or sudden hearing loss;
chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
swelling in your hands, ankles, or feet;
a light-headed feeling, like you might pass out.
redness or warmth in your face, neck, or chest;
cold symptoms such as stuffy nose, sinus pain, sore throat, cough;
muscle pain, back pain, pain in your arms or legs.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
10 mg orally taken prior to anticipated sexual activity. The maximum recommended dosing frequency is once per day in most patients.
Alternatively, 2.5 mg orally once daily, without regard to timing of sexual activity. May increase to 5 mg orally once daily based on efficacy and tolerability.
5 mg orally taken at approximately the same time every day.
40 mg orally once daily, with or without food. Dividing the dose 40 mg over the course of the day is not recommended.
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Tell your doctor about all medicines you use, and those you start or stop using during your treatment with tadalafil, especially:
an antibiotic-clarithromycin, erythromycin, telithromycin;
antifungal medication-itraconazole, ketoconazole, posaconazole, voriconazole;
heart or blood pressure medication-amlodipine nicardipine, quinidine;
hepatitis C medications-boceprevir, telaprevir;
HIV/AIDS medication-atazanavir, delavirdine, efavirenz, fosamprenavir, indinavir, nelfinavir, nevirapine, ritonavir, saquinavir;
seizure medication-carbamazepine, fosphenytoin, oxcarbazepine, phenobarbital, phenytoin, primidone; or
tuberculosis medication-isoniazid, rifabutin, rifampin, rifapentine.
This list is not complete. Other drugs may interact with tadalafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
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Phosphodiesterase type 5 inhibitors or PDEV inhibitors work by inhibiting or decreasing the effect of phosphodiesterase type 5, a substance that breaks down nitric oxide allowing for higher concentrations of nitric oxide to remain in the blood vessels. Nitric oxide is a potent vasodilator opens up the blood vessels allowing blood to flow more easily through and is deficient in the pulmonary blood vessels of pulmonary hypertension patients. The FDA Food and Drug Administration has approved two PDEV inhibitors for the treatment of PAH.
Revatio is a PDEV inhibitor available in a 20mg pill form. This drug has another name, Viagra, and is used to treat erectile dysfunction. Before the FDA approved Revatio for the use of PAH, physicians were writing for Viagra for PAH patients. This prompted a huge number of phone calls from concerned pharmacists wondering why a physician was ordering a drug for erectile dysfunction for female patients. The FDA has approved one dose of 20mg three times a day for the treatment of PAH. Many physicians use other dosing regimens which are considered off label or unapproved. This medication is available through specialty pharmacies and local retail pharmacies such as Walgreens, etc. This drug may require a prior authorization from your insurance company which can delay the start of treatment and also delay refills. Many of the pharmacies have to order this medication in so it is a good idea to order refills before you are out of medication.
This medication, like all medications used to treat pulmonary hypertension, has side effects. It is important to communicate any side effects being experienced to the physician as there are medications available to alleviate many of these symptoms. The most common side effect reported while taking Revatio is headache. Revatio is an expensive medication but there are assistance programs so let your nurse coordinator know if your copay is high and they can assist in connecting you to the appropriate program. You should not stop taking this medication without speaking to your health care professional. Each patient should speak with their physician about the risk, benefits, and alternatives before initiating this therapy.
Adcirca is a PDEV inhibitor approved for the treatment of pulmonary arterial hypertension. Like Revatio it also has another name, Cialis, and is used for the treatment of erectile dysfunction. Adcirca was approved for treatment of pulmonary arterial hypertension in May of 2009. The recommended dose is two 20mg tablets together once a day. This medication is available through specialty pharmacies and local retail pharmacies such as Walgreens, etc. This drug may require a prior authorization from your insurance company which can delay the start of treatment and also delay refills. Many of the pharmacies have to order this medication in so it is a good idea to order refills before you are out of medication.
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MUMBAI: APTART Technical Services has advised traders to buy Ajanta Pharma for target of Rs 255. Buy Ajanta Pharma in the range of Rs 242-240 with stoploss of Rs 237 for target of Rs 255. Price and volume breakout seen in the stock, said Sandeep Wagle, founder MD, APTART. Note: Trading idea valid for time-period of 7-8 trading sessions. The entryexit price levels, stop-losses, targets as well as the time frames are indicative and viewers should use their discretion in implementing the same.
January 30, 2009 ET Bureau
MUMBAI: Ajanta Pharma on Thursday said its net profit for the quarter ended December 31, rose by 16.5% to Rs 4.6 crore. The company had a net profit of Rs 3.9 crore for the same quarter FY08, Ajanta Pharma said in a filing to BSE. Total income of the company rose to Rs 74.8 crore for the quarter under review, against Rs 70.8 crore in the same period last year. For the nine months ended December 31, the company has posted a net profit of Rs 12.1 crore, against Rs 9 crore in the corresponding period a year-ago.
December 29, 2008 Paramita Chatterjee Khomba Singh, ET Bureau
NEW DELHI: US-based drugmaker Alcon has won a trademark case against its Indian counterpart Ajanta Pharma preventing the latter from selling its popular eyedrop under the brand Travaxo here. The Bombay High Court HC granted an injunction in favour of Alcon, restricting Ajanta Pharma from using its product Travaxo on grounds of trademark infringement. The medicine directly competes with Alcons Travatan in the highly competitive Rs 33, 000-crore drug retail market. Alcon, with over 4.4 billion global sales, manufactures and markets Travatan, an eye drop for the treatment of glaucoma and has registrations for its trademark in several countries including India.
September 12, 2008 Kiran Kabtta Nina Mehta, ET Bureau
MUMBAI: The pharma industry has turned the old maxim, wisdom comes with age, on its head. An analysis of pharma companies show that the older entities have proved to be laggards when compared to younger players. Barring a few like Cipla, Ranbaxy and Lupin, most of the pharma companies which have been around for more than 35 years have shown a slower growth. They have been outperformed by younger players which are less than 30-year old. Many of the early starters seem to have missed the bus during the 80s and 90s boom in the pharma sector.
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Results in ED Population in US Trials The 2 primary US efficacy and safety trials included a total of 402 men with erectile dysfunction, with a mean age of 59 years range 27 to 87 years. The population was 78% White, 14% Black, 7% Hispanic, and 1% of other ethnicities, and included patients with ED of various severities, etiologies organic, psychogenic, mixed, and with multiple co-morbid conditions, including diabetes mellitus, hypertension, and other cardiovascular disease. Most 90% patients reported ED of at least 1-year duration. Study A was conducted primarily in academic centers. Study B was conducted primarily in community-based urology practices. In each of these 2 trials, Cialis 20 mg showed clinically meaningful and statistically significant improvements in all 3 primary efficacy variables see Table 11. The treatment effect of Cialis did not diminish over time.
Results in General ED Population in Trials Outside the US The 5 primary efficacy and safety studies conducted in the general ED population outside the US included 1112 patients, with a mean age of 59 years range 21 to 82 years. The population was 76% White, 1% Black, 3% Hispanic, and 20% of other ethnicities, and included patients with ED of various severities, etiologies organic, psychogenic, mixed, and with multiple co-morbid conditions, including diabetes mellitus, hypertension, and other cardiovascular disease. Most 90% patients reported ED of at least 1-year duration. In these 5 trials, Cialis 5, 10, and 20 mg showed clinically meaningful and statistically significant improvements in all 3 primary efficacy variables see Tables 12, 13 and 14. The treatment effect of Cialis did not diminish over time.
Table 13: Mean Post-Baseline Success Rate and Change from Baseline for SEP Question 2 Were you able to insert your penis into the partners vagina? in the General ED Population in Five Pivotal Trials Outside the US
Table 14: Mean Post-Baseline Success Rate and Change from Baseline for SEP Question 3 Did your erection last long enough for you to have successful intercourse? in the General ED Population in Five Pivotal Trials Outside the US
In addition, there were improvements in EF domain scores, success rates based upon SEP Questions 2 and 3, and patient-reported improvement in erections across patients with ED of all degrees of disease severity while taking Cialis, compared to patients on placebo.
Therefore, in all 7 primary efficacy and safety studies, Cialis showed statistically significant improvement in patients ability to achieve an erection sufficient for vaginal penetration and to maintain the erection long enough for successful intercourse, as measured by the IIEF questionnaire and by SEP diaries.
Efficacy Results in ED Patients with Diabetes Mellitus Cialis was shown to be effective in treating ED in patients with diabetes mellitus. Patients with diabetes were included in all 7 primary efficacy studies in the general ED population N235 and in one study that specifically assessed Cialis in ED patients with type 1 or type 2 diabetes N216. In this randomized, placebo-controlled, double-blinded, parallel-arm design prospective trial, Cialis demonstrated clinically meaningful and statistically significant improvement in erectile function, as measured by the EF domain of the IIEF questionnaire and Questions 2 and 3 of the SEP diary see Table 15.
Future. Click here for more relevant insider technical background about these ultra famous telescopes.
Galileo opened the Pandoras box of Quantum Mechanics in his development of the high powered telescope. This led to the invention of the spectroscope which allowed us to measure the chemistry of the stars and everything else
Combining The of the instruments of optics and electricity.
The instruments that generate high voltage, high current of electricity when mixed with spectroscopes
One of our early spark gap crystal set radio station.
Similar to the one that Edison used to invent the light bulb.
The interaction of Plasmas and magnetic field pushing electrons and ions around, makes for even bigger and better atom smashers.
A lso the generation atomic and ionic spectrum of Hydrogen. Oxygen, Nitrogen, Mercury etc. to study the stars and Atomic bombs
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W e have helped a new inexpensive form of video projects for spreading the good news of work going on in science and engineering. This pilot project called Chemical Explorers is about a recent discovery at MIT of a new catalytic method of electro-chemically producing hydrogen more cheaply than ever before. To see the results. Click Here
The Galvanometer. 1825 The little simple instrument that inspired all of the serious discoveries in all branches of science and the explosion of inventions.
The Spectroscope Displaying the rain bow of air heated to the surface temperature of the sun. Discovering new elements and generating the need for quantum physics
What a scientific paper printed less the photographs in a prestigious journal of physics looks like.
Plasmas and magnetic field pushing electrons and ions around, The spectrum of glowing Hydrogen. Oxygen, Nitrogen, Mercury
We Advise, sell and rent Scientific Engineering Instruments for Props in Movies, TV Programs Museum Displays and Demonstrations. Many of these wonderful item are For Sale
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With regard to our project of the Galileo Telescope for the Griffith Observatory Rhoda I can not thank the staff of the ISTITUTE E MUSEO DI STORIA DELLA SCIENZA Florence Italy enough for their help on our recent visit to gather data on Galileo Telescope. Most of us cannot appreciate enough the hard work and dedication of the museum staff behind the scenes that preserve and prepare for display those precious things that demonstrate so well the positive attributes of the scientific community.
This is a beautiful Museum for art lovers and scientist alike. The Instrument are truly works of art which also have had a major influence on our quality of life.
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Apcalis is one remarkable yet simplest remedy discovered to assist men get rid of impotence distress. This oral-intended inexpensive pill is one best method invented to cure erectile dysfunction in majority of the men worldwide.
One good thing about Apcalis pill is that it can be easily bought from online stores at an affordable price. The reason why majority of the men opt to buy generic medicines from online is that they are pocket friendly, saves times and money too.
Time it takes to begin its work: It usually begins to show its work within 20 minutes of consumption of the pill.
Apcalis includes an active ingredient called as Tadalafil. It clears the inhibiting work of dreadful enzyme PDE5 that is held responsible to limit the blood flow in the male organ. The work of this pill begins to show when a man is sexually stimulated.
Apcalis further produces the good enzyme cGMP due to which the blood supply to the male organ receive the penile erection quickly as compared to other medicines, which he can hold for maximum hours and have a successful yet pleasurable sexual intercourse with his partner.
How long does the effect last? The effect of Apcalis lasts for the maximum duration 36 hours.
The suggested daily dosage of this pill is 20mg.
This medicine is consumed within thirty to forty five minutes before beginning with the sexual act.
Take a single pill of Apcalis with water as it easily dissolves the tablet in the bloodstream of the men.
Men suffering with severe health issues must consume the smallest dosage of this pill.
A gap of 24 hours is required after the intake of first dosage.
Men who are suffering with high sugar levels need to seek medical advice before consuming Apcalis. The dosage of this pill must not be increased as this might put a pressure on the male organ.
Fatigue and Blurred vision are the common causes linked with the intake of Apcalis.
Men with an allergy to PDE5 inhibitors must stay away from this pill.
Heavy meals or consumption of alcohol should be strictly avoided as this might reduce the effect of the pill.
The dosage of this pill can be increased but only after consult the doctor.
Men suffering from Peyronies disease should consult your doctor before consuming this pill.
This list may not describe all possible effects of Apcalis. Check with your doctor of advice if you notice any symptom that worries you while you are under this medication.
Do not overdose these pills, as it can be health hazardous.
If you are a sufferer of any other health ailments, then consult your doctor before getting into the treatment with Apcalis
Avoid consuming alcohol, excessive cigarette smoking and intake of fatty foods or grape vine as this can hold back the effects of this pill.
0100 The enriched sample can be collected from the final chamber, N
in this example. At the end of each time step, there is no N
Instead, a small fraction of that N
volume is collected 70, and the same volume of racemic mixture is injected 72 into N
The partial amount of solution with enriched enantiomers that can be extracted from the last chamber is V/2N, throughput is V/2N per time step, where V is the volume of a single chamber so V/2 is the volume of the upper half, and N is the number of amplification steps 10, in this example. Extracting this volume of solution and substituting the same volume of racemic solution keeps both the volume and the average concentration in the last chamber constant from one time step to the next. This scheme enables continuous purification enrichment of enantiomers.
0101 The above description assumed that increasing average concentrations in the respective consecutive chambers are pre-established at the start. These concentrations can be set up initially within a short period of time as shown in FIG. 5. We first fill N
with a racemic mixture the first row in the table, , with concentrations of 100-100 for both the left-handed and right-handed molecules. We assume 10 arbitrary units of volume in each chamber. Then we run chamber N
transfer the upper half volume which has average concentrations of 105 and 95 of right-handed and left-handed molecules, respectively to N
and transfer the lower half volume which has average concentrations of 95 and 105 of right-handed and left-handed molecules, respectively to N
is completely empty, and N
are each half full with their respective correct average concentrations, V
with a racemic mixture again, V
line 2 of the table, without any transfers from N
is empty. We repeat the initial process of filling N
with a racemic mixture, and at each time step transfer half of the volume of the outermost chambers that are full to their subsequent neighbors until all the chambers are filled. Note that the total time it takes to fill the whole setup is not on the order of 2
since we can start doing multiple half-volume transfers in parallel as more and more chambers are being filled. Instead, the initial set-up time is linear with number of steps, on the order of 4N, where 2N comes from the fact that it takes two time steps to fill the outermost chamber, another N because we need to wait a third time step before we can make a transfer out of the outermost chamber, and another final N to fill up all the half-filled chambers at the end of the initial setup. In FIG. 5, we can see that it takes three time steps to bring each additional chamber into operation in the system so setup time is on the order of 3N. We need a final stage t
for cleanup on the order of another N.
0103 As shown in FIG. 16, a system 220 for receiving and processing chiral objects 228 and delivering, for example, enriched chiral objects 230 after processing, can include a set 222 of chambers 224, a fluid subsystem 226 and an electrical subsystem 250 both coupled to each of the chambers, and controls 268 that provide control signals 234, 264 to and receive feedback signals 232, 266 from the subsystems to cause the set of chambers to safely, efficiently, effectively, and quickly produce the enriched chiral objects.
Have you any idea precisely what is distinctive about Levitra? It is actually Vardenafil hydrochloride, a powerful compound having a weight of 488.604 garyPermol. For a PDE5 chemical, Vardenafil is meticulously related inside operate and marketing and advertising to Sildenafil and Cialis though it features a rather limited efficient time with much less cases of failing. People who have Levitra experience, have noticed that compared with other Impotence drugs, Levitra worked for him or her on the very first test.
Enable uncover the particular promoting details in the ED medication Levitra around its challengers.
The chief factor of Levitra, Vardenafil hydrochloride is actually a efficient particle which needs more compact amount to get into complete steps. The professionals consider the particle as considerably more more powerful than Sildenafil and Tadalafil.
Levitra operates like a charm males who received poor or failed exposure to The blue pill. This statement has become affirmed time and again by caused by distinct clinical tests.
Vardenafil hydrochloride in Levitra can be a blessing on the diabetics, that are with a and the higher chances of impotence problems because of uncontrolled sweets in blood that impedes the the circulation of blood to your manhood. Levitra has been proven as effective even in limited situations like hypertension and even diabetes mellitus type2 when other Erectile dysfunction medicines have failed to work.
Levitra top dose of 20 mg is equal to 100 mg maximum serving of The blue pill. Now, check out the smallest dosage for Viagra, 12.5 milligrams and evaluate it to two.5 mg tablet of Levitra, its least expensive medication dosage.
These, who had been click down below the harness, are located to achieve a lower number of uncomfortable side effects as compared to other obtainable PDE5 inhibitors. The gentle and many prevalent adverse reactions are severe headaches, nose traffic jam, eradicating. What is more, with Levitra, you shouldnt be worried about the eye area simply because it doesnt have adverse unwanted effects on vision. Theres an additional add-on help with Levitra its significantly less sensitive to food items and alcoholic beverages, yet again, providing you sufficient prospects for an intimate dinner with your ladylove whilst getting all set finest time.
All the PDE5 inhibitors should have it share in the impotence marketplace. Apparently Levitra carries a offering foreseeable future onward, because, Vardenafil hydrochloride is sufficiently strong enough to grant an erection to the diabetic patients, that are probably the most simple affected individuals of impotence problems, consequently regarded as an amazing chunk of ED industry.
The rising sector of erection problems is experiencing a go-on competitors from the group of 3. Personally, the Impotence problems current market case is rather obvious! Viagra, Levitra Cialis, these have an existing to supply. If Viagra offers the lengthiest history, Cialis has 36 hours of measures to present, though Levitra has developed success and provides sturdy hard-on to diabetics in spite of lesser doses.
The Edward industry huge is always Viagra although, on account of its regularity in overall performance but Levitra is victorious in strict circumstances like diabetes.
Louis, Missouri pop 352, 572 Raleigh, North Carolina pop 342, 812 Santa Ana, California pop 340, 865 Anaheim, California pop 333, 229 Cincinnati, Ohio pop 331, 310 Islip, New York pop 329, 043 Tampa, Florida pop 325, 800 Pittsburgh, Pennsylvania pop 316, 299 Toledo, Ohio pop 301, 728 Aurora, Colorado pop 296, 861 Oyster Bay, New York pop 296, 820 Bakersfield, California pop 295, 769 Riverside, California pop 290, 417 Stockton, California pop 287, 069 Corpus Christi, Texas pop 282, 972 Newark, New Jersey pop 280, 007 Buffalo, New York pop 279, 138 Anchorage, Alaska pop 275, 474 St. Paul, Minnesota pop 275, 084 Lexington-Fayette, Kentucky pop 267, 929 Plano, Texas pop 250, 654 St. Petersburg, Florida pop 248, 365 Fort Wayne, Indiana pop 247, 000 Glendale, Arizona pop 243, 144 Jersey City, New Jersey pop 239, 395 Lincoln, Nebraska pop 239, 196 Greensboro, North Carolina pop 233, 459 Henderson, Nevada pop 232, 014 Chandler, Arizona pop 231, 728 Norfolk, Virginia pop 230, 775 Birmingham, Alabama pop 230, 726 Scottsdale, Arizona pop 227, 584 North Hempstead, New York pop 222, 656 Madison, Wisconsin pop 221, 545 Baton Rouge, Louisiana pop 221, 148 Hialeah, Florida pop 220, 611 Chesapeake, Virginia pop 218, 219 Garland, Texas pop 216, 478 Babylon, New York pop 215, 852 Orlando, Florida pop 213, 250 Akron, Ohio pop 210, 771 Chula Vista, California pop 210, 563 Lubbock, Texas pop 209, 946 Rochester, New York pop 209, 662 Laredo, Texas pop 208, 935 Modesto, California pop 206, 885 Reno, Nevada pop 205, 794 Durham, North Carolina pop 204, 680
A 100ml beaker is used for holding up to 100 ml of a substance/fluid. Often this is in a laboratory environment. The contents could be the input into some work or the output/result of an experiment or process.
Each state gets two senators to represent themselves, and there are 50 states, so yes there are 100 senators.
Stud 100 makes that sexy time even more entertaining for the ladies. Reducing the sensitivity of the male parts allows for longer sex increasing youre reputation amongst the ladies.
You use which if it is something nonessential to the sentence, and you use
is mentioned use a. The next time it is mentioned use the - because the reader knows the thing
and is a conjunction and would use it to link clauses, subjects or verbs. I went to the store
Using Has is referred a past tense. Such as: He has taken the garbage out already. Using Is for example is referred a Present tense. Such as: He is taking out the garbage.
theres an easy way to decide whether to use I or me in such sentences. All you have to do is drop the word
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A consideration, when exclamation takes area direct earlier the coition is title d early exclamation. Thither is no claim definition for this constituent. Lots of sexologists attempt to insert this pathology with the longness of coition, the assets of frictions and change with partners climax; no ace is allay competent to afford a dead definition.
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Last Updated: February 10, 2011
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Effects associated with it. It is shown to exhibit a great tendency to produce muscle growth with Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs a milder effect than Dianabol, however as said before the water retention and the Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs androgenic effects are not a is not capable of converting into estrogen so any sensitive individuals this drug is Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs a great way to go since gyno is no problem. Since estrogen is the culprit of producing water retention this steroid is capable of producing Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs lean, quality look to the physique with no fear of excess poundage except for muscle growth. This is why it makes this a favorable drug for pre-contest or to gain a ripped look especially if stacked with a non-aromatizing or milder aromatizing drugs such as Halotestin, Primobolan, Deca or Equipose. One should Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs take in consideration that with the C17-AA alteration to bypass the livers first pass it will cause stress on the liver with Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs the oral preparation It could possibly happen with the injectable as well. Stanozolol also plays a role in strong adverse changes in HDL/LDL Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs cholesterol levels, especially with the oral form because of the method of administration, which may cause concern for this side effect. Combination with Proviron to the test cycle should prove useful by enhancing the free state of this potent muscle building androgen. The usage of this drug should be in the length of no more than 8 weeks since Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs liver problems could arise so always check blood levels and liver enzymes. It is also important to note that while Women may receive some small benefit from the drug Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs although testosterone is really not a steroid for females, they must be very careful with it. Those who are, or might become pregnant, Kamagra Gold 100mg Sildenafil Citrate x 4 Tabs should never take or even handle a ProscarPropecia tablet. The DHT blocking action can cause severe developmental problems to an unborn fetus, even in very small amounts. Since the drug can
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counterfeit. You always get the real deal with us! Kamagra 100 mg TabletP contains active ingredient Sildenafil citrate. Kamagra Gold comes in a strip of 4 Tablets. Kamagra Tablet is used to treat Foreplay function problems such as impotence or erectile dysfunction. In combination with Forepaly stimulation, this medicine works by helping the blood flow into the Male Secret Organ to achieve and maintain an erection.
Kamagra Tablet is equivalent to regular Sildenafil Citrate tablet. It is used to treat men erection problems.
How do you create backlinks? Within typical instances, each time a person is intimately triggered, the penis fills up with blood stream. When erection problems develops, enough body wont pass to result in a harder erection. Caverta, with Sildenafil citrate, unwinds the pennis capillaries whenever a male is sexually activated. This will give circulation into your penile, resulting in more durable. The construction reduces following sexual intercourse, just as it is supposed to in regular disorders.
Make sure you be aware that Caverta isnt a endocrine or aphrodisiac, it functions provided that men is sexually activated.
How much time manages to do it decide on function? Bring Caverta about a couple of hours prior to want to have intercourse. From about half-hour which last for up to 4 time, Caverta will let you recieve an penile erection if you are while making love excited. Invest the Caverta after having a great-extra fat meal just like, cheeseburger and french-fried potatoes, the medicine may well take a little longer to start out doing work. Caverta can help you get an construction when youre while making love fired up. Youll not purchase an construction through using the formula.
What Caverta will not do? Caverta wont heal impotence. This can be a remedy for erectile dysfunction. Caverta would not safeguard you and your companion from finding sexually transmitted diseases, which includes Human immunodeficiency virus-herpes which causes Products. Caverta isnt a hormone or perhaps aphrodisiac.
Side effects As with any remedies, Caverta sildenafil citrate might cause some unwanted side effects. These consequences are often gentle to mild in most cases put on stay longer than some hours. Most of these uncomfortable side effects are more inclined to come about with greater dosage amounts.
The most prevalent uncomfortable side effects of sildenafil citrate are frustration, purging from the facial area and irritated abdominal. Less frequent side effects that will appear are temporary adjustments to colour perspective.
Do not take far more CAVERTA than your physician prescribes. If you feel you want a greater dosage of CAVERTA, consult a medical expert.
CAVERTA ought not to be utilised in persons underneath 18 years old.
Caverta can be considered as a boon to men who are suffering from erectile dysfunctions. It is used to treat erectile dysfunctions in men. Caverta is known to improve the erotic capabilities of men and bring their sexual life back on track. The main component of Caverta is a chemical called Sildenafil citrate. Caverta comes in tablet form and it is approved by FDA, which speaks volumes about its quality. This drug treats ED by increasing the blood flow to the penis. This enables erection during the sexual intercourse and makes it possible to give perfect sexual performance.
Risk Summary Based on animal data, Cialis is not predicted to increase the risk of adverse developmental abnormalities in humans.
Animal Data Animal reproduction studies showed no evidence of teratogenicity, embryotoxicity, or fetotoxicity when tadalafil was given to pregnant rats or mice at exposures up to 11 times the maximum recommended human dose MRHD of 20 mg/day during organogenesis. In one of two perinatal/postnatal developmental studies in rats, postnatal pup survival decreased following maternal exposure to tadalafil doses greater than 10 times the MRHD based on AUC. Signs of maternal toxicity occurred at doses greater than 16 times the MRHD based on AUC. Surviving offspring had normal development and reproductive performance.
In a rat prenatal and postnatal development study at doses of 60, 200, and 1000 mg/kg, a reduction in postnatal survival of pups was observed. The no observed effect level NOEL for maternal toxicity was 200 mg/kg/day and for developmental toxicity was 30 mg/kg/day. This gives approximately 16 and 10 fold exposure multiples, respectively, of the human AUC for the MRHD of 20 mg.
Tadalafil and/or its metabolites cross the placenta, resulting in fetal exposure in rats.
Cialis is not indicated for use in women.
Tadalafil and/or its metabolites were secreted into the milk in lactating rats at concentrations approximately 2.4-fold greater than found in the plasma.
Cialis is not indicated for use in pediatric patients. Safety and efficacy in patients below the age of 18 years has not been established.
Of the total number of subjects in ED clinical studies of tadalafil, approximately 25 percent were 65 and over, while approximately 3 percent were 75 and over. Of the total number of subjects in BPH clinical studies of tadalafil including the ED/BPH study, approximately 40 percent were over 65, while approximately 10 percent were 75 and over. In these clinical trials, no overall differences in efficacy or safety were observed between older 65 and 75 years of age and younger subjects 65 years of age. Therefore no dose adjustment is warranted based on age alone. However, a greater sensitivity to medications in some older individuals should be considered. see Clinical Pharmacology 12.3.
In clinical pharmacology studies, tadalafil exposure AUC in subjects with mild or moderate hepatic impairment Child-Pugh Class A or B was comparable to exposure in healthy subjects when a dose of 10 mg was administered. There are no available data for doses higher than 10 mg of tadalafil in patients with hepatic impairment. Insufficient data are available for subjects with severe hepatic impairment Child-Pugh Class C. see Dosage and Administration 2.6 and Warnings and Precautions 5.8.
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Population pharmacokinetics In patients with pulmonary hypertension not receiving concomitant bosentan, the average tadalafil exposure at steady-state following 40 mg was 26% higher when compared to those of healthy volunteers. The results suggest a lower clearance of tadalafil in patients with pulmonary hypertension compared to healthy volunteers.
In healthy male elderly subjects 65 years or over after a 10 mg dose, a lower oral clearance of tadalafil, resulting in 25% higher exposure AUC with no effect on C max was observed relative to that in healthy subjects 19 to 45 years of age.
In clinical pharmacology studies using single-dose tadalafil 5 to 10 mg, tadalafil exposure AUC doubled in subjects with mild creatinine clearance 51 to 80 mL/min or moderate creatinine clearance 31 to 50 mL/min renal impairment. In subjects with end-stage renal disease on hemodialysis, there was a two-fold increase in C max and 2.7- to 4.1-fold increase in AUC following single-dose administration of 10 or 20 mg tadalafil, respectively. Exposure to total methylcatechol unconjugated plus glucuronide was 2- to 4-fold higher in subjects with renal impairment, compared to those with normal renal function. Hemodialysis performed between 24 and 30 hours post-dose contributed negligibly to tadalafil or metabolite elimination see Dosage and Administration 2.2 and Warnings and Precautions 5.3.
In clinical pharmacology studies, tadalafil exposure AUC in subjects with mild or moderate hepatic impairment Child-Pugh Class A or B was comparable to exposure in healthy subjects when a dose of 10 mg was administered. There are no available data for doses higher than 10 mg of tadalafil in patients with hepatic impairment. Insufficient data are available for subjects with severe hepatic impairment Child-Pugh Class C see Dosage and Administration 2.2 and Warnings and Precautions 5.4.
In male patients with diabetes mellitus after a 10 mg tadalafil dose, exposure AUC was reduced approximately 19% and C max was 5% lower than that observed in healthy subjects. No dose adjustment is warranted.
Pharmacokinetic studies have included subjects from different ethnic groups, and no differences in the typical exposure to tadalafil have been identified. No dose adjustment is warranted.
In healthy female and male subjects following single and multiple-doses of tadalafil, no clinically relevant differences in exposure AUC and C max were observed. No dose adjustment is warranted.
Tadalafil is a substrate of and predominantly metabolized by CYP3A. Drugs that inhibit CYP3A can increase tadalafil exposure.
For patients chronically taking potent inducers of CYP3A, such as rifampin, avoid use of Adcirca see Drug Interactions 7.2 and Clinical Pharmacology 12.3.
Start dosing at 20 mg once daily. Increase the dose to 40 mg once daily based upon individual tolerability see Dosage and Administration 2.2 and Clinical Pharmacology 12.3.
Avoid use of Adcirca because of increased tadalafil exposure AUC, limited clinical experience, and the lack of ability to influence clearance by dialysis see Dosage and Administration 2.2 and Clinical Pharmacology 12.3.
Because of limited clinical experience in patients with mild to moderate hepatic cirrhosis, consider a starting dose of 20 mg once daily Adcirca see Dosage and Administration 2.2 and Clinical Pharmacology 12.3.
Patients with severe hepatic cirrhosis have not been studied. Avoid use of Adcirca see Dosage and Administration 2.2 and Clinical Pharmacology 12.3.
Physicians should advise patients to seek immediate medical attention in the event of a sudden loss of vision in one or both eyes. Such an event may be a sign of non arteritic anterior ischemic optic neuropathy NAION, a cause of decreased vision, including permanent loss of vision that has been reported rarely postmarketing in temporal association with the use of all PDE5 inhibitors. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or other factors. Physicians should also discuss with patients the increased risk of NAION in individuals who have already experienced NAION in one eye, including whether such individuals could be adversely affected by use of vasodilators such as PDE5 inhibitors see Adverse Reactions 6.2.
Patients with known hereditary degenerative retinal disorders, including retinitis pigmentosa, were not included in the clinical trials, and use in these patients is not recommended.
Physicians should advise patients to seek immediate medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including Adcirca. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors see Adverse Reactions 6.2.
Tadalafil is also marketed as CIALIS. The safety and efficacy of taking Adcirca together with CIALIS or other PDE5 inhibitors have not been studied. Inform patients taking Adcirca not to take CIALIS or other PDE5 inhibitors.
There have been rare reports of prolonged erections greater than 4 hours and priapism painful erections greater than 6 hours in duration for this class of compounds. Priapism, if not treated promptly, can result in irreversible damage to the erectile tissue. Patients who have an erection lasting greater than 4 hours, whether painful or not, should seek emergency medical attention.
Adcirca should be used with caution in patients who have conditions that might predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, or in patients with anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronies disease.
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Silagra has some possible side effects such as stomach problems, headache, facial flushing; less common side effects are bluish or blurred vision and sensitivity to light. There also have been issues with prolonged erections, which can continue for over 4 hours, and require medical intervention. We strongly suggest anyone who is taking any medication become acquainted with the instructional material enclosed.
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In rare instances, men taking prescription ED tablets, including CIALIS, reported a sudden decrease or loss of vision or hearing sometimes with ringing in the ears and dizziness. Its not possible to determine if these events are related directly to the ED tablets or to other factors. If you have a sudden decrease or loss of vision or hearing, stop taking any ED tablet, including CIALIS and call a healthcare provider right away.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit /medwatch or call 1-800-FDA-1088.
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CIALIS is available by prescription only. For additional information, talk to your healthcare provider and see full Patient and Prescribing Information.
The brand listed is a trademark of its respective owner and is not a trademark of Eli Lilly and Company. The maker of this brand is not affiliated with and does not endorse Eli Lilly and Company or its products.
2014, Lilly USA, LLC. All rights reserved. This site is intended for use by United States residents aged 18 or older.
CIALIS is approved to treat erectile dysfunction ED, the signs and symptoms of benign prostatic hyperplasia BPH, and both ED and the signs and symptoms of BPH. Taking CIALIS with finasteride when starting BPH treatment has been studied for 26 weeks. CIALIS is not for women or children.
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tadalafil, or any of its ingredients. Call your healthcare provider or get help right away if you experience any symptoms of an allergic reaction, such as rash, hives, swelling of the lips, tongue or throat, or difficulty breathing or swallowing
After taking a single tablet, some of the active ingredient of CIALIS remains in your body for more than 2 days. The active ingredient can remain longer if you have problems with your kidneys or liver, or you are taking certain other medications.
Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
What Should I Tell My Healthcare Provider Before Taking CIALIS?
CIALIS is not right for everyone. Only your healthcare provider and you can decide if CIALIS is right for you. Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. You should not take CIALIS if your healthcare provider has told you not to have sexual activity because of your health problems. Before taking CIALIS, tell your healthcare provider about all your medical problems, particularly if you have or ever had:
heart problems such as chest pain angina, heart failure, irregular heartbeats, or have had a heart attack
retinitis pigmentosa, a rare genetic runs in families eye disease
severe vision loss, including a condition called NAION
blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
Can Other Medicines Affect CIALIS?
some types of antibiotics such as clarithromycin, telithromycin, erythromycin several brand names exist, please contact your healthcare provider to determine if you are taking this medicine
CIALIS is also marketed as ADCIRCA for the treatment of pulmonary arterial hypertension. Do not take both CIALIS and ADCIRCA. Do not take sildenafil citrate Revatio
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Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness; abnormal thoughts; chest pain; confusion; decreased urination; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; increased saliva production or drooling; increased sweating; memory loss; menstrual changes; muscle pain, weakness, or stiffness; new or worsening mental or mood changes eg, depression, hallucinations; one-sided weakness; seizures; severe or prolonged dizziness or headache; shortness of breath; suicidal thoughts or actions; swelling of the hands, legs, or feet; symptoms of high blood sugar eg, increased thirst, hunger, or urination; unusual weakness; symptoms of high prolactin levels eg, enlarged breast size, decreased sexual ability, missed menstrual period, nipple discharge; tremor; trouble concentrating, speaking, or swallowing; trouble sitting still; trouble walking or standing; uncontrolled muscle movements eg, arm or leg movements, jerking or twisting, twitching of the face or tongue; unusual bruising; vision changes; yellowing of the skin or eyes.
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MD: Scamera Politicians try to make it legal to TICKET INNOCENT MOTORIST!
Encodes into law that a 5% rate of errors 1 in 20 is considered acceptable. So if Baltimores speed camera audit had revealed 30, 000 errors instead of 70, 000, that would have been A-OK.
Marylands speed camera law is well on its way to being a national disgrace. And with the press in a feeding frenzy and a flurry of reform bills coming out, what are the true believers in this corrupt due process destroying revenue collection system to do?
Well, of course, you get the leadership of the committee whom all speed camera bills must go through to sponsor a bill which contains a lot of confusing words which really do nothing, claim that it will fix the problems with the system, and then decree that all other reform bills which would actually change the way speed camera programs do business shall not pass the committee.
Thats basically what Delegate James Malone Environmental Matters Committee Vice Chair, D, Baltimore and Howard Counties and Senator James Robey D, Howard County apparently have in mind.
Encodes into law that a 5% rate of errors 1 in 20 is considered acceptable. So if Baltimores speed camera audit had revealed 30, 000 errors instead of 70, 000, that would have been A-OK.
PRETENDS to eliminate the bounty system, but really doesnt. The bills language contains several apparently deliberate loopholes to allow it to continue, notably that it would permit any payments based on ticket volume so long as it is not called per ticket ie a single dollar amount for a single ticket, but paying a set amount for every 10 tickets, setting quotas, or paying a percentage of each ticket fine would be allowed, even though all of those are still based on the number of tickets but not per ticket. Even Governor OMalley has said The law says youre not supposed to charge by volume. I dont think we should charge by volume, OMalley said. If any county is, they need to change their program. /2012-12-11/news/bs-md-speed-cameras-omalley-201212111xerox-state-camera-program-camera-vendors
Not per by they are not supposed to be incentivizing contractors to issue more tickets. It is not the SEMANTICS that are the problem, the problem is the REALITY of what they are doing.
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For the purpose of increasing and sustaining business and regional long-term competitiveness, information and training modules were developed to enrich cluster development policies with tools that give incentives for and facilitate outward-looking open innovation and forward-looking foresight, technology assessment activities and thus provide strategic guidance for developing future-proof, open innovation processes. After testing the tools in ICT, mechatronics and life sciences clusters, they are now being applied in a trans-regional foresight approach to develop a joint research agenda for clusters in the economically more and more important creative industries.
In 2006, the City of Vienna initiated a far-reaching, open strategy process on the orientation of its future research, technology and innovation RTI policy. The aim was to develop, in a participatory process, a comprehensive strategic framework and concrete proposals for municipal RTI policy actions until the year 2015. By then, Vienna is aiming to be among Europes leading metropolitan areas in research, technology and innovation, as the hub of a network of research locations in the Central European Region CENTROPE. The objectives, challenges and fields for action to be tackled in order to reach this position were translated into a set of concrete measures, some of which are to be started in 2008.
Modern materials sciences take as their objective to develop and tailor materials with a desired set of properties suitable for a given application. Next to conventional approaches, predictive modelling and simulation is more and more used. This results into a rapidly increasing knowledge base, allowing for more precise experimental set-ups, more precise simulations and tailoring of goal-oriented materials. They play a key role in the value chain and in product innovation. Although limited profits are made from materials, materials are technology enablers for new high added value products and therefore a key in innovation acceleration. More success and increased opportunities for applications is the outcome. The SMART project aimed at providing support for future strategic decisions in this sector to foster the strengthening of the European Research Area.
The purpose of the project was to gain insight in the future of biotechnology to support the work of COGEM, including technical and scientific risk analysis as well as the facilitation of public debate on biotechnology.
The objective of this Platform Foresight project is the analysis of emerging science and technology priorities in public research policies of the European countries, the US and Japan. The aim is to provide the European Commission and the member states with policy recommendations as to become leaders in these emerging technologies.
Some patients struggle to swallow medicine in tablet form. A new popular form of Kamagra is now available in Oral Jelly sachets. The jelly comes in 7 flavours. Users simply squeeze the sachet onto a spoon to take orally. Lower side effects are often reported and many users claim the treatment starts to work quicker than conventional tablet form although this is circumstantial. It is more expensive than the cost of tablets but this reflects supplier costs and increased weight in postage.
Users already taking or planning to take Nitrate based medications must not use this product. See our list below or consult your doctor if you are unsure about medicine you are already taking.
We always aim to deliver the exact flavours that you require, on occasion we may exhaust our stock of a particular flavour, if this happens then we will substitute your request to mixed flavours. Please note that all Kamagra Oral Jelly contain 100mg sindenafil citrate and work in exactly the same way - regardless of the flavour.
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If you are older than age 65, or have serious liver or kidney problems, you should NOT use Kamagra Oral Jelly as the 100mg dose may be too high for you. If you are taking protease inhibitors, such as for the treatment of HIV, you should NOT use Kamagra Oral Jelly as the 100mg dose may be too high for you.
In rare instances, men taking PDE5 inhibitors oral erectile dysfunction medicines, including Kamagra Oral Jelly reported a sudden decrease or loss of vision. It is not possible to determine whether these events are related directly to these medicines or to other factors. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including Kamagra Oral Jelly, and call a doctor right away.
The company has conceded that it has no scientific studies that substantiate any of its Enzyte claims.
Dr. Ira Sharlip, a spokesman for the American Urological Association, has said, There is no such thing as a penis pill that works. These are all things that are sold for profit. Theres no science or substance behind them.
Despite being a mixture of herbs, minerals, and vitamins, Enzyte formerly promoted itself under the seemingly scientific name of Suffragium asotas. While Enzytes manufacturer claims this term translates as better sex, this is incorrect: Suffragium in Latin means vote, and asotas is not a Latin word at all. Harvard teaching fellow Rhett Martin says that the term might be an erroneous form of suffragor asotis, meaning refuge for the dissipated.
Most of the above ingredients are commonly available as over the counter herbal or dietary supplements, and most have anecdotal reports, but marginal or unproven scientific evidence, of efficacy on various systems in the human body. Several of the herbal ingredients are included only in very low quantities.
One notable ingredient, yohimbe, was included in the original formulation of Enzyte, produced until at least 2004; however, as yohimbe s legal status in Canada is unclear, Enzyte produced after 2004 no longer contains yohimbe extract.
Additionally, zinc is an ingredient in Enzyte. Some men who have low zinc levels in their body have had success using zinc supplements to treat erection problems.
Overdosage of zinc is a hazard to health. Zinc supplements are available without prescription at significantly lower prices than Enzyte.
Currently, the effectiveness of Enzyte is unproven. The Center for Science in the Public Interest has urged the Federal Trade Commission which has power under federal law to regulate advertising to disallow further television advertising for Enzyte because of a lack of proper clinical trials. The company has agreed to pay 2.5 million to settle allegations of deceptive sales practices made by the attorneys general of various states
and has altered its advertising to be more truthful.
Enzyte originally advertised that use of the Enzyte product would promote permanent physical penile growth or the company would return purchasers double their cost. Those who attempted to collect this refund claim they either received a partial refund or were duped into signing away the right to a refund. Enzyte advertising was changed to state that the product is intended to create a firmer erection by temporarily increasing blood flow to the penis. The advertising change was made after lawsuits against the company and its rebate policies began to surface. No evidence exists showing Enzyte to be effective in any of its claims. The product advertising states in small print that it is not intended or promoted to diagnose, or treat any disease and since erectile dysfunction is a recognized disease, the advertising is considered legal.
A civil lawsuit alleged Enzyte does not work as advertised.
Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure, as the combination of these medications with tadalafil may add to the blood-pressure-lowering effect of these medications.
Dehydration: If you lose a large amount of body fluids dehydration through excessive sweating; from not drinking enough fluids; or from being sick with a fever, vomiting, or diarrhea, contact your doctor. Dehydration can make you more likely to experience low blood pressure while you are taking this medication.
Grapefruit juice : Grapefruit juice can increase the amount of sildenafil in your bloodstream. Talk to your doctor about drinking grapefruit juice when taking this medication.
Hearing changes: If you experience a decrease or loss of hearing while taking this medication, seek immediate medical attention.
Heart problems: People with heart disease or other heart problems may be more likely to experience low blood pressure while taking this medication and should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: People with mild to moderately reduced kidney function may require a lower dose of this medication. Talk to your doctor. People with severely reduced kidney function should not take this medication.
Liver function: If you have mild to moderately reduced liver function, you may require a lower dose of this medication. Talk to your doctor. People with severely reduced liver function should not take this medication.
Lung problems: Tadalafil is not recommended for people with a form of high blood pressure in the lungs called pulmonary veno-occlusive disease. If you have pulmonary veno-occlusive disease or experience sudden cough, shortness of breath, chest pain, or rapid breathing, talk to your doctor before taking this medication.
Nitrate-containing medications: Tadalafil should never be taken with any medications that contain nitrates. Blood pressure may suddenly drop to life-threatening levels if tadalafil is taken with any nitrate-containing medication, nitroglycerin tablets, spray, or patches or any other nitrates, isosorbide dinitrate or amyl nitrite poppers. Dizziness, fainting spells, heart attack, or stroke may be experienced.
Penis deformation: Men with a deformation of the penis such as angulation, cavernosal fibrosis, or Peyronies disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Prolonged erection: Before taking this medication, tell your doctor if you have ever had an erection that lasted longer than 4 hours, or if you have sickle cell anemia or leukemia.
Vision problems: If you have or have had a temporary decrease or permanent loss of vision in one or both eyes, including a condition called non-arteritic anterior ischemic optic neuropathy NAION, or if you have have retinitis pigmentosa, tell your doctor before taking this medication.
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