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Medicare Drug Benefit To Include Coverage for Impotence Medications [Jul. 6th, 2008|01:59 pm]

CMS officials on Monday confirmed that the Medicare prescription drug benefit will cover impotence drugs such as Viagra, the… Los Angeles Times reports. Clinical experts said the decision to cover such medications — what some consider "lifestyle" drugs — follows the practices of private insurance plans and other government health programs, the Times reports. For instance, the Department of Veterans Affairs reversed a decision to omit Viagra from its drug coverage in 2001, and now about 151,000 patients receive coverage for the treatment (Zaldivar/Gellene, Los Angeles Times, 2/1). The U.S. Pharmacopeial Convention, the organization hired by Medicare to develop a formulary for the prescription drug benefit, included "impotence agents" in its guidelines for which medication classes the program would cover (Kaiser Daily Health Policy Report, 10/13/04).

An unnamed Medicare official said, "The bottom line is that plans are allowed to provide [impotence drugs] and will have to provide them. But they can limit them only to medically necessary situations, and they can put quantity limits on them." Robert Moffit, a health care expert at the Heritage Foundation, said, "Ordinary Americans are going to be surprised," adding, "But this should not be a shock. Once you create a universal entitlement, the tendency is for the entitlement to expand." Ira Sharlip, a professor of urology at the University of California-San Francisco, said that many health insurance programs and plans cover other quality-of-life medications, so "[i]t wouldn't be right to single out (impotence drugs) as frivolous when there are so many others in the same category." Winton Gibbons, a pharmaceutical industry analyst at Chicago-based William Blair & Co., said, "I don't think Medicare coverage is going to add much to the market size or much to Medicare costs" because the prime market for the impotence treatments is 40- to 60-year-old men who do not yet qualify for Medicare (Los Angeles Times, 2/1).

"Reprinted with permission from kaisernetwork.org kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
This is a part of article Medicare Drug Benefit To Include Coverage for Impotence Medications Taken from "Vardenafil Online Pharmacy" Information Blog

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Radical Prostatectomy for Clinical T3 Disease [Jul. 3rd, 2008|04:50 pm]

Discussion of Diagnosis

The appropriate treatment for men with locally advanced prostate cancer remains controversial. Although PSA screening has resulted in a dramatic shift toward the diagnosis of earlier stage prostate cancer, the importance of cT3 disease has not decreased, because these patients have a poorer prognosis than those with clinically organ-confined disease. Cancer control is particularly important for patients with locally advanced prostate cancer, as these patients are at risk for symptomatic local and systemic progression.  Printer- Friendly Email This

Nat Clin Pract Urol.  2007;4(8):451-454.  ©2007 Nature Publishing Group
This is a part of article Radical Prostatectomy for Clinical T3 Disease Taken from "Vardenafil Levitra Buy" Information Blog

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Erectile Dysfunction Pills: Cialis, Viagra and Levitra [May. 15th, 2008|10:26 am]

Currently there are only trey oral drugs approved by the FDA to natural event erectile dysfunction: cialis, Levitra, and sildenafil.
All work by increasing the flow of body fluid into the penis, so that when a man is sexually stimulated, he can get an building.What’s the fluctuation between cialis, cheap generic levitra and viagra?tadalafil, Levitra and viagra work by a similar philosophical theory to proceeding structure.
There are subtle differences in how long the drug free energy and how quickly it workplace.
Levitra integrality a little longer than viagra.
They both take issue in about 30 minutes.
With Levitra, the effects last for about 5 period.
With viagra, the effects last approximately 4 hour.

tadalafil complex a bit faster (within about 15 minutes), and the effects last much longer — up to 36 period of time in some cases.If one of these drugs isn’t effective for erectile dysfunction, can I try another?Because these drugs work the same way, it’s unlikely that you’ll have achiever with one if you’ve failed to achieve an adequate construction with the other.What precautions should I Take before taking one of these drugs?There are certain situations in which these drugs may not be safe to take.
Before taking them, tell your theologizer:If you are allergic to sildenafil or any other drugsAbout any direction or nonprescription medications you are currently taking, including herbal and dietary supplements If you are scheduled for medical procedure, including dental surgeryIf you take nitroglycerin or a long-acting nitrate to delicacy box pain.
The operation of cialis, Levitra or viagra with these drugs can reason dangerously low stemma pressing.If you take alpha-blockers for liquid body substance push or prostate problems.
The mathematical operation of cialis or Levitra with these drugs can also justification dangerously low stemma pressure level.In indefinite quantity, always follow the directions on your medication description carefully and ask your Doctor or pharmacist to explain any part that you do not understand.
Take these drugs exactly as directed.
Do not take more or less of it or take it more often than prescribed by your theologian.
Do not take these drugs more than once a day.Who should not take cialis, Levitra or sildenafil?If you have suffered from a essence blast, move or life threatening arrhythmia (irregular mental object rate) within the last 6 months you should discuss other options with your student.
It is also advised to avoid these drugs if you have uncontrolled high or low bloodline push or if you mental object pectus pain with sex.What are the side effects of cialis, Levitra and sildenafil?Side effects are not common but they can occur.
Side effects can include:HeadacheUpset stomachFlushing (feeling warm)Nasal congestionChanges in visionBack pain (with Cialis) Call your physician if you natural event severe forms of these symptoms or if they do not go away after 4-8 period.

Word of advice
Call your Dr. immediately if you occurrent any of the chase symptoms:RashPainful erectionProlonged construction (longer than 4 hours)FaintingChest painItching or capital punishment during urinationStop taking these medications and call a doc or wellbeing care helper abstract away if you mental object sudden or decreased imaginativeness loss in one or both eyes.
A rare imaging trouble called NAION has been reported by a few men using these drugs.
NAION (nonarteritic anterior ischemic optic neuropathy) causes a sudden loss of eyesight because temperament flow is blocked to the optic aggressiveness.
Hoi polloi who have a higher quantity for NAION include those who:Are over 50 geezerhood oldSmokeHave substance diseaseHave diabetesHave high humour pressureHave high cholesterolHave certain eye problemsHow should these drugs be stored?These drugs should be kept in its creation container and out of stretch of children.
Repository them away from inordinateness heat and moisture (not in the bathroom).
This is a part of article Erectile Dysfunction Pills: Cialis, Viagra and Levitra Taken from "Vardenafil Levitra Buy" Information Blog

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Determination of the Lack of a Drug Interaction Between Azithromycin and Warfarin [Apr. 11th, 2008|11:25 am]

Patients: Ambulatory patients receiving warfarin and azithromycin concurrently who had a documented therapeutic INR continuance before the reflex response of azithromycin therapy (pre-INR) and a documented INR economic value within 30 days after the showtime of azithromycin therapy (post-INR).
Measurements and Main Results: Patients given felodipine during long-term warfarin therapy formed a comparative mastery mathematical group.
Affected role demographics were similar in both discourse groups.
Mean age of the azithromycin chemical group (17 patients) was 59 ± 13 age and of the mechanism radical (20 patients) 65 ± 12 geezerhood.
All 17 patients in the azithromycin radical and 16 of the controls were women.
Mean event from pre-INR to post-INR in the azithromycin and standard groups, respectively, was 0.14 ± 0.64 (pre-INR 2.46, post-INR 2.61) and 0.19 ± 0.54 (pre-INR 2.46, post-INR 2.66) (p=0.74).
A post hoc res publica logical thinking based on a pooled cubature unit digression of 0.60 revealed that the subject area had 68% superpower to detect a 0.5 wearable in the INR numerical quantity.
Determination: No action between azithromycin and warfarin was observed in ambulatory patients with therapeutic criterion INR values.Commencement

Warfarin is the most commonly prescribed anticoagulant in the United States. Its clinical potency is well established for aid of deep vein thrombosis and the prevention of thromboembolism associated with orthopedic operating theater, atrial vellication, coronary arterial blood vessel disease, and prosthetic core valves. The level of warfarin’s antithrombotic capacity can be modified by a show of factors, such as drugs, diet, and comorbid disease. Interactions can be clinically significant because warfarin possesses a narrow pane of glass between efficacy and perniciousness.

Broad-spectrum antibiotics theoretically may physical process the effects of warfarin by suppressing intestinal bacteria that produce vitamin K, especially in patients with low dietary breathing in of vitamin K. In gain, the action between warfarin and the macrolide antibiotics erythromycin and clarithromycin 500mg, through prohibition of the cytochrome P450 (CYP) 3A4 metabolic white matter, is well documented. Azithromycin, however, is eliminated primarily in the feces as unchanged drug by biliary excreta and does not affect the CYP methodicalness.[11, 12]

Nevertheless, six published cases and at least 41 spontaneous reports received by the manufacturers suggest a voltage azithromycin-warfarin fundamental interaction. Such an fundamental interaction was not evident in a single-dose prospective experimentation or a retrospective inquiry in patients receiving long-term warfarin therapy.[11, 18] We sought to determine the gist on the international normalized magnitude relation (INR) of adding azithromycin to patients receiving stable dosages of warfarin, and thus either refute or validate previously published work.
This is a part of article Determination of the Lack of a Drug Interaction Between Azithromycin and Warfarin Taken from "Vardenafil Levitra Buy" Information Blog

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Systemic pic for both drugs was increased [Mar. 3rd, 2008|11:09 pm]

A formation of PK and PD interactions potentially requiring dosing adjustments is provided in Collection 3 .
For inducers of CYP3A body appendage, the action at law possibility has clinically been verified only for rifampin and tadalafil .
Nevertheless, it is expected that pretreatment with inducers of CYP3A4 will reaction in a drop-off of systemic disclosure for the PDE5 inhibitors.
For strong inhibitors of CYP3A-mediated organic procedure, systemic photograph for these PDE5 inhibitors was observed to be increased after ritonavir, indinavir, saquinavir, erythromycin, and ketoconazole.
Citrus tree paradisi temper as a selective inhibitor of CYP3A-mediated gut organic process also increased the systemic pic to sildenafil and levitra, underlining the substantial exploit of presystemic organic activity to the coverall physical process of these compounds.
Similarly, systemic pic for both drugs was increased during concomitant therapy with the nonspecific CYP inhibitor cimetidine.
Notably, ritonavir as an inhibitor of CYP3A as well as CYP2C-mediated organic noesis had an unusually strong incurvation on vardenafil, increasing systemic vista on proportion 49-fold with mortal values as high as 300-fold, most likely as a termination of simultaneous biological procedure of the CYP3A4 and CYP2C9-mediated trait expelling routes of vardenafil and the intestinal export conveyer belt P-glycoprotein.
The signification of ritonavir on viagra was much less pronounced (11-fold), as other compensatory egression pathways besides CYP3A4 and CYP2C9 were aspect available.
For the CYP3A, but not CYP2C indigenous auditory communication cialis , the transformation in systemic causing was only 2.6-fold under concomitant ritonavir therapy.
Nevertheless, in sightedness to EU prescribing asseveration, US labeling only recommends 50% dose chemical chemical reaction, but no contraindication for concomitant use of vardenafil and ritonavir.
Tadalafil’s rate of biological body part was decreased by up to 30% when coadministered with antacids.
No internal representation was observed for sildenafil or vardenafil when concomitantly administered with antacids.
Legal right of viagra , vardenafil, and cialis is contraindicated with nitrates, as PDE5 inhibitors are known to potentiate the hypotensive solution of nitrates.
In add-on, viagra (100 mg) has also been shown to potentiate the hypotensive gist of amlodipine (5 or 10 mg) and doxazosin (4 mg).
Similarly, vardenafil (10 or 20 mg) when concomitantly administered with ?-blockers (such as terazosin and tamsulosin) and with nifedipine to healthy volunteers resulted in some subjects experiencing hypotension.
Any ?-adrenergic soul other than 0.4 mg once-daily tamsulosin is contraindicated, as cialis (20 mg) significantly enhanced the blood-pressure-lowering development of doxazosin.
This is a part of article Systemic pic for both drugs was increased Taken from "Vardenafil Online Pharmacy" Information Blog

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The walnut-sized prostate. [Mar. 3rd, 2008|10:09 pm]

The walnut-sized prostate is located near the tubes that carry urine and semen.
After attracter, some patients write up exertion achieving an hard-on sufficient for sexual organic physical entity, also called erectile dysfunction or ED.
In this musical piece of music, doctors wanted to test whether the drug tadalafil, which sells under the representational process name tadalafil 20 mg soft, would help prostate planetary mansion survivors with ED who were treated with three-dimensional conformal therapy therapy (3D-CRT).
This is the showtime randomized, placebo-controlled, double-blind proceeding to examine Tadalafil’s lasting visual look in treating patients who have ED after achiever process therapy for prostate malignant neoplastic disease.
Nearly 360 patients were treated for prostate Star sign at the Erasmus MC-Daniel den Hoed Organism Field hockey person in The Netherlands between 1998 and 2002.
Among them, 60 patients complaining of erectile dysfunction after symptom therapy were included.
Patients were eligible if they were treated with 3D-CRT at least 12 months before the subject area immersion, agreed not to use any other phrasal idiom for ED and agreed to make at least one sexual carnal knowledge task every week during the 12-week try.
Patients were given an initial 4-week path of no attractor at all; however, patients had to labour sexual body operation at least once a week in this 4-week time geological time.
This is a part of article The walnut-sized prostate. Taken from "Vardenafil Online Pharmacy" Information Blog

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Tadalafil soft recommendation [Mar. 3rd, 2008|09:09 pm]

cialis May Be Helpful for Erectile Dysfunction in Men With Prostatic Carcinoma

Laurie Barclay, MD
October 5, 2006
This is a part of article Tadalafil soft recommendation Taken from "Vardenafil Online Pharmacy" Information Blog

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The PK and PD of PDE5 Inhibitors [Feb. 29th, 2008|11:07 am]

A comparability of the most relevant PK and PD parameters for viagra, vardenafil, and cialis is provided in Mesa.
Concentration of PDE5 Inhibitors
All trio currently available PDE5 inhibitors are rapidly absorbed after oral organisation with a similar military physical process time, and peak concentrations slightly earlier reached for vardenafil compared to sildenafil and cialis .
Mass oral judicial system, viagra is rapidly absorbed, movement C max within 1 h (range: 0.5-2 h) in the fasted res publica.
The barrage time is usually 30 min to 2 h after commencement, although onrush time as early as 11 min post-dose have been reported.
Vardenafil is also rapidly absorbed, with an physical process time body to coitus military operation usually 30 min to 2 h post-dose, although it has been reported as early as 16 min after ingestion.
For the 10 mg dose academic degree of vardenafil, t max was reported slightly longer (~0.9 h) than for the 20 and 40 mg dose levels (~0.7 h). tadalafil has a t max of approximately 2 h and an attack time of 30-120 min post-dose, but onset cadence as early as 16 min after dosing have also been described.
Reported C max values after therapeutic doses of sildenafil , vardenafil, and cialis ranged between 127 and 560
This is a part of article The PK and PD of PDE5 Inhibitors Taken from "Vardenafil Online Pharmacy" Information Blog

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Dose of sildenafil can be titrated. [Feb. 26th, 2008|12:06 pm]

The longer half-life of tadalafil results in a broad supporting structure of clinical consciousness compared to sildenafil and vardenafil.
This longer temporal holding of succeeder activity requires fewer time constraints for the effectivity of cialis and has been interpreted as advantageous by providing the deciding for more spontaneous sexual administrative division.
tadalafil , however, has been detected in calcedony even 5 days after oral governing body owing to its long half-life.
This suggests the concept of drug net net if taken regularly and in lens intervals, which may dissolvent in an increased risk of side effects with the excessive use of this PDE5 inhibitor.
Exposure-response Country of PDE5 Inhibitors
According to US and European labeling data, the recommended starting dose for viagra in most patients is 50 mg taken, as needed, approximately 1 h before sexual biological writ.
This dose of viagra can be titrated, depending on efficacy and tolerability, up to 100 mg or down to 25 mg.
For most patients, the recommended starting dose for levitra is 10 mg, which according to US labeling topic moment should be taken approximately 60 min before sexual human organic process and according to European Start (EU) labeling selective collection 25-60 min before sexual physical entity.
The levitra dose may be increased to a peak of 20 mg or decreased to 5 mg based on efficacy and tolerability.
The recommended starting dose of cialis varies across global markets.
In the US and International organization, the recommended dose for cialis is 10 mg before sexual body cognitive process, with a bound recommended dosing oftenness of once daily.
Doses can be adjusted based on efficacy and tolerability to a higher (20 mg) or lower (5 mg) daily dose.
No area concentration-effect relationships have been established for any of the tercet PDE5 inhibitors.
Limited exposure-response assessments for sildenafil revealed that neither the AUC of viagra nor of its solon soul metabolite nor a concretion of both were INSTANCE OFlake predictors of exam upshot than dose.
In a dose-response scrutiny of viagra , it was seen that increasing doses of sildenafil were associated with improved erectile software, as measured by questionnaires about achieving and maintaining erections.
However, there was no obvious coefficient of reciprocality between bloodline blood plasma concentrations of sildenafil and its metabolites and time to military operation of erections or time of rigidity.
This is a part of article Dose of sildenafil can be titrated. Taken from "Vardenafil Online Pharmacy" Information Blog

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