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Buying ED Drugs Online: What’s the Risk?

“You can get hard without expensive prescription drugs that have dangerous side effects!”

It’s a familiar claim among sellers of online erectile dysfunction (ED) drugs — and there are a lot of them. A search for “buy erectile dysfunction drugs” brings up nearly 22 million web sites.

On these sites, you can order medications like Cialis (tadalafil), Levitra and Staxyn (vardenafil), Stendra (avanafil), and Viagra (sildenafil) without a prescription. Or, you can get a “natural” herbal remedy that promises to give you the same results. Often these drugs cost far less than they would at your local pharmacy. Buying online also lets you bypass the embarrassment of having to discuss your erection problems with a doctor.

But are ED drugs purchased online safe? Experts say think twice before you buy.

The Truth About ED Drugs Sold Online

The erectile dysfunction drugs and herbal remedies you buy online aren’t always what they seem. An FDA investigation found that more than one-third of “dietary supplements ” sold for ED actually contained prescription drugs, including sildenafil, the active ingredient in Viagra. Some ED drugs sold online contained entirely different medicines, such as the antibiotic metronidazole and the fertility drug clomiphene.

Even if a drug contains the right medicine, it may not be the right dosage. When samples of 100-milligram Viagra tablets purchased online were tested, only 10% were even close to the advertised strength.

When you buy from an unknown company, you run the risk of getting counterfeit medicines. By some estimates, more than half of all ED drugs sold online are fakes. Some of these drugs include ingredients you wouldn’t want to put in your body — things like talcum powder, paint, and printer ink.

The FDA warns of several products in particular that have contained potentially harmful or undeclared ingredients. Included among them are

  • 4EVERON
  • Actra-Rx
  • Actra-Sx
  • Adam Free
  • Blue Steel
  • Energy Max
  • Erextra
  • Hero
  • HS Joy of Love
  • Lady Shangai
  • Libidus
  • Liviro3
  • Lycium Barbarum L.
  • Nasutra
  • Naturalë Super Plus
  • NaturalUp
  • Neophase
  • Rhino V Max
  • Shangai Regular, also marketed as Shangai Chaojimengnan
  • Shangai Ultra
  • Shangai Ultra X
  • Strong Testis
  • Super Shangai
  • True Man
  • V.Max
  • Vigor-25
  • Xiadafil VIP tablets (Lots 6K029 and 6K209-SEI only)
  • Yilishen
  • Zimaxx

Continued

Health Risks of Online Drugs

Erectile dysfunction drugs such as Cialis, Levitra, Staxyn, Stendra, and Viagra work by increasing blood flow to the penis. Just like any other medicine, these drugs can have side effects.

A real drug masquerading as an herbal remedy can be dangerous — even life-threatening. Take the drug sildenafil, which the FDA says is hidden in some natural ED treatments sold online; if you’re already using nitrates for heart disease. sildenafil can lead to a dangerous drop in blood pressure. In 2008, 150 people in Singapore were hospitalized for low blood pressure after taking ED drugs. Doctors discovered that the drugs actually contained a large dose of the diabetes medicine, glyburide .

ED drugs can be especially dangerous for people with certain conditions, especially heart disease. They can also cause side effects or interact with other medicines you’re taking, such as blood thinners and some alpha blockers, which are used to treat high blood pressure and prostate conditions. Even mixing them with grapefruit juice can worsen side effects. These are issues your doctor needs to discuss with you when you get a prescription.

Buying Safely Online

Before buying ED drugs online, see your doctor to find out exactly what’s causing the problem. It may turn out that you don’t need to take these drugs at all. Health conditions that contribute to ED, such as diabetes or high blood pressure. can be treated. If ED is a side effect of a medicine you’re taking, your doctor may suggest that you stop taking the drug or take a lower dose.

The FDA is trying to stop the flow of illegal ED drugs, but these medicines still circulate freely on the Internet. Legitimate online pharmacies do exist. It just takes a little bit of sleuthing to find them.

Here’s what to look for when you buy ED drugs online:

  • A licensed pharmacy with an address in the U.S. (Check with your state board of pharmacy or the National Association of Boards of Pharmacy.)
  • A pharmacy that requires a prescription from your doctor
  • Drugs that are approved by the FDA
  • Containers that are clearly labeled with the name of the drug and the dosage
  • A licensed pharmacist who is available to answer your questions
  • A contact phone number to call if you have questions or problems
  • A clearly stated privacy policy that protects your credit card number and other personal information

WebMD Medical Reference Reviewed by Stuart Bergman, MD on August 12, 2015

Sources

FDA: “Hidden Risks of Erectile Dysfunction ‘Treatments’ Sold Online.”

FDA: “The Possible Dangers of Buying Medicines over the Internet.”

National Kidney & Urologic Diseases Information Clearinghouse: “Erectile Dysfunction.”

American Academy of Family Physicians: “Erectile Dysfunction — Overview.”

Jackson, G. International Journal of Clinical Practice. March 2010.

Anonymous. Bulletin of the World Health Organization. April 2010.

News release, FDA.

© 2015 WebMD, LLC. All rights reserved.

Tadalafil 20 mg

Tadalafil is the tablet which made to treat the symptoms of erectile dysfunction. Tadalafil 20 mg effects the smooth muscles of the penis. It inhibits the enzyme phosphodiesterase-5 type (PDE-5), preventing destruction of cyclic guanosine monophosphate (cGMP) that helps to relax the muscles, resulting an increased blood flow. As a result, you get a strong and enduring erection, the presence of sexual stimulation.

Tadaсip – a drug that produced by the well-known Indian company “Cipla Ltd.”
Cipla – Indian Pharmaceutical Holding, which produces products of exceptional quality. The company was founded in 1935, is located in Mumbai (India) and has a staff of over 7,000 people. The different drugs of this holding for many years sold in 180 countries in the world, indicating that the stability of product quality and strict control of each batch produced.

  • Almond-shaped tablets with light orange color.
    The tablets are packaged in blisters of 4 pcs. And blisters – in cardboard boxes.
    Active ingredient: tadalafil (20 mg)
  • Get 1 tablet of Tadalafil 20 mg an drink it with a glass of water.
    The duration of its action reaches 36 hours after intake. In addition, the majority of people, improvement of the erection occurs through 30 minutes after taking Tadalafil 20 mg.
  • Tadalafil is contraindicated for those who are using medications containing nitrates, which are usually prescribed for the treatment of angina pectoris. One of the most frequent – nitroglycerin, which can also be found in creams, sprays, candy and blisters. Other containing nitrates drugs isosorbide dinitrate, isosorbide Mononitrate. Nitrates are also present in the poppers in the form of amyl nitrite.
  • The combination of this ED medicines with nitrates can cause a sharp decrease in blood pressure that can lead to heart attack, stroke, and sometimes to death.
  • You should consult your doctor or pharmacist to find out whether your medication of nitrates.
  • Tadalafil is also contraindicated to use with alpha-blockers of any type. Alpha blockers prescribed to people who suffer from high blood pressure and prostate adenoma. Cases of acceptance of the ED drugs with alpha-blockers may lead to a sudden decrease in blood pressure, weakness, and dizziness.

The increase of the recommended doses without the consent of the doctor can be dangerous. It is not recommended for patients to take this ED medication being informed about the risk for your own organism in case of having allergy or hypersensitivity to one or more of its components. Before you buy Tadalafil and take it – tell your doctor about the following diseases, in case of their presence:

• Heart disease.
• Kidney disease.
• Diseases of the liver.
• Cases of heart attacks, strokes and seizures arrhythmia.
• Cases of severe vision loss.
• Stomach ulcer.
• Gastro-intestinal bleeding.
• Multiple myeloma.
• Leukemia.
• Cases of priapism.
• Distortion of the penis.
• Peyronie’s Disease.
• Allergy.
• Hypertension.

  • The most frequently in the study group patients have headache (in 11% of cases) and dyspepsia (B7% of cases).
  • Tadalafil side effects have quite small or medium degree of the effect for the patients. If you have- do not despair, because side effects as a rule, short-lived and will decrease with the further taking of the preparation.
  • Also you may experience the following side effects: myalgia, back pain, nasal congestion, and tides blood to a person. The rarest Tadalafil side effects are: pain in the eyes, swelling of the eyelids, hyperemia of the conjunctiva, dizziness.
  • Over the last decade millions of men around the world faced a problem of erectile dysfunction. But investigations in this sphere had a significant progress during last years. At the present time there are several effective oral medications for the treatment of violations of the penis related to the pharmacological group inhibitors of phosphodiesterase type 5, one of which is Tadalafil.
  • Cialis (Tadalafil Online) pills are not soluble in water. Tadalafil 20mg is manufactured in the form of tablets and should be taken orally with a glass of water. These pills were found more effective than Viagra, and have less Tadalafil side effects because of the relatively small doses. Tadalafil 20 mg also effectively acted on people suffering from diabetes and high blood pressure. Tadalafil is the main active ingredient, in addition, this medicine contains other components.
  • Tadalafil has been rightly described as «the pill for a weekend». A man need only one tablet, to have a good erection all weekend, so it can be considered the best drug for erection.
  • There are many factors affecting the duration of action of Tadalafil 20 mg in the body, including some drugs. In the course of the trials of the drug, the researchers tried to measure the success of the sexual relations in the percentage after 24 and 36 hours among patients who took the drug and a placebo.

Via AC 24 hours successful results were observed in:

• 42 % of those who accepted placebo.
• 56 % of those who accepted Tadalafil 10 mg.
• 67 % of those who accepted Tadalafil 20 mg.
After AC 36 hours successful results were:

• 33 % of the placebo group.
• 56 % of the group Tadalafil 10 mg.
• 62 % of the group Tadalafil 20 mg.

The use of Tadalafil:

Tadalafil can be used after the approval of a doctor. In the day just one dose of the preparation, you should not exceed the norm. A certain dose of Tadalafil is 10 mg or 20 mg which is recommended to be taken 20 minutes before the sexual act. Sexual stimulation is needed to achieve the erection.

The use of Tadalafil does not protect against pregnancy, sexually transmitted diseases and HIV. Therefore, the use of means of protection will need to avoid these diseases.

You can find the reviews from men who already experienced Tadalafil treatment. The last received review: “Mick, 48 y.o. Cipla is the best in producing ED drugs. I use a lot of generics every month. The most effective pill is Cialis or generic Tadacip. Be sure- you will not find anything better.”

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Where Are The Best Places to Buy Cialis Online?

Just like Viagra, people always ask me “Where is the best place to buy Cialis online?” Before writing this page, we investigated the top websites that sell Cialis online. We keep this information up-to-date, so all shoppers should find the Cialis costs to be current. After doing research we found out that convenience, privacy, and Authentic Medications are the reason shoppers chose some websites over others.

Who Does CoreyNahman.com Recommend?

Stay away from the bootlegs. If you are looking for genuine, brand-name Cialis Online manufactured by Eli Lilly, I recommend AccessRx.com. They have been in business since 1998. They are located in the USA in Tempe Arizona. They offer overnight shipping, and they keep their Cialis cost reasonable.

They have a 24 hour telephone number for customer service. They even have licensed physicians and pharmacists on staff to answer your medical questions.

Their prices are higher than the generics but you are assured of getting brand-name, American, FDA-Approved Cialis (and other medications) delivered to your door in a couple of days without having to go to a doctor and provide a co-pay.

If you plan to buy Cialis online, definitely check out AccessRx before you make a decision.

Who is Buying Cialis Online

More and more people are choosing to buy Cialis online. In 2003 worldwide Cialis sales were $203.3 million. According to Eli Lilly, in 2008 worldwide Cialis sales jumped to $1.44 billion. a 700% increase since it was launched in the United States!

Cialis’ popularity is catching up to Viagra (which sold $1.934 billion worldwide in 2008). This is the first time Cialis is within $500 million in sales to Viagra worldwide. In 2008 daily Cialis was launched. which should boost Cialis sales even further towards reaching Viagra.

Since so many people are buying Cialis, it is a tempting pill for unscrupulous online merchants to bootleg or make counterfeit copies of, with the eye on making a quick dollar.

Q: Is there a generic Cialis?
A: No

There is no such thing as an FDA approved generic Cialis. The Cialis patent is good until at least 2015 (source = Eli Lilly 2009 annual report, p 50). This means that Lilly has a legal monopoly on all versions of Cialis.

If you see a website advertising generic Cialis for sale, that means it is an unapproved, unauthorized bootleg version or an outright counterfeit pill. As mentioned earlier, the cost of Cialis that is authentic and approved by the FDA is more than illegal “generic” Cialis.

Q: What if I tried generic Cialis and it worked?
A: If you buy “generic” Cialis online, it may work. BUT.

you have no way of telling for sure what the active ingredient is or how much is present. You might be paying for a 20 mg dose but only getting 7mg or 8mg. Or you might be getting a dangerously high dose without knowing it.

The tablets may contain tadalafil (the active ingredient in Cialis) but they may contain something like silendafil (the active ingredient in Viagra or vardenafil the active ingredient in Levitra). It’s a crapshoot.

The only way to tell for sure would be for you to send the pills out to a pharmaceutical laboratory for a chemical analysis, but unless you are a scientist or a CSI expert this is not a realistic option. When you buy Cialis online that is sold as “generic,” you become your own guinea pig and you hope for the best. Although the your Cialis cost will be higher for the authentic version, you will have peace of mind knowing that the medication is safe and effective.

Q: If it’s not legitimate, why do they sell it?
A: The number of people sell fake Cialis online, outnumber the agencies that regulate this type of thing and the government can’t keep up.

The government considers generic Cialis to be an illegal substance. They are concerned about public health and safety issues, particularly since many non-regulated internet pharmacies sell you pharmaceuticals without a doctor’s prescription.

They don’t go after the people who buy generic Cialis online but postal authorities will interdict it at the border whenever possible. Every once in a while they go after the major players and shut down their operations.

The sellers are usually charged with mail fraud and or conspiracy to introduce misbranded drugs into interstate commerce in violation of the Federal Food, Drug, and Cosmetic Act .

Q: Where is the best place to buy Cialis Online?
A: There is no one best place to buy Cialis online but there are red flags for spotting scam Cialis sellers:

– The Cialis price should be realistic. You get what you pay for. Genuine, FDA approved Cialis should cost at least $38 per pill. If you are seeing offers for $3.00 or $4.00 per dose it is a guarantee that you are not getting the real thing.

– Google the operation that is selling the Cialis online. Do a little detective work. If they are selling shady products, or they have ripped people off in the past there is a good chance that someone has complained about them on a message board or in a blog. Google their phone number, their address, the name of the website, etc. You would be surprised to see what turns up.

– Lots of pharmacies selling Cialis online pretend to be American or Canadian but are actually located in developing nations, particularly India, Mexico and the Caribbean Basin. You want to screen out these non-North American operations.

The online pharmacy should have a physical address (not a just P.O. box) in the Unites Stated or Canada and a working telephone number. Call the number and test it out. Speak with a customer service representative. Ask a few questions such as, “what is your shipping policy? What is your return policy? What is the name of your supervising pharmacist? What is your pharmacy license number”. They should answer your questions courteously in perfect English. If they sound fishy on the phone stay away.

– Their ad should purport to sell “genuine Cialis”, “FDA approved Cialis” or “Brand Name Cialis”.

– If the ad says generic Cialis, chewable Cialis, Cialis strips, liquid or gelcaps this is a big red flag since as we have discussed above there is no such thing as generic Cialis. Generic Cialis or Cialis in any formulation other than tablets mean bootlegged product or a product that contains no active ingredient.

– A prescription should be required. If they are a reputable outfit, You should be required to do one of the following:
(A) Have one of their doctors examine you via a questionnaire or an online examination.
(B) Mail or fax them a prescription.
(C) Have them call your doctor to get a telephone prescription.

If the ad says. "No Prescription Needed", that’s a bad sign. That means that you are probably dealing with an offshore internet pharmacy that sells anything to anyone. Just because a person has a website and a computer does not mean they should be trusted to sell Cialis online. Use good judgment when you buy Cialis online.

Who this site recommends & why we recommend them:

If you are looking for the authentic Brand Name Cialis, I recommend AccessRx.com. They do not sell generic Cialis, which is good considering that it is illegal and dangerous to your health. AccessRx.com has been serving customers conveniently and safely since 1998. They are located in the USA in Tempe Arizona. Their customer service representatives are available 6-days a week and they have licensed physicians and pharmacists on staff to answer your medical questions.

AccessRx.com does have higher prices than generics but you are 100% assured that you will be getting the brand-name American, FDA-Approved Cialis delivered to your door conveniently in a couple of days without having to visit your own doctor.

1/10/08: A New Way To Take Cialis; Every Single Day!

Beginning in January of 2008, Lilly began marketing Cialis in a different manner. Cialis became approved for every day low-dose administration as an option for men with erectile dysfunction who engage in sex frequently (more than twice per week) so that men can engage in sex any time between doses rather than waiting for a pill to kick in.

Cialis for every-day-administration is given in a lower dose – 2.5mg to start (as opposed to the 10mg or 20mg that occasional users take). If the 2.5mg per day is inadequate, the dose can be doubled to 5mg per day. Your Cialis cost for a week’s worth of low dose therapy is comparable for what a man would pay if he takes two tablets per week. The cost of Cialis, unfortunately, has increased to more than $25 per pill, but that’s still better than risking your health by taking illegal “generic” Cialis.

Cialis is available 2.5mg, 5mg, 10mg and 20mg tablets.

If you are going to take Cialis the traditional way, every once in a while in anticipation of having sex, the recommended dose is 10mg taken prior to anticipated sexual activity without regard to food. In those patients in whom 10mg does not produce an adequate effect, 20mg might be tried.

It can be taken from 30 minutes to 12 hours prior to sexual activity. The efficacy of tadalafil may persist up to 24 hours post-dose. The maximum recommended dose of the 10mg or 20mg tablets is one pill per day.

How Does Cialis Work?

When an erection goes limp, you have PDE5 to thank.
Specialized penis tissue produces a substance called cyclic guanosine monophosphate (cGMP) in response to sexual stimulation. The more cGMP available, the more Durable the erection. Cialis inhibits the PDE5 enzyme, preserving cGMP levels, therefore aiding erection viability and durability.

Cialis is a member of a family of drugs known as PDE5 enzyme inhibitors.

Cialis is known as the “36 hour pill” or the “weekend pill” because unlike other similar drugs, Cialis has a long duration of action.

Cialis blocks an enzyme that causes an erection to go flaccid. Although Cialis is similar to Levitra and Viagra, its dose, onset of action, and duration of action is unique.

Cialis is a member of a family of drugs called PDE5 Inhibitors. Cialis is now marketed in approximately 40 countries and is available by prescription in pharmacies on five continents.

Cialis was developed by Icos, a small biotech company located in Washington State. Icos formed a 50/50 joint venture with Eli Lilly & company. Eventually, Lilly bought out Icos.

The BIG Discovery: cyclic guanosine monophosphate (cGMP)

When a man gets sexually stimulated, a chain reaction occurs in the tissue of the penis that results in elevated levels of a substance called cyclic guanosine monophosphate (cGMP).

As long as there are sufficient levels of cGMP, the penis can remain erect. The more cGMP, the more robust and durable the erection.

If you inhibit the degradation of cGMP it stays around in the penis longer, producing a more durable erection.

Cialis is that it preserves the elevated levels of cGMP that are created when a man is sexually stimulated for a stronger, more durable erection.

Cialis blocks the enzyme phosphodiesterase-5 (PDE5) which is responsible for the neutralization of cGMP. Cialis (tadalafil) is a highly selective inhibitor of PDE5. (PDE5 is not the only phosphodiesterase involved in the erectile physiology but it appears to be the most important one).

The nice thing about Cialis is that it won’t cause erections at inappropriate times because it only blocks degradation of cGMP produced in reaction to sexual stimulation, such as thinking about something sexy. If you are not being sexually stimulated, there is no cGMP to protect, so the drug remains in the background.

How Does Cialis Compare To Viagra and Levitra?

One huge difference is that Cialis is used to tread erectile dysfunction as though it is a chronic condition. As stated above, only Cialis is approved by the FDA to be taken once-per-day whether or not you are going to engage in sex. Viagra, on the other hand, is only taken just before sex. Here is a complete table that shows the difference between Viagra, Cialis, and Levitra.

Cialis Versus Viagra
Cialis Versus Viagra From Forbes magazine 12/03/03; M. Herper; side by side comparison of various characteristics of Cialis and Viagra in slide show format.

Cialis Versus Viagra Versus Levitra (2004 Media Report)
Viagra Faces Stiff Competition On Airwaves � Viagra focuses on depicting happy men in their ads. Levitra uses a woman’s testimonial and sports star Mike Ditka. Cialis, which is more subtle and longer-lasting, focuses on the relationship. [ WFTV.com]
Editor’s Note: Above report offers comparison between Cialis, Viagra and Levitra in terms of advertising.

Absorption, Onset, Bioavailability

Cialis is readily absorbed from the bloodstream. It is about 16% bioavailable. Tadalafil is about 94% bound to plasma protein. Maximum plasma concentration of Tadalafil was achieved 2 hours post dose. The Cialis label states that It can be taken from 30 minutes to 12 hours prior to sexual activity. Efficacy of tadalafil may persist up to 24 hours post-dose.

Metabolism, Half Life, Excretion

Cialis is mostly metabolized in the liver by an enzyme known as CYP3A4 and to a lesser extent CYPC2. Tadalafil breakdown products are excreted in the feces (61%) and in the urine (36%). Cialis’ mean half life is 17.5 hours in healthy men.

If you are going to take any of the PDE5 inhibitors such as Cialis, it is very important that your doctor be aware if you have a liver condition (such as cirrhosis) or kidney condition ( such as if you are on dialysis) because you may need a special dosage adjustment.

Likewise, if you try to buy Cialis online, please make sure that the person authorizing your prescription knows the true status of your liver function and your kidney function.

Non-Sexual Uses Of Cialis (tadalafil):

Benign Prostate Enlargement:
Recent information published in scientific journals indicate that Cialis may be useful for treating lower urinary tract symptoms associated with benign enlargement of the prostate. Of the doses studied, the 5 mg Cialis dose seemed to be the most appropriate dose.
See Also: J Urol. 2008 Aug 21. (abstract). CONCLUSIONS: Once daily tadalafil demonstrated clinically meaningful and statistically significant efficacy and it was well tolerated in men with benign prostatic hyperplasia lower urinary tract symptoms.
See Also: Impotence Drug Eases Prostate Problems. new research, funded by Eli Lilly, the company that owns the rights to the drug tadalafil, shows a daily dose of the drug may help ease some of the urinary symptoms related to an enlarged prostate. [WebMD]

Altitude Sickness
Because of Cialis’ effect on the cardiovascular system, researchers are looking into if it is beneficial to administer Cialis it to people who are susceptible to high altitude sickness. Early data indicates it has a moderate beneficial effect:
See Also: Am J Physiol Heart Circ Physiol. 2008 Apr;294(4):H1651-7. Epub 2008 Feb 29. Evidence supportive of impaired myocardial blood flow reserve at high altitude in subjects developing high-altitude pulmonary edema.
See Also: Ann Intern Med. 2006 Oct 3;145(7):497-506. Both tadalafil and dexamethasone may reduce the incidence of high-altitude pulmonary edema: a randomized trial �[ Annals of Internal Medicine; Abstract]
See Also: Stroke. 2005 Mar;36(3):557-60. Epub 2005 Feb 3. Effects of high altitude exposure on cerebral hemodynamics in normal subjects �[Stroke; Abstract]

Cialis Price Check. 10 top sites that sell Cialis; simple comparison shopping.

Cialis.com. Brand new website; prescribing information, patient information, safety information, FAQ, etc.

Cialis Prescribing Information. Dose, mechanism of action, side effects, precautions, warnings; patient information; very technical, don’t get scared when you come to the section on warnings and side effects. [ This is the information that doctors will use when they are considering prescribing Cialis]

Cialis Side Effects & Drug Interactions. 2,800 word report regarding side effects and drug interactions taken from Cialis’ official FDA label; includes seven charts and graphs.

Cialis Recall Information – up to date information regarding possible Cialis recalls if appropriate.*
* There has never been a Cialis recall so this page should be blank.

FDA Cialis Page. Cialis talk paper, Cialis label, Cialis approval letter, Questions and answers for Cialis, Cialis consumer drug information sheet.

Cialis Talk Paper [FDA]. from FDA’s official website; explains how Cialis is different from other erectile dysfunction drugs, starting dose, metabolism, possible drug interactions, contraindications.

Cialis Questions & Answers [FDA]. what is Cialis used for, how does it work, how is it different from similar drugs, how do you take cialis, common doses, etc. Similar to the drugtore flyer you get when you pick up a prescription at the drugstore.

Cialis Scientific Papers (from the National Library of medicine) automated Medline search; a listing of scientific papers in abstract form regarding Cialis.

Cialis News (from Google) recently published news regarding Cialis.

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