Drug of the Week
Each week, Dr. Mike features a commonly used medication or class of drugs. Learn what they are used for, how they work, and any news updates or controversies.

Viagra (Sildenafil), along with Cialis (tadalafil) and Levitra (vardenafil), is used to treat erectile dysfunction. These medications, which belong to class of drugs known as phosphodiesterase-5 inhibitors (PDE-5 inhibitors), can be taken at least an hour before you plan to be sexually active. PDE-5 inhibitors have a high success rate, are easy to use, and often result in an erection if you are sexually stimulated.

How PDE-5 Inhibitors Work
For the duration of an erection, blood fills tissue in your penis, causing it to enlarge and become stiff. The PDE-5 inhibitors relax smooth muscle, allowing your penis to fill with blood.

Side Effects of the PDE-5 Inhibitors
The more common side effects of the PDE-5 inhibitors include skin flushing, stuffy or runny nose, diarrhea, indigestion, and headache. You may also experience some vision problems for several hours after taking a PDE-5 inhibitor, including a slight bluish tinge to your vision or increased sensitivity to light.

Do Not Use a PDE-5 Inhibitor If… you are taking any medications that contain nitrates (such as nitroglycerin used to treat chest pain) or using an alpha-blocker (such as Cardura used to treat high blood pressure or an enlarged prostate). The combination of these medications with a PDE-5 inhibitor can lower your blood pressure significantly, possibly causing a stroke or heart attack. Talk to your doctor to discuss treatment options for you erectile dysfunction.

Viagra and the CIA
Last month, the Washington Post reported that a 60-year-old Afghan tribal chief with four younger wives was given Viagra by a CIA officer. According to the article, the officer “returned four days later to an enthusiastic reception. The grinning chief offered up a bonanza of information about Taliban movements and supply routes -- followed by a request for more pills.” Perhaps the four wives were smiling as well!

What do you think? Leave a comment below or in the Medication Forum.

To ask me a question about medication, email me at drugs.guide@about.com.

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Medication Side Effects
Each week, Dr. Mike shares information about a common side effect.

Constipation Is a Predictable, Expected Side Effect of Narcotic Painkillers
Oxycontin (oxycodone), Percocet (Acetaminophen; Oxycodone), and Vicodin (Acetaminophen; Hydrocodone), used for the treatment of mild to moderate pain, are among the best-selling medications in the U.S. In 2007, more than 100 million prescriptions were written for these drugs. One of the most common side effects of these medications is constipation. If you use one of these drugs, there is a good chance that you will develop some degree of constipation.

Getting Treatment
If you are scheduled for minor surgery or you have developed pain from an accident or health condition, you doctor may prescribe a narcotic painkiller. Talk to your doctor about constipation at the time that you get your narcotic prescription. She may recommend that you increase your fiber and water intake, and take a stool softener, such as docusate (Colace and others) or a stimulant laxative, such as bisacodyl (Ex-Lax Ultra and others). Your pharmacist is another resource for recommending which laxative to use.

A Personal Story
Last summer, I had a wisdom tooth pulled. My dentist prescribed several days of Vicodin for the pain. I got pain relief, but I also got constipated, which lasted several weeks and was worse than my toothache. When I needed to have a second tooth pulled, I declined the Vicodin and used acetaminophen (Tylenol and others) and an ice pack. I was uncomfortable for a day, but NO CONSTIPATION!

What do you think? Leave a comment below or in the Medication Forum.

To ask me a question about medication, email me at drugs.guide@about.com.

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Save Money on Your Medications
Each week, Dr. Mike offers a tip on how to save money on your medications.

Splitting pills has become a popular way for people to save money on some prescription medications. Splitting pills can save you money because drug companies often charge a similar price for varying doses of medication.

Mr. Jones Splits Viagra and Saves
Each month, Mr. Jones uses 8 tablets of Viagra (sildenafil) 25mg to treat his erectile dysfunction. At a retail pharmacy where he lives, he pays $15.00 for each pill. His monthly cost is $120.00, which he pays for out of his pocket since it is not covered by his Medicare Part D health plan.

To save money, Mr. Jones decided to try pill splitting. These are the steps Mr. Jones took to save $696.00 this coming year.

1. He did some research and found out that it was safe to split Viagra.
2. He asked his doctor to write a prescription for Viagra 50mg, twice the dose that he usually takes.
3. When he had his prescription filled, he noted that the price for each pill was $15.50; only 50 cents more, even though each pill had twice the amount of Viagra. Although the Mr. Jones’ cost to have his prescription filled was $124.00, the medication will now last for two months. Each time Mr. Jones has sex, he splits one of the Viagra 50mg pills in half using a pill splitter recommended by his pharmacist. He takes half the pill and saves the other half for the next time he has sex.

Mr. Jones monthly cost for his Viagra is now $62.00 (one-half of $124) instead of $120, a monthly savings of $58.00, which on a yearly basis is a savings of almost $700.00.

Other Ways Mr. Jones Can Save
Mr. Jones can also save more money by purchasing his Viagra online from a reputable American or Canadian pharmacy.

What do you think? Leave a comment below or in the Medication Forum.

To ask me a question about medication, email me at drugs.guide@about.com.

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Monday Morning Medication Safety Tip
Each week, Dr. Mike shares information on how to take your medications safely.

Drug errors are a common cause of hospitalization and deaths that can be prevented by understanding the safe use of medications. Following these tips is a good start to safely using your medications:

1. Keep a list of all the prescription medications, over-the-counter drugs, vitamins, and dietary supplements you take.
2. Keep your medication list updated and bring it with you to all appoinments with your doctor. Share the list with your pharmacist.
3. Use the same pharmacy to buy all of your medications so that a record of all your prescriptions will be in one place.
4. Read and save the patient information sheet that comes with your medication. It is often stapled to the bag from the pharmacy. If you do not get an information sheet, ask your pharmacist. If you do not understand the information sheet, ask the pharmacist or your doctor to explain the information.
5. If you are having side effects from your medication, tell your doctor. You may be able to take a different amount of the medication or your doctor may want to change your medication.

What do you think? Leave a comment below or in the Medication Forum.

To ask me a question about medication, email me at drugs.guide@about.com.

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