Is apcalis a good medication for impotence?

There are many generic versions of Viagra being sold for erectile failure. The majority of these medications are either made in China or India. Like Viagra, apcalis works by inhibiting a certain enzyme in the penile tissues and potentates an erection.   

 The majority of these generic pills like apcalis are sold online by fake pharmacies. One of the problems of buying pharmaceutical pills online is that you will most likely not get a quality product. Both Indian and Chinese pharmaceutical companies are well known to produce fakes and counterfeit pills. Sure apcalis is cheaper than the real Viagra available in a retail pharmacy, but there is always a question if you will get a pill that works.

If you are desperate for an erection, then only buy a few pills at first and see if they work. If money is not an issue, then buy the real pill from a retail pharmacy. When you order apcalis online, never buy the pill from outside of North America. Not only will you not get the right pill, you will have to pay shipping and have a lot of explaining to provide to the customs officer.   

Remember, practice safe sex as apcalis does not provide protection against any sexually acquired infection.

My doctor started on me on nifedipine for my fast heart rate. I soon noticed that I have become very constipated, is this related?

You bet it is related.

Calcium channel blockers like nifedipine are notorious for causing severe constipation. You have two choices, ask your doctor to switch the drug or you need to be on continuous medications that help loosen your stools. 

Most people need to go off the nifedipine as the constipation can be quite severe. Do not stop the drug until you see your doctor. In the meantime, drink ample fluids, eat a high fiber diet and take lactulose twice a day

What is the best drug for treatment of my obsessive compulsive disorder?

Obsessive-Compulsive Disorder (OCD) is a mental disorder characterized by recurrent intrusive thoughts (obsessions) and compulsions (repeatedly performing the same behavior). Like most things in mental health, no one knows the cause of OCD. 

There are a variety of drugs that are used to treat OCD but unfortunately not everyone responds to the same medications. Moreover some individuals often start to lose the effectiveness after a few years.  Doctors usually prescribe one medication, then determine the response and the move on to another medication.

The currently available medications used to treat OCD include Luvox (fluvoxamine), Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Celexa (citalopram), and Anafranil (clomipramine). Overall, many people appear to respond to Anafranil but over time its effectiveness also fades. 

The only way to know which medication s good for you is to try one out. Speak to your doctor. You may have to undergo a trial and error process to discover the best medication for you

What is the current status of Avandia?

Avandia or rosiglitazone can lower blood sugars but recent data indicate that the drug also raises LDL and triglyceride levels. It is now believed that Avandia may in fact increases the risk of heart disease in diabetics. More data is becoming known that the manufacturer of Avandia simply did not report the negative aspects of the drug from the early clinical trials. 

It is obvious from the early studies that Avandia increases the risk of heart attacks, strokes. Now the FDA has sent a strong warning to the manufacturers that the drug should have a label indicating its potential detrimental effects on the heart. However, the drug is still on the market.

Avandia is of great concern especially in people who already have heart failure a weak heart, kidney disease and high blood pressure.

There is also some concern that Avandia may decrease bone density and make people prone to bone fractures. For these reasons, Avandia should not be a first choice drug for diabetics. Instead, metformin is far better, cheaper and effective for diabetics.


For those who are already on Avandia, you definitely are at a high risk of heart attacks and should contact their doctor. Do not stop this drug until you see your doctor. Today, Avandia is only restricted for people who are unable to control their blood sugars by no other means.

I have been started on lisinopril and have started to develop leg cramps especially at night. Are the cramps related to my medication?

Lisinopril is an ACE inhibitor and is quite effective for blood pressure.

The most common reported side effects of this medication include a drug cough, mild nausea, diarrhea, vomiting, headaches and dizziness. Muscle cramps or spams are very rare with lisinopril but they have been reported. The cramps often occur after long term use and usually subside when the drug is discontinued. 

The best advice is to see your doctor,  get some blood work done and look at the levels of calcium and potassium. Perhaps your doctor should also check your legs and ensure that you do not have any peripheral vascular disease. If the cramps are severe, you may need a change in your blood pressure medication. 

In the mean time, do not stop or change the dose of lisinopril until you have been seen by your doctor

Should I take an aspirin every day? I am 55 and have no medical problems!

Well, it appears that there are many doctors who do not keep up with current literature. Unlike the past, the latest evidence suggests that not everyone will benefit from a daily aspirin. 

Recent work shows that taking an aspirin everyday does not prevent a heart attack, stroke or reduce the risk of dying.  In fact, aspirin can cause bleeding from a stomach ulcer or a brain hemorrhage. 

The potential risks of these bleeding problems from aspirin far outweigh any of its benefits. So if you are healthy, do not take aspirin. Aspirin is only recommended for individuals who have risk factors for heart disease. However, in order to maintain good health, exercise daily, stop smoking and eat healthy- and tell your doctor to start reading current literature.

I am 55-year-old Type 2 diabetic. What are the current guidelines regarding aspirin?

The new revised American Diabetes Association (ADA) guidelines suggest that not all diabetics need to take aspirin. Previously all diabetics were encouraged to take a daily aspirin. This is hogwash now. 

Today, aspirin is only supposed to be taken for diabetics over the age of 50 and only in those who have risk factors for heart disease. This includes men over age 50 or women over age 60 with at least one additional major risk factor for heart disease. 

In other words, according to the ADA, younger diabetic patients (< 45) without associated cardiovascular risk factors have no benefit from taking aspirin.