Can I use two pills of Viagra to increase the potency of my erection?

It is safer to start with one pill and then wait at least 45-60 minutes to develop an erection. If after this time, you fail to develop an erection, then you may take another Viagra. However, if the second pill does not work, then you have either been sucked into buying some crap cheap stuff online or your erection problems can’t be fixed with a pill. 

You have to understand that Viagra only works in 70% of men. However, it has been observed that individuals who do not respond to  Viagra appear to respond to levitra or cialis. Again, a word of warning- you need to buy these pills from bona fide stores and not some scam online pharmacies.

I am a 47 year old male and smoke. Can I use Viagra?

Both Viagra and levitra can be taken by men of all ages, and that includes elderly males. However, individuals who have a history of heart disease, angina, stroke or chest pain should first speak to their doctor before taking Viagra like pills. In addition if you have had allergy to Viagra, you should not take any of these impotence medications.

The only caution is that you should buy your pills from a reputable pharmacy. There are many fake impotence pills on the market.

If you decide to buy online, always buy a few pills initially and try them out. Further avoid all the generic pills from India and China- it is unlikely they will give you an erection, but more likely give you a major headache and lots of frustration.

Are the proton pump inhibitors safe for long-term use?

You can rest assured that the PPIs are safe. While many drugs have side effects, this cannot be said about the proton pump inhibitors. these drugs have been used all over the globe for many years and so far nothing disastrous has been reported. PPIs are probably one of the safest drugs on the market.

Inside the packaging of PPIs there is a warning about cancer. However, this was only seen in a few rats and has never been reported in humans. Most experts feel that this complication has nothing to do with PPIs and more to do with the genetic strains of rat used in the studies. So far, there has been no increase in human cancer following PPIs usage.

Some people may develop a mild headache. Other rare side effects after long-term usage include decreased absorption of vitamin B12 and iron. When the drugs are used continuously for two or more years, there are reports that one may develop fractures of the spine and hip. This has only been seen in people who take extremely high doses of prilosec.

People who take PPIs for long periods should get levels of iron and vitamin B12 measured periodically. Do not waste your money buying extra vitamin supplements- just eat fresh fruit on a regular basis.

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.