Taking Cialis Ok On Med?

[lover4you]

Hi guys.poz for last year here and ok however find holding an erection an issue.recently my doctor perscribed cialis.pharmacy reduced dose to 5mg and said take no more than one every 72hrs even though doc had perscribed 10 mg and said she would increase to 20 mg if needed and never mentioned only taking one every 72 hrs.was pharmacist correct or over cautious?anyone else taking drugs for erectile dysfunction and do they have effect on their med. ..appreciate any advice

[atlbtmpig]

I too am having trouble maintaining an erection. Besides my HIV meds I take high blood pressure meds. Will Cialias or Viagra help and is it safe?

[bearbandit]

HIV, diabetes related ED and hypertension here...

The interaction between viagra and friends and HIV drugs is caused by ritonavir and cobicistat which are used less for their anti-HIV properties than for the fact that they pre-empt the very same pathway the liver uses to metabolise oter drugs like oral ED drugs and ecstacy - in the UK there was a spate of ecstacy-related deaths around the turn of the century. What was happening was that people were taking ritonavir (and maybe other protease inhibitors were involved - I honestly can't remember) in the prescribed overdoses giving the liver a massive job in processing the ritonavir, and other drugs were forced to wait. Not knowing how ritonavir was blocking the metabolisation of other drugs, people kept taking another e, and another, eventually dying from what was basically an ecstacy overdose. Advice I had from a friendly pharmacist ("if I tell you 'don't' you'll do it anywayy; I just want to make it as safe as I can for you") was to try a quarter of a normal dose and if more were needed, proceed in very small amounts, much smaller than the increments others would use.

In Wales it's part of diabetes screening that all men are asked about ED and the appropriate helper drug prescribed as necessary: because I take ritonavir with my darunavir I get quarter doses. When I could tolerate the side-effects of blue vision and intense migraine-like headache I was taking a tablet and a half of viagra as 25mg wasn't enough. (I note that at least one online pharmacy is now selling pill cutters.)

 

Slightly different situation with blood pressure medication: oral ED medication works by messing with your blood pressure at a very specific point, stopping blood from leaving your dick. Anything that messes with your normal blood pressure, like blood pressure medication or poppers, does not play nicely with oral ED medication. If I'm expecting sex in the next day or so I leave off taking my BP medication (night) and leave the ritonavir (morning) out of my usual daily routine, figuring that the odd missed dose is worth it. I'm also bottoming more...

 

Part of the problem is that most GPs don't understand HIV medications as, in the UK at least, they're only prescribed by specialists, which leads to the GP knowing fuck all about possible interactions. An excellent site (and possibly one to make your GP aware of) is http://www.hiv-druginteractions.org/ . It's good enough that my HIV doctor (who I rate to be the best I've ever met and is definitely in the top ten in the UK) uses it as a reference.

Disclaimer: I'm not a doctor, what I've just written is based on my understanding of the drugs and my own personal experience of them...