Impotence Trial Pack

• Contains five different erection pills
• Try which one suits your needs
• Use only for erectile dysfunction
• Caution with alcohol

There are many different types of pills for erectile dysfunction (ED). Each pill works in a different way and has different instructions for use. This sample pack allows you to try out which ED pill you like best.

The pack contains tablets of the five most widely used and prescribed ED medicines:

• Viagra (active substance: sildenafil).
• Cialis (active substance: tadalafil).
• Levitra (active substance: vardenafil).
• Vardenafil (generic alternative to Levitra).
• Tadalafil (generic alternative to Cialis).
• Sildenafil (generic alternative to Viagra).

The ED pills in the sample pack belong to a group of medicines called phosphodiesterase type 5 (PDE 5) inhibitors. These medicines work by relaxing the blood vessels in the penis. This allows the blood to flow into the penis more easily and temporarily restores men’s ability to get an erection.

These types of ED pills will not help if you do not have erectile dysfunction, a condition in which a man has difficulty getting or maintaining an erection. Bear in mind that they work only with sexual stimulation.

The pill should be taken about 30 minutes (Cialis, Tadalafil, Levitra, Vardenafil) to an hour (Viagra, Sildenafil) before sexual activity. The pills can be taken with or without food. It may take longer for the pill to take effect if it is taken with food.

The effect of the ED pills lasts several hours:

• Viagra, Sildenafil, Levitra and Vardenafil: about four to five hours.
• Cialis and Tadalafil: up to 36 hours.

During this time, you may achieve an erection with sexual stimulation. See the package leaflet for more information on the use of the ED pills.

Dosage

Do not take more than one tablet a day. The recommended starting dose in adult men is:

• Viagra and Sildenafil: 50 mg.
• Levitra, Vardenafil, Cialis and Tadalafil: 10 mg.

Your doctor may adjust the dose if you feel the effect is too weak or too strong. ED pills are not intended for use by women and adolescents under the age of 18. For more information on dosage, see the package leaflet of the ED medicine you are using.

Alcohol/driving

These types of ED medications may cause side effects that will impair your ability to drive. If you experience symptoms such as dizziness or blurred vision, you should avoid driving or operating machinery until these symptoms have passed.

Limit your alcohol intake! Alcohol may trigger or intensify the side effects of ED medications. Drinking alcohol can also temporarily impair your ability to get an erection.

If you use more than you should/forget to use ED pills

If you take more pills than you were told to, contact your doctor or pharmacist.

The medication should be taken 30 minutes to an hour before sexual activity as it needs some time to work. If you forgot to take your pill, you should take it as soon as you remember. Bear in mind it may take up to 30 minutes to get a firm erection. Never take a double dose. Do not take more than one pill a day.

The ED pills in the sample pack are not suitable for everyone. You should not use these ED medicines if:

• You are allergic to the active substance or any other ingredient in the medicine.
• You are taking medicines called nitrates, as the combination may lead to a dangerous fall in your blood pressure. Tell your doctor if you are taking these medicines which are often given for relief of angina pectoris (or 'chest pain'). If you are unsure, ask your doctor or pharmacist.
• You are taking products that release nitrogen monoxide, such as amyl nitrite (‘poppers’). This too can result in dangerously low blood pressure.
• You have a serious heart or liver problem.
• You have had a recent stroke or heart attack, or have low blood pressure.
• You have a rare hereditary eye condition called retinitis pigmentosa.
• You have ever had loss of vision because of nonarteritic anterior ischemic optic neuropathy (NAION).

For more information on warnings, see the package leaflet of the ED medicine you are using.

When should these types of ED medicines be used with caution?

In some situations, you should talk to your doctor before using ED medicines. For instance, if:

• You have leukaemia, sickle cell disease, multiple myeloma (Kahler’s disease), or any deformation of your penis or undesired or prolonged erections lasting more than four hours.
• You have a serious liver or kidney problem.
• You have any hereditary eye disease.
• You have any heart problems other than your pulmonary hypertension.
• You have blood pressure problems.

For more information on warnings, see the package leaflet of the ED medicine you are using.

Pregnancy and breastfeeding

ED pills are not for women.

Other medicines and ED medicines

Please tell your doctor if you are using, have recently used or might use any other medicines, including medicines obtained without a prescription, herbal medicines or other natural products.

The ED pills in this sample pack are known to interact with other medicines, including:

• Alpha blockers (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia).
• Other medicines to treat high blood pressure.
• Nitrates (for chest pain).
• Riociguat.
• 5alpha reductase inhibitors (used to treat benign prostatic hyperplasia).
• Protease inhibitors for treatment of AIDS or HIV infection (ritonavir).
• Phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines).
• Rifampicin, erythromycin, clarithromycin and itraconazole (for bacterial infections).
• Medicines such as ketoconazole or itraconazole (antifungal medicines).
• Bosentan (another treatment for pulmonary arterial hypertension).
• Other treatments for erectile dysfunction.

For more information on warnings, see the package leaflet of the ED medicine you are using. Your doctor will also have a list of medicines that you should avoid mixing the ED pills in this sample pack with.

Like all medicines, ED medications can cause side effects, although some people may not experience any. Side effects that are known to be associated with the ED pills in the sample pack are:

• Headache.
• Digestive problems.
• Back pain.
• Nasal congestion.
• Facial flushing.
• Dizziness.
• Faster than normal heartbeat (tachycardia), palpitations.
• Blurred vision, eye pain.

The side effects may vary depending on the ED pill. Always consult the package leaflet of the chosen medication before use. The package leaflet will also have a complete list of possible side effects. Consult a doctor immediately if the side effects are severe.

The active substance in Viagra is sildenafil (as citrate salt). The other ingredients are:

• Tablet core: microcrystalline cellulose, calcium hydrogen phosphate (anhydrous), croscarmellose sodium, magnesium stearate.
• Film coating: hypromellose, titanium dioxide (E171), lactose monohydrate, triacetin, indigo carmine aluminium lake (E132).

The active substance in Sildenafil is sildenafil (as sildenafil citrate). The other ingredients are:

• Tablet core: cellulose microcrystalline, calcium hydrogen phosphate anhydrous, croscarmellose sodium, magnesium stearate.
• Film coating: hypromellose (E464), titanium dioxide (E171), indigo carmine (E132), triacetin.

The active substance in Levitra is vardenafil (as hydrochloride). The other ingredients are:

• Tablet core: crospovidone, magnesium stearate, microcrystalline cellulose, colloidal anhydrous silica (anhydrous).
• Film coating: macrogol 400, hypromellose, titanium dioxide (E171), iron oxide yellow (E172), iron oxide red (E172).

The active substance in Vardenafil is vardenafil (as hydrochloride). The other ingredients are:

• Tablet core: crospovidone, magnesium stearate, microcrystalline cellulose, colloidal anhydrous silica (anhydrous).
• Film coating: polyvinyl alcohol (E1203), titanium dioxide (E171), talc (E553b), macrogol//PEG 3350 (E1521), methacrylic acid-ethyl acrylate copolymer (1:1) Type A, iron oxide yellow (E172), sodium bicarbonate (E500 (ii)), iron oxide red (E172).

The active substance in Cialis is tadalafil. The other ingredients are:

• Tablet core: lactose monohydrate, croscarmellose sodium, hydroxypropylcellulose, microcrystalline cellulose, sodium laurilsulfate, magnesium stearate.
• Film coating: lactose monohydrate, hypromellose, triacetin, titanium dioxide (E171), iron oxide yellow (E172), talc.

The active substance in Tadalafil is tadalafil. The other ingredients are:

• Tablet core: lactose monohydrate, sodium laurilsulfate, povidon k12, crospovidone type B, sodium stearyl fumarate.
• Film coating: polyvinyl alcohol, macrogol 3350, titanium dioxide (E171), talc, iron oxide yellow (E172).

The manufacturers of the ED medicines in the sample pack are:

Viagra:

• Pfizer PGM, Zone Industrielle, 29 route des Industries, 37530 Pocé-sur-Cisse, France.

Sildenafil:

• McDermott Laboratories Limited trading as Gerard Laboratories, 35/36 Baldoyle Industrial Estate, Grange Road, Dublin 13, Ireland.
• Mylan Hungary Kft, H-2900 Komarom, Mylan utca 1, Hungary.

Cialis:

• Lilly S.A., Avda. de la Industria 30, 28108 Alcobendas, Madrid, Spain.

Tadalafil:

• Lek Pharmaceuticals d.d., Verovškova 57, 1526 Ljubljana, Slovenia.
• PLIVA Croatia Ltd., Prilaz baruna Filipovica 25, Zagreb, Croatia.

Levitra:

• Bayer AG, Kaiser-Wilhelm-Allee, 51368 Leverkusen, Germany.

Vardenafil:

• Actavis Ltd., BLB015-016, Bulebel Industrial Estate, ZTN 3000, Zejtun, Malta.

Read the package leaflet before use.