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generic cialis dangers

generic cialis dangers


Cialis Dangers

Cialis ® (tadalafil ) is approved for the treatment of erectile dysfunction (also known as ED or impotence ). It is also approved to treat enlarged prostate symptoms. Most men tolerate the medication without any problems; however, there are some potential dangers with Cialis to be aware of. For example, it may cause serious side effects, such as a severe allergic reaction or an erection lasting longer than four hours, that often require prompt medical attention.

In addition, Cialis can be dangerous to men with certain medical conditions or who are taking certain other medications. For example, men who have a history of heart disease may be more likely to experience problems with Cialis. Men who are taking a nitrate for angina may need to take a different erectile dysfunction medication .

To ensure a safe, effective treatment process, tell your healthcare provider about all medicines you are taking, including vitamins, supplements, and nonprescription products, and provide a complete medical history, detailing any other medical conditions you have.

(Click Cialis Side Effects and Cialis Precautions and Warnings for more information on potential dangers of Cialis. These articles provide a more complete list of side effects and go into more detail about who should avoid this drug and why.)

Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD

Yesterday’s Miami Herald published a truncated version of the Great Vacation Tips for 2016. Here on the blog, we’re going into more detail.

So this tip might seem obvious: You better shop around. Especially when it comes to expensive trips.

But that doesn’t just mean going to Trivago or Kayak or Expedia. It means getting on a phone. And it means comparing more than just price.

Sing-sing in Papua New Guinea.

A friend who is planning a trip to Papua New Guinea — far away and yes, pricey — got a quote from several top-end travel arranger. Because she wants to visit during the August tribal gathering called the Sing-Sing, she’s required to travel with a group, at least for that part of the trip. She cares passionately about great guides. As for hotels, well, as someone who has been to PNG, let’s just say that there’s little choice. One company gave her a great itinerary — and an equally lofty price. A second company gave her an itinerary that was virtually identical, right down to the hotels — at half the price.

Another example: A group that’s traveling on the Danube this summer. A half-dozen cruise lines offer similar itineraries. Each couple in the group was given a list of details to investigate and assigned a company. On the check-out list were items including price, dates, travel time between the tour’s city of origin — Bucharest or Istanbul — and the ship, costs, inclusions and touring options. When the chart came together, it was clear that the trip that looked to be the least expensive didn’t include as much and involved larger tour groups with fewer land excursion options. For nearly the same price, the group could get a trip with smaller day touring groups and significantly more excursion options. And the cabin configuration was more appealing.

The lesson: Do enough research to figure out what you want, then compare options from well-regarded companies and suppliers. If this is a once-in-a lifetime experience, focus on the one thing that is most important to you — A great guide? The best hotel? — and let the rest fall where it may. If it’s a nice trip but not an important anniversary, you might be more mindful of cost than luxuries.

I rarely manage enough points with any one hotel brand to get a free stay. But hotels often offer discounts for members and include extras, like Wifi, for members. Twice recently I found discounts far deeper than what I could get via AAA, AARP or online sites by joining the hotel chain loyalty club and booking directly on its website. And let’s face it: Who doesn’t like a deal?

There is a trade-off: Your information and a flood of new emails in your box. My information is already in the giant universal meta database, just by virtue of the fact that I exist. Handing my address and email to one more company isn’t going to make much difference, I figure. (I never allow them to store my credit card info, just to be extra safe.) As for the extra emails…that’s where Unroll.me comes in. (Check previous posts for details.)

If you travel a lot on business, of course, those hotel points can quickly add up to free stays. But even if you’re an occasional roadside motel / family traveler, take a look at loyalty programs. Choice Hotels include 11 familiar brands – including Clarion and Comfort Inn; most years they run summer specials where a handful of stays will earn you a free night. At Hotels.com, 10 nights in any hotel booked on the site will earn you a free night. Other chains and booking sites have similar programs.

So what’s that free night worth? Maybe not so much if you’re roadtripping to Georgia. But if you’re heading to the other Georgia, that could be a free night at a Tbilisi hotel like the Radisson or Marriott that normally charges around $275.

On my last trip to Copenhagen, my free night was worth more than $250 in high season. Not a bad deal.

Now that you know when you can take off, and where you want to go, you know which destination deals you want to track.

There seem to be a grillion (and possibly more) websites out there that will help you. Here are a few worth checking. (Please share you faves, too!)

Smartertravel.com. Subscribe to this website for a daily email on the latest airfare and package deals, along with articles written some of the consumer travel industry’s most knowledgeable experts. (If you find the daily newsletter more irritating than entertaining, you can subscribe to Unroll.me and have it put into your daily email roll up.). You can also sign up for alerts by city of origin, so you can track all the cheap flights from your local airport.

AirfareWatchdog. a sister company to Smartertravel (both are owned by the same people as Cruise Critic and TripAdvisor ) offers terrific alerts on air deals. Unlike most sites that lean entirely on computer algorithms, AirfareWatchdog has actual humans who test the deals before sending out alerts. The site also allows you to watch specific route pairings.

Online booking sites Travelocity and Expedia also offer deal alerts. Travelocity’s Destination Watcher lets you designate whether you’re looking for air, hotel or car deals.

When it comes to getting a deal on a business-class fare, TravelZoo is one of the few sites that regularly highlights these; you can find them on their own tab under airfares. Better yet, sign up for their alerts. Skyluxtravel.com also highlights business class sales.

Luxury travel is a different conversation — one we’ll get to. So are cruises, hotels, packages and tours. We’ll get to those another day.

You have carried us around the globe more times than we can reckon,

You were our perfect bags: Lightweight, rollable, presentable enough for a decent hotel, equipped with sturdy backpack straps that allowed us to haul you up the stairs of a Santorini cave house on our honeymoon and into a raw wood hut on our trek through Cameroon. When flights were delayed, you served as backrests, card tables, pillows. Your dusty exterior belied your value, thwarting theft.

From Irian Jaya to India, Mali to Mongolia, Uzbekistan to Alaska, you were our unfailing companions. In your caring folds you hauled trekking boots and little black dresses, underwear and socks, dry sacks and charging chords, carpets and ceremonial crowns from Tibet and and Ethiopia. The handicraft gifts so carefully chosen from far away places came home in your canvas holds; you kept them safe despite the knowledge that the relatives who would receive them would scratch their heads and wonder, why?

Airlines did their best to rend your wheels, your straps, your handles. You held steadfast, with the aid of rare visits to the Eagle Creek infirmary. When Eagle Creek declared that your lifetime guarantee was not a warranty for our lifetimes but some arbitrary “lifetime of the bag,” we were forced to relegate you to storage. There, humidity and mildew wreaked the irreparable damage that no chicken plane or baggage conveyor belt ever delivered.

Today you go to rest, For decades of dreams and miles of memories, you have our enduring thanks. Fare thee well.

January generally brings a new round of sales: Travel sales.

The last-minute deals of years past are largely gone, swept away in the desire by businesses to book as much business as they can early in the year. For cruise lines, hoteliers, packagers, tour operators — and even airlines — this often means January deals.

Some of those special prices will apply only through spring. But others might be good far later in the year. Since you’ve already identified your free-travel spaces, you already know what works for you time-wise.

Now, you just need to prioritize your wish-list.

If you don’t have one, it’s time to make one. If you do, it’s probably time for an update.

I keep two lists, one for once-in-a-life trips (polar bear watching in the High Arctic) and other for that-could-be-fun places and return visits. (Colorado’s Broadmoor, Brussels). As you move places up and down your list, you’ll want to consider the following:

How much time do you need for a reasonable visit? (Five days in Paris or London is a decent little trip, but anything less than two weeks in China isn’t really worth it.)
  • Are any of the places on your list at risk? The glaciers of Alaska are receding. Relations with Russia have been dicey; now might be the time for that visit to St. Petersburg. Is Myanmar becoming too popular, making it a now or never trip? Are you longing to go to Cuba during this historic change?
  • What’s in recovery? During the Ebola crisis, even unaffected destinations far from the disease suffered tourism losses…meaning this could be a year for great deals.
  • Are your traveling companions aging or, alternatively, about thinking about getting pregnant in the next few years? You might want to book that trekking trip while you know you can.
  • When the deals appear, you’re ready to pounce!

    Tip No. 2: Identify free time.

    When you factor in work schedules, school commitments, parents and spousal priorities, getting away for a trip might seem like an impossibility.

    Jaipur, India, 2011, during the Holi festival.

    Alex V. a busy executive married to another busy professional, suggests matching schedules the old fashioned way: On paper. On a paper calendar, she wrote in all her out-of-town and committed dates in one color, then did the same with her husband’s schedule in a different color. They quickly were able to spot a few weeks when neither was booked, and reserved that time for travel.

    And don’t just depend on what’s written in the calendar. Check with your partner and other critical parties to be sure there aren’t any floating issues out there, like that college reunion my husband said he was hosting “sometime this July.” Even though the dates aren’t set, I know not to get my heart set on going to some out-of-town festival that month — at least not with him.

    May, 2009: Canal barge cruise through Burgundy, France. Photos by Jane Wooldridge / ONE TIME USE ONLY.

    Tip 1: Update your 2016 travel datebook.

    Family wedding? Conference? Business trip? Get the dates and places onto the calendar.

    Once you know when and where you’re already going, you can figure out if you want to add additional time to any of those trips, so you can leverage your travel time and airfare.

    Or not. If you’re of the school that fish and family both have a three-day limit, or your annual professional conference is in West Boringsville, you can save those precious vacation days for a trip that really makes your heart sing.

    Where are you going in 2016? That question has been on the lips of nearly everyone I’ve spoken with in the past week.

    For travel addicts, the reason is clear: A trip — or just the prospect of one — helps ease the difficulty of getting back to work. Even if you’re not a total travel fanatic, the idea of a great vacation can give you a little purr.

    On the royal lake in Udaipur.

    Ah, but there’s the frisson of potential discord: How do you GET a great vacation?

    For the next several weeks, I’m posting a tip a day for getting a great vacation in 2016. The goal is 30 Tips, 30 Days. But I’m hoping friends and followers will kick in with more ideas beyond those already on my list, so we can keep going.

    Can we make 365? Maybe. With breaks, of course, for travel.

    Dangerous Problems with Counterfeit Viagra

    The world, including the US, is being flooded with counterfeit Viagra and other erectile dysfunction medications. A report in the Feb 12, 2009 issue of the New England Journal of Medicine highlights the dangerous problems.

    The article reports on a total of 150 non-diabetic patients with severe hypoglycemia (low blood glucose) were admitted to the five public hospitals in Singapore. The admissions were between January 1 and May 26, 2008. All the patients were men except one, ages ranged from 19 to 97 years (median, 51). Seven patients remained comatose as a result of prolonged decrease glucose to the brain,and four subsequently died.

    Several patients (45/150 or 30%) admitted to ingesting illegal sexual-enhancement drugs before the onset of hypoglycemia. Samples of the drugs obtained from these patients and from drugs seized in police raids were analyzed by means of high-performance liquid chromatography. It was found that many of the preparations were contaminated with Glyburide (a powerful medication used to treat diabetes).

    So people thought they were taking Cialis or Viagra. What they were often taking were herbal preparations (e.g. Santi Bovine Penis ErectingCapsule) that contained small amounts of the active ingredient (Cialis or Viagra), but which also contained glyburide.

    Since none of the men were diabetic, they experienced a severe drop in blood sugar (hypoglycemia). Seven men sustained serious brain damage due to low blood sugar, of which four ultimately died.

    Harmful ingredients found in counterfeit medicines include boric acid, leaded road paint, floor polish, shoe polish to get the sheen on the tablet, talcum powder, cement powder, chalk and brick dust, nickel and arsenic. Any active drug ingredient is usually minimal or simply wrong – one supply batch of fake Viagra was in fact amphetamine and not Viagra (sildenafil).

    Here are some signs (from eDrugStore) to help you identify illegal "generic Viagra" [Cialis or Levitra:

    В· The site sells "generic VIAGRA" or "generic sildenafil citrate" [Viagra does not have a generic form available.]

    В· The site claims to sell a cheaper form of VIAGRA

    В· The price is cheaper than VIAGRA, by as much as 70%

    В· The site claims the drug is made to World Health Organization (WHO) standards, which may be a lie. The WHO does not review or approve any medication

    В· The drug is sold as a pill, but looks different from VIAGRA's normal color, shape and imprinting

    В· Delivery times may be extended (4 -21 days) due to product being shipped into the United States from a foreign country

    В· Shipping is initiated using a foreign country postal service to minimize chances of detection and seizure when entering United States

    An Unusual Outbreak of Hypoglycemia ; N Engl J Med 2009 360: 734-736; Kao, Shih Ling, Chan, Cheng Leng, (Pharm.), B.Sc. Tan, Belinda, (Pharm.), B.Sc. Lim, C.C. Tchoyoson, Dalan, Rinkoo, Gardner, Daphne, Pratt, Edward, Lee, Marilyn, Lee, Kok Onn

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