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The amount pharmacies charge patients when medicines are supplied privately, or the amount the NHS pays to pharmacies on NHS prescriptions, is usually based on the wholesale prices paid by pharmacies, but there are numerous other factors affecting the cost to patients and the NHS. This saves money for the NHS. Drug companies usually take out more than one patent on new active ingredients, and may hold patents on slight chemical variations in the active ingredients.
What precautions should I take?
Viagra is known to interact adversely with certain drugs and substances:
you should avoid grapefruit - when combined with sildenafil, the fruit can cause low blood pressure
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Men with the following conditions should not take Viagra without further assessment from their GP:
Taking medicines called nitrates (often given for chest pain)
Taking or intend to take amyl nitrite ('poppers')
Taking riociguat (to treat high blood pressure in the lungs)
Low or high blood pressure
Allergies or reactions to past ED treatments
Recent heart attack (within 6 weeks) or suffer from angina (heart pain on exertion) or any form of heart disease
History of strokes or mini-strokes (transient ischaemic attack)
History of vision problems caused by circulation problems
History in the family of rare degenerative eye disease
Serious kidney (renal) or liver disease
Peyronie's disease – angulation or deformity of the penis
Leukaemia, multiple myeloma or sickle cell disease
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