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All you need to know when buying cialis Online brand cialis online without prescription Adverse events Sildenafil (Viagra), whose labeling was approved by the U.S. Food and Drug Administration (FDA) in March 1998, is the first oral medication to be marketed for the treatment of erectile dysfunction. Sildenafil inhibits the conversion of cGMP to guanosine monophosphate in the corpus cavernosum, thereby increasing the available concentration of cGMP. This reaction is largely catalyzed by the enzyme phosphodiesterase type 5. Sildenafil inhibits this enzyme, resulting in relaxation of the cavernosal smooth muscle.17 Sildenafil is absorbed rapidly, with peak plasma levels achieved within an hour. It undergoes hepatic metabolism and has a half-life of about four hours. is a staff urologist at Naval Hospital Jacksonville. Dr. Green is a graduate of the University of Texas Health Science Center at San Antonio and completed his residency at Naval Medical Center, Portsmouth, Va. Q. Is it difficult to persuade a man to inject his penis?