How can I save money on prescriptions?

Generic medications are less expensive
copies of brand-name medications. Ask your doctor if you can take a
generic equivalent for the brand-name medication that
you take now. Generic equivalents are made according to the same strict U.S.
Food and Drug Administration (FDA) standards as brand-name drugs and therefore
have the same quality, strength, purity, and stability as their more expensive
counterparts.

Unfortunately, generic equivalents are not available for every
brand-name medication. If there is not an equivalent, ask your doctor if there
is a similar medication in the same class that may be less expensive or that
has a generic equivalent. For example, Flomax, which is used to treat an
enlarged prostate, is a relatively expensive medication that does not have a
generic equivalent. However, another medication that also is used for enlarged
prostate, Hytrin, does have a less expensive generic equivalent.

Always shop around for the best deal on
medications. The retail cost of medications can vary widely from pharmacy to
pharmacy. While finding a good deal is important, it’s also important that your
pharmacist (or pharmacists) knows your medical history, including all the
drugs-both prescription and nonprescription, as well as dietary supplements and
herbs-you take, even if they are not dispensed at that particular pharmacy.
That way he or she can provide valuable advice about any potential for drug
interactions, side effects, or other problems.

Also, compare costs of buying medications online. Some large
drugstore chains have Web sites that offer savings. See a complete list of Web
sites on the National Association of Boards of Pharmacy (NABP) site at
http://www.nabp.net/vipps/consumer/search.asp. Look for Web sites that display
the NABP VIPPS (Verified Internet Pharmacy Practice Sites) seal, which means
they have met state and federal requirements.

The U.S. Medicare Web site, http://www.medicare.gov, has a useful
tool for comparing prices of hundreds of prescription drugs and generic
equivalents at pharmacies near you and also available by mail order. You can
access this information by answering “Yes” to the question “Do you have
Medicare?” and entering your Zip code. The Web site requires that you answer
several screens of questions and have some familiarity with computers. People
who have difficulty can call 1-800-MEDICARE (1-800-633-4227) to receive lists
of prices for the drugs they use.

Pill splitting is another strategy that
can help you save money without losing drug effectiveness or safety. Some
tablets are available at double the dose and at the same or almost the same
cost as lower doses. By splitting the larger dose, you can essentially get two
doses for the price of one. However, many medications are not suitable for pill
splitting, including timed-release pills and capsules. The chart below lists 10
commonly prescribed medications that researchers have determined can be split
safely and effectively with significant cost savings.²

Ask your doctor or pharmacist if any of your prescription
medications are sold at higher dosages and if it’s possible to split them. Talk
to your pharmacist about how to split pills with an inexpensive, easy-to-use
pill
splitter.

Buying prescriptions in bulk can also
save you money. Ask your doctor to write a prescription for several months’
supply of medications that you take consistently. Mail-order services can often
save you money on large orders.

Are prescription medications always necessary?

There may be an over-the-counter alternative for your
prescription medication. For example, nonprescription Aleve is a fraction of
the cost of the prescription equivalent Naprosyn. (Generic versions of
over-the-counter medications can save you even more money.) Often
nonprescription equivalents of prescription medications come in lower
strengths, so get instructions from your doctor on how to take them.

In the case of antibiotics, recent research has found that
antibiotics are not always necessary. For example, up to 80% of ear infections
get better without antibiotics.³ Your doctor might
recommend that you take a wait-and-see approach before buying expensive
antibiotics. Likewise, randomized trials show that 69% of people who had
ed meds
sinus infection recovered without any antibiotics.⁴

Can I save money by purchasing prescription medications from Canada? Is it safe?

The answer to the first question is “Yes.” You can buy most
prescription medications, either over the Internet, by mail order, or in
person, for less money from Canadian pharmacies than from their U.S.
counterparts. Whether it is legal to do so remains erectile dysfunction pill
.

The FDA warns that the safety of drugs bought from other
countries cannot be ensured. However, many doctors acknowledge that Canada also
demands safety and efficacy for medications, and they would rather their
patients buy medications from Canada than have to skip doses because they can’t
afford their medications. U.S. citizens have been buying medications in Canada
for years, although officially federal law prohibits the practice. Currently,
the U.S. Customs Service allows Americans to bring a 90-day supply of
prescription drugs across the Canadian borders for personal use.⁵

Talk to your doctor if you decide to import your medications, and
be sure to buy only from licensed Canadian pharmacies and wholesalers.

How can my doctor help?

To enlist your doctor’s help, tell him or her that your
prescription medication bill is a financial burden. Ask for drugs that are less
expensive but just as effective. Often, several medications can be used to
treat the same condition, and your doctor may be able to prescribe the one that
is the most economical. For example, researchers have found that older, less
expensive antibiotics such as amoxicillin work better than newer antibiotics
for children who need treatment for middle ear inflammation.⁶

Often, drug companies give doctors medication samples free of
charge. You might ask your doctor if he or she has medication samples,
especially when you are trying out a new medication to see whether it will
work.

How can my insurance plan help save me money?

Take time to find out about how your medical insurance or
managed health care plan covers medication costs. Some insurance companies
cover only generic medications if they are available. With some insurance
plans, you may have to pay more for medications that are not on the plan’s list
of preferred medications. Some insurers cover medications that are bought only
at participating pharmacies. Your insurance company also may not pay for
certain medications such as weight-loss and hair-growth drugs. Ask the customer
service representative whether your medications are covered, whether you need
to buy at participating pharmacies, and about your copayment. Many insurance
companies also list this information on their Web sites.

If you have a choice between plans, check what your copayment for
prescription drugs will be, the maximum amount the plan will pay in a year, and
other particulars. Choose the plan that best suits your needs. When buying
medications, find out which payment option will be the least expensive. Some
factors to consider include whether there is a generic version of a preferred
medication, and whether an over-the-counter equivalent is cheaper than your
copayment. Remember, having the right information can save you time and
money.

What about the Medicare drug program?

Beginning in January 2006, a new Medicare drug program-the
Medicare Part D prescription drug benefit-will begin. For the most current
information about what the Medicare Part D Act means for you, go to
http://www.medicare.gov or call 1-800-MEDICARE. Your doctor, pharmacist, or
social worker may also be able to help you understand
your Medicare benefits.

What other resources are available?

See whether the pharmaceutical company that makes your
medication has a patient assistance program. Many pharmaceutical companies
offer free or discounted drugs for people who cannot afford them. These
companies often require that your doctor contact them first about your case. In
any case, your doctor will need to be involved, and the application process can
be complex. You may need to provide documentation to verify your income. The
nonprofit organization RxAssist provides doctors and other health care
providers with the information they need to access these programs. You can find
out more at http://www.rxassist.org. This Web site
also lists state programs for seniors and disabled and low-income people.

If you have a rare disease, you may be eligible for the National
Organization for Rare Disorders (NORD) medication assistance program. This
program helps people with rare diseases whose income is too high to qualify for
Medicaid but too low to pay for their prescribed medications. For more
information, visit http://www.rarediseases.org/programs/medication.

Most veterans know that the Veterans Administration offers
prescription drug coverage for retired veterans. But many people don’t know
that the same service is available for their families and survivors. Call the
VA Health Benefits Service Center toll-free at 1-877-222-VETS (8387), or go to
http://www1.va.gov/health_benefits/.

Some generic erectile dysfunction drug offer special discounts on prescription drugs
for their members. For example, members of AARP save 17% on brand drugs and at
least 50% on generic drugs. Also, many pharmacies offer some form of a discount
plan for seniors.

Diabetes is a very common cause of erectile dysfunction (ED). Clinical
experience and numerous studies suggest that at least 50% of diabetic patients
will experience difficulties with erections. When compared to nondiabetic men,
men with diabetes are up to 3 times more likely to have ED and appear to get it
earlier in life. The significance of ED increases with the severity and
duration of diabetes as well as with advanced age.

There is evidence that controlling blood sugars and cholesterol as well as
participating in a consistent exercise program may help in preventing the
development of ED and, in some cases, may even improve symptoms in those with
ED. If you are one of the many men with diabetes and ED, you have many
treatment options to consider, including:

Oral Drugs

The three oral medications available — Viagra, Cialis, and Levitra — to
treat ED have been used successfully in people with diabetes. In general,
however, the success rate of these medications is less than the reported
success rates in people without diabetes. These medications may help 50% to 60%
of men with diabetes.

Injection Treatment

When oral medications are ineffective, intracavernous injection therapy (the
injection of medication directly into the erection chamber of the penis) may be
helpful in facilitating intercourse. Among diabetic men, the success rates with
this method range from 60% to 80%. The medications used include:

• Alprostadil (brand names Caverject Impulse, Edex, and Prostin VR)
• Papaverine erectile dysfunction pill
  
• Erectile dysfunction medication
  mesylate

In many cases, it may take a mixture of the three medications to produce an
adequate response. Although injections may be reasonably effective in diabetic
patients, about 50% of users stop after several years.

Vacuum Original viagra
Devices (VCD)

VCDs have been helpful in
facilitating intercourse among diabetic patients. They work in up to 80% of
users; however, like injection therapy, many people discontinue treatment after
several years.

This device consists of an acrylic cylinder that is placed over the penis. A
lubricant is used to create a good seal between the body and the cylinder. A
pump mechanism is used to create a vacuum inside the cylinder, allowing a
patient to achieve an adequate erection. If an adequate erection can be
achieved, a band or ring is then placed over the base of the penis (the part of
the penis closest to the body) and is used to help maintain the erection.

Learn more about vacuum constriction
devices.

Intraurethral Therapy

This treatment involves using an applicator to place a suppository or pellet
containing medicine into the urethra (canal in the penis that carries
urine).

Learn more about intraurethral
therapy.

Penile Implants

Clinical studies have shown a high degree of patient satisfaction with
penile implants when other therapies have not worked. Patients need to be
suitable surgical candidates and it is preferable that patients have reasonably
good diabetic control before surgery.

Learn more about penile
implants.

Get the facts about diabetes and
ED.

View the full table of contents
for the ED guide.

Reviewed by the doctors at the Glickman Urological
Institute at The Cleveland Clinic.

To treat erectile erectile dysfunction tablets
(ED), you have to lower your blood pressure
first. Some people are able to do that through lifestyle changes alone. Others
need help from prescribed blood pressure medication.

A problem for many men, however, is that some types of blood pressure
medicines can actually cause erectile dysfunction. That may make it
difficult to stay on your medication, especially if your high blood pressure
never caused any symptoms before. An estimated 70% of men who have side effects
from blood pressure medicine stop taking it.

Many drugs used to treat high blood pressure have been linked to erectile
dysfunction. But some are much less likely than others to cause problems.
Certain of the blood pressures drugs may even improve erectile
dysfunction for some men.

It’s known that diuretics (or water pills, like hydrochlorothiazide) and
beta-blockers (like Atenolol) can cause erection problems. These are also the
first drugs that a doctor is likely to prescribe if you are not able to lower
your blood pressure through diet and exercise.

If you’re taking a diuretic, you should stay on your medicine until your
blood pressure is under control. If your erection problem persists, or your
blood pressure goes back up, then your doctor might switch you to a drug that’s
less likely to cause erectile dysfunction. Or, a combination of medications
might work better to control your blood pressure and reduce the risk of
erectile dysfunction.

If you take a beta blocker you may also want to ask your doctor if it might
cause erectile dysfunction. You might be better off on a medication less likely
to cause a problem.

Erection-Friendly High Blood Pressure Drugs

Some families of high blood pressure drugs rarely cause erectile dysfunction
as a side effect:

• ACE inhibitors
• Alpha-blockers
• Calcium channel blockers
• ARBs

ACE (buy loss phentermine prescripti viagra weight
converting enzyme) inhibitors — such as Lotensin, Capoten,
Zestril, Prinivil, etc. — widen blood vessels and increase blood flow.
Erectile dysfunction is rarely a side effect, occurring in less than 1% of
patients. There are several different medications in the category. This seems
to be true of all of them.

There are also medications known as calcium channel blockers, such as
Diltiazem, Verapamil, or Amlodipine. As a group, they rarely cause erectile
dysfunction. But erection problems may be less common with some individual
drugs within that group than with others. Your doctor can tell you which.

In general, alpha-blockers do not often cause erection problems either. In
one study published in the journal Hypertension in 1997, a small
number of men actually had a 100% improvement in their erectile dysfunction
after two years on the alpha-blocker Cardura.

Drugs known as ARBs (angiotensin II receptor blockers, like Losarten) are
not only unlikely to cause erection problems, but they may actually
improve sexual function in men with high blood pressure.

A 2001 study published in the American Journal of the Medical
Sciences looked at the drug Cozaar, an ARB. At first, just 7% of men and
women in the study said they felt sexually satisfied overall. After 12 weeks of
Cozaar, about 58% said they were sexually satisfied. The percentage of men who
reported having erectile dysfunction dropped from 75% to 12%.

Another study compared the drug Diovan, an ARB, with Coreg, a beta-blocker.
The study, published in the American Journal of Hypertension in 2001,
compared the effect of the two drugs on blood pressure and frequency of sexual
tadalafil and generic
.

The drugs controlled blood pressure equally well. But people who took the
ARB reported having sex more often during the 16 weeks of treatment. They said
they had sex about eight times a month before, and 10 times a month after.
People taking the beta-blocker had sex much less often: eight times a month
before, and four times a month after.

Steps to Take If Your Medicine Causes Erection Problems

Tell your doctor if you think your blood pressure medicine may be causing
problems with your erections.

If it is your medication, and not just your high blood pressure,
switching to another prescription may solve the problem. Never stop taking your
medicine without your doctor’s OK.

But high blood pressure itself still could be to blame for your erectile
dysfunction. In that case, ask about trying an erectile dysfunction drug like
Viagra, Cialis, or Levitra.

You should only take these drugs once your blood pressure is under control.
They are not safe for men with untreated high blood pressure. They are also not
safe for men taking alpha-blockers, or men taking nitrate drugs for heart
disease.

Doctors in primary care fields often hear their patients complain of night
sweats. Night sweats refer to any excess sweating occurring during the night.
However, if your bedroom is unusually hot or you are using too many bedclothes,
you may begin to sweat during sleep–and this is normal. In order to
distinguish night sweats that arise from medical causes from those that occur
because ones surroundings are too warm, doctors generally refer to true night
sweats as severe hot flashes occurring at night that can drench sleepwear and
sheets, which are not related to an overheated environment.

In one study of 2267 patients visiting a primary care physician, 41%
reported experiencing night sweats during the previous month, so the perception
of excessive sweating at night is fairly common. It is important to note that
flushing (a warmth and redness of the face or trunk) may also be hard to
distinguish from true night sweats.

There are many different causes of night sweats. To determine what is
causing night sweats in a particular individual, a doctor must obtain a
detailed medical history and order tests to decide if an underlying medical
condition is responsible for the night sweats. Some of the known conditions
that can cause night sweats are:

1. Menopause
   The hot flashes that accompany the menopausal
   transition can occur at night and cause sweating. This is a very common cause
   of night sweats in perimenopausal women.

1. Idiopathic hyperhidrosis Idiopathic hyperhidrosis is a condition
   in which the body chronically produces too much sweat without any dysfunction pills
   
   medical cause.

1. Infections Classically, tuberculosis is the infection most
   commonly associated with night sweats. However, bacterial infections, such as
   endocarditis (inflammation of the heart valves), soft viagra
   (inflammation
   within the bones), and abscesses all may result in night sweats. Night sweats
   are also a symptom of AIDS virus (HIV) infection.

1. Cancers Night sweats are an early symptom of some cancers. The
   most common type of cancer associated with night sweats is lymphoma. However,
   people who have an undiagnosed cancer frequently have other symptoms as well,
   such as unexplained weight loss and fevers.

1. Medications Taking certain medications can lead to night sweats.
   In cases without other physical symptoms or signs of tumor or infection,
   medications are often determined to be the cause of night sweats.
   Antidepressant medications are a common type of medication that can lead to
   night sweats. All types of cure dysfunction erectiles can cause night sweats as a side
   effect, with a range in incidence from 8 to 22% of persons taking
   antidepressant drugs. Other psychiatric drugs have also been associated with
   night sweats. Medicines taken to lower fever such as aspirin and compare generic viagra wholesale prices
   
   can sometimes lead to sweating. Other types of drugs can cause flushing, which,
   as mentioned above, may be confused with night sweats. Some of the many drugs
   that can cause flushing include:

• niacin (taken in the higher doses used for lipid disorders),
• tamoxifen,
• hydralazine,
• nitroglycerine, and
• sildenafil (Viagra).

Many other drugs not mentioned above, including cortisone medications such
as prednisone and prednisolone, may also be associated with flushing or night
sweats.

1. Hypoglycemia
   Sometimes low blood glucose can cause
   sweating. People who are taking insulin or oral anti-diabetic medications may
   experience hypoglycemia at night that is accompanied by sweating.

1. Hormone disorders - Sweating or flushing can be seen with several
   hormone disorders, including ed pills
   , carcinoid syndrome, and
   hyperthyroidism.

1. Neurologic conditions Uncommonly, neurologic conditions including
   autonomic dysreflexia, post-traumatic syringomyelia, stroke, and autonomic
   neuropathy may cause increased sweating and possibly lead to night sweats.

• During a
  relapse, to make the attack shorter and less
  severe.
• Over a long period of time, to alter the natural course of
  the disease (disease-modifying therapy).
• To control specific
  symptoms as they occur.

Controlling a relapse

Medications can shorten a sudden relapse and help you recover
more quickly. Temporary treatment with medications called
corticosteroids is the most common treatment used to
control a relapse. These medications have not been shown
to affect the long-term course of the disease or to prevent disability.

Altering the course of MS using disease-modifying treatment

Strong evidence suggests that MS is caused by the
immune system causing
inflammation and attacking the myelin-the coating
surrounding the nerve and nerve fibers. Medications that change the activity of
the immune system can reduce the number and severity of attacks that damage the
protective myelin.

Currently, interferon beta (Avonex and Rebif, and Betaseron),
glatiramer acetate (Copaxone), and mitoxantrone (Novantrone) are the only
medications that have been approved for this purpose. For people with
dysfunction pills
MS, these medications can reduce
the number and severity of relapses and can result in fewer brain lesions. They
may also delay disability in some people. Betaseron and Novantrone may delay
disease progression in some people with
secondary progressive MS.

Currently, there is no effective disease-modifying treatment for
primary progressive MS.

Relieving symptoms

Treating specific symptoms can be effective, even if it does not
stop the progression of the disease. Symptoms that can often be controlled or
relieved with medication include:

• Fatigue. Medications to reduce fatigue
  or help you sleep better may include amantadine (Symmetrel), modafinil
  (Provigil), or fluoxetine (Prozac).
• Muscle stiffness
  (spasticity) and tremors. Medications that may reduce muscles spasms or
  stiffness include baclofen (Lioresal), tizanidine (Zanaflex), dantrolene
  (Dantrium), gabapentin (Neurontin), diazepam (Valium), or clonazepam
  (Klonopin). Sometimes a combination of these medications works best to reduce
  your muscle symptoms.
• Urinary problems and constipation.
  Medications used to reduce frequent urination may include propantheline
  (Pro-Banthine), oxybutynin (Ditropan), or tolterodine (Detrol). Medications
  sometimes used to relieve constipation include bulk agents such as psyllium
  (Metamucil) or daily use of laxatives.
• Pain and
  abnormal sensations. Depending on the severity of the pain, both
  prescription and nonprescription medications may be tried. Prescription
  medications commonly used to reduce pain associated with MS include baclofen
  (Lioresal), carbamazepine (Tegretol), or gabapentin (Neurontin).
  Nonprescription medications may include acetaminophen, ibuprofen, or naproxen
  sodium.
• Depression. Antidepressant medications may be used to
  reduce depression that often occurs as a result of having MS. Antidepressants
  often tried include tricyclic over the counter erectile dysfunction drug
  as amitriptyline (Elavil),
  desipramine (Norpramin), or imipramine (Tofranil)-or selective serotonin
  reuptake inhibitors (SSRIs)-such as fluoxetine (Prozac) or sertraline (Zoloft)
  among others.
• Sexual difficulties. Medications used
  to relieve sexual difficulties that can be associated with MS include
  sildenafil (Viagra) for both men and women. Yohimbine and clomipramine may also
  be given to improve
  erectile dysfunction.

MS can affect many parts of the nervous system and produce a wide
range of symptoms. The choice of medications depends on your symptoms.
Medication may be used only some of the time or regularly, depending on how
severe or constant a particular symptom is. Changes in diet, schedule,
exercise, and other habits can also help manage some of these symptoms. See the
Home Treatment section of this topic.

Medication Choices

Symptom management

Medications used to treat symptoms of an attack of multiple
sclerosis (MS) and help you recover more quickly from a relapse include:

• Generic erectile dysfunction drugs
  (such as
  methylprednisolone).
• ACTH (adrenocorticotropic
  hormone).
• Intravenous immunoglobulin (IVIG) or
  plasma exchange (neither is used frequently).

Relapsing-remitting MS

Medications used specifically for relapsing-remitting MS to
reduce the number and severity of relapses and possibly delay disability
include:

• Interferon beta (Avonex, Rebif, and
  Betaseron).
• Glatiramer acetate
  (Copaxone).
• Mitoxantrone (Novantrone) for relapsing-remitting MS
  that is rapidly getting worse.

Secondary-progressive MS

Medications used to treat and possibly delay the progression of
secondary progressive MS that is also relapsing include:

• Interferon beta-1b (such as
  Betaseron).
• Mitoxantrone (Novantrone).

Before buying free sample viagra
MS

No medicines have been clearly proven to help, and none have
been approved for primary-progressive MS. Some of the newer and experimental
medications, such as
immunosuppressants and
other medications and biological chemicals (derived
from or identical to substances produced by the body) are being tested for
primary-progressive MS.

Medications being studied

A variety of
immunosuppressants and
other medications and biological chemicals (derived
from or identical to substances produced by the body) have been tried as
therapy for MS. While none have been clearly proven beneficial and none have
been approved for treatment of MS, these medications may be used when standard
therapy fails.

Several medicines are currently being tested in
clinical trials. People with MS who have not responded
to standard therapy sometimes choose to participate in these trials. To learn
more about clinical trials, talk to your doctor or contact the National
Multiple Sclerosis Society at http://www.nationalmssociety.org.

What To Think About

Long-term treatment with interferon beta and glatiramer acetate
can improve the quality of life for some people who have relapsing-remitting MS
by making relapses less frequent and less severe. Some evidence suggests that
these medications may also reduce or delay future disability caused by this
form of the disease.

The National Multiple Sclerosis Society recommends that treatment
with interferon beta or glatiramer acetate be started as soon as it is clear
that you have MS. Most
neurologists support this recommendation and now agree
that permanent damage to the
nervous system may occur early on, even while symptoms
are still quite mild. Early treatment may help prevent or delay some of this
damage. In general, treatment is recommended until it no longer provides a
clear benefit.

Despite the recommendation, however, some people find it
difficult to decide whether to begin disease-modifying therapy, especially when
their symptoms have been fairly mild. Some may not want to bear the risks and
flu-like side effects of interferon therapy when they are not sure they need
it. Some may want to see whether their disease worsens before starting therapy.
A small percentage of people diagnosed with MS may never have more than a few
mild episodes and may never develop any disability, but the disease is
unpredictable. For more information, see:

Should I have disease-modifying therapy for
MS?

If you decide not to try disease-modifying therapy at this time,
work with your doctor to monitor your health through regular checkups and
periodic MRI scans to evaluate whether the disease is progressing. If new
lesions are developing or existing lesions are growing, you may want to
reconsider your decision and begin treatment.

Treating symptoms and relapses

The need and desire for medication vary. If your symptoms are
mild, you may choose to manage them without any medication. If you have
specific symptoms that are causing problems, certain medications may help you
keep them under control. Or you may want to use medication only during a
relapse.

You may also want to consider:

• The possible side effects of using steroids
  or other medications to treat symptoms or control a relapse. Some people have
  only minor side effects, but others may have side effects that concern them
  more than their MS symptoms.
• The costs of treating symptoms and
  controlling relapses. In some cases, using medication to control symptoms and
  relapses may reduce the need for hospital stays.
• Other personal
  issues that you face at work or at home.

Also keep in mind that it can be hard to tell whether
medication is helping. Multiple sclerosis is a disease with spontaneous
remissions, which means that your condition can improve on its own, without any
treatment. Just because your symptoms improve after treatment does not mean
that a treatment is working.