Viagra Substitutes

[caliguy]

A little off the topic:

 

foreign form of PrEP.

 

No matter what the cost, I'm just not willing to take that risk.

The cost is about 35-40% of the American Pharmaceuticals.

[+ BenjaminNicholas]

Well, since the alternative is nothing if you don't have insurance then maybe a pause and then oh well.

 

All hope is not lost for the uninsured. There are a fair number of state program subsidies, as well as assistance directly from Gilead:

 

https://start.truvada.com/paying-for-truvada

 

I'm not saying any of this is fool-proof, but it's a lot better than what could be pipedream medication from an unknown source.

[Bearofdistinction]

My concern is how to identify reliable sources when we discuss drugs. Pharma is way too powerful everywhere and I am not confident about these warnings.

Anyway, what I was looking for is an alternative source in case mine from Argentina gets interrupted. I have plenty of information responding to my concern here and in my PM inbox, thank you so much to you and to everyone who helped.

I am specially interested in [uSER=14388]@OliverSaks[/uSER] tip, we can get it for free!

 

What If I want more than the TIP --- Id want to wangle the whole wang dang

[caliguy]

All hope is not lost for the uninsured. There are a fair number of state program subsidies, as well as assistance directly from Gilead:

 

https://start.truvada.com/paying-for-truvada

 

I'm not saying any of this is fool-proof, but it's a lot better than what could be pipedream medication from an unknown source.

Many of the Indian Pharmacies have been approved by the FDA as safe. Cipla is one of them for HIV drugs.

 

I learned that from a documentary I was watching about an organization called Pepfar and how low cost hiv drugs got approval from the American Government. That and how evil American Phamacies are but's another subject.

[corndog]

When I asked my doctor about about prescribing an ED drug, he immediately offered me a prescription for generic Sildenafil, which is technically an off-label prescription, but since it is exactly the same medication as Viagra, I'm pretty certain that there isn't any professional risk. The drug company's patent for Sildenafil for it's original use has expired, but they still have a patent for use as an ED drug. I suspect that doctors who have relationships with pharmaceutical sales reps make agreements not to prescribe generic instead of Viagra, and therefore get a steady supply of samples, but if your doctor isn't in bed with the drug companies, I don't think there is any ethical reason why this "off-label" prescription is wrong. The generic version comes in a 20mg dose, as opposed to to viagra witch comes in 50mg or 100mg. The dosage instructions, provided my doctor, and printed on the bottle by the pharmacist, say "take 3 tablets 45 minutes before sexual activity" so there is no pretense here that the drug is being used for its approved pulmonary hypertension.

 

My insurance won't cover "off-label" use, and offers extremely limited coverage of ED drugs anyway. So, using an app/website called goodrx.com, I found a coupon to bring down the cost down. I took my prescription and the coupon to Costco's pharmacy, and got a 90-tablet (30 dose) bottle for $44. Not free, but at about $1.50 per dose, the cost is totally reasonable.

 

GoodRx, by the way, is a very eye-opening service. In addition to providing discounts, it shows the prices at various pharmacies in your area. I've learned from this to avoid the big pharmacies at all costs (except when using insurance, when it doesn't really matter much). The same prescription that costs $44 to fill at Costco, shows $585 at Walgreens, $1525 at Riteaid, $212 at Walmart, $80 at CVS, $55 at HealthWarehouse (a mail order pharmacy), $49 at Target/CVS, and the prices at local grocery store pharmacies were really good too.

[+ LIguy]

Thanks to a posting on this site I am getting generic 5mg cialis from Canadian World Pharmacy for 44.00 for 84 tablets as opposed to 785.00 for name brand through my insurance's pharmacy site and I see no difference in how it's working as compared to the name brand.

[+ purplekow]

If you are given Revatio, it is approved for Pulmonary hypertension in the 20 mg dose. Use for ED is off label for those drugs. Revatio comes in a 20 mg dose and it is to be used three times daily for pulmonary hypertension.

The prescription for sildenafil for erectile dysfunction is 50 mg or 100 mg 30 minutes to one hour before sexual activity. If you write Revatio 20 mg 3 tabs 45 minutes before sexual activity, that is an off label use. In theory. a doctor can be held accountable for bad effects of using drugs for off label use. It does not have to be deceptive, but it is off label. Your PCP may feel comfortable with the risk, but there is a risk, small though it may be. Should someone wind up with priapism from 60 mg prescribed as 20 mg three times a day , that is a different legal situation than if that same person winds up with priapism from 50 mg or 100 mg as labelled for ED. I am not condemning nor condoing the practice, just stating that it is off label. By the way, if you had pulmonary hypertension, it is likely you would get coverage for your pharmacy for the 20 mg TID. So it is not the drug, it is the indication which makes it off label, as you plainly stated.

Similarly, advising your patient to cut the Viagra in half or to bite into it to speed up effect are also off label. IF the patient chooses to do so without medical supervision, then that falls to the patient, probably.

[+ purplekow]

Just as a more ludicrous example: A physician may write Vicodin 7.5/300 mg every 6 hours for pain #120, there would have to be a pattern of inappropriate prescribing in order for a prescriber to get in trouble. One prescription for Vicodin 7.5/300 mg 4 pills at once to get buzzed #10, may be accurate but that one prescription for off label use is probably enough to lose a license.

[Rudynate]

My concern is not branding. My purchases from Argentina have been during my visits there, so I brought the pills with me. I am afraid if I order from India or Canada the shipment maybe confiscated and I could get in legal problems. That is why I was asking @nycman about his experience.

 

 

If you try to import scheduled drugs ( sedatives, opiates) , there is a possiblity that they will be confiscated and you will get a slap on the hand from the government - don't remember who from, Customs or Postal Service. Otherwise, it is extremely rare that prescription drugs are confiscated.

[+ José Soplanucas]

Thank you all guys for your input. As usual you all have been very helpful.

[kewtex]

The same generic drug may be marketed under two different names. For example, Wellbutrin (Buproprion) is an antidepressant, while Zyban (Buproprion) is used for smoking cessation. Insurance companies usually pay for Wellbutrin, and not Zyban. When doctors write a prescription for Wellbutrin. they may receive an inquiry concerning the details. Writing the prescription for Wellbutrin instead of Zyban is perfectly legal, though in writing for off label use of Wellbutrin for smoking cessation, the physician assumes more legal respnsibility. Many insurance companies have a verification process to assess whether drugs are prescribed for covered conditions and not in amanner as to circumvent the insurance coverage. If a physician is less than honest with this process, he may be perpetrating fraud.

 

OliverSaks is proposing one:

1 Asks for ED medication (there should be an established diagnosis of ED)

2 Requests that the doctor choose off label Adempas or Revatio (pulmonary hypertension

drugs chemically identical to Viagra, just in different doses).

3. Assume the cost for the prescription, side stepping arbitrary insurance regulations.

4 Utilize a pharmacy willing to turn a blind eye to the volume of prescriptions received for a rather uncommon condition, pulmonary hypertension.

5. Apply for a manufacturer rebate program designed to assist those purchasing the drug for pulmonary hypertension.

 

This is all legal. OliverSaks is suggesting that you co-opt your doctor into writing medication for a condition you do not have, so as to supply you with pulmonary hypertension medication which is to be used off label for ED. He is then suggests accepting money back from the manufacturer of the drug from a program which was designed to to reimburse those suffering with an unusual and oft times fatal disease.

 

This is not Iran Contra. The risk to the doctor doing the prescribing is small. The damage to the rebate program and company funding it, is small. If you can live with the ethical shadiness of this, then you can definitely get inexpensive Viagra equivalent.

 

I wonder if a monthly script for Revatio could put one at risk of being labeled as having pulmonary hypertension as a pre-existing condition?

[+ José Soplanucas]

I wonder if a monthly script for Revatio could put one at risk of being labeled as having pulmonary hypertension as a pre-existing condition?

 

Why, why does it have to be so complicated securing a reliable and long lasting hard on?

http://25.media.tumblr.com/fd60283b88e8ced47b17e4579efc4e24/tumblr_mqikbaFVZr1qikwnmo1_500.gif

[+ purplekow]

I wonder if a monthly script for Revatio could put one at risk of being labeled as having pulmonary hypertension as a pre-existing condition?

There would be a record of the drug but unless there is a documented diagnosis somewhere, it is unlikely that someone would get labeled as having PH. However, with increased surveillance and investigation into all things computerized, who knows.

[Rudynate]

There would be a record of the drug but unless there is a documented diagnosis somewhere, it is unlikely that someone would get labeled as having PH. However, with increased surveillance and investigation into all things computerized, who knows.

 

 

Big data companies, for years now, have been working at perfecting things like using data mining techniques to discover medicare fraud.

[kewtex]

Big data companies, for years now, have been working at perfecting things like using data mining techniques to discover medicare fraud.

 

And one could imagine Rx histories being used against people when changing insurance providers.

[+ Gar1eth]

Here is the magic - assuming you have an accessible, reasonable compounding pharmacy - I expect that any compounding pharmacy had this capability, but I put the info for the place that I get it and this absolutely works (I have like a shitton of pills because my doc knew I was traveling and out of country)

 

Get doctor to write you a Rx for Revatio 20 mg ("new" pulmonary hypertension med - also same exact drug as Viagra/sildenafil) - up to 3 pills per day is what my doctor did - go to compounding pharmacy and get it filled (I use unasource pharm in troy, MI - (248) 312-0037 )) - since Revatio is off-label for ED, you're good in the hood having doctor write it as Revatio 20 - at unasource, it is 2$ per pill for legit USA Viagra - cash payment, no insurance

 

The kicker:

Sign up for the Revatio savings program through the drug company's website - submit your receipt to them from Unasource - they will reimburse you for 100% of the cost of the 2$ / pill

 

I've done this a few times and sent several people to do this successfully.

 

Mazel Tov.

 

PS: shameless plug: if ya'll get this sick deal to work, I have an amazon wishlist with mostly books and a charity I support (givedirectly.org)

 

 

 

There may be an easier way in the US of A. Get the doctor to write for the generic of Revatio. Then look up the Goodrx website or app. I'm currently paying about $23 for 50 - 20 mg tablets-i.e. about $2 a tablet using the coupon from Goodrx at Safeway.

 

The deal about using either Revatio or generic is that due to the way the pills are compounded -fillers and etc -they may not be absorbed exactly the same way as brand name Viagra. So while they should work-they MIGHT work quicker or take longer to work-in addition the dose you need might be slightly different due to differences in absorption. But I doubt the difference would be anything significant.

 

Gman

[Rudynate]

And one could imagine Rx histories being used against people when changing insurance providers.

 

Under current federal law, that would be illegal. Even if the ACA's pre-existing conditions protection goes away, some states have similar provisions.

[+ TylerandAce]

Try a product called Silver Sword from noahpills.com. Works like a champ every time and is $1 per pill.

[kewtex]

Under current federal law, that would be illegal. Even if the ACA's pre-existing conditions protection goes away, some states have similar provisions.

 

Thank you for that clarification.

[+ José Soplanucas]

Try a product called Silver Sword from noahpills.com. Works like a champ every time and is $1 per pill.

 

Thank you, but I am not looking for something I have to take everyday. What I like of sildenafil is that you take 50mg one hour before sex and it works perfectly.

 

I would take your suggestion if I had sex everyday or multiple times a day, which I am sure it is your situation. I hate you.

[+ TylerandAce]

Thank you, but I am not looking for something I have to take everyday. What I like of sildenafil is that you take 50mg one hour before sex and it works perfectly.

 

I would take your suggestion if I had sex everyday or multiple times a day, which I am sure it is your situation. I hate you.

Lol...don't I wish. No, this is just situational dosage like viagra or cialis. It takes about 15-20 minutes to kick in most of the time. Stays in the system for around 24 hours and give a rock-hard result for both of us. It's reliable and delivers in a great tin container with blister-pack cards for dispensing.

[+ José Soplanucas]

Lol...don't I wish. No, this is just situational dosage like viagra or cialis. It takes about 15-20 minutes to kick in most of the time. Stays in the system for around 24 hours and give a rock-hard result for both of us. It's reliable and delivers in a great tin container with blister-pack cards for dispensing.

 

You all are wonderful!

http://66.media.tumblr.com/9afea8d444a2a0d03194dd306777191c/tumblr_o9jcxpK7et1spguxzo1_250.gif

[+ Just Sayin]

@TylerandAce having just spent $583 for 10 Viagra pills at Walgreen's yesterday, tell us more about Silver Sword...do you know what's in it; and how long does noahpills.com take to ship? thanks!

[Jose305]

Try a product called Silver Sword from noahpills.com. Works like a champ every time and is $1 per pill.

You've personally used it?

[Rudynate]

@TylerandAce having just spent $583 for 10 Viagra pills at Walgreen's yesterday, tell us more about Silver Sword...do you know what's in it; and how long does noahpills.com take to ship? thanks!

 

FDA says it contains sildenafil. I wouldn't care about that myself, since I take sildenafil anyway. I'm going try it on the strength of the recommendation from @TylerandAce. I don't take any meds or use any recreational substances that don't go with sildenafil. Sounds like a reasonable low-cost alternative.