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Pfizer Goes Direct With Online Viagra Sales To Men

Those are counterfeit Viagra pills on the left (top and bottom) and real ones on the right (top and bottom).

Viagra is a frequent target of counterfeiters. And a slew of online pharmacies tout cut-price Viagra. But people who buy drugs online are "playing Russian roulette," Matthew Bassiur, a Pfizer security specialist told The Associated Press.

Still, the hefty price of Viagra won't change. The medicine runs about $25 a pill. And many insurers don't cover it. Add in the embarrassment factor, and you start to understand why many men have preferred to buy Viagra online, even before there was a manufacturer-authorized way of doing so.

But will it work? That depends on each man's motivation.

"Is this about embarrassment or price?" asks Richard Evans. a longtime drug industry analyst now at SSR Health, an independent investment research boutique. "The reality is, it's probably about both. I think it's more about price."

If that's true, the response to Pfizer's offer may be muted. "You're always going to get a better offer from someone other than Pfizer," Evans tells Shots. "The question is whether it's legitimate or not."

This direct-selling approach is unusual in the drug industry. The AP called it a first.

A few years ago, Pfizer took a step in this direction by offering patients taking the cholesterol-fighter Lipitor a discount program that included fulfillment of prescriptions through a mail-order pharmacy.

That program required patients to enroll first and was motivated mainly by competition from generic versions of Lipitor.

That's not on the horizon for Viagra. Pfizer expects that U.S. patents will protect the brand-name drug from generic competition until 2020.

Tesla is finally making a car you can afford – here’s when it will be released

During Tesla’s earnings conference call on Wednesday, Elon Musk finally disclosed when Tesla plans to reveal what the highly anticipated Tesla Model 3 will look like. What’s more, Musk at long last gave us a launch window (read: year) that, we can only hope, won’t be subject to change in the months ahead.

According to Musk, Tesla will take wraps off the Model 3 sometime in March of 2016. Given how sleek the Model S and the upcoming Model X are, there’s going to be a lot of pressure to deliver a stunning design with the Model 3 which, it’s worth noting, will be about 20% smaller than the sizeable Model S.

As for a launch window, Musk said that Tesla will be releasing the car in 2017. He did qualify that statement, however, in saying that a launch window in late 2017 is more likely. Now keep in mind, Tesla has a pesky history of delivering its cars a bit late, so hopefully the Model 3 launch won’t be pushed back into early to mid 2018.

For those unfamiliar with the Model 3, the car represents the linchpin in Musk’s grand plan to bring affordable electric cars to the mainstream. Sure, the Tesla Model S is incredible, but cheap is not a word you’d ever use to describe it. Same thing goes for the upcoming Model X, the Tesla crossover vehicle slated for release later this year, albeit in limited quantities.

Lastly, Tesla will be aiming to price the Model 3 at around $35,000.

Strong quake rocks Papua New Guinea, tsunami threat lifted

SYDNEY (AP) - A powerful earthquake rattled Papua New Guinea on Thursday, the fourth strong quake to hit the South Pacific island nation in a week. The temblor prompted officials to issue a local tsunami warning, but it was lifted shortly afterward with no reports of damage.

The 7.1-magnitude quake struck about 150 kilometers (94 miles) southwest of the town of Panguna on Bougainville Island at a depth of 23 kilometers (14 miles), the U.S. Geological Survey reported.

The Pacific Tsunami Warning Center said tsunami waves of up to 1 meter (3 feet) were possible within 300 kilometers (186 miles) of the epicenter on the coast of Papua New Guinea. The agency lifted the warning about an hour later.

There were no reports of damage, said Chris McKee, assistant director of the Geophysical Observatory in the capital, Port Moresby. Because the epicenter was so far offshore, the chance of serious damage on land was less likely, he said.

"The earthquake appears to have not been as big as first estimated," McKee said. "I think the threat from that event is basically passed now. So we'll just wait for the next one."

Thursday's quake was located in a different area of Papua New Guinea than the previous three temblors that rattled the region over the past week, and was therefore an unrelated event, McKee said. Still, the area has been unusually active.

"We think it's probably something along the lines of just regional readjustment - movements in one area allow stress to be redistributed and that allows other areas to rupture," McKee said.

Betha Lorenz, owner of Rising Sun Lodge in the town of Arawa on Bougainville Island, said the quake delivered a powerful jolt, but did not appear to have caused any damage.

"One of my neighbors. she ran down the stairs and I was laughing and she said, 'Am I gonna live?' and I said 'Yeah, nothing will happen - just relax,'" Lorenz said.

When the shaking started, Lorenz ran outside, but the rumbling ended a few seconds later. Her lodge weathered the quake with no damage, and she hadn't heard of any tsunami waves hitting the coast.

"Everyone is OK," she said with a laugh. "We are happy."

Papua New Guinea sits on the Ring of Fire, the arc of seismic faults around the Pacific Ocean where earthquakes are common.

Cancerous fish caught in Susquehanna River

This shocking catch is a testament to the realities of water pollution. A smallmouth bass was pulled from Pennsylvania's Susquehanna River with a massive tumor jutting out of its body.

Following the catch, the Pennsylvania Fish and Boat commission ordered lab testing to further investigate the state of the Susquehanna River. The lab found that the smallmouth bass' tumor was indeed cancerous, a clear indicator that water pollution was adversely effecting the river's inhabitants.

Not only is the water pollution a major environmental threat, it puts Pennsylvania's thriving fishing industry at risk as well.

"As we continue to study the river, we find young-of-year and now adult bass with sores, lesions and more recently a cancerous tumor, all of which continue to negatively impact population levels and recreational fishing," said John Arway, the executive director of the commission.

California approves first statewide seawater desalination rules

(Reuters) - California regulators on Wednesday adopted the first statewide rules for the permitting of seawater desalination projects that are expected to proliferate as drought-stricken communities increasingly turn to the ocean to supplement their drinking supplies.

The action, which sets uniform standards for minimizing harm to marine life, was welcomed by developers of the state's two largest desalination projects as bringing much-needed certainty and clarity to the regulatory approval process.

"It reaffirms that the Pacific Ocean is part of the drinking water resources for the state of California," Poseidon Water executive Scott Maloni told Reuters after the rule was enacted on a voice vote in Sacramento by the State Water Resources Control Board.

The measure leaves the permitting process in the hands of the state's regional water boards while establishing a single framework for them to follow in evaluating applications to build seawater treatment plants, expand existing ones and renew old permits.

But regional decisions could now be appealed to the state board for review if opponents of a project felt a permit was wrongly approved.

Before Wednesday's action, developers and regulators of desalination plants had no specific guidance for meeting federal and state clean water standards, complicating review of the projects, state water board spokesman George Kostyrko said.

Desalination has emerged as a promising technology in the face of a record dry spell now gripping California for a fourth straight year, depleting its reservoirs and aquifers and raising the costs of importing water from elsewhere.

Critics have cited ecological drawbacks, such as harm to marine life from intake pipes that suck water into the treatment systems and the concentrated brine discharge from the plants.

The newly approved plan sets specific brine salinity limits and rules for diffusing the discharge as it is pumped back into to the ocean.

It also requires seawater to be drawn into the plants through pipes that are sunk into beach wells or buried beneath the sea floor, where possible. Such subsurface intakes are viewed as more environmentally friendly.

The Western Hemisphere's biggest desalination plant, a $1 billion project under construction since 2012 in the coastal city of Carlsbad, California, is due to open in November.

It will deliver up to 50 million gallons (190 million liters) of water a day to San Diego County, enough to supply roughly 112,000 households, or about 10 percent of San Diego County's drinking water needs, according to Poseidon.

Approval is being sought for a final permit to begin construction of a second plant of similar size in Huntington Beach, south of Los Angeles, next year.

About a dozen much smaller desalting plants have already been built along the coast, state water officials said.

On Tuesday, the state water board enacted California's first rules for mandatory statewide cutbacks in municipal water use. The emergency regulations, which require some communities to trim water consumption by as much as 36 percent, were approved unanimously just weeks after Democratic Governor Jerry Brown stood in a dry mountain meadow and ordered statewide rationing.

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Important Patient Information

SILDENAFIL (ERECTILE DYSFUNCTION) - ORAL (sil-DEN-a-fil) COMMON BRAND NAME(S): Viagra

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

USES: Sildenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice "safe sex" such as using latex condoms. Consult your doctor or pharmacist for more details.

HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist. To treat erectile dysfunction-ED, take this drug by mouth as directed by your doctor, usually as needed. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). Do not take more than once daily. A high-fat meal may delay how quickly the drug begins to work. The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Tell your doctor if your condition does not improve.

SIDE EFFECTS: Dizziness, headache, flushing, or stomach upset may occur. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea. Rarely, sudden decreased vision in one or both eyes (NAION) may occur. This effect may or may not be caused by sildenafil. If this serious problem occurs, stop taking sildenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems ("crowded disk"), high blood pressure, if you are over 50, or if you smoke. Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking sildenafil and get medical help right away if these effects occur. In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease, liver disease, high or low blood pressure, a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie's disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION), bleeding disorders, active stomach ulcers. This drug may make you dizzy or cause vision problems. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). This brand of the drug is usually not used in women. During pregnancy, sildenafil should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. A product that may interact with this drug is: riociguat. Sildenafil can cause a serious drop in your blood pressure when used with nitrates, which can lead to dizziness, fainting, and rarely heart attack or stroke. Do not use sildenafil with any of the following: certain drugs used to treat chest pain/angina (nitrates such as nitroglycerin, isosorbide), recreational drugs called "poppers" containing amyl or butyl nitrite. If you are also taking an alpha blocker medication (such as doxazosin, tamsulosin) to treat an enlarged prostate/BPH or high blood pressure, your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure. Other medications can affect the removal of sildenafil from your body, which may affect how sildenafil works. Examples include azole antifungals (such as itraconazole, ketoconazole), macrolide antibiotics (such as clarithromycin, erythromycin), HIV protease inhibitors (such as ritonavir, saquinavir), hepatitis C virus protease inhibitors (such as boceprevir, telaprevir), rifampin, among others. Do not take this medication with any other product that contains sildenafil or other similar medications for erectile dysfunction-ED or pulmonary hypertension (such as tadalafil, vardenafil).

OVERDOSE: If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include severe dizziness, fainting, painful/prolonged erection.

MISSED DOSE: Not applicable.

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company. or local waste disposal company for more details about how to safely discard your product.

This product information is intended for United States residents only. Before prescribing, please refer to the patient information. You can view the document and also download it on your computer. You may also consider printing out a copy for yourself.

• View US Prescribing Information - PDF Version

To view the PDF document, you need Adobe Acrobat Reader which you can download for free here .

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