Like other psychotropic drugs, you should ease off gabapentin gradually. There are some known withdrawal symptoms. This mostly comes from people who take high doses of the drug and suddenly stop. You should only abruptly discontinue this drug because of a serious side effect, and even then, it should be done with your doctor’s supervision and direction.
Gabapentin Dosage and Administration
Typically, your doctor will prescribe 300 mg once a day, usually in the evening, to start. The dose will then be increased every three to five days. Some people will take 600 mg/day, others will increase to 3,600 mg/day—the maximum dose approved by the FDA.
If used as a mood stabilizer or anti-depressant, the dose is usually between 900 and 2,000 mg a day. But, it may also be increased for better results. Some people see improvement in their symptoms about a week after starting treatment. Others need about a month before they see significant improvement.
Gabapentin has a half-life of about six hours, so it must be taken three to four times a day.
Gabapentin Overdose and Toxicity
It’s possible to fatally overdose on gabapentin. Reports of gabapentin being abused alone, and with opioids, prompted the FDA to release a warning statement (in December 2019) about the fatal risk of respiratory depression. Signs of overdose include:
Ataxia (decreased muscle coordination)
Drowsiness and lethargy
If you suspect an overdose, you need immediate medical treatment. The only way to remove the drug is through kidney dialysis in the emergency room.
Gabapentin and Alcohol Use Disorder
Gabapentin may be helpful in treating alcohol use disorder and withdrawal. Between 2004 and 2010, The Veterans Affairs Department conducted a double-blind, placebo-controlled, randomized dose-ranging trial of 150 men and women over 18, struggling with alcohol dependence.3 The results of the study showed that gabapentin (particularly the 1800 mg dosage) was effective in safely treating alcohol dependence and relapse-related symptoms including insomnia, dysphoria, and cravings.
The drug duration and the onset of action can be affected y several factors, including:
Alcohol. Alcohol-containing beverages decrease the blood flow to the penis. As a result, it becomes harder to achieve and maintain an erection necessary for sexual intercourse. One glass of good wine or one beer will not decrease the speed of sildenafil, but larger amounts of alcohol will surely slow down the effects of the drug and may even cause adverse reactions making it harder to get an erection;
Old Age. Men over 60 report that the drug starts working later because with age the body’s metabolism slows down. However, this means that sildenafil tablets will last longer in older men;
Dosage. The dosages may range from 25 mg to 100 mg. The higher dose you take, the more potent and long-lasting effects you will notice. Remember that only a doctor can determine the correct dosage of this generic medication for your case. Do not engage in self-treatment!
Heavy foods. If you eat too many fatty foods just before you take a pill, you may need to wait more time until the drug starts working since your body will be busy digesting the food. But if you take the pill on an empty stomach, the onset of action will occur quickly;
Drug interactions. Some medications can slow down the speed of the drug. For, example, antibiotic rifampicin can change the speed of the action. Always consult your doctor about any medications you are taking or going to take. This way you can ensure that generic Viagra (Sildenafil) is safe for your body;
Health condition. If you any pathological problems with kidney or liver, the medication can last longer. The thing is that the pill will be absorbed by your organism much longer. You should always inform a medical specialist about all medical conditions you have.
Is it Safe to Take Viagra with Alcohol?
Viagra was one of the first FDA-approved oral medications to be offered to men who have erectile dysfunction (ED) and is the most well-known ED drug—think “the little blue pill.” ED is a medical condition in which a man cannot get or maintain an erection long enough to have satisfactory sex. Viagra is still a commonly prescribed treatment for ED, which affects 30 million men, according to the American Urological Association (AUA, 2018).
The active ingredient in Viagra is sildenafil citrate, a type of drug called a phosphodiesterase 5 (PDE5) inhibitor. PDE5 inhibitors help treat ED by relaxing the muscles in the penis to allow for more blood to flow to the area. This increased blood flow enables you to have and maintain a satisfactory erection. Other PDE5 inhibitors used to treat ED include vardenafil (brand name Levitra) and tadalafil (brand name Cialis). Viagra is taken anywhere from 30 minutes to four hours before engaging in sexual activity. The drug alone will not give you an erection—you need to be aroused for the medication to work.
Is it safe to take Viagra with alcohol?
Many men drink alcohol on the days they plan to use Viagra. Alcohol can help you relax, and it decreases inhibitions, etc. As long as you are not drinking excessively (and have cleared it with your healthcare provider), it is likely safe for you to have a glass or two of wine (or the equivalent serving of beer or spirits) while taking Viagra.
However, people who abuse alcohol (more than 15 drinks a week) and take Viagra for recreational (non-medical) purposes may have a higher risk of side effects (Kim, 2019). One study showed that over 45% of men who took Viagra with alcohol for recreational purposes had a higher risk of side effects, including facial flushing, headaches, chest pain, changes in vision, and light headedness (Kim, 2019).
The type of alcohol you drink may matter. A study looking at men who drank red wine and took Viagra showed no clinically significant interaction with the combination (Leslie, 2004). However, if you prefer grapefruit juice with your cocktails, there may be an interaction with the Viagra.
Viagra is broken down by the liver, and grapefruit juice may affect how well the liver can accomplish this. Researchers looked at men who took Viagra with grapefruit juice and found that the combination can increase the amount of the drug circulating in your body (Jetter, 2002). While this is not usually a dangerous outcome, higher levels of Viagra may increase the risk of side effects like headaches, flushing, or low blood pressure. To be safe, you should avoid taking Viagra with grapefruit juice.
Alcohol and ED
ED tends to affect men in older age groups, especially those aged 70 years and over. However, ED does not only happen in old age—it can also occur in younger men. Lifestyle factors can also increase the risk of developing this condition. These include obesity, smoking, lack of physical activity, and excessive alcohol consumption.
Impotence: how is it different from erectile dysfunction?
A common term for ED after drinking alcohol is “whiskey dick.” The effects of alcohol on a man’s erectile function will vary. In general, alcohol acts as a depressant, meaning that it has a sedating or relaxing effect on the brain and body. While this sounds good, it can also negatively affect some of the pathways involved in sexual arousal, blood circulation, and nerve sensitivity—all of these need to be functioning properly to have a satisfying sexual encounter.
For example, alcohol intoxication can slow the signals between the brain and the penis responsible for getting an erection. Drinking alcohol can also lead to dehydration, which reduces blood flow and impacts your ability to get an erection.
The amount of alcohol you drink matters. Excessive (more than 15 drinks per week) or binge drinking (5 or more drinks on a single occasion) can contribute to ED by affecting the pathways by which nerves and blood vessels allow you to get and maintain an erection. Heavy alcohol use can also decrease your testosterone levels, thereby reducing your sexual desire and ability to have satisfactory sex (Wang, 2018). One study looked at 100 men with diagnosed alcohol abuse disorders and found that over 72% of them had some form of sexual dysfunction, with ED being one of the most common (Benegal, 2007).
Alcohol is not all bad when it comes to ED. One study showed that moderate alcohol use (which they defined as 14.5 drinks per week) was associated with a 34% decreased risk of ED (Wang, 2018). Studies have also found that moderate alcohol consumption of up to two drinks per day could have other health benefits, like raising “good” HDL cholesterol and lowering the risk of diabetes (AHA, 2019). As with many other things in life, moderation is key.
In summary, if you are going to consume alcohol while taking Viagra, be sure to do so responsibly. Limit your alcohol intake to 1–2 drinks per day. According to the Centers for Disease Control and Prevention (CDC), a standard drink is one of the following:
12 ounces of beer (5% alcohol content)
8 ounces of malt liquor (7% alcohol content)
5 ounces of wine (12% alcohol content)
1.5 ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey)
Drink water or nonalcoholic beverages in between the alcoholic drinks to prevent dehydration. Know your limits, and be sure to stop drinking alcohol when you start to feel intoxicated.
Erectile dysfunction (ED) is a common problem amongst men who have diabetes affecting 35-75% of male diabetics. Diabetes mellitus, commonly known as diabetes, is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make.
Untreated high blood sugar from diabetes can damage your nerves, eyes, kidneys, and other organs.
Up to 75% of men suffering from diabetes will experience some degree of erectile dysfunction (erection problems) over the course of their lifetime.
Men who have diabetes are thought to develop erectile dysfunction between 10 and 15 years earlier than men who do not suffer from the disease.
Over the age of 70, there is a 95% likelihood of facing difficulties with erectile function.
The Connection Between ED And Diabetes
According to the National Institutes of Health, men with diabetes are 2 to 3 times more likely to have ED than those who do not have diabetes. Men with diabetes experience ED 10 to 15 years earlier on average than others.
ED below the age of 45 can actually be an early sign of type 2 diabetes. The percentage of ED in male diabetics ranges from 20 to 75 percent.
There are factors that increase a man’s risk of developing sexual and urological problems, including:
Poor blood glucose control
High blood pressure
Being older than 40
The Boston University Medical Center studied the link between type 2 diabetes and erectile dysfunction and found that about half of men who receive type 2 diabetes diagnoses will develop ED within five to 10 years.
Type 2 diabetes with heart disease increases the risk of ED even more. Blood circulation and the nervous system affect sexual stimulation and response. When diabetes damages these systems, it can impact a man’s ability to achieve erection.
You may be most at risk of developing ED and other diabetes complications if you’re:
Maintaining a poor diet
Not physically active
What causes erectile dysfunction amongst diabetics?
Causes of ED are extremely complex, and are based around changes that occur to the body over time affecting nerve, muscle and blood vessel functions.
In order to obtain an erection, men need to have healthy blood vessels, nerves, male hormones and a desire to have sex
Without blood vessels and nerves that control erection, ED can still occur despite a desire to have sex and normal male hormones.
Factors amongst men
Many other factors bear on erectile dysfunction amongst diabetic men.
Taking too little exercise and other lifestyle factors.
Surgery can damage nerves and arteries linked to the penis, as can some injuries.
Many common medications (including antidepressants and blood pressure drugs) can produce ED.
Psychological factors also have an enormous influence.
Anxiety, guilt, depression, low self-esteem and paranoia about sexual failure are estimated to cause between 10% and 20% of ED cases.
How is ED diagnosed?
Erectile dysfunction is diagnosed using several different methods. Patient history often informs the degree and nature of the ED.
Medical and sexual past often has an influence, as does prescription or illegal drug use. ED patients may be physically examined, and bodily features can give clues to the cause. Laboratory tests can also be key for diagnosing ED.
Further tests such as monitoring nocturnal erection (nocturnal penile tumescence) can help to cancel some causes out.
Furthermore, psychological examination can reveal psychological factors.
Why Does Diabetes Pose a Challenge in Treating ED?
The first step in treating ED is to visit your doctor. You will need a sexual history and physical exam to understand and treat your dual conditions. Blood glucose, blood pressure, and cholesterol can all affect the development of ED.
As a diabetic with ED, adopting a healthier lifestyle may be all you need to reverse or ease the symptoms of erectile dysfunction.
Getting your blood sugar, weight, cholesterol and blood pressure under control by eating healthfully and exercising can reduce diabetes symptoms. These steps would all improve your sexual health as well. You may also want to consider certain medications to control symptoms.
Some drugs that diabetics use to treat high blood pressure, depression and other symptoms may contribute to erectile problems. Men with diabetes often have chronic conditions that make ED worse.
Unfortunately, diabetic patients won’t always see the results that non-diabetic patients see with just an oral ED medication like Viagra. Instead, they will have to use alternate methods or more than one medication in combination.
To get to the bottom of ED with diabetes, you must work with a doctor to make sure you address all related health problems, not just one. Stress can worsen ED, so you may also want to speak to a psychiatrist to learn ways to control stress and anxiety levels.
As a diabetic with ED, your case is unique. You will need a physician who understands both conditions and their connection. Luckily, there are effective treatments for ED in patients with diabetes.
How to Fix Erectile Dysfunction in Diabetics ?
The best way to fix erectile dysfunction in diabetics is through a tailored treatment plan with help from a doctor. Patients should work closely with specialists to find an ED treatment that also takes the diabetes into consideration.
Personalized medical treatment can result in methods such as hormone therapy, or compounded medications. Compounded medications are custom drugs that can include treatments for ED and diabetes in the same pill.
Compounded medications can potentially solve ED issues in diabetes such as retrograde ejaculation – which is caused by poor blood sugar control and related nerve damage. This occurs when semen goes into the bladder instead of out of the tip of the penis during ejaculation, due to the muscles not functioning properly.
If you have diabetes and retrograde ejaculation, there are medications that can strengthen the internal muscles, or sphincters, in the bladder to prevent retrograde ejaculation. Compounded oral medications with sildenafil, tadalafil, vardenafil or other ingredients can increase blood flow to the penis, helping to solve ED and maintain an erection that’s hard enough for penetration.
At the same time, men with diabetes need to take medications that control symptoms of this condition as well, without taking those that could exacerbate the symptoms of erectile dysfunction. A conversation with a primary doctor can elicit the best medications for each particular case, as well as a referral to the right compounding pharmacy.
Are there treatments for men with diabetes and erectile dysfunction?
Men who have diabetes and are having trouble achieving or maintaining an erection can take oral medicine The NHS can provide the following medications on prescription for men with diabetes:
Brand names include:
However, these medicines can all affect the heart rate, and detailed consultation with your doctor is necessary to determine the best course of action.
If pills aren’t a good option for you, your doctor might recommend a tiny suppository you insert into the tip of your penis before sex. Another possibility is medication you inject into the base or side of your penis. Like oral medications, these drugs increase blood flow that helps you get and maintain an erection.
vacuum constriction devices –
This device, also called a penis pump or a vacuum pump, is a hollow tube you put over your penis. It uses a pump to draw blood into your penis to create an erection.
A band placed at the base of the penis maintains the erection after the tube is removed. This hand- or battery-powered device is simple to operate and has a low risk of problems.
If a vacuum-constriction device is a good treatment choice for you, your doctor might recommend or prescribe a specific model. That way, you can be sure it suits your needs and that it’s made by a reputable manufacturer.
Intraurethral therapy – Intraurethral agents, sometimes called transurethral agents, are medications that treat ED by increasing blood flow to the penis to achieve and maintain erection. Medicated urethral suppository for erection (MUSE®) is the only intraurethral agent approved by the U.S. Food and Drug Administration (FDA).
Penile implants. In cases where medications or a penis pump won’t work, a surgical penis implant might be an option. Semirigid or inflatable penile implants are a safe and effective option for many men with erectile dysfunction.
Psychotherapy can have an enormous influence on erectile dysfunction.
Further treatment such as surgery and vacuum devices may also have a role to play in some specific cases.
Non-oral treatments for erectile dysfunction
Additional treatments include vacuum constriction devices, intraurethral alprostadil suppository or intracavernous injection therapy and sex therapy.
Vacuum pumps consist of a plastic tube, in which you place your penis. The pump, which may be battery or hand pump operated, creates a vacuum that will draw blood into the penis making it erect. A rubber ring will need to placed around the bottom of the penis to keep it erect. A vacuum pump is not for use if you have a bleeding disorder or take anticoagulants.
Alprostadil is a form of hormone medication that stimulates blood flow to penis, and may be given by two different methods:
Intracavernosal injection – whereby alprostadil is given by injection into the penis
Intraurethral application – whereby a pellet (1.6mm diameter and 6mm length) of alprostadil is inserted into the urethra via a urethral stick
Alprostadil may be prescribed if you do not respond to other treatments, or you are unwilling to try oral medications or vacuum pump therapy. Your health team may provide training on how to inject or insert alprostadil.
Which treatment is the best for diabetes and ED?
The most suitable treatment will depend on the health of the patient and their own ability to tolerate the treatment. Specialists such as urologists can work with individual cases and determine the best treatment.
What is the future of diabetes and erectile dysfunction?
There are frequent advances in this field. Better medications, implants, vacuum devices and suppositories have all increased options for diabetic men with ED.
Gene therapy is not being tested, and at some point may offer a permanent therapeutic approach to tackling diabetes and erectile dysfunction.
How can I get rid of ED when I have diabets ?
Don’t underestimate the difference a few changes can make. Try these approaches to improve erectile dysfunction and your overall health:
Stop smoking. Tobacco use, including smoking, narrows your blood vessels, which can lead to or worsen erectile dysfunction. Smoking can also decrease levels of the chemical nitric oxide, which signals your body to allow blood flow to your penis.If you’ve tried to quit on your own but couldn’t, don’t give up — ask for help. There are a number of strategies to help you quit, including medications.
Lose excess pounds. Being overweight can cause — or worsen — erectile dysfunction.
Include physical activity in your daily routine. Exercise can help with underlying conditions that play a part in erectile dysfunction in a number of ways, including reducing stress, helping you lose weight and increasing blood flow.
Limit or cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for men older than age 65, and up to two drinks a day for men age 65 and younger.