Sildenafil (Viagra^®): Viagra (nicknamed “the little blue pill”) is the branded version of the drug Sildenafil that is used to treat erectile dysfunction (ED). Viagra was FDA-approved to treat erectile dysfunction over two decades ago and has been used by millions of men.

Tadalafil (Cialis®): Tadalafil (Cialis) is used to treat erectile dysfunction (ED, impotence; inability to get or keep an erection), and the symptoms of benign prostatic hyperplasia (BPH; an enlarged prostate) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency in adult men. Tadalafil (Adcirca) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Tadalafil is in a class of medications called phosphodiesterase (PDE) inhibitors. It works to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Tadalafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow more easily.

If you are taking tadalafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Tadalafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

Oxytocin: A continuously increasing amount of research shows that oxytocin is involved in numerous central functions. Among the functions in which oxytocin is thought to be involved are those that play a role in social and sexual behaviors, and the involvement of central oxytocin in erectile function and sexual behavior was indeed one of the first to be discovered in laboratory animals in the 1980s. The first part of this review summarizes the results of studies done in laboratory animals that support a facilitatory role of oxytocin in male and female sexual behavior and reveal mechanisms through which this ancient neuropeptide participates in concert with other neurotransmitters and neuropeptides in this complex function, which is fundamental for the species reproduction. The second part summarizes the results of studies done mainly with intranasal oxytocin in men and women with the aim to translate the results found in laboratory animals to humans. Unexpectedly, the results of these studies do not appear to confirm the facilitatory role of oxytocin found in male and female sexual behavior in animals, both in men and women. Possible explanations for the failure of oxytocin to improve sexual behavior in men and women and strategies to attempt to overcome this impasse are considered.

1. Test it solo first. Try your medication without a partner first so you see how it affects you/your body.

2. Take at least 60 minutes before sex. Your medication stays in the body for approx. 4-6 hours.

3. Works best on a close to empty stomach. Avoid fatty food and alcohol prior to using treatment.

4. Arousal required. REMi Reddi^® won’t automatically give you an erection if you’re not aroused, so start with foreplay to see the best results.

Sildenafil: The most common side effects of sildenafil reported by REMiRx members include: stuffy/runny nose, flushing, headaches, heartburn, dizziness, muscle aches, and nausea.

Do not take Sildenafil if you take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) as this can result in a sudden, dangerous drop in blood pressure. You should not use Sildenafil if you are not healthy enough for sex. Seek emergency treatment if an erection lasts more than 4 hours. Use caution when taking Sildenafil with alpha-blockers or other anti-hypertensives because it may lead to a drop in blood pressure. Stop Sildenafil and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION). Stop Sildenafil and seek medical care if sudden decrease or loss of hearing occurs. The most common side effects are headache, flushing, upset stomach, abnormal vision, stuffy or runny nose, back pain, muscle pain, nausea, dizziness, and rash.

Tadalafil: Tadalafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache

• indigestion or heartburn

• nausea

• diarrhea

• flushing

• pain in the stomach, back, muscles, arms, or legs

• cough

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• sudden decrease or loss of vision (see below for more information)

• blurred vision

• changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)

• sudden decrease or loss of hearing (see below for more information)

• ringing in ears

• erection that lasts longer than 4 hours

• dizziness

• chest pain

• hives

• rash

• difficulty breathing or swallowing

• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

• blistering or peeling of skin

Some patients experienced a sudden loss of some or all of their vision after they took tadalafil or other medications that are similar to tadalafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking tadalafil, call your doctor immediately or get emergency medical treatment. Do not take any more doses of tadalafil or similar medications such as sildenafil (Revatio, Viagra) or vardenafil (Levitra) until you talk to your doctor.

Some patients experienced a sudden decrease or loss of hearing after they took tadalafil or other medications that are similar to tadalafil. The hearing loss usually involved only one ear and did not always improve when the medication was stopped. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking tadalafil, call your doctor immediately. Do not take any more doses of tadalafil or similar medications such as sildenafil (Revatio, Viagra) or vardenafil (Levitra) until you talk to your doctor.

Tadalafil may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Oxytocin: Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Oxytocin may cause serious side effects. Call your doctor at once if you have:

• a fast, slow, or uneven heart rate;

• excessive bleeding long after childbirth;

• severe headache, blurred vision, pounding in your neck or ears; or

• confusion, severe weakness, feeling unsteady.

Oxytocin may cause serious or life-threatening side effects in the newborn baby, including:

• slow heartbeats or other abnormal heart rate;

• jaundice (a yellow appearance of the baby's skin);

• a seizure;

• eye problems; or

• problems with breathing, muscle tone, and other signs of health problems.

Talk with your doctor about the risks of using oxytocin. In most cases, the benefits of inducing labor with oxytocin will outweigh the risks to the baby.

Common side effects of oxytocin may include:

• nausea, vomiting; or

• more intense or more frequent contractions (this is an expected effect of oxytocin).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.