Ärztin für Psychiatrie und Psychotherapie
Dipl. prozessorientierte Psychotherapeutin ASP
Winterthur · Berlin
Role in Improving Sexual Confidence and Relationships
An initial consultation fee will be charged separately (2,500 JPY for first visits, 1,000 JPY for follow-ups). While AGA (Androgenetic Alopecia) is widely known to affect men, many women also suffer from hair loss. In particular, Female Androgenetic Alopecia (FAGA) can be treated or prevented with topical or oral medications. We also welcome consultations regarding hair loss in individuals using hormone therapy, especially transgender men. From the second visit onward, no consultation fee will be charged if you are receiving a prescription only. Effects: Normalizes the hair cycle and promotes the growth of thicker, longer hair. Side effects: Initial hair loss, decreased libido, erectile dysfunction (ED) 3-month: 10,500 JPY (3,500 JPY/month) 6-month: 18,000 JPY (3,000 JPY/month) Effects: Said to be three times as effective at promoting hair growth and inhibiting 5-alpha-reductase type II compared to Finasteride.
- Vardenafil enhances erectile response, while dapoxetine reduces the urgency of ejaculation.
- The fixed-dose combo offers a convenient solution for certain sexual dysfunctions.
- Combining these drugs should only be done under medical supervision.
- The medications are usually taken as a single tablet before planned sexual activity.
- Vardenafil dosage varies; common doses range from 5 to 20 mg.
- Dapoxetine is typically taken 1-3 hours prior to sexual activity.
- Patients with liver or kidney issues need dose adjustments or monitoring.
- Possible interactions include nitrates, other ED medications, or antidepressants.
- Avoid heavy meals or high-fat foods immediately before taking the medication.
- These combined tablets are not suitable for men with a history of certain heart diseases.
- Do not take more than prescribed; overdose can lead to severe adverse effects.
- Always check for allergies or contraindications before starting treatment.
Side effects: Initial hair loss, decreased libido, erectile dysfunction (ED) 3-month: 13,500 JPY (4,500 JPY/month) 6-month: 24,000 JPY (4,000 JPY/month) Effects: Stimulates the division of hair-producing cells and increases blood flow to the scalp, thereby facilitating hair growth. Side effects: Initial hair loss, scalp rash, skin reactions (redness, itching, rash), hypertrichosis, low blood pressure Dosage: Half to one tablet per use 3-month: 10,500 JPY (3,500 JPY/month) 6-month: 18,000 JPY (3,000 JPY/month) Product: Topical Minoxidil Solution 5% (Fuji Chemical Industries, Over-the-counter Drug) Effects: Stimulates the division of hair-producing cells and increases blood flow to the scalp, thereby facilitating hair growth.
| Condition | Patient Profile | Usage Recommendation |
|---|---|---|
| Erectile Dysfunction (ED) | Men aged 40-65 | 1 tablet prior to sexual activity |
| Premature Ejaculation (PE) | Men experiencing early ejaculation | Dapoxetine component benefits |
| Comorbid ED and PE | Men with both conditions | As directed by a healthcare provider |
Side effects: Initial hair loss, scalp rash, skin reactions (redness, itching, rash) Dosage: Apply 1ml twice a day to areas of thinning hair 3-month: 13,500 JPY (4,500 JPY/month) 6-month: 24,000 JPY (4,000 JPY/month) Overview: In addition to treating hair thinning in women, it is also used to treat acne and excessive hair growth.
Levifil Super Power Tablet Price & Cost
Note: Ella is an FDA-approved emergency contraceptive, widely used internationally. It remains effective for up to 5 days after intercourse and has minimal side effects such as nausea. Its active ingredient, ulipristal acetate (a progestin), is also used in the treatment of uterine fibroids. Price: 7,000 JPY (1 tablet / dose) Dosing time: 1 tablet / dose within 72 hours (3 days) after intercourse for contraceptive effect BMI*: Only for those with less than 30 A consultation fee will be added separately (initial visit 2,500 JPY, follow-up visit 1,000 JPY). The prices for acne treatment and prevention medications and pigmentation care are listed in the table below.
Trusted by Customers
All services are not covered by Japanese national insurance. We provide acne treatment and prevention for people of all genders. Oral medications for dapoxetine sildenafil online whitening and hyperpigmentation are not used for acne treatment or prevention. For acne treatment and prevention, please refer to the sections on topical medications, oral medications and skincare under [Acne treatment and prevention]. When started within 48 hours after exposure to someone with influenza, these medications are said to reduce the risk of developing the illness by 60–90%.
What are the most common side effects of vardenafil?
Please consult us if you wish to lower your risk of infection, such as before traveling or studying abroad. *This is not a substitute for vaccination (can be used together). Influenza vaccination can also be administered on the same day! Influenza prevention medication and vaccines are not covered by Japanese national health insurance. – Those who wish to avoid illness for such as international travels, studying abroad, long-term business trips or important exams – Those living with infected individuals such as family members or in shared accommodations like dormitories – Individuals at higher risk of complications such as older adults or those with chronic respiratory conditions, heart disease, diabetes or kidney dysfunction (subject to doctor’s evaluation) We offer the following influenza prevention medications. Treatment can be started with a low dose and gradually increased. Its tadalafil dapoxetine anti-androgenic action prevents DHT, the main cause of AGA and FAGA, from binding to androgen receptors in the scalp. Side Effects: Electrolyte imbalance (especially hyperkalemia), impaired kidney function, low blood pressure, frequent urination, irregular menstruation, breakthrough bleeding and breast tenderness Dosage: Depends on the severity of FAGA (typically starts around 50 mg) We perform regular blood tests to monitor for electrolyte imbalances and kidney function issues to ensure safe use of spironolactone. Effect: Promotes the division of hair matrix cells and enhances blood circulation in the scalp, delivering nutrients to these cells and supporting hair growth. Side Effects: Initial hair shedding, scalp rash, skin reactions (redness, itching, irritation), excessive hair growth and low blood pressure Dosage: 0.5 to 1 tablet per dose 3-month: 10,500 JPY (3,500 JPY/month) 6-month: 18,000 JPY (3,000 JPY/month) Product: Topical Minoxidil Solution 1% (Fuji Chemical Industries, Over-the-counter Drug) Features: Effective for preventing hair loss and promoting hair growth in women, influenced by factors such as age, stress, and lifestyle.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Levitra Professional | 20mg | 180 + 4 Pills | 502.31€ 478.39€ | |
| Kamagra Polo | 100mg | 12 Pills | 60.21€ 57.34€ | |
| Viagra Original | 100mg | 64 + 4 Pills | 264.15€ 251.57€ | |
| Priligy Generic Dapoxetine | 60mg | 120 + 10 Pills | 341.26€ 325.01€ | |
| Priligy Generic Dapoxetine | 60mg | 180 + 10 Pills | 494.76€ 471.20€ | |
| Viagra Generic | 50mg | 180 + 8 Pills | 158.82€ 151.26€ | |
| Priligy Generic Dapoxetine | 60mg | 10 Pills | 47.63€ 45.36€ | |
| Cialis Generic | 60mg | 90 + 6 Pills | 196.67€ 187.30€ | |
| Viagra Original | 100mg | 22 + 2 Pills | 120.71€ 114.96€ | |
| Priligy Generic Dapoxetine | 60mg | 60 + 8 Pills | 183.06€ 174.34€ | |
| Priligy Generic Dapoxetine | 60mg | 30 + 6 Pills | 106.65€ 101.57€ | |
| Levitra Generic | 60mg | 10 Pills | 47.42€ 45.16€ | |
| Priligy Generic Dapoxetine | 60mg | 90 + 10 Pills | 265.64€ 252.99€ | |
| Priligy Generic Dapoxetine | 60mg | 20 + 4 Pills | 77.31€ 73.63€ | |
| Cialis Generic | 60mg | 20 Pills | 65.61€ 62.49€ |
Suitable for treatment of female pattern hair loss. Effects: Stimulates the division of hair-producing cells and increases blood flow to the scalp, thereby facilitating hair growth. Side effects: Initial hair loss, scalp rash, skin reactions (redness, itching, rash) Dosage: Apply 1ml twice a day to areas of thinning hair 3-month: 12,000 JPY (4,000 JPY/month) 6-month: 22,000 JPY (3,667 JPY/month) Content: By prescribing a combination of Finasteride (oral) and Minoxidil (topical/oral), we provide an economical way to promote hair loss prevention and hair growth.
Dosage guide: using Levitra Super Force 20/60mg responsibly
An initial consultation fee will be charged separately (2,500 JPY for first visits, 1,000 JPY for follow-ups). While AGA (Androgenetic Alopecia) is widely known to affect men, many women also suffer from hair loss. In particular, Female Androgenetic Alopecia (FAGA) can be treated or prevented with topical or oral medications. We also welcome consultations regarding hair loss in individuals using hormone therapy, especially transgender men. From the second visit onward, no consultation fee will be charged if you are receiving a prescription only.
Value Packages
Effects: Normalizes the hair cycle and promotes the growth of thicker, longer hair. Side effects: Initial hair loss, decreased libido, erectile dysfunction (ED) 3-month: 10,500 JPY (3,500 JPY/month) 6-month: 18,000 JPY (3,000 JPY/month) Effects: Said to be three times as effective at promoting hair growth and inhibiting 5-alpha-reductase type II compared to Finasteride. Side effects: Initial hair loss, decreased libido, erectile dysfunction (ED) 3-month: 13,500 JPY (4,500 JPY/month) 6-month: 24,000 JPY (4,000 JPY/month) Effects: Stimulates the division of hair-producing cells and increases blood flow to the scalp, thereby facilitating hair growth. Side effects: Initial hair loss, scalp rash, skin reactions (redness, itching, rash), hypertrichosis, low blood pressure Dosage: Half to one tablet per use 3-month: 10,500 JPY (3,500 JPY/month) 6-month: 18,000 JPY (3,000 JPY/month) Product: Topical Minoxidil Solution 5% (Fuji Chemical Industries, Over-the-counter Drug) Effects: Stimulates the division of hair-producing cells and increases blood flow to the scalp, thereby facilitating hair growth. Side effects: Initial hair loss, scalp rash, skin reactions (redness, itching, rash) Dosage: Apply 1ml twice a day to areas of thinning hair 3-month: 13,500 JPY (4,500 JPY/month) 6-month: 24,000 JPY (4,000 JPY/month) Overview: In addition to treating hair thinning in women, it is also used to treat acne and excessive hair growth.
How should Varda Super Power be stored?
Treatment can be started with a low dose and gradually increased. Its tadalafil dapoxetine anti-androgenic action prevents DHT, the main cause of AGA and FAGA, from binding to androgen receptors in the scalp. Side Effects: Electrolyte imbalance (especially hyperkalemia), impaired kidney function, low blood pressure, frequent urination, irregular menstruation, breakthrough bleeding and breast tenderness Dosage: Depends on the severity of FAGA (typically starts around 50 mg) We perform regular blood tests to monitor for electrolyte imbalances and kidney function issues to ensure safe use of spironolactone. Effect: Promotes the division of hair matrix cells and enhances blood circulation in the scalp, delivering nutrients to these cells and supporting hair growth. Side Effects: Initial hair shedding, scalp rash, skin reactions (redness, itching, irritation), excessive hair growth and low blood pressure Dosage: 0.5 to 1 tablet per dose 3-month: 10,500 JPY (3,500 JPY/month) 6-month: 18,000 JPY (3,000 JPY/month) Product: Topical Minoxidil Solution 1% (Fuji Chemical Industries, Over-the-counter Drug) Features: Effective for preventing hair loss and promoting hair growth in women, influenced by factors such as age, stress, and lifestyle. Recommended for: Those concerned about AGA or who want to start prevention, those troubled by hair loss or hair quality, etc. 1-month: 7,000 JPY (You can save 1,000 JPY) 3-month: 18,000 JPY (6,000 JPY/month) (You can save 3,000 JPY) 6-month: 30,000 JPY (5,000 JPY/month) (You can save 6,000 JPY) 1-month: 8,000 JPY (You can save 1,000 JPY) 3-month: 22,500 JPY (7,500 JPY/month) (You can save 1,500 JPY) 6-month: 40,000 JPY (6,667 JPY/month) (You can save 2,000 JPY) 1-month: 11,000 JPY (You can save 2,000 JPY) 3-month: 30,000 JPY (10,000 JPY/month) (You can save 4,500 JPY) 6-month: 52,000 JPY (8,667 JPY/month) (You can save 8,000 JPY) Content: By prescribing a combination of Dutasteride (oral) and Minoxidil (oral/topical), we provide an economical way to promote hair loss prevention and hair growth. This set offers more potent AGA treatment compared to Finasteride alone.
Frequently Asked Questions
Structurally, vardenafil (38.3.2) is very similar to sildenafil (38.3.1) and differs in that the pyrazolo-pyrimidine heterocycle is replaced by an isosteric imidazo-triazine core. Recommended for: Those who want to start serious AGA treatment, not just prevention, or those who have found single-drug treatments insufficient. 1-month:8,000 JPY (You can save 1,000 JPY) 3-month: 21,000 JPY (7,000 JPY/month) (You can save 3,000 JPY) 6-month: 36,000 JPY (6,000 JPY/month) (You can save 6,000 JPY) 1-month:9,000 JPY (You can save 1,000 JPY) 3-month: 25,500 JPY (8,500 JPY/month) (You can save 1,500 JPY) 6-month: 46,000 JPY (7,667 JPY/month) (You can save 2,000 JPY) 1-month:12,000 JPY (You can save 2,000 JPY) 3-month: 33,000 JPY (11,000 JPY/month) (You can save 4,500 JPY) 6-month: 58,000 JPY (9,667 JPY/month) (You can save 8,000 JPY) Only for the first time, a consultation fee (2,500 JPY for the first visit / 1,000 JPY for a revisit) will be charged separately. If you visit us more than 15 weeks after your previous contraceptive injection, additional contraception such as condoms or emergency contraception is required. A consultation with a doctor is necessary (a consultation fee applies).
Benefits of Varda Super Power
Suitable for treatment of female pattern hair loss. Effects: Stimulates the division of hair-producing cells and increases blood flow to the scalp, thereby facilitating hair growth. Side effects: Initial hair loss, scalp rash, skin reactions (redness, itching, rash) Dosage: Apply 1ml twice a day to areas of thinning hair 3-month: 12,000 JPY (4,000 JPY/month) 6-month: 22,000 JPY (3,667 JPY/month) Content: By prescribing a combination of Finasteride (oral) and Minoxidil (topical/oral), we provide an economical way to promote hair loss prevention and hair growth. Recommended for: Those concerned about AGA or who want to start prevention, those troubled by hair loss or hair quality, etc. 1-month: 7,000 JPY (You can save 1,000 JPY) 3-month: 18,000 JPY (6,000 JPY/month) (You can save 3,000 JPY) 6-month: 30,000 JPY (5,000 JPY/month) (You can save 6,000 JPY) 1-month: 8,000 JPY (You can save 1,000 JPY) 3-month: 22,500 JPY (7,500 JPY/month) (You can save 1,500 JPY) 6-month: 40,000 JPY (6,667 JPY/month) (You can save 2,000 JPY) 1-month: 11,000 JPY (You can save 2,000 JPY) 3-month: 30,000 JPY (10,000 JPY/month) (You can save 4,500 JPY) 6-month: 52,000 JPY (8,667 JPY/month) (You can save 8,000 JPY) Content: By prescribing a combination of Dutasteride (oral) and Minoxidil (oral/topical), we provide an economical way to promote hair loss prevention and hair growth.
How is vardenafil supplied (dosage forms)?
This set offers more potent AGA treatment compared to Finasteride alone. Recommended for: Those who want to start serious AGA treatment, not just prevention, or those who have found single-drug treatments insufficient. 1-month:8,000 JPY (You can save 1,000 JPY) 3-month: 21,000 JPY (7,000 JPY/month) (You can save 3,000 JPY) 6-month: 36,000 JPY (6,000 JPY/month) (You can save 6,000 JPY) 1-month:9,000 JPY (You can save 1,000 JPY) 3-month: 25,500 JPY (8,500 JPY/month) (You can save 1,500 JPY) 6-month: 46,000 JPY (7,667 JPY/month) (You can save 2,000 JPY) 1-month:12,000 JPY (You can save 2,000 JPY) 3-month: 33,000 JPY (11,000 JPY/month) (You can save 4,500 JPY) 6-month: 58,000 JPY (9,667 JPY/month) (You can save 8,000 JPY) Only for the first time, a consultation fee (2,500 JPY for the first visit / 1,000 JPY for a revisit) will be charged separately. If you visit us more than 15 weeks after your previous contraceptive injection, additional contraception such as condoms or emergency contraception is required. A consultation with a doctor is necessary (a consultation fee applies).
Vaccine Prices
When using the contraceptive injection (Depo-Provera), individuals who are considered high-risk according to our criteria are required to have a consultation at least once a year. * Discount is applied if you purchase PrEP, doxy-PEP or medication for the prevention of vaginal candida from us. We offer Slinda, a new formulation of the mini pill.For first-time users, Slinda is available at 2,500 JPY per sheet, and you may purchase as many sheets as needed. A consultation fee (2,500 JPY for the first visit / 1,000 JPY for a revisit) will be charged separately. Price: 7,000 JPY (1 tablet / dose) Dosing time: Take one tablet within 120 hours (5 days) after intercourse for 98.9% contraceptive effectiveness. When using the contraceptive injection (Depo-Provera), individuals who are considered high-risk according to our criteria are required to have a consultation at least once a year. * Discount is applied if you purchase PrEP, doxy-PEP or medication for the prevention of vaginal candida from us. We offer Slinda, a new formulation of the mini pill.For first-time users, Slinda is available at 2,500 JPY per sheet, and you may purchase as many sheets as needed. A consultation fee (2,500 JPY for the first visit / 1,000 JPY for a revisit) will be charged separately. Price: 7,000 JPY (1 tablet / dose) Dosing time: Take one tablet within 120 hours (5 days) after intercourse for 98.9% contraceptive effectiveness. Note: Ella is an FDA-approved emergency contraceptive, widely used internationally.
- These tablets should be stored securely out of reach of children.
- Never exceed the recommended dose to prevent serious health risks.
- If you experience chest pain, seek emergency medical treatment immediately.
- The effect duration varies but typically lasts up to 4-6 hours.
- Dapoxetine may cause temporary nausea or dizziness at the start of treatment.
- The medication can be part of a broader sexual health treatment plan.
- Men with liver problems require careful evaluation before use.
- Always report any unusual or prolonged side effects to your healthcare provider.
- Abstinence from alcohol and recreational drugs is advised during treatment.
- Do not use this medication to enhance sexual performance beyond prescribed guidelines.
- Use in combination with psychological therapy can improve outcomes.
- Follow the instructions for use carefully to ensure safety and effectiveness.
It remains effective for up to 5 days after intercourse and has minimal side effects such as nausea. Its active ingredient, ulipristal acetate (a progestin), is also used in the treatment of uterine fibroids. Price: 7,000 JPY (1 tablet / dose) Dosing time: 1 tablet / dose within 72 hours (3 days) after intercourse for contraceptive effect BMI*: Only for those with less than 30 A consultation fee will be added separately (initial visit 2,500 JPY, follow-up visit 1,000 JPY). The prices for acne treatment and prevention medications and pigmentation care are listed in the table below.
- Vardenafil with dapoxetine can be a part of a comprehensive sexual health plan.
- Men should discuss their medical history to determine suitability for these medications.
- The tablets should be taken only as prescribed to minimize health risks.
- They are not intended for use in women or children.
- Dapoxetine causes temporary increase in serotonin levels, affecting mood.
- Vardenafil works by inhibiting PDE5 enzyme, relaxing blood vessels.
- Combining these drugs may lead to lower blood pressure; caution is advised.
- Ensure adequate sexual arousal for the medication to work effectively.
- The tablets do not provide protection against pregnancy or STDs.
- Seek emergency medical help if experiencing symptoms of an allergic reaction.
- Avoid driving or operating machinery until you know how the medication affects you.
- Keep track of any side effects to inform your healthcare provider during follow-up.
All services are not covered by Japanese national insurance. We provide acne treatment and prevention for people of all genders. Oral medications for dapoxetine sildenafil online whitening and hyperpigmentation are not used for acne treatment or prevention.
- Vardenafil with dapoxetine is a rapid-onset treatment option for sexual dysfunction.
- It is important to follow dosing instructions carefully to prevent adverse effects.
- The drug may be less effective if taken with high-fat foods.
- Side effects in some cases include diarrhea or indigestion.
- Men should wait at least 24 hours before taking another dose.
- The medication should not be used with medications containing similar active ingredients.
- Sexual stimulation is necessary for the medication to produce an erection.
- Avoid taking the medication if you have been advised against sexual activity.
- The combination therapy offers a dual approach to ED and PE management.
- Men with psychiatric conditions should consult their doctor prior to use.
- Always complete the prescribed course unless advised otherwise by your doctor.
- Proper medical guidance ensures the safe and effective use of vardenafil with dapoxetine.
For acne treatment and prevention, please refer to the sections on topical medications, oral medications and skincare under [Acne treatment and prevention]. When started within 48 hours after exposure to someone with influenza, these medications are said to reduce the risk of developing the illness by 60–90%.
What should to discuss with your doctor?
A doctor’s consultation is required to receive a prescription (2,500 JPY for first-time visits, 1,000 JPY for follow-ups). We do not prescribe this medication to children under 37.5 kg dapoxetine over counter (82.7 lb). For children under 10, the dose is 20 mg (4,000 JPY). Not suitable for children who cannot perform inhalation. For night and holiday consultations, please use our clinic.
Product Image
Compared to emergency outpatient visits at secondary emergency medical institutions or medical treatment by emergency transportation, we can offer treatments at about 1/2 to 1/3 cost. * An additional fee is incurred in accordance with the calculation criteria of the Ministry of Health, Labour and Welfare of Japan. We offer a range of cosmetics exclusive to medical institutions, available for everyone to purchase. No appointment is required; please feel free to speak to our reception staff if interested. Vardenafil (38.3.2) is another selective PDE-5 inhibitor that is approved for the treatment of erectile dysfunction.
Do Vardenafil and Dapoxetine Tablets interact with blood thinners?
It is effective in a broad spectrum of underlying conditions of patients. Vardenafil potentiates the increase in intracellular cGMP in the corpora cavernosa in response to sexual stimuli, resulting in enhanced and prolonged erections. The overall tolerability and safety profile is acceptable. The major side effects observed by some patients are headache, flushing, rhinitis, and dyspepsia [96-107]. Vardenafil is considered five to 10 times more potent than sildenafil. Please consult us if you wish to lower your risk of infection, such as before traveling or studying abroad.
| Parameter | Vardenafil | Dapoxetine |
|---|---|---|
| Absorption Time | 30-120 minutes | 1-3 hours |
| Peak Plasma Concentration | 1 hour | 1-2 hours |
| Half-life | 4-5 hours | 19-24 hours |
| Metabolism | Liver (CYP3A4 enzyme) | Liver (CYP3A4 and CYP2D6) |
*This is not a substitute for vaccination (can be used together). Influenza vaccination can also be administered on the same day! Influenza prevention medication and vaccines are not covered by Japanese national health insurance. – Those who wish to avoid illness for such as international travels, studying abroad, long-term business trips or important exams – Those living with infected individuals such as family members or in shared accommodations like dormitories – Individuals at higher risk of complications such as older adults or those with chronic respiratory conditions, heart disease, diabetes or kidney dysfunction (subject to doctor’s evaluation) We offer the following influenza prevention medications. A doctor’s consultation is required to receive a prescription (2,500 JPY for first-time visits, 1,000 JPY for follow-ups). We do not prescribe this medication to children under 37.5 kg dapoxetine over counter (82.7 lb). For children under 10, the dose is 20 mg (4,000 JPY). Not suitable for children who cannot perform inhalation. For night and holiday consultations, please use our clinic. Compared to emergency outpatient visits at secondary emergency medical institutions or medical treatment by emergency transportation, we can offer treatments at about 1/2 to 1/3 cost. * An additional fee is incurred in accordance with the calculation criteria of the Ministry of Health, Labour and Welfare of Japan. We offer a range of cosmetics exclusive to medical institutions, available for everyone to purchase. No appointment is required; please feel free to speak to our reception staff if interested. Vardenafil (38.3.2) is another selective PDE-5 inhibitor that is approved for the treatment of erectile dysfunction. It is effective in a broad spectrum of underlying conditions of patients. Vardenafil potentiates the increase in intracellular cGMP in the corpora cavernosa in response to sexual stimuli, resulting in enhanced and prolonged erections. The overall tolerability and safety profile is acceptable. The major side effects observed by some patients are headache, flushing, rhinitis, and dyspepsia [96-107]. Vardenafil is considered five to 10 times more potent than sildenafil. Structurally, vardenafil (38.3.2) is very similar to sildenafil (38.3.1) and differs in that the pyrazolo-pyrimidine heterocycle is replaced by an isosteric imidazo-triazine core.