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    Men with erectile dysfunction may be able to avoid the awkwardness of a doctor’s visit by buying the drug Cialis without a prescription, under a proposal announced Wednesday by the drug’s maker, Eli Lilly, and the French pharmaceutical company Sanofi. Under the plan, Sanofi is buying the rights to seek approval to sell Cialis over the counter in the United States, Europe, Canada and Australia after certain patents expire. Cialis is to lose its patent protection in the United States and Europe in 2017, after which sales are expected to drop sharply as cheaper generic alternatives arrive on the market. If approved for over-the-counter use, Cialis could gain an advantage over prescription competitors like Viagra, sold by Pfizer. said the agency would need to review what types of studies would be needed for an erectile dysfunction drug like Cialis to be sold without a prescription. But it is not clear whether the Food and Drug Administration or other regulatory bodies overseas would approve such a move: In 2008, Pfizer abandoned an effort to make Viagra available without a prescription after the European Medicines Agency raised concerns.“Millions of men worldwide trust Cialis to treat E. Ricks, president of Lilly Bio-Medicines, the unit of Lilly that oversees Cialis. Drug companies frequently seek approval to move popular drugs to over-the-counter sales in an effort to hang onto sales when a best-selling product loses its patent protection. “We are pleased to work with Sanofi to pursue a path that could allow more men who suffer from E. to obtain convenient access to a safe and reliable product without a prescription.”Although more than 45 million men have taken Cialis, according to Lilly, the drug is not without risks: Like similar treatments, it should not be taken with some heart medications because it could cause an unsafe drop in blood pressure. In 2003, Astra Zeneca got approval to sell its blockbuster heartburn drug Prilosec without a prescription, and in 2012, it sold over-the-counter rights to a similar drug, Nexium, to Pfizer. The nonprescription product, Nexium 24HR, went on sale this week. clomid 50mg for sale One of the new generics is made by Teva Pharmaceuticals, and the other by Greenstone, a subsidiary of Pfizer, the company that manufactures Viagra. The generic versions of the little blue pill (sildenafil) will likely be cheaper than brand-name Viagra for most men. And more generic versions are expected next year, which could drive prices even lower. Viagra came on the market in 1998 as the first drug to treat impotence. Cialis (tadalafil) and Levitra (vardenafil) are two other erectile dysfunction medications. They work by relaxing muscle cells in the penis, which allows for greater blood flow, according to the Urology Care Foundation. Pfizer says the current wholesale cost for a 50 milligram or 100 milligram Viagra is $61.54 a pill.

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