Plot the lock. Then issue the sheet.
A Vienna protocol bench for seven medicines. Each sheet keeps one labelled strength in the title line, traces the label and the trials, and goes to Dr. Lena Hofer before it is issued. We do not fill bottles here.
How a sheet is issued
Plot, trace, bench, issue
Plot
Pick the labelled lock that this domain will hold in the title, the H1 and the three descriptions. Cialis stays 10-20 mg as needed. Viagra stays 50 mg. Levitra stays 10-20 mg. Cipro stays 750 mg. Neurontin stays 600 mg. Emverm stays the two-dose 100 mg pinworm course. Stromectol stays 3 mg counted at 200 mcg/kg.
Trace
Read the live FDA label, the EMA assessment when it adds a limit, MedlinePlus, and the named trial that actually moved the indication. Second-hand blogs are pointers, not sources.
Bench
Dr. Lena Hofer checks the draft against the same documents and writes the consultation answers herself. A named internist in Vienna is attached to every issued sheet.
Issue
The sheet goes live with a review date, a freshness stamp, and a cash window that uses sourced dollars only. We do not invent a pharmacy price. We do not rank a chain.
Briefings
Shorter reads for the question people actually type
One briefing per lock: daily versus as-needed tadalafil, sildenafil timing after food, vardenafil and the QT line, when a 750 mg ciprofloxacin course is even worth discussing, gabapentin 600 mg for nerve pain, the Emverm two-dose pinworm card, and what ivermectin is labelled to treat.
Briefing
750 mg Cipro is cheap. The boxed warning is the real bill.
Briefing
Should the tadalafil order be a daily 5 mg or a 10-20 mg occasion?
Briefing
A 600 mg Neurontin tablet is a rung, not the finish
Briefing
Count 3 mg tablets for Strongyloides. Skip the viral shopping list.
Briefing
Two peach chewables on two dates beat one forgotten tablet
Briefing
Why a 50 mg tablet can stall after dinner
Briefing
Read the QT line before you praise a 10-20 mg vardenafil review
The specialist
Lena Hofer signs every issued sheet
Internal medicine, clinical pharmacology, and an infectious-disease liaison desk in Wien. She answers the consultation on each lock. Nitrates stay banned with the PDE5 tablets. Fluoroquinolones keep the boxed warning. Gabapentin is tapered. Ivermectin is not a home antiviral.
The locks
Seven sheets, each with one labelled strength in the title
Full sheets sit under tadalafil, sildenafil, vardenafil, ciprofloxacin, gabapentin, mebendazole and ivermectin. The body may name the rest of the labelled ladder. The search line stays on the lock above.
Anthelmintic (benzimidazole)
Two Emverm 100 mg chewables, day 0 and day 14
Gabapentinoid / anticonvulsant
Neurontin 600 mg is a mid-climb tablet you also have to leave
PDE5 inhibitor
Start sildenafil at 50 mg, then watch the meal
Fluoroquinolone antibiotic
A 750 mg Cipro tablet is a reserve lock, not a casual fill
PDE5 inhibitor
Tadalafil 10-20 mg as needed, not a daily habit
Antiparasitic (avermectin)
Count Stromectol 3 mg tablets from the 200 mcg/kg table
PDE5 inhibitor
Levitra 10-20 mg as needed, with a QT caution first
The comparison
Three PDE5 locks on one row
The PDE5 comparison sets Cialis 10-20 mg as needed, Viagra 50 mg, and Levitra 10-20 mg on onset, food, duration and the nitrate rule. It does not pick a winner for a reader it has never met.
Origins
Labs and regulators the traces actually use
Sandwich, Bothell, Wuppertal, Leverkusen, Ann Arbor, Beerse, Kitasato, then FDA and EMA. The origins page keeps the addresses. The sheet keeps the label.
Pfizer, Sandwich (discovery campus)
Ramsgate Road, Sandwich, Kent CT13 9NJ, United Kingdom
Sildenafil was drawn up here as UK-92,480, a candidate for angina. The heart numbers were flat; a side effect the volunteers kept reporting was not, and the blueprint was redrawn. Viagra — and the whole PDE5 line that followed — dates back to this Kent site.
ICOS Corporation with Eli Lilly
22021 20th Avenue SE, Bothell, WA 98021, USA
Tadalafil was identified at this Washington biotech and taken through late trials with Eli Lilly. Its signature was drafted in the pharmacokinetics, not the chemistry: it left the body far more slowly than its rivals, which is the single line that turned it into the long-window tablet the class now measures itself against.
Bayer, Wuppertal
Aprather Weg 18a, 42113 Wuppertal, Germany
The Wuppertal laboratories drew vardenafil, later sold as Levitra and the orodispersible Staxyn. Milligram for milligram it grips PDE5 more tightly than either sibling, which is why its labelled doses read so much smaller than sildenafil's on the same page.
Bayer, Leverkusen
Kaiser-Wilhelm-Allee 1, 51373 Leverkusen, Germany
Ciprofloxacin came off Bayer's fluoroquinolone drawing board in the early 1980s — a fluorine atom and a piperazine ring bolted onto the older nalidixic-acid frame, giving a broad-spectrum antibiotic that reaches tissues most oral drugs cannot. The same chemistry explains both its reach and the tendon and nerve cautions now set in bold on its label.
Parke-Davis / Warner-Lambert (historic)
2800 Plymouth Road, Ann Arbor, MI 48105, USA
Gabapentin was drafted at Parke-Davis as a GABA analogue meant to quiet over-firing neurons. It never touched the GABA receptor as planned; it damped calcium channels instead and found a durable second use in nerve pain and epilepsy. Warner-Lambert, and later Pfizer, carried Neurontin to market from this Michigan base.
Janssen Pharmaceutica
Turnhoutseweg 30, 2340 Beerse, Belgium
Mebendazole came out of the benzimidazole programme Paul Janssen's laboratories ran in the 1960s and 70s. The blueprint was elegant and narrow: starve the parasite by blocking its uptake of glucose, and leave the host largely untouched because the drug is so poorly absorbed from the gut. Vermox traces to this Belgian campus.
Merck & Co. with the Kitasato Institute
Kitasato University, Minato City, Tokyo, Japan
Ivermectin began as an avermectin drawn from a single soil Streptomyces isolate found by Satoshi Ōmura's team in Japan and developed with Merck's William Campbell — work that shared the 2015 Nobel Prize in Medicine. It reshaped veterinary and then human parasitology, above all in river blindness.
WHO / Mectizan Donation Program
Avenue Appia 20, 1211 Genève, Switzerland
The World Health Organization frames the mass-treatment programmes that made ivermectin famous — onchocerciasis and lymphatic filariasis — and its guidance sits beside the FDA label in our reading of the antiparasitics. The Mectizan donation, running since 1987, is the backdrop to most of what ivermectin is actually approved to do.
U.S. Food and Drug Administration
10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
The American regulator whose approved prescribing information fixes the doses, boxed warnings and interaction rules we quote. Where a page here and the current FDA label diverge, the label is the authority — the nitrate contraindication for the PDE5 drugs and the fluoroquinolone boxed warning above all.
European Medicines Agency
Domenico Scarlattilaan 6, 1083 HS Amsterdam, Netherlands
The EU regulator whose scientific assessments and product information sit alongside the FDA label in our reading. Its reviews are particularly useful on the fluoroquinolone safety restrictions and on the reasoning behind each approved European indication.