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But it’s possible that taking Viagra with certain other illicit drugs could also have dangerous effects on your heart and blood pressure l-arginine erectile dysfunction treatment generic viagra 50 mg with amex. Examples of illicit drugs that could have dangerous effects if taken with Viagra include:If you’re thinking of using illicit drugs with Viagra erectile dysfunction and diabetes leaflet cheap viagra 75 mg on-line, talk with your doctor about whether this is safe for you to erectile dysfunction pills wiki buy viagra on line amex do erectile dysfunction pills at gnc cheap viagra 100 mg online. Taking Viagra with alpha-blockers can cause your blood pressure to drop even lower. And if you take one of the drugs listed above, tell your doctor if you feel very dizzy, lightheaded, or faint after taking Viagra. Viagra and AdderallViagra hasn’t been tested for use with Adderall, so it’s not known what effects the drugs would have if taken together. Adderall has stimulant effects in your body, and it could cause serious heart-related side effects. So it’s possible that taking it with Adderall could have dangerous effects on your heart or blood pressure. If you take Adderall, ask your doctor if it’s safe for you to take Viagra as well. Viagra and XanaxViagra hasn’t been tested for use with Xanax, so it’s not known what effects the drugs would have if taken together. So it’s possible that taking it with Xanax could have dangerous effects on your heart or blood pressure. Viagra and antidepressantsIt’s usually fine to take Viagra with antidepressants. If you have questions about whether you can take Viagra with an antidepressant, talk with your doctor. Viagra and certain antimicrobialsTaking Viagra with certain antimicrobials (drugs used to treat infection) can slow the breakdown of Viagra in your body. This can cause Viagra to build up inside your body, which may increase your risk of side effects from the drug. Viagra and herbs and supplementsThere aren’t any herbs or supplements that have been specifically reported to interact with Viagra. However, you should still check with your doctor or pharmacist before using any of these products while taking Viagra. Viagra and foodsThere aren’t any foods that have been specifically reported to interact with Viagra. If you have any questions about eating certain foods with Viagra, talk with your doctor. Viagra and grapefruitGrapefruit juice can affect the levels of some medications in your body. But there’s not much evidence to show that the fruit or its juice can affect Viagra levels. It showed that drinking grapefruit juice with Viagra slightly increased people’s blood level of the drug. This could possibly increase the risk of certain side effects such as headaches, flushing, or dizziness. If you want to drink grapefruit juice or eat grapefruit while you’re taking Viagra, talk with your doctor. If you do have increased side effects with this combination, try avoiding grapefruit while you’re taking Viagra. You should take Viagra according to your doctor’s or healthcare provider’s instructions. When to takeFor most people, it’s recommended that you take Viagra as needed, about 1 hour before you plan to have sex. But Viagra can actually be taken anywhere from 30 minutes to 4 hours before sexual activity. It’s important to remember that you shouldn’t take the medication more than once a day. But if you take it with a meal, the drug may take about an hour longer than usual to start working. This is especially the case if you eat a high-fat meal, such as a cheeseburger with fries. It’s also important to remember that if Viagra gives you indigestion, taking the drug with food may help to reduce this side effect. The safety and effectiveness of Viagra tablets that are crushed, split, or chewed haven’t been tested. It’s not known if crushing or chewing the tablets will make them work any differently than usual. If you have trouble swallowing Viagra tablets, you might find it easier to swallow the tablet with different drinks, such as water, juice, or milk. If you want to crush, split, or chew Viagra tablets, ask your doctor or pharmacist if this is safe to do. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition. In these studies, men who used the drug had an improved ability to have and keep erections that allowed for successful sex. Across the studies, between 43% and 83% of men who took Viagra had improved erections. Effectiveness of Viagra at different dosesSome studies looked at the effect of different doses of Viagra. Improved erections were reported in:84% of men who took Viagra26% of men who took a placeboOff-label use for ViagraIn addition to the use described above, Viagra may be used off-label. Off-label drug use is when a drug that’s approved for one condition is given for a different condition that’s not approved. Viagra for Raynaud’s diseaseViagra isn’t approved to treat Raynaud’s disease, but sometimes it’s used off-label for this condition. With Raynaud’s disease, the blood vessels in your hands and feet spasm and temporarily become narrowed. This can cause your fingers and toes to look white and feel cold, painful, or numb. Viagra works to treat Raynaud’s disease by relaxing and widening certain blood vessels in your body. If you have questions about using Viagra for Raynaud’s disease, talk with your doctor. Or you may be wondering if there’s a drug similar to Viagra that can help women with sexual dysfunction. And there isn’t enough evidence to show that Viagra works for treating sexual problems in women. One review of studies showed that current research has conflicting results on how Viagra affects women. For example, in women with female sexual arousal disorder, the review showed the following findings:In one study, some women who’d gone through menopause were given Viagra. These women had improved arousal, vaginal lubrication, and orgasm when they took the drug. In another study, both women who’d gone through menopause and those who hadn’t were given Viagra. So in theory, if a woman takes Viagra, it could increase blood flow to her genitals. This could explain why Viagra has less of a physical effect in women than it does in men. And keep in mind that sexual problems in women often have a lot to do with reduced sexual desire and arousal. While Viagra isn’t approved for use in women, a drug called Addyi is approved for use in certain women. Below, we describe the condition Addyi is approved to treat and how the drug works. Unlike Viagra, which improves blood flow to male genitals, Addyi doesn’t work by improving blood flow to female genitals. Instead, Addyi affects the activity of certain neurotransmitters that are involved in sexual desire and arousal. For example, in clinical studies, treatment with Addyi was compared with that of a placebo (no active drug). When you get Viagra from the pharmacy, the pharmacist will add an expiration date to the label on the bottle.
Give the medicine at about the same times each day so that this becomes part of your child’s daily routine erectile dysfunction pills in pakistan viagra 50 mg generic, which will help you remember impotence supplements generic viagra 50 mg otc. Your doctor will work out the amount of sildenafil (the dose) that is right for your child erectile dysfunction treatment by injection cheap viagra line. They may then increase the dose as your child gets used to can erectile dysfunction cause low sperm count purchase cheapest viagra and viagra the medicine and depending on how your child responds to it. It is important that you follow your doctor’s instructions about how much to give. You can dissolve the tablet in a small glass of water and then add some strong-flavoured drink. Then add some more water or squash to the glass, swirl it round and ask your child to drink it. You can crush the tablet and mix it with a small amount of soft food such as yogurt, honey or jam. Liquid medicine: measure out the right amount using an oral syringe or medicine spoon. It will start to work within a few days, although you may not notice any difference in your child. If your child is sick less than 30 minutes after having a dose of sildenafil, give them the same dose again. If your child is sick more than 30 minutes after having a dose of sildenafil you do not need to give them another dose. You are unlikely to do harm if you give an extra dose of sildenafil by mistake, although your child may have more side-effects. We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects). Encourage them to stand up slowly, and to sit or lie down if they feel dizzy or lightheaded. If this happens too often, contact your doctor to check your child’s blood pressure, as it may be too low. Your child may get some of the following side-effects when they first start taking sildenafil. They are usually mild and should usually wear off after a few days as your child gets used to the medicine. If they are still a problem after 2 weeks, or you are worried, contact your doctor, but continue to give sildenafil. Your child’s eyesight may become blurry or double and their eyes may become red and painful or sensitive to bright light. They may get mild indigestion or stomach pain, or may feel sick (nausea) or be sick (vomit). You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to. Tell your doctor and pharmacist about any other medicines that your child is taking before giving sildenafil. Check with your doctor or pharmacist before giving any other medicines to your child. Do not suddenly stop giving sildenafil to your child as their symptoms may come back. Write the date that you start it on the bottle and make sure you do not keep it past the expiry date given on the bottle. You may have heard that Viagra (which is one of the brands for sildenafil) is used to treat erectile dysfunction (impotence). However, your child will be taking a much lower dose of it for pulmonary hypertension. General advice about medicines Try to give medicines at about the same times each day, to help you remember. If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Never give it to anyone else, even if their condition appears to be the same, as this could do harm. If you think someone else may have taken the medicine by accident, contact your doctor. Order a new prescription at least 2 weeks before you will run out (longer for liquid medicine). Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Who to contact for more information Your doctor, pharmacist or nurse will be able to give you more information about sildenafil and about other medicines used to treat pulmonary hypertension. Endothelial dysfunction seems to be the early underlying pathophysiology across both conditions. Sildenafil is effective in several specific patient populations including the difficult-to-treat subpopulations such as diabetes mellitus and after radical prostatectomy. It is associated with rapid onset of action – within 14 minutes for some men – and an extended duration of action for up to 12 hours. Sildenafil improves quality of life and satisfaction for treated men and is well tolerated with a favorable safety profile. New data suggest that sildenafil has beneficial effects in several chronic conditions. Numerous articles have suggested that it improves endothelial function and a possible role on premature ejaculation or treatment of lower urinary tract symptoms has been suggested. More than 30 million of men are treated worldwide with sildenafil accompanied by vast experience and research with more than 2600 papers published in Medline as of July 2006. Furthermore, new data suggest that sildenafil has beneficial effects in several chronic conditions. The time to maximum plasma concentration is about 1 h while the plasma half-life is about 4–5 h. The recommended starting dose is 50 mg and adapted according to efficacy and tolerability. Patients are instructed to take sildenafil approximately 1 h before sexual intercourse with a maximum dosing frequency of once daily. The window of opportunity to engage in sexual intercourse is maintained from 30 min to 4–5 h from administration. However, the onset of action can be 14 min for about 35% of patients (Figure (Figure1)1) (Padma-Nathan et al 2003) and efficacy may be maintained for up to 12 h (Moncada et al 2004). Contraindications for the use of sildenafil and need for dose adjustments are summarized in Table Table11 (Langtry and Markham 1999). Minimal time to successful intercourse after sildenafil citrate: results of a randomized, double-blind, placebo-controlled trial. In the 6 trials in which sexual event log data were collected, significantly greater percentages of successful attempts at intercourse were reported by patient subgroups receiving sildenafil (52. Long-term effectiveness of sildenafil was assessed in 3 open-label, flexible-dose (25 mg to 100 mg) studies. After 12 months of treatment (3 years in one study) or at the time of discontinuation, patients were asked if they were satisfied with the effect of the medication on erections, and if the treatment improved their ability to engage in sexual activity. Satisfaction and improvement in ability to engage in sexual activity reported in 96% and 99% of patients respectively. Of the 11% of patients who discontinued treatment, 2% discontinued for treatment-related reasons (1. Most patients were receiving 100 mg sildenafil doses (88% at 3 years) (Carson et al 2002). Success with sildenafil, defined as 75% successful intercourse, was reported by 82% of patients with 77% being successful at every attempt (Guay et al 2001). Response rates in elderly men (≥65 years) are comparable with general population regardless of age (Wagner et al 2001). No differences in response rates were demonstrated in ethnic groups (Young et al 2002). In another multicenter, randomized, double-blind, placebo-controlled, flexible dose-escalation study in diabetic patients, 56% of patients reported improved erections and 61% reported at least 1 successful intercourse attempt compared with 10% and 22% in the placebo group, respectively (Rendell et al 1999). Diabetic patients are one of the most difficult to treat subgroups (Behrend et al 2005). In patients after bilateral nerve-sparing radical prostatectomy, 76% responded to sildenafil (defined as successful vaginal intercourse) (Raina et al 2004).
Study protocols erectile dysfunction massage purchase discount viagra, obtained from the manufacturer erectile dysfunction vyvanse proven viagra 50 mg, documented adequate measures to drugs for treating erectile dysfunction buy genuine viagra on-line conceal allocation for 26 trials erectile dysfunction uti buy discount viagra 75 mg on-line. Exclusion criteria used in most trials included genital anatomic deformity; primary nonerectile sexual disorder (eg, hypoactive sexual disorder); hyperprolactinemia; hypogonadism; major psychiatric disorders not well controlled with therapy (including schizophrenia and major depression); alcohol or substance abuse; major hematologic, renal, or hepatic abnormalities; spinal cord injury; poorly controlled diabetes mellitus; recent cardiovascular events (stroke, myocardial infarction, congestive heart failure exacerbation, unstable angina, or life-threatening arrhythmia within 6 months); uncontrolled hypertension or hypotension (eg, blood pressure >170/100 or Men in these trials had a mean age of 55 years, with 21% aged 65 years or older (Table 2). The most common comorbid conditions in men participating in these trials were hypertension (28%), diabetes mellitus (22%), and ischemic heart disease (10%). Use of sildenafil produced a large and statistically significant improvement in erectile function compared with use of placebo. Treatment benefit was found for all outcome measures in all patient subgroups evaluated and across all studies. Analyses in which men with missing end-of-treatment data were assumed, on average, to have experienced no change from baseline erectile function, and were included with men reporting end-of-treatment data, produced results similar to the main results for the mean percentage of successful intercourse attempts and for improvement in erections. The mean percentage per participant of intercourse attempts that were successful appeared greater at 50 or 100 mg compared with at 25 mg but no different between the 2 higher doses. In contrast, the percentage of men that reported at least 1 successful sexual intercourse attempt in the 4 weeks preceding the end-of-treatment assessment appeared the same with each sildenafil dose. Improvement in erections was reported more frequently with each increase in treatment dose. Data on the likelihood of successful sexual intercourse attempts are available from 9 of the 14 trials, whereas improvement in erections was assessed in all 14 trials. Data for men with spinal cord injury and men with spina bifida are available only from crossover or fixed-dose trials. All subgroup data for intercourse success outcomes are presented using the primary analysis method that considered all intercourse attempts. Although men younger than 65 years appeared to be more likely than older men to experience improved erections and successful sexual intercourse when compared within treatment groups, in both age categories, sildenafil treatment resulted in significantly better outcomes than placebo use. In comparison, older men receiving sildenafil had successful intercourse during 46% of attempts (vs 14% for the placebo group), 74% had at least 1 successful intercourse attempt during treatment (vs 36% for the placebo group), and 69% reported improved erections (vs 18% for the placebo group); all differences were statistically significant (Table 3). Compared with placebo treatment, sildenafil treatment significantly enhanced intercourse success and improved erections in all ethnic groups evaluated, with treatment response seeming to be roughly comparable between different ethnic groups. Asian men receiving sildenafil had successful sexual intercourse during 61% of attempts vs 24% of attempts in those allocated to the placebo group, with nearly 90% of Asian men in the sildenafil group reporting 1 or more successful attempts at intercourse during treatment (vs 49% in men receiving placebo) (Table 3). Data on intercourse success were available for few black men because black participants constitute fewer than 5% of all participants in completed sildenafil trials. Nevertheless, results indicate that black men randomized to sildenafil use had significantly greater intercourse success and improvement in erections than did those randomized to placebo use (Table 3). Three quarters of men allocated to the sildenafil group experienced at least 1 successful intercourse attempt during treatment compared with 39% of those randomized to receive placebo. Men with ischemic heart disease were significantly more likely to experience improved erectile function with sildenafil use compared with placebo use for all measured efficacy outcomes (Table 3). Data on the efficacy of sildenafil treatment relative to placebo treatment are available for few men with peripheral vascular disease (Table 3). Seventy percent of men receiving sildenafil were able to have successful intercourse at least once during treatment, significantly more than the 34% of men who received placebo. History of radical prostatectomy Relatively little information is available regarding the efficacy of sildenafil treatment for men with a history of radical prostatectomy. Compared with men randomized to receive placebo, those who received sildenafil had a significantly higher mean percentage of successful intercourse attempts (25% vs 3%; n = 42) and a greater likelihood of experiencing 1 or more successful intercourse attempts during treatment (47% vs 14%; n = 37). Men receiving sildenafil also were significantly more likely to experience at least 1 successful intercourse attempt during treatment than were men receiving placebo (81% vs 26%). In fixed-dose studies, dropouts also were reduced relative to placebo at each treatment dose (25-100 mg), with no substantial difference between the sildenafil doses or between the results for fixed-dose and flexible-dose studies. The most commonly reported adverse events in men receiving sildenafil were headache (11% vs 4% for the placebo group), flushing (12% vs 2% for the placebo group), dyspepsia (5% vs 1% for the placebo group), and visual disturbances (3% vs 0. Data from fixed-dose trials indicated that all of these adverse effects were more frequent at higher doses. The incidence of these adverse events appeared comparable across different subgroups of patients (data not shown). The incidence of death and serious cardiovascular events, such as angina pectoris and myocardial infarction, were infrequent in individuals enrolled in these randomized trials. In data available from 24 of 27 eligible trials, the combined outcome of angina or chest pain of possible cardiac origin was reported by 0. In all 27 trials (4240 men in sildenafil treatment arms and 2707 in the placebo arm), myocardial infarction occurred in 0. In results restricted to men with ischemic heart disease not taking nitrates (664 men from 24 of 27 eligible trials), angina was reported by 2. Overall, compared with men receiving placebo, those allocated to the sildenafil group had a higher percentage of successful sexual intercourse attempts, were more likely to have successful intercourse at least once during follow-up, and were more likely to report improved erections. Treatment benefit was found across all trials and for all evaluated patient subgroups. Although each of the sildenafil doses used in clinical practice (25, 50, and 100 mg) had significantly greater efficacy than placebo, the difference between these active treatment doses appeared modest and was not present for all outcomes. When data were analyzed excluding intercourse attempts reported to have failed for reasons other than an insufficiently firm or long-lasting erection, overall and subgroup results appeared comparable to those derived using the primary analysis method, although with an apparent increase in the relative benefit of sildenafil use over placebo use. Additional analyses suggested that overall results change little when men without outcomes data are assumed to have had no change from baseline erectile function and are included in the analyses. Some differences in treatment outcome may be related to the level of baseline erectile function. For example, men with a history of radical prostatectomy had among the lowest levels of intercourse success during the open run-in periods that preceded most trials (data not shown). Differences in treatment outcome also may be related to variation in placebo responsiveness. We estimated placebo effect for each subgroup by comparing its mean percentage of successful intercourse attempts during the run-in phase with its success rate during the double-blind phase among the men who received placebo. Finally, differences between specific subgroups also may be affected by confounding due to other patient variables, a possibility that could not be investigated in this trial-level meta-analysis. Safety data from the trials in this meta-analysis suggest that sildenafil administration was generally well tolerated. Although adverse events were significantly more frequent with sildenafil use than with placebo use, they were mostly mild or moderate in severity, and dropout rates due to adverse events or to laboratory abnormalities occurred no more frequently with sildenafil use than with placebo use. Differences in reports of angina or chest pain of cardiac origins between men receiving sildenafil and those allocated to placebo use did not reach statistical significance, and myocardial infarction and death were uncommon and appeared to be no more likely in men receiving sildenafil than in those receiving placebo. Although even large meta-analyses such as the present one may have limited power to detect modest increases (eg, 34 postmarketing data do not provide any conclusive evidence for an excess cardiovascular risk with sildenafil use as prescribed in the United States and England. The authors caution that the possibility of differences between the cohort of sildenafil users and men in the general population of England limits the conclusions that may be drawn from these data. Although these trials provide clinically meaningful information on the treatment efficacy and adverse events associated with sildenafil treatment, overall and for most important subgroups, only limited efficacy data are available for black or Hispanic men and for men with a history of radical prostatectomy, peripheral vascular disease, depression, or spina bifida. In addition, none of these trials lasted longer than 26 weeks, so long-term efficacy and safety data from randomized controlled trials are not available. Longer-term trials would help clarify the degree to which efficacy and safety of sildenafil are maintained over time. Additional data are needed to more precisely determine the efficacy and safety of sildenafil treatment in black and Hispanic patients and in men with a history of radical prostatectomy, peripheral vascular disease, or depression. In addition, it is important to more fully elucidate the safety of sildenafil treatment in men possibly at increased risk for cardiovascular events, such as those with stable ischemic heart disease. Ongoing prescription adverse event monitoring37 and other database surveillance may provide additional information that further evaluates the apparent safety of sildenafil use in appropriate populations of men. End points should include intercourse success, patient and partner preference, sexual function–related quality of life, and adverse effects, including cardiovascular events. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. A two-part pilot study of sildenafil (Viagra) in men with erectile dysfunction caused by spinal cord injury. Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies.
For these reasons erectile dysfunction effects on women buy generic viagra on-line, before you start taking sildenafil it is important that your doctor knows: If you have any disease erectile dysfunction treatments vacuum purchase viagra with american express, injury or deformity of your penis impotence examination buy viagra with visa. If you have any problems with the way your liver works or with the way your kidneys work impotence over 50 order viagra on line amex. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines, and recreational drugs. It will give you more information about the tablets and will provide you with a full list of the side-effects which you may experience from taking them. You should take one tablet about an hour before you plan to have sex, although it may still be effective up to five hours after taking the tablet. You can take the tablet either before or after food but, if you have just eaten a large meal, it may take longer for it to work. It is likely that you will be given the 50 mg strength tablet to begin with, but this may be changed subsequently depending upon how you react. Each time you collect a prescription, check to make sure it contains the strength of tablet you are expecting. If you have been supplied with a brand of tablet called Nipatra, these are chewable tablets. You and your partner will still need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction. Drinking too much alcohol can reduce your ability to get an erection and this may prevent you from getting the maximum benefit from the tablets. This is because there is a chemical in grapefruit juice which can increase the amount of sildenafil in your bloodstream and this makes side-effects more likely. Keep your regular appointments with your doctor so your progress can be monitored. If you feel the tablets are too strong for you, discuss this with your doctor as your dose may need to be reduced. Alternatively, if you do not get an erection after taking sildenafil, or if it does not last long enough for you to have sex, you should discuss this with your doctor do not take more tablets than you have been told to. You should not take sildenafil if you are using any other products or taking any other medicines to treat erectile dysfunction. Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome. Very common sildenafil side-effects (these affect more than 1 in 10 men) What can I do if I experience this? If the headaches continue, let your doctor know Common sildenafil side-effects (these affect less than 1 in 10 men) What can I do if I experience this? Flushing, feeling sick, indigestion, blocked nose These should soon pass Feeling dizzy, visual changes such as blurred vision or colour distortion If either of these happen, do not drive and do not use tools or machines until your reactions/vision have returned to normal Important: if your erection lasts for longer than four hours, or if you get chest pains or a sudden loss of vision, contact a doctor for medical attention straightaway. If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice. If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking. Never give it to other people even if their condition appears to be the same as yours. The upper images obtained using the Hermes Wiscan imaging system is representative of the data. Sildenafil is metabolized in the liver by cytochrome P450 and is converted into an active metabolite with characteristics similar to the parent compound. You must ensure that the solution obtained, in the previous addition, is a clear solution before proceeding to add the next solvent. Physical methods such as vortex, ultrasound or hot water bath can be used to aid dissolving. Bio Calculators Molarity Calculator Molarity Calculator Calculate the mass, volume or concentration required for a solution. Dilution Calculator Dilution Calculator Calculate the dilution required to prepare a stock solution. Definitions of molecular mass, molecular weight, molar mass and molar weight: Molecular mass (molecular weight) is the mass of one molecule of a substance and is expressed in the unified atomic mass units (u). Topics include how to prepare stock solutions, how to store inhibitors, and issues that need special attention for cell-based assays and animal experiments. Handling Instructions Tel: +1-832-582-8158 Ext:3 If you have any other enquiries, please leave a message. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. Other Uses This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional. Sildenafil is also available in other brands and strengths for high blood pressure in the lungs (pulmonary hypertension). How To Use Read the Patient Information Leaflet provided by your pharmacist before you start taking sildenafil and each time you get a refill. Take sildenafil at least 30 minutes, but no more than 4 hours, before sexual activity (1 hour before is the most effective). The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Sexual activity may put extra strain on your heart, especially if you have heart problems. If this serious problem occurs, stop taking sildenafil and get medical help right away. Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash itching/swelling (especially of the face/tongue/throat) severe dizziness trouble breathing This is not a complete list of possible side effects. Precautions Before taking sildenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Since high blood pressure in the lungs is a serious condition that can harm both a pregnant woman and her unborn baby, do not stop this medication unless directed by your doctor.
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