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VIAGRA
VIAGRA ONLINE
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine
must be weighed against the good it will do. This is a decision
you and your doctor will make. For sildenafil, the following
should be considered:
Allergies—Tell your doctor if you have ever
had any unusual or allergic reaction to sildenafil. Also tell your
health care professional if you are allergic to any other
substances, such as foods, preservatives, or dyes.
Pregnancy—Sildenafil is not indicated for
use in women. Sildenafil has not been studied in pregnant women.
However, sildenafil has not been shown to cause birth defects or
other problems in animal studies.
Breast-feeding—It is not known whether
sildenafil passes into breast milk. Sildenafil is not indicated
for use in women.
Older adults—Elderly people are especially
sensitive to the effects of sildenafil, which may increase their
chance of having side effects. Patients 65 years of age and older
are started on a low dose, 25 mg, of sildenafil. The dose may be
increased by a doctor as needed and tolerated.
Other medicines—Although certain medicines
should not be used together at all, in other cases two different
medicines may be used together even if an interaction might occur.
In these cases, your doctor may want to change the dose, or other
precautions may be necessary. When you are taking sildenafil, it
is especially important that your health care professional know if
you are taking any of the following:
 | Cimetidine (e.g., Tagamet)
| Erythromycin (e.g., E.E.S. or Ery-Tab)
| Itraconazole (e.g., Sporanox)
| Ketaconazole (e.g., Nizoral)
| Mibefradil (e.g., Posicor)
| Ritonavir (e.g., Norvir)
| Saquinavir (e.g., Fortovase or Invirase)—These medicines
may increase the unwanted effects of sildenafil, unless lower
starting doses of sildenafil are used |
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| Nitrates, such as nitroglycerin (e.g., Nitrostat or
Transderm-Nitro)—Sildenafil increases the lowering of blood
pressure by nitrates too much and their use together is not
recommended |
Other medical problems—The presence of other
medical problems may affect the use of sildenafil. Make sure you
tell your doctor if you have any other medical problems,
especially:
| Arrhythmias (irregular heartbeat) or
| Coronary artery disease or
| Heart attack, history of (within the last 6 months) or
| High blood pressure or
| Low blood pressure or
| Stroke, history of (within the last 6 months)—Chance of
problems occurring may be increased |
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| Abnormal penis, including curved penis and birth defects of
the penis—Chance of problems occurring may be increased |
| Bleeding problems or
| Retinitis pigmentosa—Chance of problems occurring may be
increased. It is not known if the medicine is safe for use in
these patients |
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| Conditions causing thickened blood or slower blood flow,
including leukemia; multiple myeloma (tumors of the bone
marrow); or polycythemia, sickle cell disease, and
thrombocythemia (blood problems) or
| Priapism (history of)—Although sildenafil does not cause
priapism (erection lasting longer than 6 hours), patients with
these conditions have an increased risk of priapism and it
could occur while using sildenafil |
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| Heart or blood disease—Sexual activity increases the heart
rate and blood flow and can increase the chance of problems
occurring for some patients who use any type of medicine,
including sildenafil, that increases sexual ability |
| Kidney problems (severe) or
| Liver problems (severe)—Chance of problems occurring may
be increased. Lower starting doses may be used and doses
increased as needed and as tolerated |
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Proper Use of This Medicine
Special patient directions come with sildenafil. Read the
directions carefully before using the medicine.
This medicine usually begins to work within 30 minutes after
taking it. It continues to work for up to 4 hours, although its
action is usually less after 2 hours.
Dosing—
The dose of sildenafil will be different for different
patients. Follow your doctor's orders or the directions on the
label. The following information includes only the average
doses of sildenafil. If your dose is different, do not change
it unless your doctor tells you to do so.
| For oral dosage form (tablets):
| For treatment of erectile dysfunction:
| Adults up to 65 years of age—50 mg as a single
dose no more than once a day, 1 hour before sexual
intercourse. Alternatively, the medicine may be taken
30 minutes to 4 hours before sexual intercourse. If
needed, your doctor may increase your daily dose to
100 mg or decrease your daily dose to 25 mg.
| Adults 65 years of age and older—25 mg as a single
dose no more than once a day, 1 hour before sexual
intercourse. Alternatively, the medicine may be taken
30 minutes to 4 hours before sexual intercourse. If
needed, your doctor may increase your daily dose.
| If you are taking protease inhibitors, such as for
the treatment of HIV, your doctor may recommend a 25
mg dose and may limit you to a maximum single dose of
25 mg of Viagra in a 48 hour period |
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Storage—
To store this medicine:
| Keep out of the reach of children.
| Store away from heat and direct light.
| Do not store in the bathroom, near the kitchen sink, or in
other damp places. Heat or moisture may cause the medicine to
break down.
| Keep the medicine from freezing. Do not refrigerate.
| Do not keep outdated medicine or medicine no longer needed.
Be sure that any discarded medicine is out of the reach of
children. |
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Precautions While Using This Medicine
Sildenafil has not been studied with other medicines used
for treatment of erectile dysfunction. Presently, using them
together is not recommended .
Use sildenafil exactly as directed by your doctor. Do
not use more of it and do not use it more often than your doctor
ordered. If too much is used, the chance of side effects is
increased.
If you experience a prolonged or painful erection for 4
hours or more, contact your doctor immediately. This
condition may require prompt medical treatment to prevent tissue
damage of the penis and possible permanent impotence.
Side Effects of This Medicine
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some
unwanted effects. Although not all of these side effects may
occur, if they do occur they may need medical attention.
Less common
| Abnormal vision, including blurred vision, seeing shades of
colors differently than before, or sensitivity to light;
bladder pain; cloudy or bloody urine; dizziness;
increased frequency of urination ; pain on urination |
| Rare
| Bleeding of the eye; convulsions (seizures) ;
decreased vision or other changes in vision; double
vision; prolonged, painful, or inappropriate
erection of penis; redness, burning, or swelling of
the eye; vision loss, temporary |
| Note: The following rare side effects have not been
completely established as being caused by sildenafil
| Blood sugar problems (more likely with patients with
diabetes mellitus), such as anxiety, behavior change
similar to drunkenness, blurred vision, cold sweats,
confusion, cool and pale skin, difficulty in
concentrating, drowsiness, excessive hunger, fast
heartbeat, headache, nausea, nervousness, nightmares,
restless sleep, shakiness, slurred speech, and unusual
tiredness or weakness; bone pain; breast
enlargement; chest pain; chills;
confusion; convulsions (seizures);
deafness; decrease in amount of urine or in
frequency of urination; dizziness or
lightheadedness, especially when getting up from a
lying or sitting position; dry eyes; dry
mouth; dryness, redness, scaling, or peeling of
the skin; eye pain; fainting or faintness;
fast, irregular, or pounding heartbeat ; feeling
of something in the eye; groups of skin lesions
with swelling; headache (severe or continuing);
heart failure; hives; increase in size of
pupil; increased sweating; increased
thirst; itching of skin; low blood
pressure ; lower back or side pain;
migraine headache; nausea (severe or continuing)
; nervousness; numbness of hands;
painful, swollen joints; redness, itching, or
tearing of eyes; shortness of breath or troubled
breathing; skin paleness; skin rash;
skin ulcers; sore throat and fever or chills;
sudden weakness; swelling of face, hands, feet,
or lower legs; twitching of muscles;
unusual tiredness or weakness; unusual feeling
of burning or stinging of skin |
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Other side effects may occur that usually do not need medical
attention. These side effects may go away during treatment as your
body adjusts to the medicine. However, check with your doctor if
any of the following side effects continue or are bothersome:
| More common
| Flushing; headache; nasal congestion;
stomach discomfort following meals |
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| Less common
| Diarrhea |
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| Rare
| Anxiety |
| Note: The following rare side effects have not been
completely established as being caused by sildenafil
| Abdominal pain; abnormal dreams; aches
or pains of muscles; clumsiness or unsteadiness;
cough; diarrhea or stomach cramps (severe or
continuing); difficulty in swallowing; ear
pain; increased amount of saliva;
increased skin sensitivity; lack of
coordination; loss of bladder control;
mental depression ; nausea; numbness or
tingling of hands, legs, or feet; rectal
bleeding; redness or irritation of the tongue;
redness, soreness, swelling, or bleeding of gums;
ringing or buzzing in ears; sensation of motion,
usually whirling, either of one's self or of one's
surroundings; sexual problems in men
(continuing), including failure to experience a sexual
orgasm; sleepiness; sores in mouth and on
lips; tense muscles; tightness of chest or
wheezing; trembling and shaking; trouble
in sleeping; vomiting; waking to urinate
at night; worsening of asthma |
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Other side effects not listed above may also occur in some
patients. If you notice any other effects, check with your doctor.
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