Viagra (Sildenafil)

Why is this medication prescribed?
Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.

If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

How should this medicine be used?

Sildenafil comes as a tablet to take by mouth.

*If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.

*If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

*If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.

*If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking sildenafil, tell your doctor and pharmacist if you are allergic to sildenafil or any other medications...

*do not take sildenafil if you are taking or have recently taken nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.

*do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking sildenafil.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin); amlodipine (Norvasc); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin); certain barbiturates such as butalbital (in Esgic-Plus, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); bosentan (Tracleer); cimetidine (Tagamet);efavirenz (Sustiva); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Fortovase, Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction;medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products you are taking or plan to take, especially St. John's wort.

*tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.

*tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sildenafil, call your doctor.

*if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.

*if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease.

*If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.

*tell all your health care providers that you are taking sildenafil. If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took sildenafil.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.
If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
*headache
*heartburn
*diarrhea
*flushing (feeling of warmth)
*nosebleeds
*difficulty falling asleep or staying asleep
*numbness, burning, or tingling in the arms, hands, feet, or legs
*muscle aches
*changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
*sensitivity to light

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

*sudden severe loss of vision (see below for more information)
*blurred vision
*sudden decrease or loss of hearing
*ringing in ears
*erection that is painful or lasts longer than 4 hours
*dizziness or lightheadedness
*fainting
*chest pain
*worsening shortness of breath
*itching or burning during urination
*rash

Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.

There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.

Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and may not get better. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know?

*Keep all appointments with your doctor.
*Do not let anyone else take your medication. Ask your pharmacist any questions you *have about refilling your prescription.
*It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies

Whooping cough (pertussis)

Whooping cough (pertussis) is an acute, highly contagious respiratory infection that is caused by a bacterium. The first outbreaks of pertussis were described in the 16th century. The bacterium responsible for the infection, Bordetella pertussis, was not isolated until 1906. The incidence of pertussis has been steadily increasing since the 1980s. According to the U.S. Centers for Disease Control and Prevention (CDC), a total of 25,827 cases of pertussis were reported in 2004 in the U.S.

Can whooping cough be prevented with a vaccine?
Whooping cough commonly affects infants and young children but can be prevented by immunization with pertussis vaccine. Pertussis vaccine is most commonly given in combination with the vaccines for diphtheria and tetanus. (Pertussis is the "P" in the DTaP combination inoculation routinely given to children, and the "p" in the Tdap vaccine administered to adolescents and adults.) Since immunity from the pertussis vaccine wears off with time, many teenagers and adults get whooping cough.

What are the stages, symptoms, and signs of whooping cough?
*The first stage of whooping cough is known as the catarrhal stage. In the catarrhal stage, which typically lasts from one to two weeks, an infected person has symptoms characteristic of an upper respiratory infection, including runny nose, sneezing, low-grade fever, or a mild, occasional cough, similar to the common cold.
The cough gradually becomes more severe, and after one to two weeks, the second stage begins.
*It is during the second stage (the paroxysmal stage) that the diagnosis of whooping cough usually is suspected. The second stage is characterized by:

-Bursts (paroxysms) of coughing, or numerous rapid coughs, are apparently due to difficulty expelling thick mucus from the airways in the lungs. Bursts of coughing increase in frequency during the first one to two weeks, remain constant for two to three weeks, and then gradually begin to decrease in frequency.
-At the end of the bursts of rapid coughs, a long inspiratory effort (breathing in) is usually accompanied by a characteristic high-pitched "whoop."
-During an attack, the individual may become cyanotic (turn blue) from lack of oxygen.
-Children and young infants appear especially ill and distressed.
-Vomiting (referred to by doctors as posttussive vomiting) and exhaustion commonly follow the episodes of coughing.
-The person usually appears normal between episodes.
-Paroxysmal attacks occur more frequently at night, with an average of 15-24 attacks per 24 hours.
-The paroxysmal stage usually lasts from one to six weeks but may persist for up to 10 weeks.
-Infants under 6 months of age may not have the strength to have a whoop, but they do have paroxysms of coughing.
The third stage of whooping cough is the recovery or convalescent stage. In the convalescent stage, recovery is gradual. The cough becomes less paroxysmal and usually disappears over two to three weeks; however, paroxysms often recur with subsequent respiratory infections for many months.

How is whooping cough transmitted?
Whooping cough is highly contagious and is spread among people by direct contact with fluids from the nose or mouth of infected people. People contaminate their hands with respiratory secretions from an infected person and then touch their own mouth or nose. In addition, small bacteria-containing droplets enter the air during coughing or sneezing. People can become infected by breathing in these drops.

Can adults get whooping cough?

Although whooping cough is considered to be an illness of childhood, adults may also develop the disease. The illness usually is milder in adults than in children, but the duration of the paroxysmal cough is just as long as in children. The characteristic whoop that occurs after paroxysmal bouts of coughing is recognized in only 20%-40% of adults with whooping cough. Because immunity from the pertussis vaccine decreases over time but does not necessarily disappear, adults who do become infected may have retained a partial degree of immunity against the infection that results in a milder illness. Whooping cough in adults is more common than usually appreciated, accounting for up to 7% of adult illnesses that cause coughing each year. Infected adults are a reservoir (source) of infection for children.

How is whooping cough diagnosed?

When a patient has the typical symptoms of whooping cough, the diagnosis can be made from the clinical history. However, the disease and its symptoms, including its severity, can vary among affected individuals. In cases where the diagnosis is not certain or a doctor wants to confirm the diagnosis, laboratory tests can be carried out. Culture of the bacterium Bordetella pertussis from nasal secretions can establish the diagnosis. Another test that has been used to successfully identify the bacterium and diagnose pertussis is the polymerase chain reaction (PCR) test that can identify genetic material from the bacterium in nasal secretions,
How is whooping cough treated?

Antibiotics directed against Bordetella pertussis can be effective in reducing the severity of pertussis when administered early in the course of the disease. Antibiotic therapy can also help reduce the risk of transmission of the bacterium to other household members as well as to others who may come into contact with an infected person. Unfortunately, most people with pertussis are diagnosed later with the condition in the second (paroxysmal) stage of the disease. Treatment with antibiotics is recommended for anyone who has had the disease for less than 21 days. Azithromycin (Zithromax), clarithromycin (Biaxin), erythromycin, and trimethoprim/sulfamethoxazole are antibiotics which have been shown to be effective in treating whooping cough. It is unclear whether antibiotics have any benefit for people who have been ill with pertussis for longer periods, although antibiotic therapy is still often considered for this group. There is no proven effective treatment for the paroxysms of coughing that accompany pertussis.
Antibiotics are also routinely administered to people who have had close contact with an infected person, regardless of their vaccination status.

Complications of whooping cough (pertussis)

The most common complication and the cause of most pertussis-related deaths is secondary bacterial pneumonia. (Secondary bacterial pneumonia is bacterial pneumonia that follows another infection of the lung, be it viral or bacterial. Secondary pneumonia is caused by a different virus or bacterium than the original infection.) Young infants are at highest risk for whooping cough and also for pertussis-associated complications, including secondary pneumonia. Data from 2001-2003 indicate that secondary pneumonia occurred among 4.9% of all reported pertussis cases.

Pertussis can cause serious illness and even death in young children; 13 children died from the infection in 2003. From 2004-2005, 66 deaths due to whooping cough were reported to the CDC, and 56 of these were children under 3 months of age. Most of the pertussis-related deaths have occurred in children who have not been vaccinated or who are too young to have received the vaccine.
Other possible complications of pertussis include seizures, encephalopathy (abnormal function of the brain due to decreased oxygen delivery to the brain), reactive airway disease (asthma), dehydration, and malnutrition.

Watermelon Viagra

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia)

Look no further than the produce section if lust is on the shopping list. New studies show that watermelon can have the same blood flow benefits as the wildly popular erectile dysfunction drug Viagra. According to scientists, watermelon has ingredients that deliver Viagra-like effects to the body’s blood vessels, and may even increase libido.Watermelon contains an ingredient called citrulline. Citrulline reacts with enzymes to trigger the body's release of a chemical called arginine. The result of increased arginine levels is relaxed blood vessels, scientists at Texas A&M say the effect is similar Viagra. While citrulline is found in all parts of the watermelon, the rind is 60 percent richer in the ingredient. And even higher doses are found in yellow-fleshed watermelons.Arginine is an amino acid that has beneficial effects on the heart and circulation system, and maintains a good immune system. Arginine also boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has.A U.S. Department of Agriculture study corroborates the claims saying watermelon can also help with angina, high blood pressure and other cardiovascular problems. It's a fantastic homeopathic supplement to medical treatment. Additionally, watermelon is packed with key nutrients like lycopene, beta carotene, and other phytonutrients that help combat free radicals in the body which leads to cancer.One known side effects of too much watermelon intakes is its diuretic effect, not to mention all that water that might have a person running to the loo more frequently. It would take a lot of watermelon to increase the body's level of arginine, about six cups worth. Watermelon is also high in sugar which could affect those with blood sugar issues.

Watermelon Viagra

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia)

Look no further than the produce section if lust is on the shopping list. New studies show that watermelon can have the same blood flow benefits as the wildly popular erectile dysfunction drug Viagra. According to scientists, watermelon has ingredients that deliver Viagra-like effects to the body’s blood vessels, and may even increase libido.Watermelon contains an ingredient called citrulline. Citrulline reacts with enzymes to trigger the body's release of a chemical called arginine. The result of increased arginine levels is relaxed blood vessels, scientists at Texas A&M say the effect is similar Viagra. While citrulline is found in all parts of the watermelon, the rind is 60 percent richer in the ingredient. And even higher doses are found in yellow-fleshed watermelons.Arginine is an amino acid that has beneficial effects on the heart and circulation system, and maintains a good immune system. Arginine also boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has.A U.S. Department of Agriculture study corroborates the claims saying watermelon can also help with angina, high blood pressure and other cardiovascular problems. It's a fantastic homeopathic supplement to medical treatment. Additionally, watermelon is packed with key nutrients like lycopene, beta carotene, and other phytonutrients that help combat free radicals in the body which leads to cancer.One known side effects of too much watermelon intakes is its diuretic effect, not to mention all that water that might have a person running to the loo more frequently. It would take a lot of watermelon to increase the body's level of arginine, about six cups worth. Watermelon is also high in sugar which could affect those with blood sugar issues.

Watermelon Viagra

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia)

Look no further than the produce section if lust is on the shopping list. New studies show that watermelon can have the same blood flow benefits as the wildly popular erectile dysfunction drug Viagra. According to scientists, watermelon has ingredients that deliver Viagra-like effects to the body’s blood vessels, and may even increase libido.Watermelon contains an ingredient called citrulline. Citrulline reacts with enzymes to trigger the body's release of a chemical called arginine. The result of increased arginine levels is relaxed blood vessels, scientists at Texas A&M say the effect is similar Viagra. While citrulline is found in all parts of the watermelon, the rind is 60 percent richer in the ingredient. And even higher doses are found in yellow-fleshed watermelons.Arginine is an amino acid that has beneficial effects on the heart and circulation system, and maintains a good immune system. Arginine also boosts nitric oxide, which relaxes blood vessels, the same basic effect that Viagra has.A U.S. Department of Agriculture study corroborates the claims saying watermelon can also help with angina, high blood pressure and other cardiovascular problems. It's a fantastic homeopathic supplement to medical treatment. Additionally, watermelon is packed with key nutrients like lycopene, beta carotene, and other phytonutrients that help combat free radicals in the body which leads to cancer.One known side effects of too much watermelon intakes is its diuretic effect, not to mention all that water that might have a person running to the loo more frequently. It would take a lot of watermelon to increase the body's level of arginine, about six cups worth. Watermelon is also high in sugar which could affect those with blood sugar issues.

Sildenafil

Why is this medication prescribed?
Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.
If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

How should this medicine be used?

Sildenafil comes as a tablet to take by mouth.
If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.
If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.
If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking sildenafil,
tell your doctor and pharmacist if you are allergic to sildenafil or any other medications.
do not take sildenafil if you are taking or have recently taken nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.
do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking sildenafil.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin); amlodipine (Norvasc); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin); certain barbiturates such as butalbital (in Esgic-Plus, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); bosentan (Tracleer); cimetidine (Tagamet);efavirenz (Sustiva); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Fortovase, Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction;medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products you are taking or plan to take, especially St. John's wort.
tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sildenafil, call your doctor.
if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.
if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
tell all your health care providers that you are taking sildenafil. If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took sildenafil.

What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.
If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
headache
heartburn
diarrhea
flushing (feeling of warmth)
nosebleeds
difficulty falling asleep or staying asleep
numbness, burning, or tingling in the arms, hands, feet, or legs
muscle aches
changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
sudden severe loss of vision (see below for more information)
blurred vision
sudden decrease or loss of hearing
ringing in ears
erection that is painful or lasts longer than 4 hours
dizziness or lightheadedness
fainting
chest pain
worsening shortness of breath
itching or burning during urination
rash
Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and may not get better. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies

Sildenafil

Why is this medication prescribed?
Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.
If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

How should this medicine be used?

Sildenafil comes as a tablet to take by mouth.
If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.
If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.
If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking sildenafil,
tell your doctor and pharmacist if you are allergic to sildenafil or any other medications.
do not take sildenafil if you are taking or have recently taken nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.
do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking sildenafil.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin); amlodipine (Norvasc); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin); certain barbiturates such as butalbital (in Esgic-Plus, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); bosentan (Tracleer); cimetidine (Tagamet);efavirenz (Sustiva); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Fortovase, Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction;medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products you are taking or plan to take, especially St. John's wort.
tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sildenafil, call your doctor.
if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.
if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
tell all your health care providers that you are taking sildenafil. If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took sildenafil.

What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.
If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
headache
heartburn
diarrhea
flushing (feeling of warmth)
nosebleeds
difficulty falling asleep or staying asleep
numbness, burning, or tingling in the arms, hands, feet, or legs
muscle aches
changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
sudden severe loss of vision (see below for more information)
blurred vision
sudden decrease or loss of hearing
ringing in ears
erection that is painful or lasts longer than 4 hours
dizziness or lightheadedness
fainting
chest pain
worsening shortness of breath
itching or burning during urination
rash
Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and may not get better. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies

Sildenafil

Why is this medication prescribed?
Sildenafil (Viagra) is used to treat erectile dysfunction (impotence; inability to get or keep an erection) in men. Sildenafil (Revatio) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Sildenafil is in a class of medications called phosphodiesterase (PDE) inhibitors. Sildenafil treats erectile dysfunction by increasing blood flow to the penis during sexual stimulation. This increased blood flow can cause an erection. Sildenafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow easily.
If you are taking sildenafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. Sildenafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV).

How should this medicine be used?

Sildenafil comes as a tablet to take by mouth.
If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. Take sildenafil as needed before sexual activity. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. You can take sildenafil with or without food. However, if you take sildenafil with a high-fat meal, it will take longer for the medication to start to work.
If you are taking sildenafil to treat PAH, follow your doctor's directions and the guidelines in this paragraph. You will probably take sildenafil three times a day with or without food. Take sildenafil at around the same times every day, and space your doses about 4 to 6 hours apart.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sildenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
If you are taking sildenafil for erectile dysfunction, your doctor will probably start you on an average dose of sildenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if sildenafil is not working well or if you are experiencing side effects.
If you are taking sildenafil for PAH, you should know that sildenafil controls PAH but does not cure it. Continue to take sildenafil even if you feel well. Do not stop taking sildenafil without talking to your doctor.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?
Before taking sildenafil,
tell your doctor and pharmacist if you are allergic to sildenafil or any other medications.
do not take sildenafil if you are taking or have recently taken nitrates (medications for chest pain) such as isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure whether any of your medications contain nitrates.
do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking sildenafil.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin); amlodipine (Norvasc); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); anticoagulants ('blood thinners') such as warfarin (Coumadin); certain barbiturates such as butalbital (in Esgic-Plus, in Fioricet, in Fiorinal, others) and secobarbital (Seconal); beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal); bosentan (Tracleer); cimetidine (Tagamet);efavirenz (Sustiva); erythromycin (E.E.S., E-Mycin, Erythrocin); HIV protease inhibitors including amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Fortovase, Invirase), and tipranavir (Aptivus); nevirapine (Viramune); other medications or devices to treat erectile dysfunction;medications for high blood pressure; certain medications for seizures including carbamazepine (Carbatrol, Epitol, Tegretol), phenobarbital, and phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with sildenafil, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
tell your doctor what herbal products you are taking or plan to take, especially St. John's wort.
tell your doctor if you smoke, if you have ever had an erection that lasted for several hours, and if you have recently lost a large amount of body fluids (dehydration). This can happen if you are sick with fever, diarrhea, or vomiting; sweat a lot; or do not drink enough liquids. Also tell your doctor if you have or have ever had pulmonary veno-occlusive disease (PVOD; blockage of veins in the lungs); a stomach ulcer; heart, kidney, or liver disease; a heart attack; an irregular heartbeat; a stroke; chest pain; high or low blood pressure; high cholesterol; a bleeding disorder; blood circulation problems;blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosis, or Peyronie's disease); or diabetes. Also tell your doctor if you or any of your family members have or have ever had an eye disease such as retinitis pigmentosa (an inherited eye condition that causes loss of vision) or if you have ever had sudden severe vision loss, especially if you were told that the vision loss was caused by a blockage of blood flow to the nerves that help you see.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sildenafil, call your doctor.
if you are having surgery, including dental surgery, tell your doctor or dentist that you are taking sildenafil.
if you are taking sildenafil to treat erectile dysfunction, tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons or if you have ever experienced chest pain during sexual activity. Sexual activity may be a strain on your heart, especially if you have heart disease. If you experience chest pain, dizziness, or nausea during sexual activity, call your doctor immediately and avoid sexual activity until your doctor tells you otherwise.
tell all your health care providers that you are taking sildenafil. If you ever need emergency medical treatment for a heart problem, the health care providers who treat you will need to know when you last took sildenafil.

What special dietary instructions should I follow?
Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

If you are taking sildenafil for erectile dysfunction, you are unlikely to miss a dose since this medication is taken as needed, not on a regular dosing schedule.
If you are taking sildenafil for PAH, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Sildenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
headache
heartburn
diarrhea
flushing (feeling of warmth)
nosebleeds
difficulty falling asleep or staying asleep
numbness, burning, or tingling in the arms, hands, feet, or legs
muscle aches
changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
sensitivity to light
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:
sudden severe loss of vision (see below for more information)
blurred vision
sudden decrease or loss of hearing
ringing in ears
erection that is painful or lasts longer than 4 hours
dizziness or lightheadedness
fainting
chest pain
worsening shortness of breath
itching or burning during urination
rash
Some patients experienced a sudden loss of some or all of their vision after they took sildenafil or other medications that are similar to sildenafil. The vision loss was permanent in some cases. It is not known if the vision loss was caused by the medication. If you experience a sudden loss of vision while you are taking sildenafil, call your doctor immediately. Do not take any more doses of sildenafil or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor.
There have been reports of heart attack, stroke, irregular heartbeat, bleeding in the brain or lungs, high blood pressure, and sudden death in men who took sildenafil for erectile dysfunction. Most, but not all, of these people had heart problems before taking sildenafil. It is not known whether these events were caused by sildenafil, sexual activity, heart disease, or a combination of these and other causes.Talk to your doctor about the risks of taking sildenafil.
Some patients experienced a sudden decrease or loss of hearing after they took sildenafil or other medications that are similar to sildenafil. The hearing loss usually involved only one ear and may not get better. It is not known if the hearing loss was caused by the medication. If you experience a sudden loss of hearing, sometimes with ringing in the ears or dizziness, while you are taking sildenafil, call your doctor immediately. If you are taking sildenafil (Viagra) for erectile dysfunction, do not take any more doses of sildenafil (Viagra) or similar medications such as tadalafil (Cialis) or vardenafil (Levitra) until you talk to your doctor. If you are taking sildenafil (Revatio) for PAH, do not stop taking your medication until you talk to your doctor.
Sildenafil may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies

You are the love of my life

I am amazed when I look at you,
I see you smiling back at me,
It's like all my dreams come true.
I am afraid if I lost you girl,
I'd fall through the cracks and lose my track,
In this crazy, lonely world.

Sometimes it's so hard to believe,
When my nights can be so long,
And faith gave me the strength,
and kept me holding on.

You are the love of my life,
And I'm so glad you found me,
You are the love of my life,
Baby put your arms around me,
I guess this is how it feels,
When you finally find something real.
My angel in the night, you are my love...
The love of my life.

Now here you are,
With midnight closing in.
You take my hand as our shadows dance,
With moonlight on your skin.
I look in your eyes,
I'm lost inside your kiss.
I think if I'd never met you,
about all the things I'd missed.

Sometimes it's so hard to believe,
When a love can be so strong,
And faith gives me the strength,
and kept me going on.

You are the love of my life,
And I'm so glad you found me,
You are the love of my life,
Baby put your arms around me,
I guess this is how it feels,
When you finally find something real.
My angel in the night, you're my love...
The love of my life.

You are the love of my life,
And I'm so glad you found me,
You are the love of my life,
Baby put your arms around me,
I guess this is how it feels,
When you finally find something real.
My angel in the night, you are my love...
My angel in the night, you are my love...
The love of my... life.

You are the love of my life

I am amazed when I look at you,
I see you smiling back at me,
It's like all my dreams come true.
I am afraid if I lost you girl,
I'd fall through the cracks and lose my track,
In this crazy, lonely world.

Sometimes it's so hard to believe,
When my nights can be so long,
And faith gave me the strength,
and kept me holding on.

You are the love of my life,
And I'm so glad you found me,
You are the love of my life,
Baby put your arms around me,
I guess this is how it feels,
When you finally find something real.
My angel in the night, you are my love...
The love of my life.

Now here you are,
With midnight closing in.
You take my hand as our shadows dance,
With moonlight on your skin.
I look in your eyes,
I'm lost inside your kiss.
I think if I'd never met you,
about all the things I'd missed.

Sometimes it's so hard to believe,
When a love can be so strong,
And faith gives me the strength,
and kept me going on.

You are the love of my life,
And I'm so glad you found me,
You are the love of my life,
Baby put your arms around me,
I guess this is how it feels,
When you finally find something real.
My angel in the night, you're my love...
The love of my life.

You are the love of my life,
And I'm so glad you found me,
You are the love of my life,
Baby put your arms around me,
I guess this is how it feels,
When you finally find something real.
My angel in the night, you are my love...
My angel in the night, you are my love...
The love of my... life.