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Chemical Name: SILDENAFIL CITRATE

Common uses
This medicine is a phosphodiesterase inhibitor used to treat sexual function problems such as impotence or erectile dysfunction. In combination with sexual stimulation, this medicine works by helping the blood flow into the penis to achieve and maintain an erection. This medicine is not intended for use in women or children. This medicine will not protect against sexually transmitted diseases including HIV infection. Use "safe sex" practices such as latex condoms.

Before using
Do not take his medicine if you are also taking or using nitroglycerin, (e.g., tablet, patch, or ointment dose forms) or other nitrates (e.g., isosorbide), nitroprusside (or any "nitric oxide donor" medicine), or recreational drugs called "poppers" containing amyl or butyl nitrate because very serious interactions may occur. If you are not sure whether a certain medicine is a nitrate, contact your doctor or pharmacist. If you are currently using any of these medicines, tell your doctor or pharmacist before using sildenafil.
Additional monitoring of your dose or condition may be needed if you are taking other medicines for impotence, azole antifungals (e.g., itraconazole, ketoconazole), cimetidine, erythromycin, mibefradil, rifamycins (e.g., rifampin), high blood pressure medicines, or delavirdine. If you are taking an HIV protease inhibitor (e.g., ritonavir, saquinavir), do not take more than a 25 mg dose of sildenafil in a 48-hour period. If you are taking more than a 25 mg dose of sildenafil and are also taking an alpha-blocker medicine (e.g., doxazosin, prazosin, terazosin) for various conditions (e.g., enlarged prostate), separate the time between taking these medicines by more than 4 hours. See How To Use section for drug-food interaction information.
Do not start or stop any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions including penis conditions (e.g., angulation, fibrosis/scarring, Peyronie's disease), history of painful/prolonged erection (priapism), sickle cell anemia, blood system cancers (e.g., leukemia or myeloma), eye problems (e.g., retina diseases like retinitis pigmentosa), kidney or liver disease, bleeding disorders, active stomach ulcers, heart problems (e.g., recent heart attack or serious arrhythmia within past 6 months, heart failure, coronary artery disease with unstable angina, aortic stenosis, idiopathic hypertrophic subaortic stenosis), recent stroke within past 6 months, very high or low blood pressure, or allergies.

Possible side effects
Side effects that may occur while taking this medicine include headache, flushing, stomach upset, heartburn, nasal stuffiness, diarrhea, dizziness, or lightheadedness. Vision changes such as increased sensitivity to light, blurred vision, or impaired blue/green color discrimination may also occur. If these continue or are bothersome, check with your doctor or pharmacist.
Sexual activity may put extra strain on your heart, especially if you have heart problems, if you have heart problems and experience any serious side effects while having sex, stop having sex and tell your doctor immediately. These side effects include severe dizziness, fainting, chest pain, or nausea. In the unlikely event that you have a painful or prolonged erection (lasting more than 4 hours), stop using this medicine and seek immediate medical attention or permanent problems could occur.
An allergic reaction to this medicine is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, unusual swelling, severe dizziness, or trouble breathing.

Directions
Take this medicine by mouth as needed between four hours and one-half hour before sexual activity (about 1 hour before is most effective); or take as directed by your doctor. Do not take this medicine more often than once daily as needed. A high fat meal may delay the time of onset of this medicine.
Avoid eating grapefruit or drinking grapefruin juice while being treated with this medicine unless your doctor instructs you otherwise. Your dosage is based on your medical condition, your response to therapy, and other medicines you are taking (see also Before Using section).
Store this medicine at room temperature 77 degrees F (25 degrees C) in a tightly-closed container, away from heat, moisture, and light. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted.


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