Tell your healthcare provider if you have any side effect that bothers you or does not go away.Drug information on Revatio, Viagra (sildenafil (oral)), includes drug pictures,.Patients with cardiac failure or coronary artery disease causing unstable angina.Use caution when co-administering alpha-blockers with Viagra because of potential additive blood pressure-lowering effects.Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision including possible permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors.Cardiovascular: angina pectoris, AV block, migraine, syncope, tachycardia, palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy.Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach.

In the third study, a single oral dose of Viagra 100 mg or matching placebo was administered in a 3-period crossover design to 20 generally healthy males with BPH.Of the twenty subjects who were ultimately assigned to treatment, a total of 13 subjects successfully completed dose period 1, and seven had successfully completed the previous doxazosin study (using Viagra 50 mg).If it is not treated right away, priapism can permanently damage your penis.Viagra is a prescription medicine used to treat erectile dysfunction (ED).

Cimetidine (800 mg), a nonspecific CYP inhibitor, caused a 56% increase in plasma sildenafil concentrations when co-administered with Viagra (50 mg) to healthy volunteers.Hepatic Impairment: In volunteers with hepatic impairment (Child-Pugh Class A and B), sildenafil clearance was reduced, resulting in increases in AUC (85%) and C max (47%) compared to age-matched volunteers with no hepatic impairment.Sixty-three percent, 74%, and 82% of the patients on 25 mg, 50 mg and 100 mg of Viagra, respectively, reported an improvement in their erections, compared to 24% on placebo.

In another study in healthy male volunteers, co-administration with the HIV protease inhibitor ritonavir, which is a highly potent P450 inhibitor, at steady state (500 mg bid) with Viagra (100 mg single dose) resulted in a 300% (4-fold) increase in sildenafil C max and a 1000% (11-fold) increase in sildenafil plasma AUC.Sildenafil at recommended doses has no effect in the absence of sexual stimulation.Concomitant administration of Viagra and an alpha-blocker may lead to symptomatic hypotension in some patients.There are no adequate and well-controlled studies of sildenafil in pregnant women.

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Based on animal data, Viagra is not predicted to increase the risk of adverse developmental outcomes in humans.

This Patient Information leaflet summarizes the most important information about Viagra.Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mg or decreased to 25 mg.

There were no reports of postural dizziness or orthostatic hypotension.The evaluation of erectile dysfunction should include a determination of potential underlying causes and the identification of appropriate treatment following a complete medical assessment.In placebo-controlled clinical studies, the discontinuation rate due to adverse reactions for Viagra (2.5%) was not significantly different from placebo (2.3%).Studies in vitro have shown that sildenafil is selective for PDE5.Figure 1: Mean Change from Baseline in Sitting Systolic Blood Pressure, Healthy Volunteers.

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Physicians should warn patients that prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of Viagra.These events have been chosen for inclusion either due to their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors.Sildenafil has no direct relaxant effect on isolated human corpus cavernosum.

Physicians should consider whether their patients with underlying NAION risk factors could be adversely affected by use of PDE5 inhibitors.In humans, Viagra has no effect on bleeding time when taken alone or with aspirin.Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a rare condition and a cause of decreased vision including permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors.While there were no severe adverse events potentially related to blood pressure reported in this study, one subject reported moderate vasodilatation after both Viagra 50 mg and 100 mg.Physicians should inform patients not to take Viagra with other PDE5 inhibitors including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil.

Metabolic and Nutritional: thirst, edema, gout, unstable diabetes, hyperglycemia, peripheral edema, hyperuricemia, hypoglycemic reaction, hypernatremia.Viagra demonstrated statistically significant improvement compared to placebo in all 21 studies.Diary data indicated that on Viagra, 59% of attempts at sexual intercourse were successful compared to 13% on placebo.

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Even though this total dosage produced plasma sildenafil concentrations which were approximately 2 to 5 times higher than the mean maximum plasma concentrations following a single oral dose of 100 mg in healthy male volunteers, the hemodynamic response to exercise was preserved in these patients.