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VIAGRA

IMPORTANT NOTE: The following information is intended to
supplement, not substitute for, the expertise and judgment of
your physician, pharmacist or other healthcare professional. It
should not be construed to indicate that use of the drug is safe,
appropriate, or effective for you. Consult your healthcare
professional before using this drug.

SILDENAFIL - ORAL
(sill-DEN-uh-fil)

COMMON BRAND NAME(S): Viagra

USES: Sildenafil is used to treat male sexual function problems
(impotence or erectile dysfunction) by blocking a certain enzyme
(phosphodiesterase-PDE5) in the body. In combination with sexual
stimulation, sildenafil works by helping the blood flow into the
penis to achieve and maintain an erection.
This drug is not indicated for use in women.
Use of this drug does not protect against sexually transmitted
diseases (e.g., HIV, hepatitis B, gonorrhea, syphilis). Practice
"safe sex" such as using latex condoms. Consult your doctor or
pharmacist for more details.

HOW TO USE: This drug is taken by mouth as needed, at least 30
minutes, but no more than 4 hours, before sexual activity (1 hour
before is the most effective). Do not take more often than once
daily, and take as directed.
A high fat meal may delay the time of onset of this drug.
Avoid eating grapefruit or drinking grapefruit juice while you
are being treated with this medication unless your doctor
instructs you otherwise.
The dosage is based on your medical condition, response to
therapy, and other medications you may be taking (see also Drug
Interactions section). Consult your doctor or pharmacist for more
details.

SIDE EFFECTS: Headache, flushing, stomach upset, heartburn,
nasal stuffiness, diarrhea, dizziness, or lightheadedness may
occur. Vision changes such as increased sensitivity to light,
blurred vision, or impaired blue/green color discrimination may
also occur. If any of these effects persist or worsen, notify
your doctor or pharmacist promptly.
Sexual activity may put extra strain on your heart, especially
if you have heart problems. If you have heart problems and
experience any of these serious side effects while having sex,
stop and tell your doctor immediately of: severe dizziness,
fainting, chest pain, nausea.
In the unlikely event you have a painful or prolonged erection
(lasting more than 4 hours), stop using this drug and seek
immediate medical attention or permanent problems could occur.
A serious allergic reaction to this drug is unlikely, but seek
immediate medical attention if it occurs. Symptoms of a serious
allergic reaction include: rash, itching, unusual swelling,
severe dizziness, trouble breathing.
If you notice other effects not listed above, contact your
doctor or pharmacist.

PRECAUTIONS: Before taking sildenafil, tell your doctor or
pharmacist if you are allergic to it; or if you have any other
allergies.
Before using this medication, tell your doctor or pharmacist
your medical history, especially of: 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 disease, 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.
This drug may make you dizzy or cause vision changes; use
caution engaging in activities requiring alertness such as
driving or using machinery. Limit alcoholic beverages.
To minimize dizziness and lightheadedness, get up slowly when
rising from a seated or lying position.
Caution is advised when using this drug in the elderly because
they may be more sensitive to the side effects of the drug.
This drug is not indicated for use in women or children.

DRUG INTERACTIONS: See also How To Use section for drug-food
interactions.
This drug should not be used with the following medications
because very serious (possibly fatal) interactions may occur:
nitrates (e.g., nitroglycerin, isosorbide), nitroprusside (or any
"nitric oxide donor" drugs), recreational drugs called "poppers"
containing amyl or butyl nitrite.
If you are currently using any of these medications, tell your
doctor or pharmacist before starting sildenafil.
Before using this medication, tell your doctor or pharmacist
of all prescription and nonprescription products you may use,
especially of: other medications for impotence, azole antifungals
(e.g., itraconazole, ketoconazole), cimetidine, erythromycin,
mibefradil, rifamycins (e.g., rifampin), high blood pressure
medicines, delavirdine.
If you are taking an HIV protease inhibitor (e.g., ritonavir,
saquinavir), do not take more than a 25mg dose of sildenafil in a
48 hour period.
If you are taking more than a 25mg dose of sildenafil and are
also taking an alpha-blocker medication (e.g., doxazosin,
prazosin, terazosin) for various conditions (e.g., enlarged
prostate), separate the time between taking these medications by
more than 4 hours.
Do not start or stop any medicine without doctor or pharmacist
approval.

OVERDOSE: If overdose is suspected, contact your local poison
control center or emergency room immediately. US residents can
call the US national poison hotline at 1-800-222-1222. Canadian
residents should call their local poison control center directly.
Symptoms of overdose may include severe dizziness, fainting, or
prolonged erection.

NOTES: Do not share this medication with others, since they may
have a problem that is not effectively treated by this drug, or
they may have a condition that is complicated by this drug.

MISSED DOSE: Not applicable.

STORAGE: Store at room temperature at 77 degrees F (25 degrees
C) away from light and moisture. Brief storage between 59 and 86
degrees F (15-30 degrees C) is permitted. Do not store in the
bathroom. Keep all medicines away from children and pets.

The Information in this leaflet may be used as an educational aid. This information does not cover all possible uses, actions, precautions, side effects, or interactions of this medicine. This information is not intended as medical advice for individual problems.