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Drug Interactions
When you are taking Viagra, 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 Inv irase)—These medicines may increase the unwanted effects of Viagra, unless lower starting doses of Viagra are used
- Nitrates, such as nitroglycerin (e.g., Nitrostat or Transderm-Nitro)—Viagra creases the lowering of blood pressure by nitrates too much and their use together is not recommended

Before Using This Medicine
Before taking Viagra,

tell your doctor and pharmacist if you are allergic to Viagra or any other drugs.
tell your doctor if you have or have ever had a bleeding disorder; heart, kidney, or liver disease; a heart attack; irregular heartbeats; angina; a stroke; high or low blood pressure; sickle cell anemia; multiple myeloma; leukemia; conditions affecting the shape of the penis (e.g., angulation, cavernosal fibrosa, or Peyronie's disease); or a condition known as retinitis pigmentosa.
if you are having surgery, including dental surgery, tell your doctor or dentist that you ta ke Viagra.
tell your doctor if you use amyl nitrate, amyl nitrite, or butyl nitrate.

What is this medicine
Viagra (sil-DEN-a-fil) belongs to a group of medicines that delay the enzymes called phosphodiesterases from working too quickly. The penis is one of the areas where these enzymes work. Viagra is used to treat men who have erectile dysfunction (also called sexual impotence).

By controlling the enzyme phosphodiesterase, Viagra helps to maintain an erection that is produced when the penis i s stroked. Without physical action to the penis, such as that occurring during sexual intercourse, Viagra will not work to cause an erection

How should this medicine be used?
Viagra comes as a tablet to take by mouth. It should be taken as needed about 1 hour before sexual activity. However, Viagra can be taken anytime from 4 hours to 30 minutes before sexual activity. Via gra should not be taken more than once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take Viagra exact ly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Possible Side Effect
Although side effects from Viagra are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

- headache
- upset stomach
- diarrhea
- dizziness or lightheadedness
- flushing (feeling of warmth)
- nasal congestion (stuffiness)
- changes in vision
- breast enlargement

If you experience any of the follo wing symptoms, call your doctor immediately:

- rash
- painful erection
- prolonged erection (longer than 4 hours)
- fainting
- chest pain
- itching or burning during urination

Cautions
Use Viagra 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 possi ble permanent impotence.