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Other medical problems
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 side effects can this medication cause?
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

Description
Viagra is the first oral drug for male impotence. It works by dilating blood vessels in the penis, allowing the inflow of blood needed for an erection.

Special warnings about this medication
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.

Drug Interactions
If Viagra is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Viagra with the foll owing:

- Other impotence remedies including Caverject and Muse
- Alpha-blockers such as doxazosin (Cardura)
- Amlodipine (Norvasc)
- Cimetidine (Tagamet)
- Erythromycin ( E-Mycin, Ery-Tab, PCE)
- Itraconazole (Sporanox)
- Ketoconazole (Nizoral)
- Nitrates such as Isordil, Nitro-Bid, and Nitro-Dur
- Rifampin (Rifadin, Rimactane)
- Ritonavir (Nor vir)
- Saquinavir (Fortovase, Invirase)

How should you take this medication?
Doses range from 25 milligrams to 100 milligrams, depending on the drug's effect. The usual dose is 50 milligrams. If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoco nazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient. Your doctor will adjust the dosage if the drug is not working properly for you.

Take Viagra only bef ore sexual activity. The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).

To avoid low blood pressure, do not take the 50-milligram or 10 0-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.


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