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Why is this drug prescribed?
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

Before Using This Medicine
The presence of other medical problems may affect the use of Viagra. Make sure you tell your doctor if you have any other medical problems, especially:
- Heart or blood disease—Sexual activity i creases the heart rate and blood flow and can increase the chance of problems occurring for some patients who use any type of medicine, including Viagra, that increases sexual ability
- Kidney pr oblems (severe) or
- Liver problems (severe)—Chance of problems occurring may be increased. Lower starting doses may be used and doses increased as needed and as tolerated

What special precautions should I follow?
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?
Less common to rare side effects may include:
- Abdominal pain, abnormal dreams, abnormal ejaculation, allergic reactions, anxiety, asthma, bloodshot eyes, bone pain, breast enlargement, cataract s, chest pain, chills, coordination problems, cough, depression, difficulty breathing, difficulty swallowing, dilated pupils, dizziness, double vision, drowsiness, dry eyes, dry mouth, emotional or me ntal disturbances, eye inflammation or pain, other eye disorders, fainting, falling, genital problems, gout, gum inflammation, heart problems, increased night-time urination, increased pressure in the eyes,

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.

How should this medicine be used?
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.