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What special precautions should I follow?
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:
- Arrhythmias (irregular heartbeat) or
- Conditions causing thickened blood or slower blood flow, including leukemia; multiple myeloma (tumors of the bone marrow); or polycythemia, sickle cell disease, and thrombocythemia (blood problems) or
- Priapism (history of)—Although Viagra does not cause priapism (erection lasting longer than 6 hours), patients with these conditions have an increased risk of priapism and it could occur w ile using Viagra

Precautions while Using this Medicine
Viagra has not been studied with other medicines used for treatment of erectile dysfunction. Presently, using them together is not recommended .
-
- Use Viagra exactly as directed by your doc tor. 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 erec tion for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent tissue damage of the penis and possible permanent impotence.

Why is this medication 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 Taking This Medicine
Pregnancy—Viagra is not indicated for use in women. Viagra has not been studied in pregnant women. However, Viagra has not been shown to cause birth defects or other problems in animal studies.

Possible Side Effect
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

- Abnormal visio n, including blurred vision, seeing shades of colors differently than before, or sensitivity to light; bladder pain; cloudy or bloody urine; dizziness; increased frequency of urination ; pain on urination

- Bleeding of the eye; convulsions (seizures) ; decreased vision or other changes in vision; double vision; prolonged, painful, or inappropriate erection of penis; redness, b urning, or swelling of the eye; vision loss, temporary

Significant 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