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Caution is advised when PDE5 inhibitors are co-administered with alpha-blockersPDE5 inhibitorsincluding VIAGRAand alpha-adrenergic blocking agents are both vasodilators with blood pressure lowering effectsWhen vasodilators are used in combinationan additive effect on blood pressure may occurIn some patientsconcomitant use of these two drug classes can lower blood pressure significantlysee DRUG INTERACTIONS and CLINICAL PHARMACOLOGYleading to symptomatic hypotensione.gdizzinesslightheadednessfainting
Men with untreated ED had relatively low baseline scores for all aspects of sexual function measuredagain using a 5-point scalein the IIEFVIAGRA improved these aspects of sexual functionfrequencyfirmness and maintenance of erectionsfrequency of orgasmfrequency and level of desirefrequencysatisfaction and enjoyment of intercourseand overall relationship satisfaction.
Sildenafil metabolism is principally mediated by CYP3A4major routeand CYP2C9minor routeThereforeinhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearanceThe concomitant use of erythromycin or strong CYP3A4 inhibitorse.gsaquinavirketoconazoleitraconazoleas well as the nonspecific CYP inhibitorcimetidineis associated with increased plasma levels of sildenafilsee DOSAGE AND ADMINISTRATION
There are no controlled clinical data on the safety or efficacy of VIAGRA in the following groupsif prescribedthis should be done with caution.
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