Sildenafil Citrate Tablets (Generic Viagra)

Common Uses
Sildenafil Citrate (generic 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.

Before using
If you have heart problems severe enough to make sexual activity a danger, you should avoid using Sildenafil Citrate (generic Viagra). Use it cautiously, if at all. If you've had a heart attack, stroke, or life-threatening heart irregularities within the past 6 months. Be equally cautious if you have severe high or low blood pressure, heart failure, or unstable angina (crushing heart pain that occurs at any time). If you take Sildenafil Citrate (generic Viagra) and develop cardiac symptoms (for example, dizziness, nausea, and chest pain) during sexual activity, do not continue. Alert your doctor of the problem as soon as possible. If you have a condition that might result in long-lasting erections, such as sickle cell anemia, multiple myeloma (a disease of the bone marrow), or leukemia, use Sildenafil Citrate (generic Viagra) with caution. Also use cautiously if you have a genital problem or deformity such as Peyronie''s disease. If an erection lasts more than 4 hours, seek treatment immediately. Permanent damage and impotence could result. If you have a bleeding disorder, a stomach ulcer, or the inherited eye condition known as retinitis pigmentosa, use this medication with caution. Its safety under these circumstances have not yet been studied. Remember that Sildenafil Citrate (generic Viagra) offers no protection against sexually transmitted diseases, such as HIV, the virus that causes AIDS. This drug is not to be used by women. Its effects during pregnancy have not been studied.

Directions
Taking Sildenafil Citrate (generic Viagra) approximately 1 hour before sexual activity works best for most men. Depending on how and when the drug works for you, an interval of one-half hour to as much as 4 hours may prove ideal.
If you miss a dose... Sildenafil Citrate (generic Viagra) is not for regular use. Take it only before sexual activity.
Storage instructions... Store at room temperature. Do not take Sildenafil Citrate (generic Viagra) if you are taking any nitrate-based drug, including nitroglycerin patches (Nitro-Dur, Transderm-Nitro), nitroglycerin ointment (Nitro-Bid, Nitrol), nitroglycerin pills (Nitro-Bid, Nitrostat), and isosorbide pills (Dilatrate-SR, Isordil, Sorbitrate). Combining Sildenafil Citrate with these drugs can cause a severe drop in blood pressure. If Sildenafil Citrate (generic Viagra) gives you an allergic reaction, do not use it again.

Cautions
DO NOT EXCEED THE RECOMMENDED DOSE without checking with your doctor. DO NOT TAKE THIS MEDICINE MORE THAN once a day. DO NOT TAKE THIS MEDICINE IF YOU TAKE OR USE NITROGLYCERIN, including nitroglycerin tablets, patches, or ointment, OR OTHER NITRATES, such as isosorbide. If you are not sure whether a certain medicine is a nitrate, contact your doctor or pharmacist. USE OF THIS MEDICINE WILL NOT PREVENT the spread of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV). BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist.

Possible side effects
More common side effects may include: Abnormal vision (color tinge, blurring, sensitivity to light),acid indigestion, diarrhea, flushing, headache, nasal congestion, urinary tract infection. Less common to rare side effects may include: Abdominal pain,abnormal dreams, abnormal ejaculation, allergic reactions, anxiety, asthma, bloodshot eyes, bone pain, breast enlargement, cataracts, chest pain, chills,coordination problems, cough,depression, difficulty breathing, difficulty swallowing, dilated pupils, dizziness, drowsiness, dry eyes, dry mouth, emotional or mental 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, insomnia, itchy skin, joint disease, light sensitivity, loss of bladder control (urinary incontinence), low blood pressure, migraine headache, muscle ache, numbness, oral inflammation, pain, painful erection, prolonged erection, raised skin patches, rapid or throbbing heartbeat, rectal bleeding, respiratory inflammation, ringing in the ears, seizure, sinus and throat inflammation, skin rash, skin ulcer, slow reflexes, stomach or intestinal inflammation, sweating, swelling, thirst, tremor, vomiting, weakness, heart attack, stroke, heart irregularities, dangerous surges in blood pressure, and sudden death have all been reported after use of Sildenafil Citrate, usually in men with existing cardiac risk factors, and typically during or shortly after sex.

Food and Drug interaction
If Sildenafil Citrate (generic 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 Sildenafil Citrate with the following: Other impotence remedies including Caverject and Muse 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 (Norvir) Saquinavir (Fortovase, Invirase).

Dosage
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, ketoconazole, 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 Sildenafil Citrate (generic Viagra) only before sexual activity. The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).

Overdose, if you take too much
No overdose of Sildenafil Citrate (generic Viagra) has been reported. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Additional information
If your symptoms do not improve or if they become worse, check with your doctor. DO NOT SHARE THIS MEDICINE with others for whom it was not prescribed. DO NOT USE THIS MEDICINE for other health conditions. KEEP THIS PRODUCT out of the reach of children. IF USING THIS MEDICINE FOR AN EXTENDED PERIOD OF TIME, obtain refills before your supply runs out.