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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 Rosuvastatin sales 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

Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitorsPatients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitorIn those patients who are stable on alpha-blocker therapyPDE5 inhibitors should be initiated at the lowest dosesee DOSAGE AND ADMINISTRATIONIn those patients already taking an optimized dose of a PDE5 inhibitoralpha-blocker therapy should be initiated at the lowest doseStepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure when taking a PDE5 inhibitorSafety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variablesincluding intravascular volume depletion and other anti-hypertensive drugs.

Do not take Viagra if you are also using a nitrate drug for chest pain or heart problemsincluding nitroglycerinisosorbide dinitrateisosorbide mononitrateand some recreational drugs such aspoppersTaking sildenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

The most common adverse reactions reported in clinical trials2are headacheflushingdyspepsiaabnormal visionnasal congestionback painmyalgianauseadizzinessand rash.

The patients in studies had varying degrees of EDOne-third to one-half of the subjects in these studies reported successful intercourse at least once during a 4-weektreatment-free run-in period.

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