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You should not use SildenafilI with treatments for pulmonary arterialhypertension (PAH) containing sildenafil or any other PDE5 inhibitors. Currently the only dose of Viagra available over the counter in the UK is 50mg, which is available as Viagra Connect. Other doses may become available over the counter in the future.You can buy all doses of Viagra online without having to see a doctor or pharmacist face-to-face.
Studies in vitro have shown that sildenafil is selective for PDE5, which is involved in the erection process. Its effect is more potent on PDE5 than on other known phosphodiesterases. There is a 10-fold selectivity over PDE6 which is involved in the phototransduction pathway in the retina. At maximum recommended doses, there is an 80-fold selectivity over PDE1, and over 700-fold over PDE2, 3, 4, 7, 8, 9, 10 and 11. In particular, sildenafil has greater than 4,000-fold selectivity for PDE5 over PDE3, the cAMP-specific phosphodiesterase isoform involved in the control of cardiac contractility. As dizziness and altered vision were reported in clinical trials with sildenafil, patients should be aware of how they react to VIAGRA, before driving or operating machinery.
Physicians should advise patients of the potential for VIAGRA to augment the blood pressure lowering effect of alpha-blockers and anti-hypertensive medications. Concomitant administration of VIAGRA and an alpha-blocker may lead to symptomatic hypotension in some patients. The AUC of the active metabolite, N-desmethyl sildenafil, was increased 62% by loop and potassium-sparing diuretics and 102% by nonspecific beta-blockers. These effects on the metabolite are not expected to be of clinical consequence.
If you have any questions or concerns about your prescription, you should discuss them with your healthcare provider. Sildenafil, the active ingredient in Viagra, is a phosphodiesterase type 5 (PDE5) inhibitor. It works by relaxing blood vessels in the penis, allowing increased blood flow during sexual stimulation, which helps achieve and maintain an erection. Whilst Viagra 50mg tends to be the normal Viagra dose to start on, this isn’t the case for everyone.
So aside from keeping your Sildenafil close by or in your bedside draw, you don’t need to plan very far in advance before sex – which gives you extra flexibility and peace of mind. Even if you’re a man with a very active sex life, you should be covered. While it’s possible to take Sildenafil every day, there is a restriction on the daily dosage. In any case, studies have shown that a higher dose than 100mg in one day doesn’t have any added benefit – and could increase the chances of side effects.
The studies that established benefit demonstrated improvements in success rates for sexual intercourse compared with placebo. Physicians should advise patients to stop use of all phosphodiesterase type 5 (PDE5) inhibitors, including VIAGRA, and seek medical attention in the event of a sudden loss of vision in one or both eyes. Based on published literature, the annual incidence of NAION is 2.5–11.8 cases per 100,000 in males aged ≥ 50. The results suggest an approximate 2-fold increase in the risk of NAION, with a risk estimate of 2.15 (95% CI 1.06, 4.34). A similar study reported a consistent result, with a risk estimate of 2.27 (95% CI 0.99, 5.20). Other risk factors for NAION, such as the presence of "crowded" optic disc, may have contributed to the occurrence of NAION in these studies.
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Sildenafil is used to treat men who have erectile dysfunction (also called sexual impotence). These medicines prevent an enzyme called phosphodiesterase type-5 from working too quickly. Your doctor may start treatment with a lower dose of sildenafil to minimize your risk of low blood pressure.
If you experience any side effects, stop using the medication and seek immediate medical attention. When taken as prescribed, Viagra can help you get hard so you can engage in sexual activity but do not expect it to do all the work. Moderate to heavy drinking can make it — er — harder for you to get an erection.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. If you experience a sudden loss of vision in one or both eyes, contact your doctor immediately. It is important that you tell all of your doctors that you take sildenafil.
Hearing loss, indigestion, and vision loss are all possible side effects too – however, they are very uncommon. Always use this medicine exactly as per your doctor instruction or take advice from your pharmacist. Take the tablet, capsule, or liquid form by mouth 
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