SILDENAFIL belongs to a group of medicines called phosphodiesterase type 5 inhibitors. It works by helping to relax the blood vessels in your penis, allowing blood to flow into your penis when you get sexually excited. SILDENAFIL will only help you to get an erection if you are sexually stimulated. You should not take SILDENAFIL if you do not have erectile dysfunction. You should not take SILDENAFIL if you are a woman. SILDENAFIL is a treatment for men with erectile dysfunction, sometimes known as impotence. This is when a man cannot get, or keep a hard, erect penis suitable for sexual activity. 2. BEFORE YOU TAKE SILDENAFIL Do not take SILDENAFIL If you are taking medicines containing nitrates, or nitric oxide donors such as amyl nitrite ("poppers"). These medicines are often given for relief of angina pectoris (or "chest pain"). SILDENAFIL can cause a serious increase in the effects of these medicines. Tell your doctor if you are taking any of these medicines. If you are not certain, ask your doctor or pharmacist. If you are allergic (hypersensitive) to sildenafil or any of the other ingredients of SILDENAFIL . If you have a severe heart or liver problem. If you have recently had a stroke or a heart attack, or if you have low blood pressure. If you have certain rare inherited eye diseases (such as retinitis pigmentosa). If you have ever had loss of vision because of non-arteritic anterior ischaemic optic neuropathy (NAION) Take special care with SILDENAFIL Tell your doctor if you have sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), multiple myeloma (cancer of bone marrow) or any disease or deformity of your penis. These conditions may require special care when taking medicines for erectile dysfunction. if you have problems with your heart. Your doctor should in that case carefully check whether your heart can take the additional strain of having sex. if you currently have a stomach ulcer, or a bleeding disorder (such as haemophilia). if you experience sudden decrease or loss of vision, stop taking SILDENAFIL and contact your doctor immediately. You should not use SILDENAFIL with any other treatment for erectile dysfunction. Special considerations for children SILDENAFIL should not be given to children under the age of 18. Special considerations for patients with kidney or liver problems You should tell your doctor if you have kidney or liver problems. Your doctor may decide on a lower dose for you. Using other medicines Please tell your doctor or pharmacist if you are taking or have recently taken other medicines, including medicines obtained without prescription. SILDENAFIL tablets may interfere with some medicines, especially those used to treat chest pain. In the event of a medical emergency, you should tell anyone treating your condition that you have taken SILDENAFIL . Do not take SILDENAFIL with other medicines unless your doctor tells you that you can. SILDENAFIL may cause a serious increase in the effects of medicines called nitrates, and nitric oxide donors such as amyl nitrite ("poppers"). These are often used for the relief of angina pectoris (or "chest pain"). You should not take SILDENAFIL if you are taking these medicines. If you are taking protease inhibitors, such as for the treatment of HIV, your doctor may start you on the lowest dose (25 mg) of SILDENAFIL . Some patients who take alpha-blocker therapy for the treatment of high blood pressure or prostate problems may experience dizziness or light-headedness upon standing. These are symptoms of postural hypotension which is low blood pressure upon sitting or standing up quickly. Certain patients have experienced these symptoms when taking SILDENAFIL with alpha-blockers. This is most likely to occur within 4 hours after taking SILDENAFIL . In order to reduce the likelihood that these symptoms occur, you should be on a regular daily dose of your alpha-blocker before you start SILDENAFIL . Your doctor may start you on a 25 mg dose of SILDENAFIL . Using SILDENAFIL with food and drink When SILDENAFIL is taken with food, it may take a little longer for SILDENAFIL to work. Pregnancy and Breast-feeding SILDENAFIL is not indicated for use by women Driving and using machines SILDENAFIL can cause dizziness and can affect vision. You should be aware of how you react to SILDENAFIL before you drive or use machinery. Important information about some of the ingredients of SILDENAFIL If you have been told by your doctor that you have an intolerance to some sugars, such as lactose, contact your doctor before taking SILDENAFIL . 3. HOW TO TAKE SILDENAFIL Always take SILDENAFIL exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. The usual dose is 50 mg. You should take SILDENAFIL about one hour before sexual activity. Swallow the tablet whole with some water. If you have the impression that the effect of SILDENAFIL is too strong or too weak, talk to your doctor or pharmacist. SILDENAFIL will only help you to get an erection if you are sexually stimulated. The amount of time SILDENAFIL takes to work varies from person to person, but it normally takes between half an hour and one hour. You may find that SILDENAFIL takes longer to work if you take it with a heavy meal. Drinking alcohol can temporarily impair the ability to get an erection. To get the maximum benefit from your medicine, you are advised not to drink large amounts of alcohol before taking SILDENAFIL . If SILDENAFIL does not help you to get an erection, or if your erection does not last long enough for you to complete sexual intercourse you should tell your doctor. You should not use SILDENAFIL more than once a day. If you take more SILDENAFIL than you should: A dose above 100 mg does not increase the efficacy. However, it will result in an increase in undesirable effects and their severity. You should not take more tablets than your doctor tells you to. Contact your doctor if you take more tablets than you should. If you have any further questions on the use of this product, ask your doctor or pharmacist. 4. POSSIBLE SIDE EFFECTS Like all medicines, SILDENAFIL can cause side effects although not everybody gets them. These effects are normally mild to moderate. In controlled clinical trials the most common side effects were headache or facial flushing and less commonly indigestion, dizziness, stuffy nose, pounding heartbeat, or effects on vision (including colour tinge to vision, increased brightness of light or blurred vision). Since its introduction on the market, the following events have been reported in men taking SILDENAFIL : vomiting, allergic reactions, skin rash, bloodshot eyes, eye pain, rapid heartbeat or nosebleed Partial, sudden, temporary, or permanent decrease or loss of vision in one or both eyes have been reported. Sudden decrease or loss of hearing has been reported. Prolonged and sometimes painful erections have been reported after taking SILDENAFIL . If you have such an erection which lasts continuously for more than 4 hours, you should contact a doctor immediately. Also, the following events have been reported: high blood pressure, low blood pressure, fainting, stroke, irregular heartbeat, chest pain, sudden death, heart attack or temporary decreased blood flow to parts of the brain. Most, but not all, of these men had heart problems before
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