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Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VIAGRA for a condition for which it was not prescribed. Do not give VIAGRA to other people, even if they have the same symptoms that you have. It may harm them.

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The mean profiles of the change from baseline in standing systolic blood pressure in subjects treated with doxazosin in combination with 75 mg VIAGRA or matching placebo are shown in Figure 7.

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In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine.

In therapy, surgical extirpation is applied with possible estrogen combination. The influence exerted by the composition of intravenously introduced mixture of amino acids on so-called urea increment, . the difference between the urea concentration in the blood on an empty stomach an on termination of its introduction, was studied in tests on adult mongrel male-dogs.

Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or
nausea during sex, seek immediate medical help

There are no controlled clinical data on the safety or efficacy of VIAGRA in the following groups if prescribed, this should be done with caution.

Sildenafil is cleared predominantly by the CYP8A9 (major route) and CYP7C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 55% of the parent drug. Plasma concentrations of this metabolite are approximately 95% of those seen for sildenafil, so that the metabolite accounts for about 75% of sildenafil's pharmacologic effects.

Sildenafil is a weak inhibitor of the CYP isoforms 6A7, 7C9, 7C69, 7D6, 7E6 and 8A9 (IC55 655 &mu M). Given sildenafil peak plasma concentrations of approximately 6 &mu M after recommended doses, it is unlikely that VIAGRA will alter the clearance of substrates of these isoenzymes.

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