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<br> <br>Treatment with doxazosin continued for at least 7 days after dose period 1. Thereafter, VIAGRA 100 mg or matching placebo was administered simultaneously with doxazosin 4 mg (14 subjects) or doxazosin 8 mg (6 subjects) in standard crossover fashion. If you are taking sildenafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. The best time to take sildenafil is about 1 hour before sexual activity, but you can take the medication any time from 4 hours to 30 minutes before sexual activity. Sildenafil usually should not be taken more than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take sildenafil less often. How sildenafil is used Therefore, PDE5 inhibitors, including VIAGRA, shouldbe used with caution in these patients and only when the anticipated benefitsoutweigh the risks. Each oral medicine for ED has a slightly different chemical makeup. These small differences affect the way each medication works, such as how quickly it takes effect and wears off, and the possible side effects. Your doctor or other health care professional can recommend one for you based on these factors, other health conditions you have and any other medicines you take. In erectile dysfunction, however, blood flow to the penis can be too low and disrupt the ability to get or maintain an erection. The kidneys, liver, or heart of older adults may not work as well as they used to. As a result, a higher amount of a drug stays in your body for a longer time. Generic oral tablets are available for both conditions, but the brand-name drugs each treat only one of the conditions. There are several other methods for managing erectile dysfunction, including taking other medications, making lifestyle changes, and seeking therapy or counseling. VIAGRA does not protect against sexually transmitted diseases, including HIV. Contact your care team right away if you have an erection that lasts longer than 4 hours or if it becomes painful. Nitric oxide then activates the enzyme, guanylate cyclase, which causes the production of cyclic guanosine monophosphate (cGMP). It is the cGMP that is primarily responsible for the erection by affecting the amount of blood that the blood vessels deliver and remove from the penis. People with erectile dysfunction find it difficult reach or maintain an erection, even during sexual arousal. The condition can have a variety of causes, but it usually relates to poor blood flow to the penis. Your doctor will start you on the VIAGRA dose he or she thinks is right for you. Based on effectiveness and toleration, the dose may be increased to a maximum recommended dose of 100 mgor decreased to 25 mg. The maximum recommended dose of 100 mg sildenafil was not evaluated in this study [see DRUG INTERACTIONS]. The effectiveness of VIAGRA was evaluated in most studies using several assessment instruments. The patient addressed both questions at the final visit for the last 4 weeks of the study. The possible categorical responses to these questions were (0) no attempted intercourse, (1) never or almost never, buy xanax without prescrition (2) a few times, (3) sometimes, (4) most times, and (5) almost always or always. Also collected as part of the IIEF was information about other aspects of sexual function, including information on erectile function, orgasm, desire, satisfaction with intercourse, and overall sexual satisfaction. There was no effect on sperm motility or morphology after single 100 mg oral doses of VIAGRA in healthy volunteers. However, since higher plasma levels may increase theincidence of adverse reactions, a starting dose of 25 mg should be consideredin older subjects due to the higher systemic exposure [see DOSAGE ANDADMINISTRATION]. Physicians should informpatients not to take VIAGRA with other PDE5 inhibitors including REVATIO orother pulmonary arterial hypertension (PAH) treatments containing sildenafil.Sildenafil is also marketed as REVATIO for the treatment of PAH. The safety andefficacy of VIAGRA with other PDE5 inhibitors, including REVATIO, have not beenstudied [see WARNINGS AND PRECAUTIONS]. Use caution when co-administering alpha-blockers with VIAGRA because of potential additive blood pressure-lowering effects. The most common adverse reactions reported in clinical trials (≥ 2%) are headache, flushing, dyspepsia, abnormal vision, nasal congestion, back pain, myalgia, nausea, dizziness, and rash. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of VIAGRA without sexual activity. Others were reported to have occurred hours to days after the use of VIAGRA and sexual activity. They enhance the effects of a chemical the body makes that relaxes muscles in the penis, called nitric oxide. This patient had been taking minoxidil, a potent vasodilator, during the study. VIAGRA is contraindicated in patients with a known hypersensitivity to sildenafil, as contained in VIAGRA and REVATIO, or any component of the tablet. Hypersensitivity reactions have been reported, including rash and urticaria [see ADVERSE REACTIONS]. The following adverse reactions have been identified during post approval use of VIAGRA. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events have been chosen for inclusion either due to their seriousness, reporting frequency, lack of clear alternative causation, or a combination of these factors. However, in vitro studies withhuman platelets indicate that sildenafil potentiates the antiaggregatory effectof sodium nitroprusside (a nitric oxide donor). In addition, the combination of heparin and VIAGRA had an additive effect on bleeding time in the anesthetizedrabbit, but this interaction has not been studied in humans. VIAGRA has systemic vasodilatory properties and mayfurther lower blood pressure in patients taking antihypertensive medications. When VIAGRA 100 mg was co-administered with amlodipine (5 mg or 10 mg) to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic [see WARNINGS AND PRECAUTIONS, CLINICAL PHARMACOLOGY]. In placebo-controlled clinical studies, the discontinuation rate due to adverse reactions for VIAGRA (2.5%) was not significantly different from placebo (2.3%). <br>