Sildenafil has been on the market for more than 8 years. Morales and colleagues (1998) provided summarized safety until 1998 and Padma-Nathan and colleagues (2002) provided long-term safety data (>4 years). The most commonly reported treatment-related adverse events are headache, facial flushing, dyspepsia, dizziness, nasal congestion, abnormal vision, and palpitation (Table ​(Table2).2). Other adverse events uncommonly or rarely reported include back pain, influenza-like syndrome, rash, vomiting, diarrhea, cardiac arrhythmia, and hypersensitivity reactions. Adverse events are dose related, mild in nature, self-limited by continuous use. The drop-out rate due to adverse events is similar to placebo (2% for sildenafil vs 2.3% for placebo). Post-marketing case series reported higher incidence of adverse events, especially for headache (9%–39%), flushing (7%–33%) and abnormal vision (5%–11%) (Zippe et al 1998; Jarow et al 1999; Marks et al 1999; McMahon et al 2000; Moreira et al 2000; Fagelman et al 2001; Guay et al 2001; Martinez-Jabaloyas et al 2001; Palumbo et al 2001). Patients may tolerate sildenafil differently based on existing comorbidities. Ischemic heart disease and hypertension are associated with higher incidence of adverse events than diabetes (3.6%, 2.3%, and 1.9%, respectively) (Padma-Nathan et al 2002). Visual disturbances (blurred vision, flashing lights, blue haze, and change in color perception) occur due to weak inhibition of PDE6 in the retina. They are coincident with peak plasma concentrations of sildenafil and are transient and fully reversible. None persisted 6 hours after taking sildenafil and rarely consist a reason to discontinue treatment.

medicines called alpha-blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of VIAGRA with alpha-blockers can lead to a drop in blood pressure or to fainting
At his last visit, Mr. Jones was prescribed Imdur (isosorbide mononitrate) to help with his heart condition. Reading through the notes, it looks like the Imdur worked. He was feeling better, so much better that he wanted to start having sex with his wife again. And here was the problem: Mr. Jone’s doctor had renewed his Cialis prescription. Quickly, I went from a moment of elation to consternation.
The phrase “use it before you lose it” can be applied when it comes to helping men with ED regain normal erectile function. Pelvic exercises, more commonly known as kegel exercises, are used to promote urinary continence and sexual health. They help to strengthen the bulbocavernosus muscle, which does three things: allows the penis to engorge with blood during erection, it pumps during ejaculation, and it helps empty the urethra after urination, according to Healthline.
×