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Effects of VIAGRA on Blood Pressure When Nitroglycerin is Subsequently Administered.

This Patient Information leaflet summarizes the most important information about VIAGRAIf you would like more informationtalk with your healthcare providerYou can ask your healthcare provider or pharmacist for information about VIAGRA that is written for health professionals.

Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitorsPatients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitorIn those patients who are stable on alpha-blocker therapyPDE5 inhibitors should be initiated at the lowest dosesee DOSAGE AND ADMINISTRATIONIn those patients already taking an optimized dose of a PDE5 inhibitoralpha-blocker therapy should be initiated at the lowest doseStepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure when taking a PDE5 inhibitorSafety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variablesincluding intravascular volume depletion and other anti-hypertensive drugs.

VIAGRA is not indicated for use in womenThere are no adequate and well-controlled studies of sildenafil in pregnant women.

After patients have taken VIAGRAit is unknown when nitratesif necessarycan be safely administeredAlthough plasma levels of sildenafil at 24 hours post dose are much lower than at peak concentrationit is unknown whether nitrates can be safely co-administered at this time pointsee DOSAGE AND ADMINISTRATIONDRUG INTERACTIONSand CLINICAL PHARMACOLOGY

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