Sildenafil costco

Blood pressure: Tell your doctor if you are taking medications to treat high blood pressure.

The combination of these medications and sildenafil may add to the blood pressure-lowering effect of these medications. You should also let your doctor know if you have or have had low blood pressure.

Grapefruit juice: Grapefruit juice can increase the amount of sildenafil in your bloodstream. Do not drink grapefruit juice when taking this medication.

Hearing problems: If you experience a sudden decrease or loss of hearing you should seek medical attention immediately. Heart conditions: If you have or have had heart disease or a heart attack or stroke, you should speak to your doctor before taking any medication for erectile dysfunction.

If chest pains, dizziness, or nausea are experienced during sex, the exertion should be stopped and your doctor informed.

Kidney problems: If you have poor kidney function you may need lower doses of this medication.

Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects.

If you have kidney problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: If you have poor liver function you may need lower doses of this medication.

Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects.

If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Nitrate-containing medications: Sildenafil should never be taken with any medications that contain nitrates.

Blood pressure may suddenly drop to life-threatening levels if sildenafil is taken with any nitrate-containing medication (e.g., nitroglycerin tablets, spray, or patches) or any other nitrates (e.g., isosorbide dinitrate or amyl nitrite "poppers").

Dizziness, fainting spells, heart attack, or stroke may be experienced. If use of a nitrate-containing medication is considered medically necessary, you must wait 48 hours after the last dose of sildenafil before taking a nitrate, and only under close medical supervision. Penis deformation: As with other medications for erectile dysfunction, men with an anatomical deformation of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease should be closely monitored by their doctors if they take this medication.

Prolonged erection: If an erection lasts longer than 4 hours (a rare occurrence), seek immediate medical assistance.

If this condition is not treated quickly, tissue damage and permanent loss of the ability to have an erection could result.

Prostate problems:

Tell

Sexually transmitted infections: Sildenafil does not protect against sexually transmitted infections such as HIV.

Vision problems/eye conditions: If you experience a sudden loss of vision in one or both eyes or other vision related problems, contact your doctor immediately. While in some cases the condition may improve over time, it can also be permanent. This rare condition is more likely to occur if you have heart disease, high blood pressure, high cholesterol, diabetes, or

eye

Seniors: If you are 65 years of age or older, you may need a lower dose of this medication. What other drugs could interact with this medication?

There may be an interaction between sildenafil and any of the following: Grapefruit juice may increase the amounts of sildenafil in sildenafil tablets for sale the blood.

A high-fat meal may reduce the effectiveness of sildenafil. If you are taking any of these medications, speak with your doctor or pharmacist.

Depending on your specific circumstances, your doctor may want you to: stop taking one of the medications, change one of the medications to another, change how you are taking one or both of the medications, or leave everything as is. An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than the ones listed above may interact with this medication.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications melrose pharmacy sildenafil that you are taking.

Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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Clinical particulars 4.1 Therapeutic indications 4.2 Posology and method of administration 4.3 Contraindications 4.4 Special warnings and precautions for use 4.5 Interaction with other medicinal products and other forms of interaction 4.6 Fertility, pregnancy and lactation 4.7 Effects on ability to drive and use machines 4.8 Undesirable effects 4.9 Overdose 5.

Pharmacological properties 5.1 Pharmacodynamic properties 5.2 Pharmacokinetic properties 5.3 Preclinical safety data 6. Pharmaceutical particulars 6.1 List of excipients 6.2 Incompatibilities 6.3 Shelf life 6.4 Special precautions for storage 6.5 Nature and contents of container 6.6 Special precautions for disposal and other handling 7.

Date of first authorisation/renewal of the authorisation 10. This information is intended for use by health professionals.

Each tablet contains 25 mg, 50 mg or 100 mg of sildenafil (as citrate) Excipient with known effect : Lactose monohydrate. 25 mg: White to off-white, rounded diamond-shaped tablets, of dimensions 9.2 x sildenafil costco 6.7 mm, marked ?25? on one side.

50 mg: White to off-white, rounded diamond-shaped tablets, of dimensions 11.2 x 8.1 mm, marked ?50? on one side.

100 mg: White to off-white, rounded diamond-shaped tablets, of dimensions 14.1 x 10.2 mm, marked ?100? on one side.

Treatment of men with erectile dysfunction, which is the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance.

In order for Sildenafil to be effective, sexual stimulation is required.

The recommended dose is 50 mg taken as needed approximately one hour before sexual activity.

Based on efficacy and tolerability, the dose may be increased to 100 mg or decreased to 25 mg. The maximum recommended dosing frequency is once per day.

If Sildenafil is taken with food, the onset of activity may be delayed compared to the fasted state (see section 5.2).

Dosage adjustments are not required in elderly patients (? 65 years old). The dosing recommendations described in 'Use in adults' apply to patients with mild to moderate renal impairment (creatinine clearance = 30 - 80 mL/min).

Since sildenafil clearance is reduced in patients with severe renal impairment (creatinine clearance 150 ?M). Given sildenafil peak plasma concentrations of approximately 1 ?M after recommended doses, it is unlikely that Sildenafil will alter the clearance of substrates of these isoenzymes.

There are no data on the interaction of sildenafil and non-specific phosphodiesterase inhibitors such as theophylline or dipyridamole.

In vivo studies: Consistent with its known effects on the nitric oxide/cGMP pathway (see section 5.1), sildenafil was shown to potentiate the hypotensive effects of nitrates, and its co-administration with nitric oxide donors or nitrates in any form is therefore contraindicated (see section 4.3). Riociguat: Preclinical studies showed additive systemic blood pressure lowering effect when PDE5 inhibitors were combined with riociguat. In clinical studies, riociguat has been shown to augment the hypotensive effects of PDE5 inhibitors. There was no evidence of favourable clinical effect of the combination in the population studied. Concomitant use of riociguat with PDE5 inhibitors, including sildenafil, is contraindicated (see section 4.3).

Concomitant administration of sildenafil to patients taking alpha-blocker therapy may lead to symptomatic hypotension in a few susceptible individuals.

This is most likely to occur within 4 hours post sildenafil dosing (see sections 4.2 and 4.4). In three specific drug-drug interaction studies, the alpha-blocker doxazosin (4 mg and 8 mg) and sildenafil (25 mg, 50 mg, or 100 mg) were administered simultaneously to patients with benign prostatic hyperplasia (BPH) stabilized on doxazosin therapy. In these study populations, mean additional reductions of supine blood pressure of 7/7 mmHg, 9/5 mmHg, and 8/4 mmHg, and mean additional reductions of standing blood pressure of 6/6 mmHg, 11/4 mmHg, and 4/5 mmHg, respectively, were observed.

When sildenafil and doxazosin were administered simultaneously to patients stabilized on doxazosin therapy, there were infrequent reports of patients who experienced symptomatic postural hypotension.

These reports included dizziness and light-headedness, but not syncope.

No significant interactions were shown when sildenafil (50 mg) was co-administered with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolised by CYP2C9. Sildenafil (50 mg) did not potentiate the increase in bleeding time caused by acetyl salicylic acid (150 mg). Sildenafil (50 mg) did not potentiate the hypotensive effects of alcohol in healthy volunteers with mean maximum blood alcohol levels of 80 mg/dl. Pooling of the following classes of antihypertensive medication: diuretics, beta-blockers, ACE inhibitors, angiotensin II antagonists, antihypertensive medicinal products (vasodilator and centrally-acting), adrenergic neurone blockers, calcium channel blockers and alpha-adrenoceptor blockers, showed no difference in the side effect profile in patients taking sildenafil compared to placebo treatment. In a specific interaction study, where sildenafil (100 mg) was co-administered with amlodipine sildenafil dapoxetine tablets online in hypertensive patients, there was an additional reduction on supine systolic blood pressure of 8 mmHg.

The corresponding additional reduction in supine diastolic blood pressure was 7 mmHg.

These additional blood pressure reductions were of a similar magnitude to those seen when sildenafil was administered alone to healthy volunteers (see section 5.1). Sildenafil (100 mg) did not affect the steady state pharmacokinetics of the HIV protease inhibitors, saquinavir and ritonavir, both of which are CYP3A4 substrates.

In healthy male volunteers, sildenafil at steady state (80 mg t.i.d.) resulted in a 49.8% increase in bosentan AUC and a 42% increase in bosentan C max (125 mg b.i.d.).

There are no adequate and well-controlled studies in pregnant or breast-feeding women. No relevant adverse effects were found in reproduction studies in rats and rabbits following oral administration of sildenafil. There was no effect on sperm motility or morphology after single 100 mg oral doses of sildenafil in healthy volunteers (see section 5.1).

Sildenafil Pfizer may have a minor influence on the ability to drive and use machines. As dizziness and altered vision were reported in clinical trials with sildenafil, patients should be aware of how they react to Sildenafil, before driving or operating machinery.

The safety profile of Sildenafil Pfizer is based on 9,570 patients in 74 double-blind placebo-controlled clinical studies. The most commonly reported adverse reactions in clinical studies among sildenafil treated patients were headache, flushing, dyspepsia, nasal congestion, dizziness, nausea, hot flush, visual disturbance, cyanopsia and vision blurred.

Adverse reactions from post-marketing surveillance has been gathered covering an estimated period >10 years.

Because not all adverse reactions are reported to the Marketing Authorisation Holder and included in the safety database, the frequencies of these reactions cannot be reliably determined.