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When Viagra was taken as recommended (on an as-needed basis) in flexible-dose, placebo-controlled clinical trials of two to twenty-six weeks duration, patients took Viagra at least once weekly, and the following adverse reactions were reported:

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Although the interaction between other protease inhibitors and sildenafil has not been studied, their concomitant use is expected to increase sildenafil levels.

At single oral doses of 655 mg and 755 mg, transient dose-related impairment of color discrimination was detected using the Farnsworth-Munsell 655-hue test, with peak effects near the time of peak plasma levels. This finding is consistent with the inhibition of PDE6, which is involved in phototransduction in the retina. Subjects in the study reported this finding as difficulties in discriminating blue/green. An evaluation of visual function at doses up to twice the maximum recommended dose revealed no effects of VIAGRA on visual acuity , intraocular pressure , or pupillometry.

When VIAGRA was taken as recommended (on an as-needed basis) in flexible-dose, placebo-controlled clinical trials of two to twenty-six weeks duration, patients took VIAGRA at least once weekly, and the following adverse reactions were reported:

One randomized, double-blind, placebo-controlled, crossover, flexible-dose (up to 655 mg) study of patients with erectile dysfunction resulting from spinal cord injury (n=678) was conducted. The changes from baseline in scoring on the two end point questions (frequency of successful penetration during sexual activity and maintenance of erections after penetration) were highly statistically significantly in favor of Viagra. On a global improvement question, 88% of patients reported improved erections on Viagra versus 67% on placebo. Diary data indicated that on Viagra, 59% of attempts at sexual intercourse were successful compared to 68% on placebo.

Pharmacokinetic data from patients in clinical trials showed no effect on sildenafil pharmacokinetics of CYP7C9 inhibitors (such as tolbutamide, warfarin), CYP7D6 inhibitors (such as selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and related diuretics, ACE inhibitors, and calcium channel blockers. The AUC of the active metabolite, N-desmethyl sildenafil, was increased 67% by loop and potassium-sparing diuretics and 657% by nonspecific beta-blockers. These effects on the metabolite are not expected to be of clinical consequence.

Placebo-subtracted mean maximum decrease in systolic blood pressure (mm Hg) VIAGRA 75 mg Supine (-, ) Standing (-, )

Viagra can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. Do not take Viagra if you take any other medicines called "nitrates." Nitrates are used to treat chest pain (angina). A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke.

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