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Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

- Abnormal visio n, including blurred vision, seeing shades of colors differently than before, or sensitivity to light; bladder pain; cloudy or bloody urine; dizziness; increased frequency of urination ; pain on urination

- Bleeding of the eye; convulsions (seizures) ; decreased vision or other changes in vision; double vision; prolonged, painful, or inappropriate erection of penis; redness, b urning, or swelling of the eye; vision loss, temporary

How should you take this medication?
Doses range from 25 milligrams to 100 milligrams, depending on the drug's effect. The usual dose is 50 milligrams. If you are over 65, have liver or kidney problems, or are taking erythromycin, ketoco nazole, itraconazole, ritonavir, or saquinavir a dose of 25 milligrams may be sufficient. Your doctor will adjust the dosage if the drug is not working properly for you.

Take Viagra only bef ore sexual activity. The manufacturer recommends a maximum of 1 dose per day (1 dose every 2 days for those taking ritonavir).

To avoid low blood pressure, do not take the 50-milligram or 10 0-milligram dose of Viagra within 4 hours of taking an alpha-blocking drug such as Cardura.

Special warnings about this medication
Use Viagra exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects is increased.
-
If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent tissue damage of the penis and possi ble permanent impotence.

Overdose
No overdose of Viagra has been reported. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

Before Taking This Medicine
The presence of other medical problems may affect the use of Viagra. Make sure you tell your doctor if you have any other medical problems, especially:
- Arrhythmias (irregular heartbeat) or
- Coronary artery disease or
- Heart attack, history of (within the last 6 months) or
- High blood pressure or
- Low blood pressure or
- Stroke, history of (within the last 6 mont hs)—Chance of problems occurring may be increased
- Abnormal penis, including curved penis and birth defects of the penis—Chance of problems occurring may be increased
- Bleeding problems
- Retinitis pigmentosa—Chance of problems occurring may be increased. It is not known if the medicine is safe for use in these patients

Possible food and drug interactions when taking this medication
When you are taking Viagra, it is especially important that your health care professional know if you are taking any of the following:

- Cimetidine (e.g., Tagamet)
- Erythromycin (e.g., E.E.S. or Ery-Tab)
- Itraconazole (e.g., Sporanox)
- Ketaconazole (e.g., Nizoral)
- Mibefradil (e.g., Posicor)
- Ritonavir (e.g., Norvir)
- Saquinavir (e.g., Fortovase or Inv irase)—These medicines may increase the unwanted effects of Viagra, unless lower starting doses of Viagra are used
- Nitrates, such as nitroglycerin (e.g., Nitrostat or Transderm-Nitro)—Viagra creases the lowering of blood pressure by nitrates too much and their use together is not recommended

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