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To make sure Viagra is safe for you, tell your doctor if you have ever had: heart disease or heart rhythm problems, coronary artery disease; a heart attack, stroke, or congestive heart failure; high or low blood pressure; liver or kidney disease; a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia; a bleeding disorder such as hemophilia; a stomach ulcer; retinitis pigmentosa (an inherited condition of the eye); a physical deformity of the penis (such as Peyronie's disease); or. if you have been told you should not have sexual intercourse for health reasons. Viagra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking sildenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoked or were over 50 years old.

" Am J Cardiol 93 (2004): 689-93. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction. " Clin Ther 20 (1998): 1033-48.

Based on the pharmacokinetic profile of a single 100 mg oral dose given to healthy normal volunteers, the plasma levels of sildenafil at 24 hours post dose are approximately 2 ngmL (compared to peak plasma levels of approximately 440 ngmL). In the following patients: age gt; 65 years, hepatic impairment (e.cirrhosis), severe renal impairment (e.creatinine clearance lt; 30 mLmin), and concomitant use of erythromycin or strong CYP3A4 inhibitors, plasma levels of sildenafil at 24 hours post dose have been found to be 3 to 8 times higher than those seen in healthy volunteers.]