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Men with low blood testosterone levels may suffer from a lower sex drive, erectile dysfunction (ED), brittle bones (osteoporosis), low muscle mass and higher fat accumulation. However, a 2017 report from the Testosterone Trials noted that testosterone therapy can raise the risk of heart disease and stroke, and may not be safe is men with low-but-normal testosterone levels and no outward symptoms related to low T. Overall, the Testosterone Trials showed that the volume of arterial plaque increased more in the testosterone-treated group compared to the untreated "control" group, which could increase the risk over time for heart attack or stroke. The trials showed a positive benefit for bone health and anemia, but experts stated that it's unlikley testosterone will be considered a first-line treatment for those conditions, as other more effective and well-established options are available.

When VIAGRA is co-administered with an alpha-blocker, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose [see DOSAGE AND ADMINISTRATIONWARNINGS AND PRECAUTIONSCLINICAL PHARMACOLOGY ]. Amlodipine. When VIAGRA 100 mg was co-administered with amlodipine (5 mg or 10 mg) to hypertensive patients, the mean additional reduction on supine blood pressure was 8 mmHg systolic and 7 mmHg diastolic [see WARNINGS AND PRECAUTIONSCLINICAL PHARMACOLOGY ]. Ritonavir And Other CYP3A4 Inhibitors. Co-administration of ritonavir, a strong CYP3A4 inhibitor, greatly increased the systemic exposure of sildenafil (11-fold increase in AUC). It is therefore recommended not to exceed a maximum single dose of 25 mg of VIAGRA in a 48 hour period [see DOSAGE AND ADMINISTRATIONWARNINGS AND PRECAUTIONSCLINICAL PHARMACOLOGY ].

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