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Tell your health care provider if you are taking any other medicines, especially any of the following: Alpha-blockers eg, doxazosin , medicines for high blood pressure, nitrates eg, isosorbide, nitroglycerin , or nitroprusside because severe low blood pressure with dizziness, lightheadedness, and fainting may occur Azole antifungals eg, itraconazole, ketoconazole , H2 antagonists eg, cimetidine , HIV protease inhibitors eg, ritonavir, saquinavir , macrolide antibiotics eg, erythromycin , narcotic analgesics eg, dihydrocodeine , or telithromycin because they may increase the risk of Viagra's side effects Bosentan or rifampin because they may decrease Viagra's effectiveness.

This may not be a complete list of all interactions that may occur. Ask your health care provider if Viagra may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine. Viagra may cause dizziness, drowsiness, fainting, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines.

Use Viagra with caution. Do not drive or perform other possible unsafe tasks until you know how you react to it. Viagra may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects. Patients with heart problems who take Viagra may be at increased risk for heart-related side effects, including heart attack or stroke.

Symptoms of a heart attack may include chest, shoulder, neck, or jaw pain; numbness of an arm or leg; severe dizziness, headache, nausea, stomach pain, or vomiting; fainting; or vision changes.

Symptoms of a stroke may include confusion, vision or speech changes, one-sided weakness, or fainting. Contact your doctor or seek medical attention right away if you experience these symptoms. Viagra may rarely cause a prolonged eg, more than 4 hours or painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if you have an erection that lasts more than 4 hours.

Viagra will not prevent pregnancy. If your partner may become pregnant and you wish to avoid pregnancy, be sure to use an effective form of birth control. Contact your doctor if vision changes persist or are severe.

Rarely, an eye problem called nonarteritic anterior ischemic optic neuropathy NAION has been reported in patients who took Viagra. This may lead to decreased vision or permanent loss of vision in some cases. If you notice a sudden decrease in vision or loss of vision in one or both eyes, contact your doctor right away.

Sudden decreases in hearing and loss of hearing have been reported in some patients who have taken Viagra. Sometimes they also noticed ringing in the ears or dizziness. If you notice a sudden decrease or loss of hearing, contact your doctor right away. Do not use other medicines or treatments for ED while you are taking Viagra without first checking with your doctor.

Use Viagra with caution in the elderly; they may be more sensitive to its effects. Viagra is not recommended for use in children younger 18 years. Side effects All medicines may cause side effects, but many people have no, or minor, side effects.

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