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To diagnose erectile dysfunction, determine their possible causes, and select an adequate treatment, it is necessary to gather a full medical history and conduct a thorough physical examination.

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Erectile dysfunction treatments should be used with caution in patients with anatomical deformation of the penis (angulation, cavernous fibrosis, Peyronie’s disease), or in patients with risk factors for priapism (sickle cell anemia, multiple myeloma, leukemia). During post-marketing how long does viagra last studies, it was reported about the development of prolonged erection and priapism. If an erection persists for more than 4 hours, the patient should immediately seek medical attention. If priapism therapy was not performed immediately, it can cause damage to the tissues of the penis and irreversible loss of potency. Preparations for treating erectile dysfunction should not be given to men for levitra vs viagra whom sexual activity is undesirable. Sexual activity presents a certain risk in the presence of heart disease, therefore, before starting any therapy for erectile dysfunction, the doctor should refer the patient to an examination of the cardiovascular system. Sexual activity is undesirable in patients with heart failure, unstable viagra 100mg angina, suffered myocardial infarction or stroke in the last 6 months, life-threatening arrhythmias, arterial hypertension (BP> 170/100 mm Hg) or hypotension (BP 50 years in the general population.

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Should advise patients to discontinue sildenafil therapy in the event of a sudden loss of vision and immediately consult with a physician. Persons who have already had a case of NPINZN have an increased risk of relapse of NPINZN.Therefore, the doctor should discuss This risk with such patients, as well as discuss with them the potential chance viagra canada of adverse effects of PDE inhibitors 5. PDE5 inhibitors, including sildenafil, in these patients should be used with caution and only in situations where the expected benefit outweighs the risk. Patients with hereditary retinitis pigmentosa are genetically determined dysfunctions of retinal phosphodiesterase.The safety information on the use of Viagra in patients with retinitis pigmentosa is absent, therefore ildenafil should be used with ostorozhnostyu.Narusheniya Slukhai some post-marketing and clinical studies have reported cases of sudden hearing loss or degradation associated viagra connect usa with the use of PDE5 inhibitors, including sildenafil. Most of these patients had risk factors for sudden deterioration or hearing loss. There is no causal relationship between the use of PDE5 inhibitors and the sudden deterioration of hearing or hearing loss female viagra pill. In case of sudden hearing loss or hearing loss with sildenafil intake, the patient should immediately consult with a physician.

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Sildenafil increases the antiplatelet effect of sodium nitroprusside, a nitric oxide donor, on human platelets in vitro. Data on the safety of sildenafil in patients with a tendency to bleeding or exacerbation of gastric ulcer and duodenal ulcer are not available, therefore, Viagra in these patients should be used with caution. The incidence of nasal bleeding in patients with pulmonary hypertension associated with diffuse connective tissue diseases was higher (sildenafil 12.9%, placebo 0%) than in patients with primary cheap viagra pulmonary hypertension (sildenafil 3%, placebo 2.4%). Patients who received sildenafil in combination with a vitamin K antagonist had a higher incidence of nasal bleeding (8.8%) than patients who did not take a vitamin K antagonist (1.7%). Use with other erectile dysfunctions with other medications other PDE5 inhibitors or other drugs for the treatment of pulmonary hypertension containing viagra pill sildenafil (for example, Revacio) or other means of treating erectile dysfunction have not been studied, therefore the use of such combinations is not recommended The impact on the ability to drive vehicles and control mechanisms. Against the background of taking Viagra, there was no negative effect on the ability to drive a car or other technical means. However, since the admission of the drug may reduce blood pressure viagra otc, the development of chromatopsia, blurred vision, should be attentive to the individual action of the drug in these situations, especially at the beginning of treatment and when changing the dosage regimen.