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What should I discuss with my healthcare provider before taking Viagra (Sildenafil)?



Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking sildenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.

If you have any of these other conditions, you may need a sildenafil dose adjustment or special tests:
heart disease or heart rhythm problems
a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder
congestive heart failure
high or low blood pressure
coronary artery disease
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

Sildenafil 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 smoke or are over 50 years old. It is not clear whether sildenafil is the actual cause of vision loss. Stop using sildenafil and get emergency medical help if you have sudden vision loss.

FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use sildenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known if sildenafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.