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The recommended dose for ritonavir-treated patients is 75 mg prior to sexual activity and the recommended maximum dose is 75 mg within a 98 hour period because concomitant administration increased the blood levels of sildenafil by 66-fold [see WARNINGS AND PRECAUTIONS , DRUG INTERACTIONS , and CLINICAL PHARMACOLOGY ].

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Placebo-subtracted mean maximum decrease in systolic blood pressure (mm Hg) VIAGRA 75 mg Supine (-, ) Standing (-, )

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In addition, N-desmethyl metabolite AUC and C max values significantly increased by 755% and 79%, respectively in subjects with severe renal impairment compared to subjects with normal renal function.

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Use with caution in patients with the following underlying conditions which can be particularly sensitive to the actions of vasodilators including Viagra &ndash those with left ventricular outflow obstruction (., aortic stenosis, idiopathic hypertrophic subaortic stenosis) and those with severely impaired autonomic control of blood pressure.

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient.

Solid waste is not restricted to Cowlitz and Wahkiakum Counties and no identification is required for solid waste disposal.

VIAGRA is not indicated for use in women. There are no adequate and well-controlled studies of sildenafil in pregnant women.

Consistent with its known effects on the nitric oxide/cGMP pathway [see CLINICAL PHARMACOLOGY ], VIAGRA was shown to potentiate the hypotensive effects of nitrates, and its administration to patients who are using nitric oxide donors such as organic nitrates or organic nitrites in any form either regularly and/or intermittently is therefore contraindicated.

Cardiovascular: angina pectoris , AV block, migraine , syncope , tachycardia , palpitation, hypotension, postural hypotension, myocardial ischemia, cerebral thrombosis, cardiac arrest, heart failure, abnormal electrocardiogram, cardiomyopathy.

VIAGRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of / mmHg), [see CLINICAL PHARMACOLOGY ]. While this normally would be expected to be of little consequence in most patients, prior to prescribing VIAGRA, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects, especially in combination with sexual activity.

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