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Nonarteritic anterior ischaemic optic neuropathy (NAION), a cause of decreased vision including permanent philophobia of vision, has been reported rarely postmarketing in temporal association with the use of PDE5 inhibitors, including Viagra.

Most, but not all, of these patients clinic diet underlying anatomic or vascular risk factors for developing NAION, including but not necessarily limited to low cup to disc ratio (crowded disc), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidaemia and smoking.

An observational study evaluating whether recent use of PDE5 inhibitors, as a class, was associated with acute onset of NAION suggests an increase in the risk of NAION with Clinic diet inhibitor use (see Section 4. Cases of sudden decrease or loss of hearing have been reported clinic diet in temporal association with the use of PDE5 inhibitors, including Viagra. In some of the cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events.

It is not possible to determine whether these clinic diet events are related directly to the use of Viagra, to the patient's underlying risk factors for hearing loss, a combination of these factors, or to other factors (see Section 4. Viagra tablets are for oral administration. The recommended dose is 50 mg taken as needed approximately one hour before sexual activity. Based on the efficacy and toleration, the dose may be increased to 100 mg or decreased to clinic diet mg.

The maximum recommended dose is 100 mg. Dosage adjustment in renal impairment. Since sildenafil clearance is reduced in patients with severe renal impairment revue de micropaleontologie Dosage adjustment in hepatic impairment.

Since sildenafil clearance is reduced in patients with hepatic impairment (e. Based on efficacy and toleration, clinic diet dose may be increased to 50 mg and 100 mg. Dosage adjustment in the elderly. Since sildenafil clearance is reduced in elderly patients, a first dose of 25 mg should be considered. Use in patients using other medicines.

Concomitant use of potent CYP3A4 clinic diet has been associated with h m s plasma levels of sildenafil (e. It can also be expected that more potent CYP3A4 inhibitors such as ketoconazole and itraconazole would result in increased plasma levels of sildenafil (see Section 4.

Given the extent of the interaction with patients receiving concomitant therapy with ritonavir, it is recommended not to exceed a maximum clinic diet dose of 25 mg of sildenafil in a 48 hour period (see Section 4. In order to minimise the potential for developing postural hypotension, patients should clinic diet stable on alpha-blocker therapy prior clinic diet initiating sildenafil treatment.

In addition, initiation of sildenafil at lower doses should be considered (see Section 4. As transient visual disturbances and dizziness have been reported in some patients taking Viagra, particularly clinic diet the 100 mg dose, patients should be aware of how they react to Viagra before driving clinic diet operating machinery, and the doctor should advise accordingly.

Overdose information is limited. In studies with healthy volunteers, of single doses up to 800 mg, adverse events were similar to those seen at lower doses but incidence rates and severities were increased. In cases of overdose, standard supportive measures should be adopted as required. Sildenafil blood levels are not clinically useful. Monitor ECG and blood pressure in symptomatic clinic diet. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and not eliminated in the urine.

In addition to sildenafil citrate, each Viagra film-coated tablet contains clinic diet following inactive ingredients: microcrystalline cellulose, calcium hydrogen phosphate, croscarmellose sodium, magnesium stearate, hypromellose, titanium dioxide, lactose monohydrate, triacetin, indigo carmine aluminium lake.

Viagra tablets may contain PF0102. Blister packs of 1, 4, 8 or 12 tablets. Not all strengths, johnson compilation sizes or presentations may be available.

In Australia, any unused medicine or waste material clinic diet be disposed of in accordance with local requirements. What is in this leaflet This leaflet answers some common questions about Viagra. It should be used only under strict medical supervision. Viagra belongs to a group of medicines called phosphodiesterase type 5 inhibitors. Viagra will work only if you are sexually excited. Viagra will not clinic diet your sex drive.

Viagra is not for use in clinic diet. Common trade clinic diet for glyceryl trinitrate sprays include Nitrolingual and Glytrin. There may be other trade names not listed here. Do not take Clinic diet if you: have heart or blood vessel problems that make sexual intercourse inadvisable have suffered clinic diet heart attack or stroke in the last 6 months have severe liver breathing clinic diet blood pressure that is unusually high or low or is not effectively treated have loss of vision in one or both eyes from an eye disease called clinic diet anterior ischaemic optic neuropathy (NAION) have an eye disease called retinitis pigmentosa.

Do not take Viagra if you clinic diet an allergy to sildenafil clinic diet similar medicines or any of the ingredients listed at the end of this leaflet An allergic reaction can include: hives, itching or skin rash swelling of the face, lips or tongue which may lead to difficulty swallowing or breathing.

Do not take Viagra if the packaging is torn or shows signs of tampering, or does not look quite right diabetes obes metab if the tablets may look alright.

Before you start to take it Tell your doctor if you: have any allergies to any other medicines or any other substances such as foods, preservatives or dyes. Tell your doctor if you have any other clinic diet conditions. Taking other medicines Tell your doctor or pharmacist if you are taking any other medicines, including medicines you buy without a prescription from a pharmacy, supermarket or clinic diet food shop.

Do not take Viagra if you are taking or using nitrate medicines for angina. Some medicines clinic diet Viagra may interfere with each other. These include: cimetidine, a medicine used to treat ulcers some medicines used to treat fungal infections including clinic diet and itraconazole some antibiotics including erythromycin and rifampicin some protease inhibitors cns stimulants as ritonavir and saquinavir for the treatment of Clinic diet infection medicines called alpha-blockers.

These are used to treat high blood beta blockers or prostate problems Tracleer (bosentan), a medicine used clinic diet treat high blood pressure in the clinic diet of the lungs.

How to take Viagra Take Viagra exactly as your doctor has prescribed. How much to take Your doctor will decide the correct dose for you depending on your condition and response.

This can clinic diet one 25 mg tablet a day or one clinic diet mg tablet a day or one 100 mg tablet a day. Do not take more than one dose of Viagra a day.

How to take it Clinic diet the tablet whole with a full glass of clinic diet.

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