Seeing blue after the little blue pill: visual disturbances in sildenafil users

SILDENAFIL CITRATE TABLETS should not be used with SILDENAFIL TABLETS or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil]).

• Overuse or misuse of sildenafil can lead to adverse effects like priapism or cardiovascular issues.
• It is important to adhere strictly to prescribed dosages.
• Emergency medical attention is needed if painful erections occur.

Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.

• Some users experience visual disturbances, such as blue-tinged vision, after taking sildenafil.
• This side effect is generally rare and temporary.
• Report any persistent or severe visual changes to a healthcare provider.

How should I take SILDENAFIL CITRATE TABLETS?

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SILDENAFIL CITRATE- sildenafil citrate tablet, film coated Greenstone LLC What is the most important information I should know about SILDENAFIL CITRATE TABLETS? SILDENAFIL CITRATE TABLETS can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. Do not take SILDENAFIL CITRATE TABLETS if you take any other medicines called "nitrates." Nitrates are used to treat chest pain (angina). A sudden drop in blood pressure can cause you to feel dizzy, faint, or have a heart attack or stroke. Do not take SILDENAFIL CITRATE TABLETS if you take medicines called guanylate cyclase stimulators which include: sildenafil oral solution Riociguat (Adempas®) a medicine that treats pulmonary arterial hypertension and chronic-thromboembolic pulmonary hypertension.

What should I tell my healthcare provider before taking sildenafil?

Tell all your healthcare providers that you take SILDENAFIL CITRATE TABLETS. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took SILDENAFIL CITRATE TABLETS. Stop sexual activity and get medical help right away if you get symptoms such as chest pain, dizziness, or nausea during sex. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease. Ask your doctor if your heart is healthy enough to handle the extra strain of having sex.

What should I do if I miss a dose of sildenafil?

SILDENAFIL CITRATE TABLETS does not protect you or your partner from getting sexually transmitted diseases, including HIV—the virus that causes AIDS. SILDENAFIL CITRATE TABLETS is a prescription medicine used to treat erectile dysfunction (ED). SILDENAFIL CITRATE TABLETS helps a man with erectile dysfunction get and keep an erection only when he is sexually excited (stimulated). SILDENAFIL CITRATE TABLETS is not for use in women or children. It is not known if SILDENAFIL CITRATE TABLETS is safe and effective in women or children under 18 years of age. Take SILDENAFIL CITRATE TABLETS exactly as your healthcare provider tells you to take it.

Your healthcare provider will tell you how much SILDENAFIL CITRATE TABLETS to take and when to take it.

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It is important that you tell all of your doctors that you take sildenafil. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took sildenafil. Do not use this medicine if you are also using a nitrate medicine, often used to treat angina or high blood pressure. Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite). Do not use this medicine if you also use riociguat (Adempas®).

Raynaud's phenomenon

If you will be taking this medicine for pulmonary arterial hypertension, your doctor will want to check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. If you take sildenafil for pulmonary arterial hypertension, do not take Viagra®, Vibrique™ or other PDE5 inhibitors, including tadalafil (Cialis®) or vardenafil (Levitra®). If you take too much sildenafil or take it together with these medicines, the chance for side effects will be higher. It is important to tell your doctor about any heart problems you have now or may have had in the past.

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This medicine can cause serious side effects in patients with heart problems. If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent serious and permanent damage to your penis. If you experience a sudden loss of vision in one or both eyes, contact your doctor immediately. Check with your doctor right away if you have a sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears. Take SILDENAFIL CITRATE TABLETS about 1 hour before sexual activity.

5.4 Hearing Loss

Who should not take SILDENAFIL CITRATE TABLETS? Do not take SILDENAFIL CITRATE TABLETS if you: take medicines called nitrates (such as nitroglycerin) use street drugs called "poppers" such as amyl nitrate or amyl nitrite, and butyl nitrate take any medicines called guanylate cyclase stimulators such as riociguat (Adempas) are allergic to sildenafil, as contained in SILDENAFIL CITRATE TABLETS and REVATIO, or any of the ingredients in SILDENAFIL CITRATE TABLETS. See the end of this leaflet for a complete list of ingredients in SILDENAFIL CITRATE TABLETS. What should I tell my healthcare provider before taking SILDENAFIL CITRATE TABLETS? Before you take SILDENAFIL CITRATE TABLETS, tell your healthcare provider if you: have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve or heart failure have had heart surgery within the last 6 months have low blood pressure, or high blood pressure that is not controlled have had an erection that lasted for more than 4 hours have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia have retinitis pigmentosa, a rare genetic (runs in families) eye disease have ever had severe vision loss, including an eye problem called non-arteritic anterior ischemic optic neuropathy (NAION) have kidney problems or are having kidney dialysis Tell your healthcare provider about all the medicines you take1, including prescription and over-the-counter medicines, vitamins, and herbal supplements. You may take SILDENAFIL CITRATE TABLETS between 30 minutes to 4 hours before sexual activity if needed.

SILDENAFIL CITRATE TABLETS can be taken with or without food.

If you take SILDENAFIL CITRATE TABLETS after a high fat

• Proper storage of the blue sildenafil pill is in a cool, dry place away from moisture.
• Keep out of reach of children to prevent accidental ingestion.
• Expiry dates should be checked regularly to ensure potency and safety.

meal (such as a cheeseburger and french fries), SILDENAFIL CITRATE

5.8 Effects on Bleeding

SILDENAFIL CITRATE TABLETS may affect the way other medicines work, and other medicines may affect the way SILDENAFIL CITRATE TABLETS works causing side effects. Especially tell your healthcare provider if you take any of the following: medicines called nitrates (see "What is the most important information I should know about SILDENAFIL CITRATE TABLETS?") medicines called guanylate cyclase stimulators, such as riociguat (Adempas) medicines called alpha blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). In some patients, the use of SILDENAFIL CITRATE TABLETS with alpha-blockers can lead to a drop in blood pressure or to fainting. medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase) or atazanavir sulfate (Reyataz) some types of oral antifungal medicines, such as ketoconazole (Nizoral), and itraconazole (Sporanox) some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin other medicines that treat high blood pressure SILDENAFIL CITRATE TABLETS contains sildenafil, which is the same medicine found in another drug called SILDENAFIL TABLETS. SILDENAFIL TABLETS is used to treat a rare disease called pulmonary arterial hypertension (PAH). TABLETS may take a little longer to start working Do

• The pill’s active ingredient, sildenafil citrate, is classified as a PDE5 inhibitor.
• PDE5 inhibitors help relax blood vessels and improve blood flow.
• They are most effective when combined with sexual arousal.

not take SILDENAFIL CITRATE TABLETS more than 1 time a day.

Mechanism of action

If you already use medicine for high blood pressure (hypertension), sildenafil could make your blood pressure go too low. Call your doctor right away if you have blurred vision, confusion, dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly, sweating, or unusual tiredness or weakness. This medicine does not protect you against sexually transmitted diseases (including HIV or AIDS). Use protective measures and ask your doctor if you have any questions about this. Do not take other medicines unless they have been discussed with your doctor.

Other Interactions

This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: burning feeling in the chest or stomach burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings decrease in amount of urine or the frequency of urination dizziness or lightheadedness, especially when getting up suddenly from a lying or sitting position dryness, redness, scaling, or peeling of the skin increase in the size of the pupil redness, burning, or swelling of the eyes redness, itching, or tearing of the eyes seeing shades of colors differently than before swelling of the face, hands, feet, or lower legs unusual feeling of burning or stinging of the skin Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine.

Incidence not known

Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: pain or tenderness around the eyes and cheekbones diarrhea or stomach cramps (severe or continuing) numbness or tingling of the hands, legs, or feet redness, soreness, swelling, or bleeding of the gums sensation of motion, usually whirling, either of one's self or of one's surroundings sexual problems in men (continuing), including failure to experience a sexual orgasm sores in the mouth and on the lips Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.