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Note: Contraindicated in patients taking nitrates regularly or intermittently due to potentially severe hypotension. If a patient taking sildenafil develops chest pain, delay therapy with a nitrate for 24 hours. For patients taking an alpha-blocking antihypertensive agent, use sildenafil with caution and consider a lower starting dose, as sildenafil can potentiate hypotensive effects Ref ; some experts recommend against routinely using these drugs together, particularly in patients with cardiovascular disease Ref. Oral: 50 mg once daily as needed 1 hour before sexual activity; may be taken up to 4 hours before sexual activity. Reduce to 25 mg once daily if side effects occur.

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