Headache

Flushing

Nasal congestion / Stuffy nose

Muscle and joint pain

Dizziness

Stomach upset

Nausea

Decreased eyesight

Sudden decrease or loss of hearing.

Heart attack, stroke, or irregular heartbeats (most often in people with existing heart problems)

Low blood pressure

Anemia

Severe allergic reactions (e.g., difficulty breathing or wheezing, racing heart, swollen lymph nodes, swelling of the face, lips, mouth, tongue, or throat, vomiting, fever or general ill feeling, itching, skin rash, or hives, trouble swallowing or throat tightness)

Painful, prolonged erection (lasting more than four hours or unrelated to sexual stimulation)

Sildenafil and Tadalafil do not protect against sexually transmitted diseases. If you have concerns about STDs, use a condom to protect yourself and your partner.

These medications are phosphodiesterase type 5 (PDE5) inhibitors, which are generally safe but carry rare, serious potential side effects. They should never be taken simultaneously with nitrites or nitrates used to lower blood pressure.

Patients with Pulmonary Veno-Occlusive Disease (PVOD) should not use these medications.

Patients with a history of non-arteritic anterior ischemic optic neuropathy (NAION) should be cautious, as vision changes may be a potential side effect.

Dose adjustments may be necessary for patients with renal or hepatic impairment.

Patients must inform their provider of any cardiac history or risks, including chest pain, heart disease, high or low blood pressure, irregular heartbeats, coronary artery disease, aortic stenosis, idiopathic hypertrophic subaortic stenosis, coronary ischemia, heart attacks, strokes, heart defects, or heart failure.

Pilots, air traffic controllers, and drivers should not take Sildenafil (Viagra) within six hours of duty due to potential vision changes. The same applies to Tadalafil (Cialis), which can remain effective for up to 36 hours.

It’s generally best to take Sildenafil and Tadalafil on an empty stomach. Taking them with food, especially a fatty meal, may delay their effectiveness.

Avoid fatty foods at least 2 hours before taking the pill.

Avoid alcohol while taking these medications.

Do not take more than the prescribed dose within a 24-hour period.

It is recommended to take these medications about one hour before sexual activity.

Do not take Sildenafil within four (4) hours of taking an alpha-blocker to minimize the risk of hypotension. Dose adjustments may be necessary.

It is not recommended to take different types of ED medications simultaneously or within 48 hours of each other.

Do not take Sildenafil and Tadalafil together or within 48 hours of one another.

Vacuum-tube device: Creates suction around the penis, drawing blood into it. A ring at the base of the penis can temporarily maintain the erection. This ring should be removed after 30 minutes to avoid tissue damage.

Alprostadil: Can be administered as a penile suppository or injection. It acts as a vasodilator, increasing blood flow to the penis.

Surgery: Options include implanting rods, inflatable implants, or semi-rigid implants.

Healthy eating

Exercise

Adequate sleep

Stress management

Limited alcohol/nicotine intake

Heart disease

Atherosclerosis

High cholesterol

High blood pressure

Diabetes

Obesity

Metabolic syndrome

Parkinson’s disease

Multiple sclerosis

Sleep apnea

Prostate disease or other genitourinary diseases

Low testosterone

Psychological conditions