Discontinue use in case of sudden vision loss & decrease or loss of hearing occurs. Consider CV status, certain underlying conditions adversely affected by vasodilatory effects & hemodynamically stable α-blocker therapy prior to initiating treatment. Non-arteritic anterior ischemic optic neuropathy; retinitis pigmentosa; bleeding disorders, active peptic ulceration; anatomical penis deformation eg, angulation, cavernosal fibrosis, Peyronie's disease or predisposed to priapism eg, sickle cell anemia, multiple myeloma, leukemia. Not recommended in combination w/ other PDE5 inhibitors or sildenafil-containing pulmonary arterial HTN treatments. May affect ability to drive & use machines. Not to be used in women & childn <18 yr.
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