Contraindications for Sildenafil

Before you start using Kamagra (Sildenafil), be sure to tell your doctor about any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breastfeeding, and any other significant health issues.

These factors can affect how you should use Kamagra (Sildenafil):

Alcohol: Drinking alcohol in large amounts can decrease the ability to get an erection and can also temporarily lower blood pressure, causing dizziness and fainting.

Blood pressure: Tell your doctor if you are taking medicines to treat high blood pressure. The combination of these drugs and Kamagra (Sildenafil) can increase the hypotensive effect of these drugs. You should also tell your doctor if you have or have had low blood pressure.

Grapefruit juice: Grapefruit juice can increase the amount of Sildenafil in the bloodstream. Do not take grapefruit juice when taking this medicine.

Hearing problems: If you experience a sudden decrease or loss of hearing, you should seek medical attention immediately.

Cardiac conditions: If you have or have had heart disease or a heart attack or stroke, you should talk to your doctor before taking any erectile dysfunction medication. If you experience chest pains, dizziness or nausea during sex, the effort should be stopped and your doctor informed.

Kidney problems: If you have insufficient kidney function, you may need lower doses of this medicine. Kidney disease or reduced kidney function may cause this medication to accumulate in the body, causing side effects. If you have kidney problems, talk with your doctor about how this medicine can affect your medical condition, how your medical condition can affect the dosage and effectiveness of this drug, and whether any special monitoring is needed.

Hepatic function: If you have a poor liver function, you may need lower doses of this medicine. Liver disease or reduced hepatic function may cause this medication to accumulate in the body, causing side effects. If you have liver problems, talk to your doctor about how this medication can affect your medical condition, how your medical condition can affect the dosage and effectiveness of this drug, and whether any special monitoring is needed.

Nitrate-containing medicines: Sildenafil should never be taken with any medication containing nitrates. If Kamagra is taken with any medication containing nitrates (eg, nitroglycerin tablets, sprays or patches), or any other nitrate (eg, isosorbide dinitrate or amyl nitrite poppers), blood pressure may Suddenly falling to deadly levels. You may experience dizziness, fainting, heart attacks or strokes.

If the use of a nitrate-containing drug is considered medically necessary, you should wait 48 hours after the last dose of sildenafil before taking a nitrate and only under close medical supervision.

Penile Strain: As with other erectile dysfunction medications, men with an anatomical penile deformation such as angulation, cavernous fibrosis, or Peyronie’s disease should be closely monitored by their physicians if they take this medicine.

Prolonged erection: If an erection lasts more than 4 hours (a rare occurrence), seek immediate medical attention. If this condition is not treated quickly, tissue damage and permanent loss of ability to have an erection could result.

Prostate problems: tell your doctor if you are taking medicines, such as alpha-blockers (eg, doxazosin), to treat prostate problems, since the combination of these medicines with sildenafil may increase the blood pressure lowering effect of these medicines.

Sexually Transmitted Infections: Sildenafil does not protect against sexually transmitted infections such as HIV.

Vision problems / eye conditions: If you experience a sudden loss of vision in one or both eyes or other vision-related problems, contact your doctor immediately. Vision loss can be partial or complete. While in some cases the condition may improve over time, it can also be permanent.

This rare condition is more likely to occur if you have heart disease, high blood pressure, high cholesterol, diabetes, or eye problems, you are over 50 years old or if you smoke. If you have any eye conditions, such as retinitis pigmentosa or non-arteritic anterior ischemic optic neuropathy (NAION), tell your doctor.

Pregnancy and breast-feeding: Kamagra (Sildenafil) is not intended for use by women.

Children: Kamagra (Sildenafil) is not intended for use by children or adolescents under 18 years of age.

Elderly people: If you are 65 years of age or older, you may need a lower dose of this medicine.

What other drugs will interact with Kamagra (Sildenafil)?

There may be an interaction between sildenafil and any of the following:

  • abiraterone
  • alcohol
  • alpha agonists (eg, clonidine, methyldopa)
  • alpha-blockers (eg, doxazosin, terazosin)
  • alprostadil
  • amiodarone
  • angiotensin converting enzyme inhibitors (ACE inhibitors, eg, captopril, enalapril, ramipril)
  • angiotensin receptor blockers (ARBs, eg, candasartan, irbesartan, losartan)
  • aprepitant
  • aripiprazole
  • “Azole” antifungals (eg, itraconazole, ketoconazole, voriconazole)
  • barbiturates (eg, butalbital, pentobarbital, phenobarbital)
  • beta-adrenergic blockers (eg, atenolol, propranolol, sotalol)
  • bicalutamide
  • boceprevir
  • bosentan
  • calcium channel blockers (eg, amlodipine, diltiazem, nifedipine, verapamil)
  • carbamazepine
  • clonidine
  • cobicist
  • conivaptan
  • deferasirox
  • dexamethasone
  • diuretics (water pills, for example, furosemide, hydrochlorothiazide, triamterene)
  • dofetilide
  • dronedarone
  • enzyme
  • fusidic acid
  • guanfacine
  • nNon-nucleoside HIV reverse transcriptase inhibitors (NNRTIs, eg, delaviridine, efavirenz, etravirine, nevirapine)
  • HIV protease inhibitors (eg, atazanavir, indinavir, ritonavir, saquinavir)
  • hydralazine
  • macrolide antibiotics (eg, clarithromycin, erythromycin)
  • methyldopa
  • metronidazole
  • mifepristone
  • mitotane
  • nefazodone
  • nitrates (eg, nitroglycerin, isosorbide mononitrate, isosorbide dinitrate or amyl nitrite poppers)
  • norfloxacin
  • oxcarbazepine
  • peginterferon Alfa-2b
  • phenytoin
  • other inhibitors of phosphodiesterase 5 (eg, tadalafil, vardenafil)
  • pimozide
  • primidone
  • rifabutin
  • rifampin
  • riojuelo
  • grass of San Juan
  • sapropterin
  • sertraline
  • siltuximab
  • simeprevir
  • “Statins” (for example, lovastatin, simvastatin, atorvastatin)
  • stiripentol
  • telaprevir
  • tocilizumab
  • inhibitors of tyrosine kinase (eg, dasatinib, imatinib, nilotinib, sunitinib)

Grapefruit juice can increase the amounts of sildenafil in the blood. A meal rich in fat can reduce the effectiveness of sildenafil.

If you are taking any of these medicines, talk to your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • Stop taking one of the medicines,
  • Change one drug to another,
  • Change the way you are taking one or both of the medicines, or
  • Leave everything as it is.

An interaction between two medications does not always mean you should stop taking one of them. Talk with your doctor about how interactions with other medicines are being managed or should be managed.

Medications other than those listed above may interact with this medicine. Tell your doctor or prescriber about all prescription, over-the-counter and herbal medicines you are taking. Also tell them about any supplements you’re taking. Since caffeine, alcohol, nicotine from cigarettes, or street drugs can affect the action of many medications, you should tell your doctor if you use them.