Sildenafil Citrate Contraindications


Sildenafil citrate can increase hypotensive effect of organic nitrates (for example, nitroglycerin). Even if organic nitrates are taken irregularly, a sharp drop of blood pressure may happen after the use of Sildenafil citrate.

To prevent a strong hypotensive effect, men taking organic nitrates, should refrain from using Sildenafil citrate.

Some group of patients have 3 to 8 times higher than normal concentration of Sildenafil citrate in the blood plasma. These patients group are:

  • Elderly men over 65 years old
  • Men with liver disease
  • Men with severe kidney disease
  • Men taking potent cytochrome P450 inhibitors


The listed above categories of patients might need a comprehensive physical examination before the onset of ED drug treatment. Guided by the results of these trials, doctor can prescribe a minimal daily dose of Sildenafil citrate and (or) recommend to reduce the intake frequency of Sildenafil citrate up to 1-2 times per week.

If man was not recommended a sexual activity (for instance, when having heart disease or uncontrolled hypertension), he must never take Sildenafil citrate.


In addition, Sildenafil citrate should be taken cautiously by:

  • Men with history of stroke, arrhythmia and (or) myocardial infarction
  • Men with hypertension or restoring hypotension
  • Men whose heart failure or ischemic heart disease causes unstable angina
  • Men with retinitis pigmentosa (RP)
  • Men with sickle-cell disease or related anemia
  • Men taking Ritonavir (trade names: Kaletra, Norvir)


According to results of post-marketing studies, Sildenafil citrate may cause a prolonged and (or) painful erection (priapism). If erection lasts over 4 hours after the intake of Sildenafil citrate, man should immediately consult his doctor.

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