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Although Viagra (sildenafil) does not directly interact with coumadin, Betapace (sotalol), Lanoxin (digoxin), or enalapril, it should be used cautiously in patients with underlying heart conditions. Because Viagra dilates the blood vessels and can reduce the blood pressure, it may increase the blood pressure-lowering effect (hypotension) caused by enalapril and Betapace. There have been a few isolated reported incidents of heart problems in patients taking Viagra. The incidents include abnormal heart rhythm (atrial fibrillation and ventricular arrhythmia), low blood pressure, myocardial infarction, and blood clots (thromboembolism). Because of these possible events, the patients should be monitored closely. The best option is treat erectile dysfunction non-pharmacologically. Take one Cialis tablet every day at about the same time of day. Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia.
If you take too much (overdose) cialis sample pack abdominal or stomach pain?The maximum recommended daily dosage for Generic Cialis 20mg is one tablet per day. Exceeding that dosage increases the risk of possible side effects.
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Levitra is usually taken only when needed, about 60 minutes before sexual activity. The medicine can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.In the major North American fixed-dose trial, 762 patients (mean age 57, range 20-83 years; 79% White, 13% Black, 4% Hispanic, 2% Asian and 2% Other) were evaluated. The mean baseline EF Domain scores were 13, 13, 13, 14 for the Levitra 5 mg, 10 mg, 20 mg and placebo groups, respectively. There was significant improvement (p <0.0001) at 3 months with Levitra (EF Domain scores of 18, 21, 21, for the 5 mg, 10 mg, and 20 mg dose groups, respectively) compared to the placebo group (EF Domain score of 15). The European trial (total N=803) confirmed these results. The improvement in mean score was maintained at all doses at 6 months in the North American trial.
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