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YOU MUST NOT TAKE VIAGRA IF YOU ARE TAKING ANY NITRATE MEDICATION. IT MAY LEAD TO A SEVERE DROP IN YOUR BLOOD PRESSURE, WHICH MAY BE DIFFICULT TO TREAT. canadian viagra online Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor. Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors.

The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients.When taking CIALIS once-a-day (5mg), it may take up to 1 week for a full effect on Erectile Dysfunction.Cialis was the third PDE-5 inhibitor to come to market in the United States and was approved by the FDA at the end of November 21, 2003. Cialis is manufactured by Lilly ICOS LLC.