DRUG INTERACTIONS

Your doctor may adjust your dose if needed. Adults 65 years of age and older—25 mg as a single dose no more than once a day, 1 hour before sexual intercourse. For oral dosage form (film):Adults up to 65 years of age—50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse.

Side Effect	Incidence (%)	Severity	Notes
Headache	25	Mild to moderate	Common, usually temporary
Flushing	18	Mild	Reddening of face
Nasal Congestion	12	Mild	Stuffy nose
Dizziness	10	Mild to moderate	Especially when standing up quickly
Vision Changes	8	Mild	Blue tint, blurred vision

Your doctor may adjust your dose as needed. For treatment of pulmonary arterial hypertension:For oral dosage forms (suspension or tablets):Adults—20 milligrams (mg) 3 times a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 80 mg 3 times a day.Children 1 year of age and older weighing 45 kilograms (kg) or more—20 mg 3 times a day. However the dose is usually not more than 40 mg 3 times a day.Children 1 year of age and older weighing 20 to 45 kg—20 mg 3 times a day.Children 1 year of age and older weighing 20 kg or less—10 mg 3 times a day.Children younger than 1 year of age—Use and dose must be determined by your doctor. For oral dosage forms (suspension or tablets):Adults—20 milligrams (mg) 3 times a day.

Sildenafil Citrate Tablets 200mg (NEOGRA) Technical Specification:

Your doctor may adjust your dose as needed.Adults 65 years of age and older—25 mg as a single dose no more than once a day, 1 hour before sexual intercourse. Your doctor may adjust your dose as needed.Children—Use is not recommended. For oral dosage form (tablets):Adults up to 65 years of age—50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. Your doctor may adjust your dose if needed.Children—Use is not recommended. Adults up to 65 years of age—50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. Adults—20 milligrams (mg) 3 times a day.

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Viagra Generic	200mg	180 + 10 Pills	277.56€ 264.34€	Buy
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Kamagra Polo	100mg	180 + 8 Pills	446.52€ 425.26€	Buy
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Viagra Generic	150mg	270 + 10 Pills	326.61€ 311.06€	Buy
Viagra Generic	200mg	60 + 4 Pills	125.19€ 119.23€	Buy
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Viagra Generic	50mg	90 + 6 Pills	107.37€ 102.26€	Buy
Kamagra Soft Tabs	100mg	32 Pills	120.11€ 114.39€	Buy
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However, the dose is usually not more than 80 mg 3 times a day. Children 1 year of age and older weighing 45 kilograms (kg) or more—20 mg 3 times a day.

• Taking 200mg sildenafil citrate may increase risks of headache and flushing.
• Do not combine sildenafil citrate with nitrate medications due to dangerous interactions.
• Alcohol can amplify sildenafil side effects; restrict intake when using this medication.

However the dose is usually not more than 40 mg 3 times a day. Children 1 year of age and older weighing 20 to 45 kg—20 mg 3 times a day. Children 1 year of age and older weighing 20 kg or less—10 mg 3 times a day. Children younger than 1 year of age—Use and dose must be determined by your doctor. For oral dosage forms (suspension or tablets): If you miss a dose of this medicine, take it as soon sildenafil pick up as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep out of the reach of children.

Before taking this medicine

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially: Abnormal penis, including a curved penis or birth defects of the penis—Chance of problems occurring may be increased and this medicine should be used with caution in these patients. Arrhythmia (irregular heartbeat, within the last 6 months) or Blood vessel problems (eg, aortic stenosis, idiopathic subaortic stenosis) or Heart attack (within the last 6 months) or Retinitis pigmentosa (an inherited eye disorder) or Stroke (within the last 6 months)—Should not be used in patients with these conditions.

What are the most common side effects of sildenafil?

Crowded disc or low cup to disc ratio in the eye (an eye disorder) or Hyperlipidemia (high fats in the blood) or Non-arteritic anterior ischemic optic neuropathy or NAION (serious eye condition), history of or Retinitis pigmentosa (an inherited eye disorder) or Smoking—May increase the chance for a serious side effect in the eye called NAION. Stomach ulcer, or history of or—Chance of problems occurring may be increased. It is not known if the medicine is safe for use in these patients. The effects may be increased because of slower removal of the medicine from the body. Sickle-cell anemia (blood disorder)—Sildenafil should be used with caution in these patients as problems with prolonged erection of the penis may occur.

Usage of Cenforce 200

Pulmonary arterial hypertension (high blood pressure in the lungs) or Pulmonary veno-occlusive disease or PVOD (a type of lung disease)—Use with caution. Use sildenafil exactly as directed by your doctor. Do not use more of it and do not use it more often than your doctor ordered. If too much is used, the chance of side effects is increased. This medicine comes with a patient information leaflet. Do not keep outdated medicine or medicine no longer needed.

5.5 Hypotension when Co-administered with Alpha-blockers or Anti-hypertensives

Read and follow these instructions carefully before you start using sildenafil and each time you get a refill of your medicine. Ask your doctor if you have any questions. You may take this medicine with or without food. Place the film on top of your tongue. It will dissolve in your mouth and can be swallowed with saliva without using water or other liquids.

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Shake the bottle well for at least 10 seconds before each use. Remove the cap by pushing it down and twisting it counter-clockwise. Push the plunger of the syringe, then insert the tip into the bottle while holding the bottle upright on a flat surface. Slowly pull back the plunger until the required dose. If you see air bubbles in the syringe, repeat the steps.

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Place the tip of the syringe into you or your child's mouth and point it towards the cheek. This medicine usually begins to work for erectile dysfunction within 30 minutes after taking it. It continues to work for up to 4 hours, although its action is usually less after 2 hours. Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. Ask your healthcare professional how you should dispose of any medicine you do not use. Store mixed oral liquid in the refrigerator. Throw away any unused mixed Revatio® oral liquid after 60 days. It is important that you tell all of your doctors that you take sildenafil. If you need emergency medical care for a heart problem, it is important that your doctor knows when you last took sildenafil.

• Sildenafil 200mg is sometimes used by men with severe ED after failed lower doses.
• It is not a first-line treatment; lifestyle changes and lower doses are preferred.
• The high dose can improve erectile hardness in non-responders to 100mg.
• However, side effects escalate significantly without guarantee of better efficacy.
• Use in diabetic men with ED: 200mg may provide benefit but needs monitoring.
• Post-prostatectomy ED may require higher doses, but risks must be weighed.
• Psychogenic ED often responds well to lower doses, making 200mg unnecessary.
• Never self-prescribe 200mg; a urologist should evaluate underlying causes.
• Combining 200mg with other ED treatments (injections, pumps) can be dangerous.

Do not use this medicine if you are also using a nitrate medicine, often used to treat angina or high blood pressure. Some illegal ("street") drugs called "poppers" (such as amyl nitrate, butyl nitrate, or nitrite). Do not use this medicine if you also use riociguat (Adempas®).

• Generic sildenafil citrate contains the same active ingredient as branded Viagra.
• Be aware of counterfeit sildenafil which may be unsafe; always buy from reputable pharmacies.
• 200mg sildenafil citrate is not suitable for all men and requires medical approval.

If you will be taking this medicine for pulmonary arterial hypertension, your doctor will want to check your progress at regular visits.

How should I take sildenafil?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine.

Revatio for Oral Suspension

Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. For treatment of erectile dysfunction:For oral dosage form (tablets):Adults up to 65 years of age—50 women sildenafil milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. Alternatively, the medicine may be taken 30 minutes to 4 hours before sexual intercourse. Your doctor may adjust your dose if needed.Adults 65 years of age and older—25 mg as a single dose no more than once a day, 1 hour before sexual intercourse. Your doctor may adjust your dose if needed.Children—Use is not recommended.For oral dosage form (film):Adults up to 65 years of age—50 milligrams (mg) as a single dose no more than once a day, 1 hour before sexual intercourse. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. If you take sildenafil for pulmonary arterial hypertension, do not take Viagra®, Vibrique™ or other PDE5 inhibitors, including tadalafil (Cialis®) or vardenafil (Levitra®). If you take too much sildenafil or take it together with these medicines, the chance for side effects will be higher. It is important to tell your doctor about any heart problems you have now or may have had in the past. This medicine can cause serious side effects in patients with heart problems. If you experience a prolonged or painful erection for 4 hours or more, contact your doctor immediately. This condition may require prompt medical treatment to prevent serious and permanent damage to your penis. If you experience a sudden loss of vision in one or both eyes, contact your doctor immediately. Check with your doctor right away if you have a sudden decrease in hearing or loss of hearing, which may be accompanied by dizziness and ringing in the ears.

Storage Condition	Details	Shelf Life	Precautions
Temperature	Store below 30°C (86°F), in a dry place	2 years	Protect from moisture and heat
Packaging	Keep in original container, tight seal		Keep out of reach of children
Light Exposure	Store in a dark place		Prevent degradation from light
Handling	Avoid crushing or splitting tablets		Use with clean, dry hands

If you already use medicine for high blood pressure (hypertension), sildenafil could make your blood pressure go too low. Call your doctor right away if you have blurred vision, confusion, dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly, sweating, or unusual tiredness or weakness. This medicine does not protect you against sexually transmitted diseases (including HIV or AIDS). Use protective measures and ask your doctor if you have any questions about this. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements. Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur: burning feeling in the chest or stomach burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings decrease in amount of urine or the frequency of urination dizziness or lightheadedness, especially when getting up suddenly from a lying or sitting position dryness, redness, scaling, or peeling of the skin increase in the size of the pupil redness, burning, or swelling of the eyes redness, itching, or tearing of the eyes seeing shades of colors differently than before swelling of the face, hands, feet, or lower legs unusual feeling of burning or stinging of the skin Some side effects may occur that usually do not need medical attention.

Country	Approved Use	Prescription Required	Maximum Allowed Dose	Notes
United States	Erectile Dysfunction	Yes	100mg tablet max	200mg often not approved OTC
European Union	Erectile Dysfunction	Yes	100mg per dose	200mg used only under medical supervision
Australia	Pulmonary Hypertension	Yes	Up to 200mg daily	Under special prescription
India	Both Uses	Yes	200mg dose	Commonly available in pharmacies