VIAGRA - PATIENT INFORMATION SHEET:
This is an information sheet to give you instructions and warnings
concerning the medication, Viagra, which is used in the treatment of
impotence. This drug works by relaxing the smooth muscles in the
arteries of the penis to assist in erection during sexual excitement.
Fortunately, the drug works in a relatively selective fashion such
that the side effects are infrequent.


Approximately 16% of patients experience what is described as a
mild headache. Approximately 11% describe a flushing feeling. A
smaller percentage reported indigestion and runny nose.  Transient
visual disturbance described as a "blue haze" has also been
reported, but in only 3% of patients.

The drug should not be used by patients who are taking nitrates
such as nitroglycerine (oral or paste form). There may also be
problems in patients taking the antibiotic, erythromycin, the
anti-fungals, ketoconazole or itraconazole, or the stomach ulcer
medication, cimetidine.

Caution is warned in patients with cirrhosis of the liver or severe
renal impairment.

A typical initial dose will be 50 mg. The drug comes in 50 mg., 25
mg., and 100 mg. pills. Extreme caution is warned in changing the
dosage without instruction from your physician. It is recommended
that the drug be taken 1-2 hours prior to intercourse. The medication
should not be mixed with any other method to manage impotence,
i.e. Viagra should be the only medication you are using to assist
with erection.

Based on testing to date there has been no evidence of cancer risk,
effect on conception of a child, or modulation of the sex drive
(libido).

Do not request information concerning reimbursement by your
insurance company from your doctor. Check with your individual
insurance plan administrator. You can also get information directly
from the pharmaceutical company, Pfizer at 212/573-2323 or visit
their web page at www.pfizer.com.

As with any medication, your prescription will not be filled
indefinitely. You will be required to see your physician at least
annually provided that no problems are arising.


Although this medication has been very effective in the
management of impotence, it is not universally successful, and as
such, if the medication does not work for you, other therapeutic
ventures will need to be investigated.

Each individual patient may experience a difference in success and
possible side effects of the medication. As an example, there is a
small drop in the systolic and diastolic blood pressure in some
patients taking the medication. That among many other reasons is
why the medication should be dispensed and monitored concurrent
with visits with your physician.

There is currently no safety information on the administration of
Viagra to patients with bleeding disorders or active ulceration.
Additionally, caution is advised for patients with the inherited
condition of retinitis pigmentosa. If you have any of these
conditions, you should alert your physician prior to taking Viagra.

After carefully reading the above and asking questions of the
appropriate sources, please realize that the safe and effective use
of Viagra is in great part dependent on your compliance with the
instructions given. As with any new drug, additional warnings,
benefits, and instructions may become apparent as widespread use
of the drug occurs.


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