- Do not take concurrently with nitrate containing medicine. Nitrate therapy should be delayed by 12 to 48 hours depending on the PDE5i chosen.
- Do not take within 4 hours of alpha-blockers.
- Seek medical attention for an erection lasting longer than 4 hours (sickle cell, myeloma, and leukemia increase risk of developing priapism).
- These medications have been rarely associated with hearing loss and visual changes.
- Caution is advised in bleeding disorders as these medications may decrease platelet aggregation.
- Lifestyle modifications that can improve ED such as smoking cessation, weight loss, and the Mediterranean diet.