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Contraindications are nitrates, CHF, cardiac insufficiencies, and any severe ailment including optical diseases. Meds for hypertension or hypotension such as alpha blockers, like non-arteritic anterior ischemic optic neuropathy, NAION, retinitis pigmentosa, or other similar maladies leading to blindness. Taking drugs that increase side effect risks are specific antibiotics, ulcer drugs, fungal infection drugs Itraconazole and Ketoconazole, and antiretroviral drugs such as Saquinavir or other protease inhibitors. Not for women and boys. Having a deformed or abnormally shaped penis (angulation, cavernosal fibrosis, or Peyronie’s disease) also negates usage.
Side effects include pounding headaches, plugged nose, back pain etc. Overdose occurs at over 100mg or when symptomatic at any dosage, and may include priapism, a critical emergency when the penis remains engorged after 4 hours. If emergent help is not administered, diurnal impotence can result.