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Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours in duration) have been reported infrequently since market approval of Viagra. In the event of an erection that persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency could result. alternative to viagra pain or tenderness around the eyes and cheekbones?flushing (feeling of warmth)

Avoid using any other medicines to treat impotence, such as alprostadil or yohimbine, without first talking to your doctor.

Seeing a psychologist or sex therapist, therefore, can be helpful for many men or couples, even if the origins of sexual dysfunction are physical. A therapist can help an individual or couple to communicate more easily, feel less anxious, and develop realistic expectations for sex. cheapest generic cialis Medicines that treat abnormal heartbeat. These include quinidine, procainamide, amiodarone and sotalol.Patients with left ventricular outflow obstruction, (for example, aortic stenosis and idiopathic hypertrophic subaortic stenosis) can be sensitive to the action of vasodilators including PDE5 inhibitors.

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The CIALIS dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability.

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Child-Pugh class B: Film-coated tablet, 5 mg PO ~1 hour before sexual activity; not to exceed 10 mg once daily; ODT not recommended-Initial dose: 2.5 mg orally once a day at approximately the same time, without regard to timing of sexual activity

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