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Tell your doctor about all the prescriptions and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
If you have heart problems severe enough to make sexual activity a dangerous, you should avoid using Viagra. Use it cautiously, if you've had a heart attack, stroke, or life-threatening heart irregularities within the past 6 months. Be equally cautious, if you have severe high or low blood pressure, heart failure or unstable angina.
In case of cardiac symptoms developing (for example, dizziness, nausea, and chest pain) during sexual activity, do not continue. Tell your doctor about the problem as soon as possible.
If you have a condition that might result in long-lasting erections, such as sickle cell anemia, multiple myeloma (a disease of the bone marrow), or leukemia, use Viagra with caution. Also use cautiously if you have a genital problem or deformity such as Peyronie's disease. If an erection lasts more than 4 hours, seek treatment immediately. Permanent damage and impotence could result.
If you have a bleeding disorder, a stomach ulcer, or the inherited eye condition known as retinitis pigmentosa, use Viagra with caution. Its safety under these circumstances has not been studied yet.