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Sometimes a lower starting dose of 25mg will be suggested by a clinician. This route may be considered if you’re already taking certain medications for the treatment of kidney, liver or heart conditions. Or if your previous tolerance of sildenafil citrate 50mg was low.
Physicians should consider whether their patients with underlying NAION risk factors could be adversely affected by use of PDE5 inhibitors. Individuals who have already experienced NAION are at increased risk of NAION recurrence. Therefore, PDE5 inhibitors, including VIAGRA, should be used with caution in these patients and only when the anticipated benefits outweigh the risks. VIAGRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines.
Sildenafil and other PDE5 inhibitors should never be taken with nitrates. In combination with sexual stimulation, sildenafil works by increasing blood flow to the penis to help a man get and keep an erection. Sildenafil is a potent and selective inhibitor of cGMP-specific phosphodiesterase type 5 (PDE5), which is responsible for degradation of cGMP in the corpus cavernosum.
You should also not combine Viagra with other erectile dysfunction medications because this can cause serious side effects. Treatment of men with erectile dysfunction, which is the inability to achieve or maintain a penile erection sufficient for satisfactory sexual performance. Ultimately, the best dose of sildenafil for you is the one that is most effective and has the fewest side effects. Talk to your doctor to find out which dose is right for you.
Most, but not all, of these patients had preexisting cardiovascular risk factors. Many of these events were reported to occur during or shortly after sexual activity, and a few were reported to occur shortly after the use of VIAGRA without sexual activity. Others were reported to have occurred hours to days after the use of VIAGRA and sexual activity.
You can take Sildenafil, an erectile dysfunction medication, every day, up to the maximum recommended dosage of 100mg. Provided you have no pre-existing health issues, and you’re not taking any other ED medications alongside Sildenafil, it is perfectly safe to take several days in a row (or even every day). Spedra tablets treat 
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