Edyfil Special Precautions

A thorough medical history and physical examination should be undertaken to diagnose erectile dysfunction, determine potential underlying causes and identify appropriate treatment.
There is a degree of cardiac risk associated with sexual activity; therefore, physicians may wish to consider the status of the patients prior to initiating any treatment for erectile dysfunction. However, prior to prescribing sildenafil, physicians should carefully consider whether the patients with certain underlying conditions could be adversely affected by such vasodilatory effects, especially in combination with sexual activity. Patients with increased susceptibility to vasodilators include those with left ventricular outflow obstruction (eg, aortic stenosis, hypertrophic obstructive cardiomyopathy), or those with the rare syndrome of multiple system atrophy manifesting as severely impaired autonomic control of blood pressure.
Agents for the treatment of erectile dysfunction should be used with caution in patients with anatomical deformation of the penis (eg, angulation, cavernosal fibrosis or Peyronie's disease), or in patients who have conditions which may predispose to priapism (eg, sickle cell anaemia, multiple myeloma or leukaemia).
Agents for the treatment of erectile dysfunction should not be used in men for whom sexual activity is inadvisable.
The safety and efficacy of combinations of sildenafil with other treatments for erectile dysfunction have not been studied, and the use of such combinations is not recommended.
Caution is advised when sildenafil is administered to patients taking an α-blocker, as the co-administration may lead to symptomatic hypotension in a few susceptible individuals. In order to minimize the potential for developing postural hypotension, patients should be hemodynamically stable on α-blocker therapy prior to initiating sildenafil treatment. Initiation of sildenafil at lower doses should be considered.
In addition, physicians should advise patients what to do in the event of postural hypotensive symptoms.
There is no safety information on the administration of sildenafil to patients with bleeding disorders or active peptic ulceration, therefore, sildenafil should be administered with caution to these patients.
A minority of patients with inherited condition, retinitis pigmentosa, have genetic disorders of retinal phosphodiesterases. There is no safety information on the administration of sildenafil to patients with retinitis pigmentosa, therefore, sildenafil should be administered with caution to these patients.
Effects on the ability to drive or operate machinery: No recommendations.