Patients w/ left ventricular failure, left ventricular outflow tract obstruction, isolated right heart failure or sick sinus syndrome (w/ no pacemaker); stable coronary disease. Rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. Hypertensive crisis; hypotension resulting in cerebral infarction. Avoid abrupt w/drawal. Concomitant use w/ CYP3A4 inhibitors eg, antiprotease, cimetidine, ketoconazole, itraconazole, erythromycin, clarithromycin & CYP3A4 inducers eg, phenytoin, carbamazepine, phenobarb, rifampicin; other CYP3A4 substrates eg, terfenadine, astemizole, quinidine & class III antiarrhythmics eg, amiodarone. May affect ability to drive & use machines. Mild to moderate renal dysfunction. Mild hepatic impairment. Reversible biochemical changes in head of spermatozoa which can impair fecundation. Not to be used during pregnancy. Avoid during lactation. Elderly (metabolic processes slow down).
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