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Hepatic Impairment. In volunteers with hepatic impairment (Child-Pugh Class A and B), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (47 for C max and 85 for AUC). The pharmacokinetics of sildenafil in patients with severely impaired hepatic function (Child-Pugh Class C) have not been studied. A starting dose of 25 mg should be considered in patients with any degree of hepatic impairment [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY ]. In studies with healthy volunteers of single doses up to 800 mg, adverse reactions were similar to those deutschland online apotheke viagra coupons at lower viagra generic vs brand but incidence rates and severities were increased. In cases of overdose, standard supportive measures should be adopted as required. Renal dialysis is not expected to accelerate clearance as sildenafil is highly bound to plasma proteins and it is not eliminated in the urine.

1 to 1): Penile hemorrhage, hematospermia. Frequency not reported: Priapism, prolonged erection, increased erection, cystitis, nocturia, urinary frequency, urinary incontinence, abnormal ejaculation, genital edema, anorgasmia [Ref] Uncommon (0. 1 to 1): Hematuria [Ref] Hypersensitivity.

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