MENSIL 25 mg,4

• Indications:
• Erectile dysfunction, i.e. the inability to achieve or maintain an erection of the penis sufficient for sexual intercourse. Sexual stimulation is required for the drug to be effective.
• Contraindications:
• Due to the effect of sildenafil on metabolic changes involving nitric oxide and cyclic guanosine monophosphate (cGMP), it enhances the hypotensive effects of nitrates. Therefore, the concomitant use of sildenafil with nitric oxide donors (such as amyl nitrite) or nitrates in any form is contraindicated.
• Concomitant use of PDE5 inhibitors, including sildenafil, with guanylate cyclase stimulators, such as riociguat, is contraindicated as it may lead to symptomatic hypotension.
• Medicinal products for the treatment of erectile dysfunction, including sildenafil, should not be used in men for whom sexual activity is inadvisable (e.g. patients with severe cardiovascular conditions such as unstable angina or severe heart failure).
• Mensil is contraindicated in patients who have loss of vision in one eye because of non-arteritic anterior ischemic optic neuropathy (NAION), regardless of whether this episode was in connection or not with previous PDE5 inhibitor exposure.
• The safety of sildenafil has not been studied in the following groups of patients: patients with severe hepatic impairment, hypotension (blood pressure <90/50 mm Hg), recent stroke or heart attack and with known hereditary degenerative changes in the retina, such as retinitis pigmentosa (a small proportion of these patients have genetic abnormalities of retinal phosphodiesterase). Sildenafil is contraindicated in these patients.

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