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your doctor will advise on timing and dosing Avoid if you have significant cardiovascular disease, recent stroke or heart attack, severe liver impairment, or certain eye conditions (e.g., non-arteritic anterior ischaemic optic neuropathy) Common side effects include headache, facial flushing, indigestion, and nasal congestion [23] Seek urgent medical attention if you experience an erection lasting more than 4 hours (priapism), sudden vision or hearing loss, or chest pain during sexual activity If you experience side effects from any medicine, you can report them via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk