Fildena 120 mg if you: Use nitrate medicines: Such as nitroglycerin, isosorbide mononitrate, or isosorbide dinitrate for chest pain or heart disease. Use riociguat: A medicine for certain types of pulmonary hypertension. Have an allergy to sildenafil: Or any ingredient in the tablet. These combinations or conditions are specifically listed as contraindications for sildenafil. DailyMed +1 2. Conditions requiring medical assessment Speak with a doctor before using sildenafil if you have: Heart disease, recent heart attack or stroke, or a condition that makes ***** activity unsafe. Low blood pressure or uncontrolled high blood pressure. Severe kidney or liver problems. A history of sudden vision loss, certain retinal disorders, or an erection lasting more than four hours. Sickle cell disease, leukaemia, or multiple myeloma, which can increase the risk of prolonged erections. 3. Medicines and substances to watch out for Tadarise (tadalafil): Do not combine it with Fildena unless specifically directed by your doctor. Alpha-blockers such as doxazosin or tamsulosin: May cause a significant drop in blood pressure. Some antibiotics, antifungals and HIV medicines: Can increase sildenafil levels and side effects. Alcohol: Can worsen dizziness and low blood pressure. Poppers (amyl nitrite and related recreational nitrites): Never combine with sildenafil. 4. Why the 120 mg strength matters The usual recommended maximum dose of sildenafil for erectile dysfunction is 100 mg in 24 hours. Fildena 120 mg exceeds that limit and may increase the risk of severe headache, fainting, vision problems, and prolonged erection. Do not take this dose without medical supervision. SILDENAFIL tablet, film coated +1 If you have already taken it and develop chest pain, fainting, sudden vision changes, or an erection lasting more than four hours, seek emergency medical care. If you develop chest pain, tell emergency personnel you took sildenafil and when; do not take nitrate medication yourself. To help assess your risk: Are you taking any heart or blood pressure medicines, or have you used Tadarise 40 mg recently? This is particularly important because tadalafil and sildenafil can have overlapping effects.