Imdur

Precautions to keep in mind

Do not take sildenafil (e.g., Viagra), tadalafil (e.g., Cialis), or vardenafil (e.g., Levitra) if you are taking this medicine. When sildenafil, tadalafil, or vardenafil are taken with nitrates, the combination can lower blood pressure and cause dizziness, lightheadedness, or fainting. In some cases, sildenafil, tadalafil, or vardenafil taken with nitrates has caused death. If you are taking sildenafil, tadalafil, or vardenafil and you experience an angina attack, you must go to the hospital right away.

If you have been taking this medicine regularly for several weeks or more, do not suddenly stop using it. Stopping suddenly may bring on attacks of angina. Check with your doctor for the best way to reduce gradually the amount you are taking before stopping completely.

Dizziness, lightheadedness, or faintness may occur, especially when you get up quickly from a lying or sitting position. Getting up slowly may help. If you feel dizzy, sit or lie down.

The dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking this medicine, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time.

After taking a dose of this medicine you may get a headache that lasts for a short time. This is a common side effect, which should become less noticeable after you have taken the medicine for a while. If this effect continues, or if the headaches are severe, check with your doctor.

For patients taking the extended-release dosage forms of isosorbide dinitrate:

• Partially dissolved tablets have been found in the stools of a few patients taking the extended-release tablets. Be alert to this possibility, especially if you have frequent bowel movements, diarrhea, or digestive problems. Notify your doctor if any such tablets are discovered. The tablets must be properly digested to provide the correct dose of medicine.