SILDENAFIL RATIOPHARM 50 mg FILM-COATED TABLETS

2. What you need to know before you take Sildenafilo ratiopharm

Do not take Sildenafilo ratiopharm

• if you are allergic to sildenafilo or any of the other ingredients of this medicine (listed in section 6).
• if you are taking medicines that contain nitrates (e.g. trinitrate of glycerol) or nitric oxide donors (e.g. amyl nitrite, also known as "poppers"). These medicines are often used to relieve the symptoms of chest pain (angina pectoris). If you take these medicines with Sildenafilo ratiopharm, your blood pressure may be seriously affected. Inform your doctor if you are taking any of these medicines. If you are not sure, consult your doctor or pharmacist.
• if you are taking riociguat. This medicine is used to treat pulmonary arterial hypertension (i.e. high blood pressure in the lungs) and chronic thromboembolic pulmonary hypertension (i.e. high blood pressure in the lungs caused by blood clots). PDE5 inhibitors, such as sildenafilo, have shown that they increase the hypotensive effect of this medicine. If you are taking riociguat or are not sure, consult your doctor.
  • if you have a serious heart problem.
  • if you have recently had a stroke or a heart attack.
  • if you have low blood pressure.
  • if you have a serious liver problem.
  • if you have certain rare hereditary eye diseases (such as retinitis pigmentosa)
  • if you have ever had loss of vision due to a known eye disease (non-arteritic anterior ischemic optic neuropathy, NAION)

Warnings and precautions

Consult your doctor or pharmacist before taking Sildenafilo ratiopharm.

• if you have heart problems. In this case, your doctor should carefully check if

your heart is able to withstand the extra strain of having sexual intercourse.

• if you suffer from any of the following diseases or symptoms, as you may experience more side effects:
  • a red blood cell anomaly (sickle cell anemia);
  • blood cancer (leukemia)
  • bone marrow cancer (multiple myeloma);
  • any disease or deformity of the penis.

• if you suffer from any of the following diseases, inform your doctor, who will carefully check if this medicine is suitable for you:

• if you currently have a stomach ulcer;
• if you have a coagulation disorder (e.g. hemophilia)

• if you have kidney or liver problems. Inform your doctor about them. In this case, it is possible that the doctor will decide to administer a lower dose.

DO NOT take this medicine

• if you are already using another treatment for erectile dysfunction.
• if you are already using treatments for pulmonary arterial hypertension (PAH) that contain sildenafilo or any other PDE5 inhibitor.
• if you do not have erectile dysfunction
• if you are a woman.

If you experience a sudden decrease or loss of vision, stop taking Sildenafilo ratiopharm and contact your doctor IMMEDIATELY.

Children and adolescents

This medicine MUST NOT be given to children and adolescents under 18 years.

Taking Sildenafilo ratiopharm with other medicines

Inform your doctor or pharmacist if you are using, have recently used or may need to use any other medicine.

In case of a medical emergency, you must inform any healthcare professional who treats you that you have taken Sildenafilo ratiopharm.

DO NOT take Sildenafilo ratiopharm if you are taking medicines that contain nitrates (e.g. trinitrate of glycerol) or nitric oxide donors (e.g. amyl nitrite, also known as "poppers"). These medicines are often used to relieve the symptoms of chest pain (angina pectoris). Taking nitrates or nitric oxide donors with Sildenafilo ratiopharm can have serious effects on your blood pressure.

Inform your doctor or pharmacist if you are taking riociguat.

If you take Sildenafilo ratiopharm with certain medicines, you may have problems. Therefore, inform your doctor if you are taking any of the following medicines:

• ritonavir or saquinavir (medicines to treat HIV infections);
• ketoconazole or itraconazole (medicines to treat fungal infections)
• erythromycin (an antibiotic)
• cimetidine (a medicine to treat acidity and peptic ulcers)
• alpha-blockers (a group of medicines to treat high blood pressure or enlarged prostate [benign prostatic hyperplasia]). Some patients who take alpha-blockers may experience dizziness or lightheadedness when standing up. These are symptoms of a drop in blood pressure when standing up quickly from a sitting or lying position (postural hypotension). These symptoms usually occur within 4 hours of taking Sildenafilo ratiopharm. To reduce the likelihood of these symptoms, you should start taking Sildenafilo ratiopharm only when you are already well controlled with a regular daily dose of your alpha-blocker.

• medicines that contain sacubitril/valsartan, used to treat heart failure.

If you are taking any of these medicines, it is possible that your doctor will indicate that you start with the lowest dose (25 mg) of Sildenafilo ratiopharm. If you are taking ritonavir, you must not exceed a maximum dose of 25 mg of sildenafilo in a 48-hour period.

Taking Sildenafilo ratiopharm with food, drinks and alcohol

If this medicine is taken with food, it may take a little longer to work.

Alcoholic beverages can worsen erection difficulties. To get the maximum benefit from your medicine, it is recommended that you avoid consuming alcohol before taking this medicine.

Driving and using machines

This medicine may make some people feel dizzy or have vision or hearing problems. Do not drive or use machines if you feel dizzy or if your vision or hearing is affected after taking Sildenafilo ratiopharm.

Sildenafilo ratiopharm contains sodium

This medicine contains less than 1 mmol of sodium (23 mg) per film-coated tablet; this is, essentially "sodium-free".

3. How

4. Possible side effects

5. Storage of

6. Contents of the pack and further information

Composition of Sildenafilo ratiopharm

• The active substance is sildenafilo.

Each film-coated tablet contains sildenafilo citrate equivalent to 50 mg of sildenafilo.

• The other ingredients are: microcrystalline cellulose, hypromellose, croscarmellose sodium, magnesium stearate, calcium hydrogen phosphate, talc, macrogol 6000, titanium dioxide, red iron oxide.

Appearance of the product and contents of the pack

Sildenafilo ratiopharm is presented as white to off-white, elongated, film-coated tablets with a score line on one side. The tablet can be divided into equal doses.

Sildenafilo ratiopharm is presented in packs of 1, 2, 4, 8, 12 or 24 film-coated tablets, in blisters. Not all pack sizes may be marketed.

Marketing authorisation holder

ratiopharm GmbH

Graf-Arco-Straße 3

89079 Ulm

Germany

Manufacturers

Merckle GmbH

Ludwig-Merckle-Straße 3

89143 Blaubeuren

Germany

Teva Operations Poland Sp. z o.o.

ul. Mogilska 80

31-546 Kraków

Poland

HBM Pharma s.r.o.

Sklabinská 30

036 80 Martin

Slovakia

You can request more information about this medicine from the local representative of the marketing authorisation holder:

Date of last revision of this leaflet:{MM/AAAA}.

Detailed information on this medicine is available on the European Medicines Agency website http://www.ema.europa.eu.