To make sure sildenafil is safe for you, tell your healthcare provider about all your medical conditions, including if you have: Or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure Had heart surgery within the last 6 months Pulmonary hypertension Had a stroke Low blood pressure, or high blood pressure that is not controlled A physical deformity of the penis (such as Peyronie's disease) Been told you should not have sexual intercourse for health reasons and you are a male Had an erection that lasted for more than 4 hours Problems with your blood cells, such as sickle cell anemia, multiple myeloma, or leukemia Retinitis pigmentosa, a rare genetic (runs in families) eye disease Ever had severe vision loss, including an eye problem called non-arteritic anterior ischemic optic neuropathy (NAION) Pulmonary veno-occlusive disease (PVOD) Bleeding problems Have had stomach ulcers Liver problems Kidney problems or are having kidney dialysis Are pregnant or intending to become pregnant (for patients with PAH) Are breastfeeding or intending to breastfeed (for patients with PAH)

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Anticholinergic drugs include antihistamines (such as Benadryl), tricyclic antidepressants, and medicines for overactive bladder and Parkinson's disease
For example, a three-month course of lactulose therapy significantly improved sleep quality, reduced daytime sleepiness, and increased sleep duration and REM sleep in patients with minimal HE (31, 33)
Much has been written about Merck's licensing deal with the Chinese biotech Jiangsu Hansoh Pharmaceutical Group Co., Ltd