Sildenafil + Duloxetine (Malegra DXT Plus)

Read these points before you start. If any of them apply to you, talk to your doctor or pharmacist first.

• Never take it if you use a nitrate medicine for chest pain (such as nitroglycerin/GTN spray or isosorbide) or recreational "poppers" (amyl nitrite). Together they can make your blood pressure drop to a dangerous level.
• Do not take it if you use riociguat, a medicine for high blood pressure in the lungs.
• Check with your doctor first if you have heart disease, have been told to avoid sex because of your heart, or had a heart attack or stroke in the last 6 months.
• Tell your doctor if you have very low or uncontrolled high blood pressure, or liver or kidney problems.
• Tell your doctor if you have an eye disease such as retinitis pigmentosa, or have ever suddenly lost sight in one eye.
• Tell your doctor if your penis has an unusual shape (for example Peyronie's disease) or you have a condition that can cause long erections, such as sickle cell anaemia, leukaemia or multiple myeloma.
• Tell your doctor if you have a bleeding problem or an active stomach ulcer.
• Some medicines can raise the amount of this medicine in your blood, such as ritonavir and other HIV medicines, ketoconazole, itraconazole, clarithromycin and erythromycin. Alpha-blockers (for example doxazosin or tamsulosin) can make your blood pressure drop more.
• Do not drink lots of alcohol or grapefruit juice with it. They can raise side effects like dizziness and low blood pressure.
• It does not protect against pregnancy or sexually transmitted infections.
• This product also contains an antidepressant. Do not take it with other antidepressants (including MAOIs, or within 2 weeks of stopping one), lithium, linezolid, tramadol, triptans for migraine or St John's wort. This could cause serotonin syndrome.
• Tell your doctor if you have ever had depression, bipolar disorder, mania, epilepsy, glaucoma or a bleeding problem.
• Antidepressants can, rarely, cause dark thoughts, especially in people under 25. Tell someone close to you that you are taking it.
• Combination tablets like this are not approved in the USA or UK. Talk to your doctor before using it.
• It is only for adult men aged 18 and over.
• Tell your doctor if you have liver problems or drink a lot of alcohol, as duloxetine can affect the liver.
• Tell your doctor or pharmacist about every other medicine, vitamin or herbal product you use.
• Keep this product out of the reach and sight of children.