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33. Boolell M, Gepi-Attee S, Gingell JC, Allen MJ "Sildenafil, a novel effective oral therapy for male erectile dysfunction." Br J Urol 78 (1996): 257-61SILICON DIOXIDE

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Concomitant use of nitrates in any form is contraindicated [see Contraindications (4.1)].Administration of Levitra with nitrates (either regularly and/or intermittently) and nitric oxide donors is contraindicated [see Clinical Pharmacology (12.2)]. Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors, including Levitra, may potentiate the hypotensive effects of nitrates. A suitable time interval following dosing of Levitra for the safe administration of nitrates or nitric oxide donors has not been determined.

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