| Sildenafil citrate should be used with care in patients with anatomical deformation of the penis (angulation, cavernosal fibrosis or Peyronies disease), or in patients who have conditions, which may predispose them to priapism (sickle cell anemia, multiple myeloma, or leukemia). Avoid use in patients with CVS diseases in whom sexual activity is inadvisable. Patients having active peptic ulceration and bleeding problems should use the drug with special care. |