Liberize 50mg Film-Coated Tablets 4s

Always take this medicine exactly as described in the leaflet or as your pharmacist or doctor has told you. Check with your pharmacist or doctor if you are not sure.

• Take 1 tablet, as needed, approximately 1 hour before sexual activity.
• Swallow the tablet whole with water.
• Do not take more than 1 tablet a day.

Liberize will only help you achieve an erection if you are sexually aroused. You and your partner should engage in foreplay just as you would if you were not taking a medicine for erectile dysfunction.

The amount of time this medicine takes to work varies from person to person, but it normally takes between 30 to 60 minutes. You may take it up to 4 hours before sexual activity.

Relax and be patient if Liberize does not help you the first time. You can try again later but remember you can only take 1 tablet a day. For most men, Liberize will work the first or second time they try it. If it has been some time since you were able to get or keep an erection, it may take a couple of attempts before you achieve the desired effect. Talk to your doctor if you have tried Liberize and are still not able to get and keep an erection. If you feel the effect of Liberize is too strong, talk to your pharmacist or doctor.

• Active Ingredient: Sildenafil 50mg (as the citrate salt).
• Other Ingredients: Tablet core: microcrystalline cellulose, calcium hydrogen phosphate, croscarmellose sodium, magnesium stearate. Film coat: poly(vinyl alcohol), titanium dioxide (E171), macrogol 3350, talc.

• If you take more Liberize than you should If you take more tablets than recommended, contact your pharmacist or doctor immediately. Taking more than the recommended dose may result in side effects and/or more severe side effects. If you have any further questions on the use of this medicine, ask your pharmacist or doctor.
• Liberize can be taken with or without food. When this medicine is taken after a high-fat meal, it may take a little longer to start working. Do not take Liberize with grapefruit or grapefruit juice, because this can affect how the medicine works.
• Drinking excessive alcohol can temporarily reduce your ability to achieve an erection. To get a benefit from the medicine, you are advised not to drink large amounts of alcohol before sexual activity.
• Liberize can cause dizziness and can affect your vision. Do not drive or use machines if you suffer from these side effects after taking this medicine.
• Liberize contains less than 1 mmol sodium (23 mg) per tablet, that is to say essentially 'sodium free'.
• You should schedule a health check-up with your doctor as soon as possible within the first 6 months of starting to use Liberize to ensure that your erection problems are not caused by any serious health condition. Erectile dysfunction may be an early sign of: cardiovascular disease, diabetes, high blood pressure or high cholesterol. Tell your doctor about your problems if you have not already done so.

Do not take Liberize if you:

• Do not have an erection problem.
• Take any nitrate medicine for chest pain or heart failure.
• Take amyl nitrite, so called "poppers" as recreational drugs.
• Take riociguat (or other guanylate cyclase stimulators) for high blood pressure in the lungs.
• Take ritonavir for the treatment of HIV.
• Have been advised by your doctor to avoid sexual activity because of a problem with your heart or blood vessels.
• Have a severe heart problem such as a recent heart attack or stroke (within the last 6 months), unstable angina (chest pain) or severe cardiac failure (reduced pumping capacity of the heart).
• Have a severe liver problem.
• Have low blood pressure (below 90/50 mmHg) which can cause symptoms such as tiredness, dizziness, light-headedness, feeling sick, clammy skin, depression, loss of consciousness, or blurry vision.
• Have ever had severe vision loss because of nerve damage in the eyes, such as non-arteritic anterior ischaemic opticneuropathy (NAION); or have a rare inherited eye disease, such as retinitis pigmentosa.
• Have a deformed penis
• Are a woman
• Are under 18 years of age
• Are allergic to sildenafil or any of the other ingredients of this medicine.

Do not use Liberize if you take:

• Nitrate medicines: Do not take Liberize if you are taking nitrate medicines (such as glyceryl trinitrate, isosorbide mononitrate, isosorbide dinitrate) against chest pain (angina pectoris) or heart failure or "poppers" as recreational drugs (nitric
• oxide donors (such as amyl nitrite), nicorandil or sodium nitroprusside)). This is because these substances could lead to a dangerous fall in blood pressure if taken together with Liberize.
• Riociguat: Do not take Liberize if you are taking a medicine called riociguat (or other medicines of a group called guanylate cyclase stimulators). Riociguat is used to treat high blood pressure in the lungs and can lead to a dangerous fall in blood pressure if taken together with Liberize.
• Medicines to treat HIV-infections: Ritonavir is a medicine used to treat HIV-infections. Do not take Liberize if you are taking ritonavir since this combination can lead to dangerous fall in blood pressure.

Tell your pharmacist or doctor if you are taking, have recently taken or might take any other medicines. Some medicines may be affected by Liberize or they may affect how Liberize works and this may result in side effects. Talk to your pharmacist or doctor before using Liberize if you are taking:

• Medicines to treat fungal infections and antibiotics: Medicines to treat fungal infections called itraconazole or ketoconazole and an antibiotic called erythromycin increase the concentration of Liberize in the body and may result in side
• effects. You should contact your doctor before taking Liberize if you are using these medicines.
• Heartburn treatment: The medicine to treat heartburn, cimetidine, increases the concentration of Liberize in the body and may result in side effects. You should contact your doctor before taking Liberize.
• Other treatments for erectile dysfunction: The safety and efficacy of combinations of Liberize with other treatments for erectile dysfunction have not been studied and this combination is therefore not recommended.
• Alpha-blockers used to treat urinary problems or high blood pressure: Alpha-blockers used to treat urinary problems due to enlarged prostate (such as alfuzosin, doxazosin or tamsulosin) may lead to dizziness, light-headedness, nausea,
• fainting, lack of concentration, or blurred vision due to low blood pressure (symptomatic hypotension).

Sexual activity can put a strain on your heart. Talk to your doctor before taking Liberize if you:

• Get very breathless or feel any pain in the chest with light or moderate activity (e.g. walking briskly for 20 minutes or climbing two flights of stairs). Your doctor may need to check whether your heart can take the additional strain of having sex.
• Have a problem with a valve in your heart (valvular heart disease).
• Have a disease in which the heart muscle becomes inflamed and does not work as well as it should (cardiomyopathy).
• Have an irregular heart beat (arrhythmia).
• Have had surgery to improve blood flow to your heart, or you have high blood pressure which is now adequately treated.
• Have high blood pressure that is not controlled.

Talk to your doctor before taking Liberize if you:

• Have ever had an erection that lasted more than 4 hours (priapism). Some conditions can increase the probability of having a persistent erection, such as sickle cell anaemia (an abnormality of red blood cells), leukaemia (cancer of blood cells), or multiple myeloma (cancer of bone marrow). Use of impotence medicines may increase the risk of priapism. Long lasting erection may cause damage to the tissue in the penis and permanent loss of ability to have an erection.
• Have a stomach ulcer or a bleeding disorder (such as haemophilia), since Liberize can affect the aggregation of thrombocytes.
• Have previously been diagnosed with mild to moderate liver disease, or severe kidney problems. Liberize may not be suitable for you, you should consult your doctor before taking Liberize.
• Have ever had severe vision loss because of nerve damage in the eyes or a rare inherited eye disease. Cases of visual effects have been reported when using sildenafil. If you experience any sudden visual defect you should stop taking Liberize and contact your doctor immediately.