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Side Effect Frequency Severity Notes
Headache Common Mild to moderate Usually temporary
Flushing Common Mild Due to vasodilation
Dizziness Occasional Mild Avoid driving if occurs
Nasal Congestion Less common Mild Common with vasodilators
Digestive Upset Rare Mild Report to doctor if severe

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Drug Class Possible Interaction Impact
Nitrates Dangerous hypotension Avoid use entirely
Alpha-blockers Additive blood pressure lowering effects Use caution, monitor BP
Other PDE5 inhibitors Increased risk of side effects Do not combine
CYP3A4 inhibitors Increased sildenafil/dapoxetine levels Adjust dose accordingly
CYP3A4 inducers Reduced efficacy May require dose escalation

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