Allergic Reactions: Contraindicated in patients with known hypersensitivity to the active ingredients (e.g., sildenafil, tadalafil, vardenafil, dapoxetine) or any excipients in the formulation.
Concurrent Nitrate Therapy: Should not be used by individuals taking nitrates (e.g., nitroglycerin, isosorbide dinitrate) due to the risk of severe hypotension.
Severe Cardiovascular Conditions: Not recommended for patients with significant heart conditions such as recent myocardial infarction, stroke, unstable angina, severe heart failure, or those with a history of life-threatening arrhythmias.
Severe Liver Impairment: Contraindicated in patients with severe hepatic dysfunction due to altered drug metabolism.
Severe Renal Impairment: Should be used with caution in individuals with severe kidney dysfunction; dose adjustments may be necessary.
Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION): Contraindicated in patients with a history of NAION, as these medications may increase the risk of sudden vision loss.
Congenital Prolongation of the QT Interval: Avoid use in patients with congenital QT prolongation or those on medications that prolong the QT interval, especially with vardenafil.
Concurrent Use of Multiple PDE5 Inhibitors: Should not be used in combination with other PDE5 inhibitors or other erectile dysfunction treatments to avoid additive side effects.
Psychiatric Disorders: Contraindicated in individuals with a history of mania, severe depression, or other psychiatric disorders where serotonin reuptake inhibitors (SSRIs) might exacerbate the condition, especially with dapoxetine.
Concurrent Use with SSRIs or MAOIs: Should not be used in combination with SSRIs, MAOIs, or similar medications without medical supervision due to the risk of serotonin syndrome.
Severe Hypotension or Hypertension: Use is contraindicated in patients with significantly low or high blood pressure that is not well controlled.
Use with Alpha-Blockers: Caution is advised when used with alpha-blockers for prostate disorders or hypertension due to the risk of significant blood pressure drops.
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