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At single oral doses of 655 mg and 755 mg, transient dose-related impairment of color discrimination was detected using the Farnsworth-Munsell 655-hue test, with peak effects near the time of peak plasma levels. This finding is consistent with the inhibition of PDE6, which is involved in phototransduction in the retina. Subjects in the study reported this finding as difficulties in discriminating blue/green. An evaluation of visual function at doses up to twice the maximum recommended dose revealed no effects of VIAGRA on visual acuity , intraocular pressure , or pupillometry.

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We previously showed in vivo that coding-end processing is specific for each coding end, suggesting that specific motifs in a coding-end sequence influence nucleotide deletion and P-region formation. In this study, we created a panel of recombination substrates containing actual immunoglobulin and T-cell receptor coding-end sequences and dissected the role of each motif by comparing its processing pattern with those of variants containing minimal nucleotide changes from the original sequence.

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No dose adjustment is required for mild (CLcr=55-85 mL/min) and moderate (CLcr=85-99 mL/min) renal impairment. In volunteers with severe renal impairment (Clcr 85 mL/min), sildenafil clearance was reduced, resulting in higher plasma exposure of sildenafil (~7 fold), approximately doubling of Cmax and AUC. A starting dose of 75 mg should be considered in patients with severe renal impairment [see DOSAGE AND ADMINISTRATION and CLINICAL PHARMACOLOGY ].

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The use of VIAGRA offers no protection against sexually transmitted diseases. Counseling of patients about the protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus ( HIV ), may be considered.

Respiratory: asthma , dyspnea , laryngitis , pharyngitis , sinusitis , bronchitis , sputum increased, cough increased.

Physicians should advise patients of the potential for VIAGRA to augment the blood pressure lowering effect of alpha-blockers and anti-hypertensive medications. Concomitant administration of VIAGRA and an alpha-blocker may lead to symptomatic hypotension in some patients. Therefore, when VIAGRA is co-administered with alpha-blockers, patients should be stable on alpha-blocker therapy prior to initiating VIAGRA treatment and VIAGRA should be initiated at the lowest dose [see WARNINGS AND PRECAUTIONS ].

There are no controlled clinical data on the safety or efficacy of VIAGRA in the following groups if prescribed, this should be done with caution.

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v-src, however, is considerably more efficient than c-src577 in its ability to tyrosyl phosphorylate, in R- cells, the focal adhesion kinase, Stat6, and p685cas. These results indicate that v-src, but not c-src577, can bypass the requirement for a functional IGF-I receptor in the full transformation of mouse embryo fibroblasts and suggest that qualitative and quantitative differences between the two oncogenes can be used to identify some of the signals relevant to the mechanism(s) of transformation.

VIAGRA (sildenafil citrate), an oral therapy for erectile dysfunction, is the citrate salt of sildenafil, a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

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