What vision change is a stop?
Sudden loss in one or both eyes. That may be non-arteritic anterior ischemic optic neuropathy (NAION). Stop all PDE5 inhibitors, including Viagra, and get medical attention. Do not push through a blackout to finish the evening.
This board cannot clear you back onto 100 mg by email. Tell ophthalmology and the prescriber who owns the PDE5.
What NAION numbers sit on the US label?
Published annual incidence is 2.5 to 11.8 cases per 100,000 in males aged 50 or older. An observational class study suggested about a 2-fold increase in NAION risk within 5 half-lives of PDE5 use. It is not possible to say those events are caused by the tablet alone.
People who already had NAION in one eye are at higher risk of recurrence. Use caution, and only when expected benefit outweighs that risk.
What hearing change is a stop?
Sudden decrease or loss of hearing. Tinnitus and dizziness may travel with it. Stop the PDE5 inhibitor and seek prompt care. The label cannot say whether the tablet, other ear-risk factors, or both were responsible.
This is not a stuffed-nose row. Nasal congestion lives on the side-effect scan.
How common was the short color tinge?
Abnormal vision in the fixed-dose table was 1% at 25 mg, 2% at 50 mg, and 11% at 100 mg, versus 1% on placebo. Events were usually mild, transient, and a color tinge, light sensitivity, or blur.
Flexible-dose work put abnormal vision at 3% versus 0%, and only one patient discontinued for it. A tinge is not automatic proof you must leave the ladder.
What about a crowded optic disc?
Individuals with a crowded optic disc are considered at greater NAION risk than the general population. Evidence is not enough to support screening every prospective user for that uncommon finding.
Age over 50, diabetes, hypertension, coronary disease, hyperlipidemia, and smoking are the usual underlying factors listed with postmarketing NAION reports.
How do you keep the tinge and the stop apart?
A short blue-green shift that fades is the common PDE6 nuisance. A blackout or sudden field loss is the NAION warning. Treat them as different events. The sildenafil panel already splits those sentences.
Climbing from 50 mg to 100 mg raises the tinge row (2% to 11% in fixed-dose work). It does not make a sudden loss 'more normal.'