Maxon Active, 4

Hypersensitivity to the active substance or any of the excipients. Due to the effect of sildenafil on metabolic processes involving nitric oxide and cyclic guanosine monophosphate, it enhances the hypotensive effect of nitrates. Therefore, the simultaneous use of sildenafil with drugs that release nitric oxide (such as amyl nitrite) or nitrates in any form is contraindicated. Concomitant use of PDE5 inhibitors, including sildenafil, and drugs that induce guanylate cyclase, such as riociguat, is contraindicated as it may lead to symptomatic hypotension. Medicines intended to treat erectile dysfunction, including sildenafil, should not be used by men who do not want sexual activity (for example, patients with severe cardiovascular disease such as unstable angina or severe heart failure). MAXON ACTIVE is contraindicated in patients who have lost vision in one eye due to non-arteritic anterior ischemic optic neuropathy (NAION), regardless of whether it was associated with previous exposure to a PDE5 inhibitor. The safety of sildenafil has not been studied in the following patient groups: patients with severe hepatic impairment, hypotension (blood pressure <90/50 mmHg), recent stroke or heart attack, and known hereditary retinal degenerative changes such as retinitis pigmentosa (a small proportion of these patients have genetically determined retinal phosphodiesterase disorders). The use of sildenafil in these patients is contraindicated.