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ED occurs when difficulty engaging in sexual activity becomes painful or impossible. Sildenafil is a safe therapeutic option for erectile dysfunction and PAH that has been available on the market for over two decades. In the second study, a single oral dose of sildenafil 50 mg or matching placebo was administered in a 2 period crossover design to 20 generally healthy males with BPH. Physicians should inform patients that substantial consumption of alcohol eg, 5 units or greater in combination with CIALIS can increase the potential for side effects.