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Such monitoring is preferred for patients with ocular manifestations suggestive of retinal effects and in those in danger. Nonarteritic anterior ischemic optic neuropathy has been reported in temporal association with the use of all PDE type 5 inhibitors; patients should discontinue sildenafil and contact a clinician immediately if sudden vision loss or decreased vision occurs in a single or both eyes. Patients taking or considering taking a PDE type 5 inhibitor should inform their health-care professionals if they have ever endured severe lack of vision, which might reflect a prior episode of NAION. Clinicians should advise patients of the increased threat of NAION in those who have previously experienced NAION in a single eye and potential ramifications of vasodilators such as PDE type 5 inhibitors on the introduction of NAION in the next eye. Pyrexia occurred in 6% of patients with PAH getting sildenafil in a controlled clinical trial. Diarrhea or gastritis occurred in 9 or 3%, respectively, of patients with PAH acquiring sildenafil in a handled clinical trial.