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Interaction	Description	Risk Level	Advice	Notes
Nitrates	Can cause severe hypotension	High	Avoid use	Common in heart disease medications
Alcohol	May increase side effects	Moderate	Limit intake	Affects efficacy and safety
Other PDE5 inhibitors	Risk of overdose	High	Do not combine	Use only as prescribed
CYP3A4 Inhibitors	Increase drug levels	Moderate	Consult doctor	Includes antibiotics and antifungals

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Side Effect	Frequency	Severity	Associated Ingredient	Management Tips
Headache	Common	Mild	Sildenafil	Hydration, OTC pain relievers
Nausea	Moderate	Mild	Dapoxetine	Take with food
Dizziness	Common	Mild	Both	Sit or lie down, avoid driving
Flushing	Common	Mild	Sildenafil	Cool compress, stay hydrated

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• Keep all medications in their original containers with the pharmacy label.
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Country	Legal to Purchase	Prescription Required	Online Sale Allowed	Notes
USA	Yes	Yes	Yes	Under regulated pharmacy laws
UK	Yes	Yes	Yes	Via licensed online pharmacies
Canada	Yes	No	Yes	Some online restrictions
India	Yes	No	Yes	Widely available OTC