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White to off-white, round 9. The recommended dose is 50mg taken as needed approximately one hour before sexual activity. Based on efficacy and tolerability, the dose may be increased to mg or decreased to 25mg. The maximum recommended dose is mg. The maximum recommended dosing frequency is once per day. If Sildenafil is taken with food, the onset of activity may be delayed compared to the fasted state see Section 5. Based on efficacy and tolerability, the dose may be increased step-wise to 50mg and mg as necessary. Since sildenafil clearance is reduced in patients with hepatic impairment e. Based on efficacy andtolerability, the dose may be increased step-wise to 50mg and mg as necessary. Use in patients taking other medicinal products With the exception of ritonavir for which co-administration with sildenafil is not advised see Section 4.
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