natgillin/translations-raw huggingface dataset:
In the placebo-controlled study of sildenafil in patients 1 to 17 years of age with pulmonary arterial hypertension, a total of 174 patients were treated three times a day with either low (10 mg in patients >20 kg; no patients ≤20 kg received the low dose), medium (10 mg in patients ≥8-20 kg; 20 mg in patients ≥20-45 kg; 40 mg in patients >45 kg) or high dose (20 mg in patients ≥8-20 kg; 40 mg in patients ≥20-45 kg; 80 mg in patients >45 kg) regimens of sildenafil and 60 were treated with placebo. 
U placebom kontroliranom ispitivanju sildenafila u bolesnika u dobi od 1 do 17 godina s plućnom arterijskom hipertenzijom ukupno su 174 bolesnika tri puta na dan primala nisku (10 mg u bolesnika tjelesne težine > 20 kg; niti jedan bolesnik tjelesne težine ≤ 20 kg nije primao nisku dozu), srednju(10 mg u bolesnika tjelesne težine ≥ 8-20 kg, 20 mg u bolesnika tjelesne težine ≥ 20-45 kg, 40 mg u bolesnika tjelesne težine > 45 kg) ili visoku dozu (20 mg u bolesnika tjelesne težine ≥ 8-20 kg, 40 mg u bolesnika tjelesne težine ≥ 20-45 kg; 80 mg u bolesnika tjelesne težine > 45 kg) sildenafila, dok je 60 bolesnika primalo placebo.
You should tell your doctor if you have kidney or liver problems, as your dose may need to be adjusted. 
Posebna upozorenja za bolesnike s tegobama bubrega ili jetre Trebate obavijestiti svog liječnika ako imate tegoba s bubrezima ili jetrom jer će Vam možda trebati prilagoditi dozu lijeka.
A total of 134 patients were treated with sildenafil in the initial study, and their long term survival status was assessed for a minimum of 3 years. 
U inicijalnom su ispitivanju sildenafilom liječena ukupno 134 bolesnika te je praćeno njihovo dugoročno preživljenje tijekom najmanje 3 godine.
Granpidam 20 mg film-coated tablets are also provided in PVC/Alu perforated unit dose blister packs containing 15x1, 90x1 and 300x1 tablets. 
Granpidam 20 mg filmom obložene tablete su također dostupni u PVC / Alu perforiranim blisterima djeljivim na jedinične doze koji sadrže 15x1, 90x1 i 300x1 tableta.
Of the 277 subjects treated in the pivotal study, 259 entered a long-term extension study. 
Od 277 ispitanika liječenih u pivotalnom ispitivanju, njih je 259 ušlo u dugotrajan produžetak ispitivanja.
Newly reported adverse reactions, which occurred more frequently in the sildenafil/ epoprostenol group, were ocular hyperaemia, vision blurred, nasal congestion, night sweats, back pain and dry mouth. 
Novoprijavljene nuspojave koje su se javljale češće u skupini liječenoj sildenafilom/epoprostenolom bile su okularna hiperemija, zamagljen vid, kongestija nosa, noćno znojenje, bol u leđima i suha usta.
In these study populations, mean additional reductions of supine systolic and diastolic blood pressure of 7/7 mmHg, 9/5 mmHg, and 8/4 mmHg, respectively, and mean additional reductions of standing blood pressure of 6/6 mmHg, 11/4 mmHg, and 4/5 mmHg, respectively were observed. 
U populacijama bolesnika u ta tri ispitivanja zabilježeno je srednja vrijednost dodatnog sniženja sistoličkog i dijastoličkog krvnog tlaka u ležećem položaju od 7/7 mmHg, 9/5 mmHg, odnosno 8/4 mmHg te srednja vrijednost dodatnog sniženja krvnog tlaka u stojećem položaju od 6/6 mmHg, 11/4 mmHg, odnosno 4/5 mmHg.
Sildenafil (100 mg single dose) did not affect the steady state pharmacokinetics of the HIV protease inhibitor saquinavir, which is a CYP3A4 substrate/inhibitor. 
Sildenafil (jedna doza od 100 mg) nije utjecao na farmakokinetiku inhibitora HIV proteaze sakvinavira, koji je supstrat/inhibitor CYP3A4, u stanju dinamičke ravnoteže.
Consequently, should signs of pulmonary oedema occur when sildenafil is administered in patients with pulmonary hypertension, the possibility of associated veno-occlusive disease should be considered. 
Stoga, pojave li se znakovi plućnog edema kod primjene sildenafila u bolesnika s plućnom hipertenzijom, potrebno je uzeti u obzir moguću povezanost s vensko-okluzivnom bolesti.
Among these 37 deaths, the number (%) of deaths was 5/55 (9.1%), 10/74 (13.5%), and 22/100 (22%) in the sildenafil low, medium, and high dose groups, respectively. 
Od tih 37 smrtnih slučajeva, broj (%) smrtnih slučajeva bio je 5/55 (9,1%) u skupini s niskom, 10/74 (13,5%) u skupini sa srednjom i 22/100 (22%) u skupini s visokom dozom sildenafila.
CYP3A4 inducers seemed to have a substantial impact on the pharmacokinetics of sildenafil in pulmonary arterial hypertension patients, which was confirmed in the in vivo interaction study with CYP3A4 inducer bosentan. 
Činilo se da induktori CYP3A4 značajno utječu na farmakokinetiku sildenafila u bolesnika s plućnom arterijskom hipertenzijom, što je potvrđeno u in vivo ispitivanju interakcije s induktorom CYP3A4 bosentanom.
Cases of non-arteritic anterior ischaemic optic neuropathy, a rare condition, have been reported spontaneously and in an observational study in connection with the intake of sildenafil and other PDE5 inhibitors (see section 4.8). 
Slučajevi nearterijske prednje ishemijske optičke neuropatije, što je rijetko stanje, prijavljeni su spontano u opservacijskim ispitivanjima povezano s unosom sildenafila i drugih PDE5 inhibitora (vidjeti dio 4.8).
If you experience sudden decrease or loss of vision, stop taking Granpidam and contact your doctor immediately (see also section 4). 
Ako osjetite iznenadno smanjenje ili gubitak vida, prestanite uzimati Granpidam i odmah se javite svom liječniku (pogledajte i dio 4.).
At 3 years 87% of the patients were receiving a dose of 80 mg TID. 
Nakon 3 godine je 87% bolesnika primalo dozu od 80 mg TID.
After oral doses of 20 mg three times a day, the mean maximum total plasma concentration of sildenafil at steady state is approximately 113 ng/ml. 
Nakon peroralnih doza od 20 mg tri puta na dan, srednja vrijednost najveće ukupne koncentracije sildenafila u plazmi u stanju dinamičke ravnoteže iznosi približno 113 ng/ml.
Patients were naïve for specific PAH therapy and the use of prostacyclin, prostacyclin analogues and endothelin receptor antagonists was not permitted in the study, and neither was arginine supplementation, nitrates, alpha-blockers and potent CYP450 3A4 inhibitors. 
Bolesnici prethodno nisu primali terapiju specifičnu za PAH, a u ispitivanju nije bila dopuštena primjena prostaciklina, analoga prostaciklina i antagonista endotelinskih receptora kao ni uzimanje nadomjestaka arginina, nitrata, alfa-blokatora i snažnih inhibitora izoenzima CYP3A4 citokroma P450.
The most potent of the CYP3A4 inhibitors such as ketoconazole and itraconazole would be expected to have effects similar to ritonavir (see section 4.3). 
Za očekivati je da će najsnažniji inhibitori CYP3A4, poput ketokonazola i itrakonazola, imati slične učinke kao ritonavir (vidjeti dio 4.3).
Population pharmacokinetics 
Populacijska farmakokinetika
When used to treat male erectile dysfunction (ED), the following visual side effects have been reported with PDE5 inhibitors, including sildenafil at an unknown frequency; partial, sudden, temporary, or permanent decrease or loss of vision in one or both eyes. 
Kod primjene inhibitora PDE5, uključujući sildenafil, u liječenju muške erektilne disfunkcije prijavljene su sljedeće očne nuspojave: djelomično, iznenadno, privremeno ili trajno smanjenje ili gubitak vida na jednom ili oba oka.
Patients who have loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy (NAION), regardless of whether this episode was in connection or not with previous PDE5 inhibitor exposure (see section 4.4). 
Bolesnici koji su izgubili vid na jednom oku zbog nearterijske prednje ishemijske optičke neuropatije, bez obzira na to je li ta epizoda povezana s prethodnim izlaganjem inhibitorima PDE5 (vidjeti dio 4.4).
At 3 years 68% of the patients were receiving a dose of 80 mg TID. 
Nakon 3 godine je 68% bolesnika primalo dozu od 80 mg TID.
Studies in vitro have shown that sildenafil is selective for PDE5. 
Ispitivanja in vitro su pokazala da sildenafil selektivno djeluje na enzim PDE5.
Therefore dose adjustments are recommended when using CYP3A4 inhibitors (see section 4.2). 
Stoga se preporučuje prilagodba doze kod primjene inhibitora CYP3A4 (vidjeti dio 4.2).
Pack size of 90 tablets in a carton. 
Veličina pakiranja: 90 tableta u kutiji.
Effects of sildenafil on other medicinal products 
Učinci sildenafila na druge lijekove
For patients with a baseline walking distance ≥325 metres, the treatment effect was 38.4 metres in favour of sildenafil; for patients with a baseline walking distance <325 metres, the treatment effect was 2.3 metres in favour of placebo. 
U bolesnika koji su na početku ispitivanja mogli prehodati udaljenost od ≥ 325 metara, učinak liječenja iznosio je 38,4 metra u korist sildenafila; u bolesnika koji su na početku ispitivanja mogli prehodati udaljenost od < 325 metara, učinak liječenja iznosio je 2,3 metra u korist placeba.
The percent reduction at 12 weeks for sildenafil 20 mg, 40 mg and 80 mg TID in PVR (11.2%, 12.9%, 23.3%) was proportionally greater than the reduction in systemic vascular resistance (SVR) (7.2%, 5.9%, 14.4%). 
Postotno smanjenje plućnog krvožilnog otpora nakon 12 tjedana primjene sildenafila u dozama od 20 mg, 40 mg odnosno 80 mg TID (11,2%, 12,9% odnosno 23,3%) bilo je razmjerno veće od smanjenja sustavnog krvožilnog otpora (7,2%, 5,9%, odnosno 14,4%).
No data are available with sildenafil in patients with pulmonary hypertension associated with pulmonary veno-occlusive disease. 
Nema podataka o primjeni sildenafila u bolesnika s plućnom hipertenzijom povezanom s plućnom vensko-okluzivnom bolesti.
Mean baseline peak volume of oxygen consumed (VO2) values were comparable across the sildenafil treatment groups (17.37 to 18.03 ml/kg/min), and slightly higher for the placebo treatment group (20.02 ml/kg/min). 
Srednja vrijednost vršnog volumena potrošnje kisika (VO2) na početku ispitivanja bila je usporediva u svim skupinama liječenima sildenafilom (17,37 do 18,03 ml/kg/min), a nešto veća u skupini koja je primala placebo (20,02 ml/kg/min).
In a study of the hemodynamic effects of a single oral 100 mg dose of sildenafil in 14 patients with severe coronary artery disease (CAD) (>70% stenosis of at least one coronary artery), the mean resting systolic and diastolic blood pressures decreased by 7% and 6% respectively compared to baseline. 
U ispitivanju hemodinamičkih učinaka jedne peroralne doze od 100 mg sildenafila u 14 bolesnika s teškom bolešću koronarnih arterija (stenoza > 70% u barem jednoj koronarnoj arteriji), srednja vrijednost sistoličkog krvnog tlaka u mirovanju snižena je za 7%, a dijastoličkog za 6% u odnosu na početne vrijednosti.
A randomised, double-blind, placebo-controlled study was conducted in 278 patients with primary pulmonary hypertension, PAH associated with connective tissue disease, and PAH following surgical repair of congenital heart lesions. 
Randomizirano, dvostruko slijepo, placebom kontrolirano ispitivanje provedeno je u 278 bolesnika s primarnom plućnom hipertenzijom, PAH-om povezanim s bolešću vezivnog tkiva i PAH-om koji je nastao nakon kirurškog popravka urođenih srčanih lezija.
Sildenafil is a potent and selective inhibitor of cyclic guanosine monophosphate (cGMP) specific phosphodiesterase type 5 (PDE5), the enzyme that is responsible for degradation of cGMP. 
Sildenafil je snažan i selektivan inhibitor fosfodiesteraze tipa 5 (PDE5) specifične za ciklički gvanozin monofosfat (cGMP).
A downward dose adjustment to 20 mg once daily is recommended in case of co-administration with more potent CYP3A4 inhibitors clarithromycin, telithromycin and nefazodone. 
Preporučuje se snižavanje doze na 20 mg jedanput na dan u slučaju istovremene primjene sa snažnijim inhibitorima CYP3A4: klaritromicinom, telitromicinom i nefazodonom.
Long-term survival data in naive population 
Podaci o dugoročnom preživljenju u populaciji prethodno neliječenih bolesnika
Medicinal product subject to restricted medical prescription (see Annex I: Summary of Product Characteristics, section 4.2). 
Lijek se izdaje na ograničeni recept (vidjeti Prilog I.: Sažetak opisa svojstava lijeka, dio 4.2)
The most commonly reported adverse reactions that occurred (greater or equal to 10%) on sildenafil compared to placebo were headache, flushing, dyspepsia, diarrhoea and pain in extremity. 
Najčešće prijavljene nuspojave koje su se javile (10% ili više) kod liječenja sildenafilom u odnosu na placebo bile su glavobolja, navale crvenila, dispepsija, proljev i bol u ekstremitetu.
The use of prostacyclin, prostacyclin analogues and endothelin receptor antagonists was not permitted as add-on therapy, and neither was arginine supplementation. 
Nije bila dopuštena primjena prostaciklina, analoga prostaciklina ni antagonista endotelinskih receptora kao dodatne terapije, kao ni nadomještanje arginina.
The most common serious adverse events that occurred with a frequency ≥1% in sildenafil patients (combined doses) were pneumonia (7.4%), cardiac failure, pulmonary hypertension (each 5.2%), upper respiratory tract infection (3.1%), right ventricular failure, gastroenteritis (each 2.6%), syncope, bronchitis, bronchopneumonia, pulmonary arterial hypertension (each 2.2%), chest pain, dental caries (each 1.7%), and cardiogenic shock, gastroenteritis viral, urinary tract infection (each 1.3%). 
Najčešća ozbiljna nuspojava koje se pojavila s učestalošću od ≥1% bolesnika koji su primali sildenafil (kombinirane doze) bila je pneumonija (7,4%), srčano zatajenje, plućna hipertenzija (svaki po 5,2%), infekcije gornjeg dišnog sustava (3,1%), zatajenje desnog ventrikula, gastroenteritis (svaki po 2,6%), sinkopa, bronhitis, bronhopneumonija, plućna arterijska hipertenzija (svaki 2,2%), bol u prsima, zubni karijes (svaki 1,7%) i kardiogeni šok, virusni gastroenteritis, infekcija urinarnog trakta (svaki 1,3%).
Studies with sildenafil have been performed in forms of pulmonary arterial hypertension related to primary (idiopathic), connective tissue disease associated or congenital heart disease associated forms of PAH (see section 5.1). 
Ispitivanja sildenafila provedena su u sljedećim oblicima plućne arterijske hipertenzije: primarnoj (idiopatskoj), onoj povezanoj s bolešću vezivnog tkiva i onoj povezanoj s urođenom bolešću srca (vidjeti dio 5.1).
A randomised, double-blind, placebo controlled study was conducted in 267 patients with PAH who were stabilised on intravenous epoprostenol. 
Provedeno je randomizirano, dvostruko slijepo, placebom kontrolirano ispitivanje s 267 bolesnika s PAH-om koji su bili stabilizirani na intravenskoj terapiji epoprostenolom.
Efficacy of sildenafil should be closely monitored in patients using concomitant potent CYP3A4 inducers, such as carbamazepine, phenytoin, phenobarbital, St John's wort and rifampicine. 
Potrebno je pomno nadzirati djelotvornost sildenafila u bolesnika koji istovremeno uzimaju snažne induktore CYP3A4, poput karbamazepina, fenitoina, fenobarbitala, gospine trave i rifampicina.
Vaso-occlusive crises in patients with sickle cell anaemia Sildenafil should not be used in patients with pulmonary hypertension secondary to sickle cell anaemia. 
Vazookluzivne krize u bolesnika s anemijom srpastih stanica Sildenafil se ne smije primjenjivati u bolesnika s plućnom hipertenzijom koja je posljedica anemije srpastih stanica.
Based on these pharmacokinetic results co-administration of sildenafil with ritonavir is contraindicated in pulmonary arterial hypertension patients (see section 4.3). 
Na temelju ovih farmakokinetičkih rezultata kontraindicirana je istovremena primjena sildenafila s ritonavirom u bolesnika s plućnom arterijskom hipertenzijom (vidjeti dio 4.3).
After chronic dosing of 80 mg three times a day to patients with pulmonary arterial hypertension lesser effects in blood pressure reduction were observed (a reduction in both systolic and diastolic pressure of 2 mmHg). 
Nakon kronične primjene doze od 80 mg tri puta na dan u bolesnika s plućnom arterijskom hipertenzijom opaženi su slabiji učinci na sniženje krvnog tlaka (sniženje i sistoličkog i dijastoličkog tlaka za 2 mmHg).
The population pharmacokinetic analysis in pulmonary arterial hypertension patients suggested that co-administration of beta-blockers in combination with CYP3A4 substrates might result in an additional increase in sildenafil exposure compared with administration of CYP3A4 substrates alone. 
Analiza populacijske farmakokinetike u bolesnika s plućnom arterijskom hipertenzijom upućuje na to da istovremena primjena beta-blokatora u kombinaciji sa supstratima CYP3A4 može rezultirati dodatnim povećanjem izloženosti sildenafilu u usporedbi s primjenom samo supstrata CYP3A4.
The overall frequency of discontinuation in sildenafil treated patients at doses of 20 mg, 40 mg and 80 mg TID was 2.9%, 3.0% and 8.5% respectively, compared to 2.9% with placebo. 
Ukupna učestalost prekida liječenja u bolesnika liječenih sildenafilom u dozama od 20 mg, 40 mg i 80 mg TID iznosila je 2,9%, 3,0% odnosno 8,5%, u odnosu na 2,9% kod primjene placeba.
The efficacy of sildenafil has not been established in patients with severe pulmonary arterial hypertension (functional class IV). 
Nije utvrđena djelotvornost sildenafila u bolesnika s teškom plućnom arterijskom hipertenzijom (funkcionalni stupanj IV).
How to store Granpidam 
Kako čuvati Granpidam
- Medicines containing nitrates, or nitric oxide donors such as amyl nitrate (“poppers”). 
- lijekove koji sadrže nitrate ili donore dušikova oksida poput amil nitrata.
Population pharmacokinetic analysis of pulmonary arterial hypertension clinical trial data indicated a reduction in sildenafil clearance and/or an increase of oral bioavailability when co-administered with CYP3A4 substrates and the combination of CYP3A4 substrates and beta-blockers. 
Analiza podataka o populacijskoj farmakokinetici iz kliničkih ispitivanja u plućnoj arterijskoj hipertenziji ukazala je na smanjen klirens i/ili povećanu bioraspoloživost sildenafila nakon peroralne primjene kada se ovaj lijek primjenjivao zajedno sa supstratima CYP3A4 i kombinacijom supstrata CYP3A4 i beta-blokatora.
In patients with pulmonary arterial hypertension, the average steady state concentrations were 20-50% higher over the investigated dose range of 20-80 mg three times a day compared to healthy volunteers. 
U bolesnika s plućnom arterijskom hipertenzijom, prosječne koncentracije u stanju dinamičke ravnoteže su u ispitivanom rasponu doza od 20-80 mg tri puta na dan bile 20-50% više nego u zdravih dobrovoljaca.
Metabolism and nutrition disorders Common fluid retention 
Poremećaji metabolizma i prehrane često retencija tekućine
Side effects reported commonly (may affect up to 1 in 10 people) included: infection under the skin, flu-like symptoms, inflammation of the sinuses, reduced number of red blood cells (anaemia), fluid retention, difficulty sleeping, anxiety, migraine, shaking, “pins and needles”-like sensation, burning sensation, reduced sense of touch, bleeding at the back of the eye, effects on vision, blurred vision and light sensitivity, effects on colour vision, eye irritation, bloodshot eyes /red eyes, vertigo, bronchitis, nosebleed, runny nose, cough, stuffy nose, stomach inflammation, gastroenteritis, heartburn, piles, abdominal distension, dry mouth, hair loss, redness of the skin, night sweats, muscle aches, back pain and increased body temperature. 
Nuspojave koje su prijavljene često (mogu se javiti u do 1 na 10 osoba) bile su: infekcija pod kožom, simptomi nalik gripi, upala sinusa, smanjen broj crvenih krvnih stanica (anemija), zadržavanje tekućine, poteškoće sa spavanjem, tjeskoba, migrena, tresavica, osjećaj bockanja i trnjenja, osjećaj žarenja, smanjen osjet dodira, krvarenje u stražnjem dijelu oka, učinci na vid, zamagljen vid i osjetljivost na svjetlost, učinci na raspoznavanje boja, iritacije očiju, zakrvavljene oči/crvene oči, vrtoglavica, bronhitis, krvarenje iz nosa, curenje iz nosa, kašalj, začepljen nos, upala želuca, gastroenteritis, žgaravica, hemoroidi, nadimanje trbuha, suha usta, gubitak kose, crvenilo kože, noćno znojenje, bolovi u mišićima, bol u leđima i povišena tjelesna temperatura.
Of the total 229 subjects who received sildenafil, there were 55, 74, and 100 subjects in the low, medium and high dose groups, respectively. 
Od ukupno 229 ispitanika koji su primali sildenafil, 55 ispitanika bilo je u skupini s niskom, 74 ispitanika u skupini sa srednjom i 100 ispitanika u skupini s visokom dozom.
The exposure to sildenafil in patients on CYP3A4 substrates and CYP3A4 substrates plus beta-blockers was 43% and 66% higher, respectively, compared to patients not receiving these classes of medicines. 
Izloženost sildenafilu u bolesnika koji su uzimali supstrate CYP3A4 bila je 43% veća, a u onih koji su uzimali supstrate CYP3A4 s betablokatorima 66% veća u usporedbi s bolesnicima koji nisu uzimali lijekove iz navedenih skupina.
Concomitant use of riociguat with PDE5 inhibitors, including sildenafil, is contraindicated (see section 4.3). 
Istovremena upotreba riocigvata sa PDE5 inhibitorima, uključujući sildenafil je kontraindicirana (vidjeti dio 4.3).
Doses up to 80 mg TID were administered and after 3 years 68% of 133 patients on study treatment were receiving sildenafil 80 mg TID. 
Primjenjivale su se doze do 80 mg tri puta na dan te je nakon 3 godine 68% od 133 bolesnika liječenih ispitivanim lijekom primalo sildenafil u dozi od 80 mg TID.
For paediatric patients aged 1 year to 17 years old, the recommended dose in patients ≤20 kg is 10 mg three times a day and for patients >20 kg is 20 mg three times a day. 
Za pedijatrijske bolesnike u dobi od 1 do 17 godina preporučena doza u bolesnika tjelesne težine ≤ 20 kg iznosi 10 mg tri puta na dan, a u bolesnika tjelesne težine > 20 kg ona iznosi 20 mg tri puta na dan.
In this population, Kaplan-Meier estimates of 1, 2 and 3 year survival were 96%, 91% and 82%, respectively. 
U ovoj je populaciji jednogodišnje preživljenje procijenjeno Kaplan-Meierovom metodom iznosilo 96%, dvogodišnje 91%, a trogodišnje 82%.
Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearance. 
Stoga inhibitori tih izoenzima mogu smanjiti klirens sildenafila, dok ga njihovi induktori mogu povećati.
Each tablet contains 20 mg of sildenafil (as citrate). 
Jedna tableta sadrži 20 mg sildenafila (u obliku sildenafilcitrata).
In post-marketing experience with sildenafil for male erectile dysfunction, serious cardiovascular events, including myocardial infarction, unstable angina, sudden cardiac death, ventricular arrhythmia, cerebrovascular haemorrhage, transient ischaemic attack, hypertension and hypotension have been reported in temporal association with the use of sildenafil. 
Nakon stavljanja u promet sildenafila u liječenju muške erektilne disfunkcije prijavljeni su ozbiljni kardiovaskularni događaji, uključujući infarkt miokarda, nestabilnu anginu, iznenadnu srčanu smrt, ventrikularnu aritmiju, cerebrovaskularno krvarenje, prolaznu ishemijsku ataku, hipertenziju i hipotenziju, koji su bili vremenski povezani s primjenom sildenafila.
Women of childbearing potential and contraception in males and females Due to lack of data on effects of sildenafil in pregnant women, Granpidam is not recommended for women of childbearing potential unless also using appropriate contraceptive measures. 
Zbog nedostatka podataka o učincima sildenafila u trudnica ne preporučuje se primjena lijeka Granpidam u žena reproduktivne dobi, osim ako istovremeno ne primjenjuju odgovarajuće mjere kontracepcije.
Side effects reported uncommonly (may affect 1 in 100 people) included: reduced sharpness of vision, double vision, abnormal sensation in the eye, penile bleeding, presence of blood in semen and/or urine, and breast enlargement in men. 
Nuspojave koje su prijavljene manje često (mogu se javiti u do 1 na 100 osoba) bile su: smanjena oštrina vida, dvoslike, neuobičajeni osjeti u oku, krvarenje iz penisa, prisutnost krvi u sjemenoj tekućini i/ili mokraći i povećanje dojki u muškaraca.
Dose adjustments for sildenafil may be required when co-administered with CYP3A4 inducers (see section 4.5). 
Možda će biti potrebno prilagoditi dozu sildenafila kada se primjenjuje istovremeno s induktorima CYP3A4 (vidjeti dio 4.5).