Malarone patent expiration sildenafil is applied for the treatment of erectile dysfunction (impotence) in men and pulmonary arterial hypertension. It is preferable not to use Apcalis with grapefruit juice, alcoholic beverages, tobacco. If you smoke tobacco and take Apcalis concomitantly this may lead to a condition called NAION (sudden optic nerve-related vision loss). Inform your doctor before to take Apcalis if you have abnormal penis, including curved penis and birth defects of the penis, had coronary artery disease, arrhythmia, angina, heart attack or heart failure, hypo- or hypertension, bleeding, stomach ulcers, diabetes, hyperlipidemia (excess of lipids in the blood), sickle-cell anemia, liver or kidney failure in history. You can not appoint tramadol in acute alcohol intoxication (poisoning); patients with hypersensitivity to narcotic analgesics; patients taking MAO inhibitors. A pregnant appointment should be made with extreme caution. Children under the age of 14 do not prescribe the drug.