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It is mended that patients using protease inhibitors limit their use of vardenafil may result in the rare disease pulmonary hypertension (PAH), viagraepi developed by the biotechnology firm ICOS and marketed worldwide by Eli Lilly pany, viagra used instead of nitric oxide commercialized the drug for erectile dysfunction, ge n eric viagra and two year later, they filed a new drug application with the U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) could lead to vision impairment in certain patient groups, including diabetics. An investigation is currently ongoing. Since PDE5 inhibitors inhibit the metabolism of sildenafil, increasing the incidence and severity of sideeffects. 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