Adverse effects most commonly reported with sildenafil are headache, flushing, and dyspepsia. Also common are visual disturbances such as blurred vision, photophobia, chromatopsia, cyanopsia, eye irritation, pain and redness of the eyes. Retinal haemorrhage has occurred, and non-arteritic anterior ischaemic optic neuropathy (NAION) causing permanent loss of vision has been reported rarely. Other common adverse effects include dizziness, insomnia, anxiety, vertigo, epistaxis, nasal congestion, pyrexia, and gastrointestinal disturbances such as diarrhoea and vomiting. Priapism can occur.pther adverse effects include skin rashes, erythema, alopecia, limb and/or back pain, myalgia, facial oedema, fluid retention, paraesthesia, and urinary tract infection. Dyspnoea, cough, rhinitis, sinusitis, bronchitis, and cellulitis can occur. Sudden decrease or loss of hearing has been reported. Other reported effects include anaemia, leucopenia, gynaecomastia, urinary frequency or incontinence, haematuria, and seizures. Cerebrovascular haemorrhage and transient ischaemic attacks have occurred. There have also been reports of palpitations, syncope, hypertension, hypotension,and serious cardiovascular events including myocardial infarction, arrhythmias, tachycardia, unstable angina, and sudden cardiac death.