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Patients with a ‚crowded‚ optic disc may also be at an increased risk of NAION. Patients with known hereditary degenerative retinal disorders, including retinitis pigmentosa, were not included in the clinical trials, and use in these patients is not recommended. Sudden decrease or loss in hearing, sometimes with ringing in the ears and dizziness has also been reported in men taking PDE5 inhibitors, including CIALIS. It is not possible to determine whether these hearing events are related directly to the use of PDE5 inhibitors or to other factors.

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