When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to nitrates, isosorbide, or hydralazine.

How to Use This Medicine:
Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with riociguat or medicine for erectile dysfunction, including avanafil, sildenafil, tadalafil, or vardenafil.
• Some medicines can affect how this medicine works. Tell your doctor if you are using a blood pressure or beta-blocker medicine, including lisinopril, metoprolol, or propranolol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have low blood pressure or heart disease.
• This medicine may cause the following problems:
  
  • Symptoms of lupus (may go away when you stop using the medicine)
  • Worsening heart disease
• This medicine may make you dizzy or lightheaded. This is more likely to happen if you are dehydrated. Drink plenty of fluids to help prevent dehydration. Stand up slowly to help prevent dizziness. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. These symptoms may be worse if you drink alcohol.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Chest pain, fast or pounding heartbeat
• Joint pain, rash, fever
• Lightheadedness, fainting
• Numbness, tingling, or burning pain in your hands, arms, legs, or feet

If you notice these less serious side effects, talk with your doctor:

• Dizziness
• Headache

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088