Kamagra serioius cardiovascular effects are very rare; still certain groups of patients should be careful while using this medication. Patients with a recent myocardial infarction, stroke, and life-threatening arrhythmia should consult their doctor about the possibility of Kamagra use. Patients with hypotension or hypertension and patients with unstable angina (chest pain) and cardiac failure or coronary artery disease should also visit a doctor before using Kamagra. The cardiovascular and cerebrovascular status of such patients should be estimated before the treatment with Sildenafil is started.
If Kamagra is administered with ?-adrenergic blocking agents symptomatic hypotension may occur. Hypotension may be fatal in patients receiving nitrates or nitrites with Sildenafil.
Patients with severe cardiovascular disease including severe left ventricular outflow obstruction, autonomic dysfunction, fluid depletion could be negatively affected by Sildenafil especially with sexual activity. For patients who are not recommended to take part in sexual activity it is not allowed to take any oral ED medications including Kamagra to avoid dangerous and even fatal side effects.