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The following wellness problems must be mentioned to your physician as they could have an effect on the efficiency of your therapy: chest discomfort, bleeding condition, blood cell issues, problems having an effect on the shape of the penis, cardiovascular disease, eye illness such as retinitis pigmentosa, low or high blood pressure, tummy lesion, renal, liver, or heart disease, movement, uneven pulsation, lung veno-occlusive illness, very high cholesterol levels or blood circulation troubles.