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Common side effects include headaches, heartburn, and flushed skin. The primary indication of sildenafil is treatment of erectile dysfunction inability to sustain a satisfactory erection to complete intercourse. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon ; these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. In July, the FDA found that sildenafil could lead to vision impairment in rare cases, and a number of studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy. Contraindications include::

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