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Common side effects include headaches, heartburn, and flushed skin. 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 ; 19 20 these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes. Food and Drug Administration FDA found that sildenafil could lead to vision impairment in rare cases, 23 and a number of studies have linked sildenafil use with non-arteritic anterior ischemic optic neuropathy. Sildenafil compound UK, was synthesized by a group of pharmaceutical chemists working at Pfizer's Sandwich, Kent, research facility in England. The first clinical trials were conducted in Morriston Hospital in Swansea.

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