Vigora Oral Jelly can be used responsibly if it contains sildenafil and is used under appropriate medical guidance. Responsible use includes: Follow the prescribed dose and do not take it more than once in 24 hours. For sildenafil used for ED, the usual starting dose is 50 mg, with adjustments based on effectiveness and tolerability. Do not combine sildenafil with nitrate medicines such as nitroglycerin or Vigora Oral Jelly , because blood pressure can fall dangerously. Avoid combining it with other PDE5 inhibitors, such as tadalafil or vardenafil. Tell your doctor about blood-pressure medicines, alpha-blockers, heart conditions, kidney or liver problems, and other medicines you take. Seek urgent medical attention for an erection lasting more than 4 hours, sudden vision loss, or sudden hearing loss. Because oral-jelly products can vary in strength and formulation, check the active ingredient and strength on the package before use.