Manforce 50 mg (sildenafil) can be used for a long period by some men with erectile dysfunction, when used as prescribed and when it is medically appropriate. Studies have found sildenafil remained effective and generally well tolerated with long-term, as-needed use. A few important points: For ED, sildenafil is generally taken as needed, not more than once in 24 hours. Long-term use doesn't usually mean you become physically dependent on it, but it treats the erection problem rather than curing its underlying cause. Manforce 50 mg  side effects include headache, flushing, indigestion, nasal congestion, dizziness and temporary visual changes. Never use it with nitrate medicines such as nitroglycerin or isosorbide, because blood pressure can fall dangerously low. If you have heart disease, a recent heart attack/stroke, significant blood-pressure problems, or liver/kidney disease, you should have your suitability reviewed by a doctor. If you need Manforce 50 mg frequently (for example, several times a week or most weeks), it's worth having the cause of the ED evaluated, since ED can sometimes be an early sign of diabetes, high blood pressure, or cardiovascular disease. If you tell me how often you currently take Manforce 50 mg (e.g., once a week, 2–3 times a week, or daily), I can explain whether that pattern is generally considered reasonable.