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For instance, adverse events (AE) such as sixth cranial nerve palsy, hyperglycemic hyperosmolar nonketotic syndrome, elevated glycated hemoglobin, and positional dizziness are more likely to occur, which are not specifically mentioned in the product labeling

Shen et al., 2016)

Pairing it with vitamin C or other antioxidant rich foods can enhance its effectiveness

The FDA does not explicitly require a single fixed-dose maintenance strategy

Ethanol metabolism, CYP2E1 induction, compromised antioxidant defenses, mitochondrial injury, activation of Kupffer and stellate cells, hypoxia, and iron overload can all contribute to the alcohol-induced oxidative environment

Because the effect is centrally mediated (originating in the brain), it can complement other therapies for sexual performance without relying solely on vascular stimulation