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You should avoid BlueChew if you: Are taking nitrates for chest pain (e.g., nitroglycerin or isosorbide dinitrate) Use alpha-blockers for high blood pressure or prostate enlargement Have severe cardiovascular disease , including unstable angina or a recent heart attack (within 6 months) Have been advised to avoid sexual activity due to cardiac risk Have significant liver or kidney impairment Have a history of retinitis pigmentosa or hereditary eye disorders affecting the retina The combination of PDE5 inhibitors and nitrates is particularly dangerous