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If you are also taking other medications for diabetes, such as insulin or sulfonylureas, the risk of your blood sugar dropping too low increases significantly when aspirin is added to the mix

Risk Stratification and Informed Consent: Your clinical picture is assessed against our eligibility criteria and you sign a detailed consent document disclosing the off-label nature of the therapy, the evidence base, and all known risks

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Tadalafil - also a PDE5 inhibitor, FDA-approved for the same indication, with a well-documented extended duration profile