Extra Super P Force is a medication used to treat erectile dysfunction and premature ejaculation. It contains two active ingredients: sildenafil citrate and dapoxetine. As a healthcare provider, I must stress the importance of consulting with a qualified healthcare professional before starting any medication. However, I can provide some general contraindications for Extra Super P Force:

Hypersensitivity: Individuals who have a known hypersensitivity or allergy to sildenafil citrate, dapoxetine, or any of the inactive ingredients in Extra Super P Force should avoid using this medication.

Concomitant Use of Nitrates: Extra Super P Force should not be used concomitantly with nitrates or nitric oxide donors (such as nitroglycerin) due to the potential for severe hypotension (low blood pressure). Combining these medications can lead to a dangerous drop in blood pressure.

Cardiovascular Disorders: Patients with severe cardiovascular disorders, such as heart failure, unstable angina, or recent heart attack, should avoid using Extra Super P Force. This medication can increase cardiac workload and may exacerbate underlying cardiovascular conditions.

Severe Hepatic Impairment: Extra Super P Force is metabolized in the liver, so individuals with severe hepatic impairment should use this medication with caution or avoid it altogether. Dose adjustment may be necessary in patients with mild to moderate hepatic impairment.

Severe Renal Impairment: Patients with severe renal impairment (creatinine clearance less than 30 mL/min) should avoid using Extra Super P Force. Dose adjustment may be necessary in patients with mild to moderate renal impairment.

History of Priapism: Extra Super P Force should be used with caution in patients with a history of priapism (prolonged erection) or conditions predisposing to priapism, such as sickle cell anemia, multiple myeloma, or leukemia.

Concurrent Use of Other PDE5 Inhibitors or SSRIs: Extra Super P Force contains sildenafil citrate (a phosphodiesterase type 5 inhibitor) and dapoxetine (a selective serotonin reuptake inhibitor). Concurrent use with other medications in these classes may increase the risk of adverse effects and should be avoided unless specifically directed by a healthcare professional.

This list is not exhaustive, and there may be other contraindications or precautions associated with the use of Extra Super P Force. It's essential to consult with a healthcare provider before starting this medication to ensure it is safe and appropriate for you.