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    Impotence can be the first sign of heart disease, particularly in younger men, he said. And though metformin novo nordisk, it is possible to have an erection that lasts for four hours or more. Men who have had a heart attack in the past six months, those taking nitrates nitroglycerin for heart disease, and men taking protease inhibitors for an HIV infection shouldn't take erectile dysfunction drugs, Bromberg said.

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