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Here are some guidelines on when to avoid taking Kamagra Gold 100 mg if you have certain medical conditions: Cardiovascular disease: Kamagra Gold (sildenafil) should not be used in patients with certain cardiovascular conditions, such as unstable angina, recent heart attack, or severe heart failure. It can interact with nitrates used to treat angina and cause a dangerous drop in blood pressure. Liver or kidney disease: Patients with moderate to severe liver or kidney disease may need to use a lower dose of Kamagra Gold, as the drug is metabolized by the liver and kidneys. Priapism: Kamagra Gold 100mg should be avoided in men who have a history of priapism (a prolonged and painful erection lasting more than 4 hours). Retinal disorders: There have been rare reports of vision problems, including sudden vision loss, in patients taking Kamagra Gold. It should be used with caution in those with pre-existing retinal disorders. Bleeding disorders: Kamagra Gold may increase the risk of bleeding in patients with conditions like hemophilia or active peptic ulcers. Alcohol use: Consuming alcohol while taking Kamagra Gold can increase the risk of side effects, such as dizziness and drowsiness. It's important for anyone with pre-existing medical conditions to consult with a healthcare provider before taking Kamagra Gold or any other erectile dysfunction medication. The provider can assess the risks and benefits and determine if it is safe to use.