You are currently taking medications for blood pressure (telmisartan, amlodipine, metoprolol) and cholesterol (rosuvastatin). Adding sildenafil can further lower your blood pressure, potentially causing temporary dizziness or lightheadedness. While it is often possible to use sildenafil with these medications, you must consult your prescribing doctor or cardiologist first. They will evaluate your heart health to ensure sexual activity is safe for you and may recommend starting with a lower sildenafil dose to monitor how your body responds. Additionally, never take sildenafil if you are ever prescribed nitrate medications for chest pain.