I have serveral concerns in taking my first 30mg dose. It's usually taken at 10mg every day for a year. Not on and off at higher doses. This study made me feel quite a bit better:
32 healthy subjects took up to 30mg for 10 days without any side effects.
The second concern is that I want to go up to 60mg/day. This is a link to the prescribing information which mentions going to 600mg and getting liver damage. It also says there is data on its use with sildenafil.
My first day went well at 30mg. The only side effects are actually positive. This drug does do a great job at making it easier to breath. I don't have any problems. I do walk aggressively every morning and noticed I'm hardly breathing up the hills pushing my 65lb sled. I think I started getting some chest pains, so I stopped and breathed a little harder. It went away immediately. It made me drowsy, but not bad. I slept well for the first time in weeks. I'd say it counter-acted the dex nicely in this regard. We'll see how the higher doses go. I'm on 40mg now.