Levitra

Levitra (vardenafil) relaxes muscles found in the walls of blood vessels and increases blood flow to particular areas of the body.

Levitra is used to treat erectile dysfunction (impotence).

Levitra may also be used for purposes not listed in this medication guide.

Important information

Taking Levitra with certain other medicines can cause a sudden and serious decrease in blood pressure. Do not take vardenafil if you also take riociguat (Adempas) or a nitrate drug such as nitroglycerin.

Stop using Levitra and get emergency medical help if you have sudden vision loss.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect.

Before taking this medicine

You should not use Levitra if you are allergic to vardenafil.

Taking Levitra with certain other medicines can cause a sudden and serious decrease in blood pressure. Do not take vardenafil if you also take riociguat (Adempas), or if you take a nitrate drug for chest pain or heart problems. Nitrates include nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers").

To make sure Levitra is safe for you, tell your doctor if you have:

heart disease, heart rhythm problems;

a recent history (in the past 6 months) of a heart attack, stroke, or congestive heart failure;

a personal or family history of Long QT syndrome;

high or low blood pressure;

liver disease, kidney disease (or if you are on dialysis);

a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;

a bleeding disorder such as hemophilia;

a stomach ulcer;

hearing or vision problems, history of vision loss;

an eye disorder such as retinitis pigmentosa (an inherited condition of the eye);

a physical deformity of the penis (such as Peyronie's disease); or

if you have been told you should not have sexual intercourse for health reasons.

Levitra can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking Viagra or other drugs similar to vardenafil. Most of these people also had certain pre-existing eye problems or risk factors for blood vessel disorders (such as heart disease, diabetes, high blood pressure, high cholesterol, coronary artery disease, smoking, or being over 50 years old). It is not clear whether vardenafil is the actual cause of vision loss.

Although Levitra is not for use in women, this medication is not expected to be harmful to an unborn baby.

Although Levitra is not for use in women, it is not known whether this medicine passes into breast milk or if it could harm a nursing baby.

How should I take Levitra?

Take Levitra exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Levitra can be taken with or without food.

Levitra is usually taken only when needed, about 60 minutes before sexual activity. The medicine can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

Do not take this medicine more than once a day. Allow 24 hours to pass between doses.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Store at room temperature away from moisture and heat.

Levitra dosing information

Usual Adult Dose for Erectile Dysfunction:

-Initial dose: 10 mg orally once a day, as needed, approximately 60 minutes before sexual activity. Increase to 20 mg or decrease to 5 mg based on efficacy and tolerability.
-Maximum dose: 20 mg once a day

Patients on stable alpha blocker therapy:
-Initial dose: 5 mg orally once a day

Comments:
-Sexual stimulation is required for a response to treatment.
-A time interval between dosing should be considered when administering this drug concomitantly with alpha-blockers.

Use: Erectile dysfunction

Usual Geriatric Dose for Erectile Dysfunction:

65 years or older:
-Initial dose: 5 mg orally once a day, as needed, approximately 60 minutes before sexual activity

Comments: Sexual stimulation is required for a response to treatment.

Use: Erectile dysfunction

What happens if I miss a dose?

Since Levitra is used as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Levitra?

Grapefruit and grapefruit juice may interact with vardenafil and lead to unwanted side effects. Avoid the use of grapefruit products while taking vardenafil.

Drinking alcohol can increase certain side effects of Levitra.

Do not use any other drug to treat impotence unless your doctor tells you to.

Levitra side effects

Get emergency medical help if you have any signs of an allergic reaction to Levitra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using Levitra and get emergency medical help if you have sudden vision loss.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect.

Stop using Levitra and call your doctor at once if you have:

ringing in your ears, or sudden hearing loss;

heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating;

swelling in your hands, ankles, or feet;

shortness of breath;

a light-headed feeling, like you might pass out;

penis erection that is painful or lasts 4 hours or longer; or

Common Levitra side effects may include:

flushing (warmth, redness, or tingly feeling);

upset stomach; or

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Levitra?

Do not take Levitra with similar medicines such as avanafil (Stendra), sildenafil (Viagra), or tadalafil (Cialis). These medicines also have other brand names (Adcirca, Revatio) that are used to treat a condition called pulmonary arterial hypertension.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Levitra, especially:

all other medications you use for erectile dysfunction;

an antibiotic - clarithromycin, erythromycin, telithromycin, and others;

antifungal medicine - itraconazole, ketoconazole, and others;

drugs to treat high blood pressure or a prostate disorder - alfuzosin, doxazosin, prazosin, silodosin, terazosin, tamsulosin;

heart rhythm medicine - amiodarone, dofetilide, disopyramide, dronedarone, procainamide, quinidine, sotalol; or

HIV/AIDS medicine - atazanavir, indinavir, ritonavir, saquinavir, and others.

This list is not complete. Other drugs may interact with vardenafil, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

More about Levitra (vardenafil)

Consumer resources

Professional resources

Related treatment guides

Where can I get more information?

• Your pharmacist can provide more information about Levitra.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2016 Cerner Multum, Inc. Version: 10.01. Revision Date: 2015-10-09, 12:14:28 PM.

Drug Status

High Blood Pressure and Erectile Dysfunction Treatments

Even if your high blood pressure (or hypertension ) has caused erectile dysfunction (ED), you have every reason to be optimistic about the future and a healthy sex life. ED is a common problem associated with high blood pressure. but there are many proven treatments you can try.

A doctor's first choice for treating erection problems is usually one of the pills called PDE5 inhibitors. First there was Viagra. Now there's also Cialis. Levitra. and Staxyn. All of these drugs work in similar ways. They don't increase sexual desire. They make it physically possible to get an erection when you are aroused.

No one of them has been proven to work better than the others. But the time they take to start working and the duration of their effects vary. That's something you may want to consider based on your sexual habits. For example, does spontaneity matter to you, or do you usually plan sex ahead of time?

Viagra starts working in about 15 to 30 minutes and its effects last about two to four hours. Levitra starts working in about 30 to 60 minutes and lasts four to five hours. Cialis starts working in about 30 to 60 minutes and lasts as long as 36 hours.

Staxyn is an orally disintegrating tablet that contains the same active ingredient as Levitra but is not interchangeable with Levitra tablets.

Men whose blood pressure isn't under control and those who take alpha-blockers (for high blood pressure or prostate problems ) shouldn't take Cialis, Levitra, Staxyn, or Viagra.

Also, you may not be able to take these drugs if you:

When Erectile Dysfunction Pills Aren't an Option

If erectile dysfunction pills are out of the question, or if pills haven't worked for you, don't worry. There are other options.

Alprostadil is another drug for erectile dysfunction. However, it's not a pill. One brand, called MUSE, is an alprostadil pellet that you insert into the tip of your penis with an applicator. It widens blood vessels and relaxes smooth muscle tissue in the penis. allowing blood to fill the spongy tissue that makes the penis erect.

Continued

Injections directly into the penis are another way to deliver alprostadil. Phentolamine and papaverine are additional drugs that are injected into the penis to treat erectile dysfunction. When injecting these drugs there is some risk that your erection may last too long, a condition that can require medical treatment.

Next, you may want to try a vacuum device, or "penis pump." This is typically a clear plastic cylinder with a bulb or plunger and a constriction band.

You put your penis in the cylinder and start pumping. The suction creates a vacuum, so blood rushes in to fill the spaces in the spongy tissue of the penis, creating an erection. The erection lasts only as long as the blood stays in, so you slide the band down around the base of your penis, trapping the blood. It's safe to keep the band on for up to 30 minutes.

These devices are available without a prescription, but it's important to buy one from a reputable manufacturer. The device must include a safety control so you can't harm your penis with too much suction.

Surgery for Erectile Dysfunction

Most men would prefer to avoid surgery, but for some men with erection problems, penis implants are another option for regaining sexual function.

There are two kinds of penis implants. One kind is a rigid but flexible rod implanted in the penis. You bend it up for sex or down for daily living. The other kind is an inflatable implant. The device stores fluid in a reservoir under the skin of your abdomen or scrotum. You press on the reservoir to pump fluid into cylinders in the penis. That creates an erection. A valve drains the fluid out of the penis when you're done.

There are drawbacks to implants. An erection you get with an implant may be slightly shorter than a natural erection. The device itself may malfunction, in which case it would require another surgery to remove or replace it.

Getting a penis implant is a big decision. Once you have it, you may not be able to try other treatments. That's because the implant replaces the chambers in the penis that fill with blood for a natural erection.

Continued

Alternative Treatments for Erectile Dysfunction

Before Viagra hit the market in 1998, there was no proven treatment for erectile dysfunction that men could take in pill form. Doctors were interested in yohimbe. an herb that increases heart rate and blood pressure. Some doctors prescribed it to their patients in combination with other treatments for erectile dysfunction. Even then it was not a recommended treatment and is still not today. Studies have not proven that it works.

Men with high blood pressure especially shouldn't take either the prescription drug or the herb. It can dangerously raise blood pressure.

Currently, no herb or supplements have been proven to help with erectile dysfunction. Herbs and supplements that some believe are helpful for erection problems include:

Before trying any alternative treatment, be sure to ask your doctor about it. Herbs and supplements. whether they help with erections or not, have real effects on the body. They could cause dangerous reactions with other medicines you might be taking.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on April 12, 2015

Sources

American Urological Association: "Erectile Dysfunction Clinical Guidelines Panel. The Treatment of Organic Erectile Dysfunction: A Patient's Guide," 1996; and "AUA Guideline on the Management of Erectile Dysfunction: Diagnosis and Treatment Recommendations," 2005.

Gaines, K. Urologic Nursing. February 2004.

Lamm, S. The Hardness Factor. HarperCollins, 2005.

Medscape Drug Reference from First DataBank: "Alprostadil Urethral" and "Sildenafil Oral."

Vivus, Inc. "Administering MUSE," 2004.

В© 2015 WebMD, LLC. All rights reserved.

In this Article

What should I discuss with my healthcare provider before taking vardenafil (Levitra)?

Do not take vardenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite ("poppers"). Taking vardenafil with a nitrate medicine can cause a sudden and serious decrease in blood pressure.

To make sure you can safely take vardenafil, tell your doctor if you have any of these other conditions:

• heart disease, heart rhythm problems;
• a recent history (in the past 6 months) of a heart attack, stroke, or congestive heart failure;
• a personal or family history of "Long QT syndrome";
• high or low blood pressure;
• seizures;
• liver disease, kidney disease (or if you are on dialysis);
• a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
• a bleeding disorder such as hemophilia;
• a stomach ulcer;
• hearing or vision problems, history of vision loss;
• an eye disorder such as retinitis pigmentosa (an inherited condition of the eye);
• a physical deformity of the penis (such as Peyronie's disease); or
• if you have been told you should not have sexual intercourse for health reasons.

Vardenafil can decrease blood flow to the optic nerve of the eye, causing sudden vision loss. This has occurred in a small number of people taking vardenafil, most of whom also had heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old. It is not clear whether vardenafil is the actual cause of vision loss. Stop using vardenafil and get emergency medical help if you have sudden vision loss.

FDA pregnancy category B: Although vardenafil is not for use in women, this medication is not expected to be harmful to an unborn baby.

Although vardenafil is not for use in women, it is not known if vardenafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Staxyn may contain phenylalanine. Talk to your doctor before using this form of vardenafil if you have phenylketonuria (PKU).

How should I take vardenafil (Levitra)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Vardenafil can be taken with or without food.

Vardenafil is usually taken only when needed, about 60 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor's instructions.

To take the orally disintegrating tablet (Staxyn):

• Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil from the tablet blister. Do not push a tablet through the foil or you may damage the tablet.
• Using dry hands, remove the tablet and place it in your mouth. It will begin to dissolve right away.
• Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
• Swallow several times as the tablet dissolves. Do not take Staxyn with liquid.

Do not take vardenafil more than once a day. Allow 24 hours to pass between doses.

Contact your doctor or seek emergency medical attention if your erection is painful or lasts longer than 4 hours. A prolonged erection (priapism) can damage the penis.

Store at room temperature away from moisture and heat.