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For ritonavir, a single dose of 2.5 mg LEVITRA should not be exceeded in a 72-hour period.

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Cases of sudden decrease or loss of hearing have been reported post-marketing in temporal association with the use of PDE5 inhibitors, including LEVITRA. In some cases, medical conditions and other factors were reported that may have also played a role in the otologic adverse events. In many cases, medical follow-up information was limited. It is not possible to determine whether these reported events are related directly to the use of LEVITRA, to the patient’s underlying risk factors for hearing loss, a combination of these factors, or to other factors (see PRECAUTIONS, Information for Patients). The maximum dose of LEVITRA for which human data are available is a single 120 mg dose administered to eight healthy male volunteers.

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The majority of these subjects experienced reversible back pain/myalgia and/or “abnormal vision.” In cases of overdose, standard supportive measures should be taken as required. Renal dialysis is not expected to accelerate clearance because vardenafil is highly bound to plasma proteins and is not significantly eliminated in the urine. For most patients, the recommended starting dose of LEVITRA is 10 mg, taken orally approximately 60 minutes before sexual activity. The dose may be increased to a maximum recommended dose of 20 mg or decreased to 5 mg based on efficacy and side effects. The maximum recommended dosing frequency is once per day. For indinavir, saquinavir, atazanavir, ketoconazole 400 mg daily, itraconazole 400 mg daily, and clarithromycin, a single dose of 2.5 mg LEVITRA should not be exceeded in a 24-hour period.

Condition	Precaution	Explanation
Nitrate medication use	Do not use with nitrates	Risk of severe hypotension
Heart problems	Consult cardiologist before use	May exacerbate underlying conditions
Liver impairment	Dose adjustment or avoid use	Reduced drug metabolism
Allergies to components	Check ingredients	Potential allergic reactions

For ketoconazole 200 mg daily, itraconazole 200 mg daily, and erythromycin, a single dose of 5 mg LEVITRA should not be exceeded in a 24-hour period.

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For alpha-blockers, caution is advised when PDE5 inhibitors, including LEVITRA, are used concomitantly with alpha-blockers because of the potential for an additive effect on blood pressure. In some patients, concomitant use of these two drug classes can lower blood pressure significantly (see PRECAUTIONS,Alpha-blockers and Drug Interactions) leading to symptomatic hypotension (e.g., fainting).

Patient Age	Recommended Dose	Onset Time	Duration of Effect
18-65 years	10 mg, as needed	30-60 mins	Up to 4-5 hours
Over 65	Consult doctor	Varies	Varies
Special Cases	Follow medical advice	N/A	N/A

Concomitant treatment should be initiated only if the patient is stable on his alpha blocker therapy.

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LEVITRA can be taken with or without food. Sexual stimulation is required for a response to treatment. Geriatrics: A starting dose of 5 mg LEVITRA should be considered in patients ≥65 years of age (see CLINICAL PHARMACOLOGY, Pharmacokinetics in Special Populations and PRECAUTIONS). Hepatic Impairment: For patients with mild hepatic impairment (Child-Pugh A), no dose adjustment of LEVITRA is required. Vardenafil clearance is reduced in patients with moderate hepatic impairment (Child-Pugh B), and a starting dose of 5 mg LEVITRA is recommended.

What should I tell my healthcare provider before taking vardenafil?

The maximum dose in patients with moderate hepatic impairment should not mail order levitra online exceed 10 mg. LEVITRA has not been evaluated in patients with severe hepatic impairment (Child-Pugh C) (see CLINICAL PHARMACOLOGY, Metabolism and ExcretionWARNINGS and PRECAUTIONS). Renal Impairment: For patients with mild (CLcr = 50-80 ml/min), moderate (CLcr = 30-50 ml/min), or severe (CLcr<30 ml/min) renal impairment, no dose adjustment is required. LEVITRA has not been evaluated in patients on renal dialysis (see CLINICAL PHARMACOLOGY, Metabolism and Excretion and PRECAUTIONS). Concomitant Medications: The dosage of LEVITRA may require adjustment in patients receiving potent CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, atazanavir, and clarithromycin as well as in other patients receiving moderate CYP3A4 inhibitors such as erythromycin (see WARNINGS, PRECAUTIONS, Drug Interactions). In those patients who are stable on alpha-blocker therapy, LEVITRA should be initiated at a dose of 5 mg (2.5 mg when used concomitantly with certain CYP3A4 inhibitors - see Drug Interactions).

• Levitra 10mg is prescribed for erectile dysfunction treatment.
• It contains the active ingredient vardenafil.
• Usually taken about 25-60 minutes before intimacy.
• The effect of Levitra 10mg can last up to 5 hours.
• It should be taken with water, not with alcohol.
• Do not exceed one dose per 24 hours.
• Levitra 10mg may cause side effects like headache or flushing.
• Consult a doctor before using if you have heart issues.
• Avoid using with nitrates or certain medications.
• Store Levitra 10mg tablets in a cool, dry place.
• It is available by prescription only.

LEVITRA (vardenafil HCl) is formulated as orange, film-coated round tablets with debossed “BAYER” cross on one side and “10” and “20” on the other side equivalent to 10 mg and 20 mg of vardenafil, respectively.

Risks and warnings for Vardenafil

The number of living pups born to rats exposed pre- and postnatally was reduced at 60 mg/kg/day. Based on the results of the pre- and postnatal study, the developmental NOAEL is less than 1 mg/kg/day. Based on plasma exposures in the rat developmental toxicity study, 1 mg/kg/day in the pregnant rat is estimated to produce total AUC values for unbound vardenafil and its major metabolite comparable to the human AUC at the MRHD of 20 mg. There are no adequate and well-controlled trials of vardenafil in pregnant women. Elderly males age 65 years and older have higher vardenafil plasma concentrations than younger males (18 – 45 years), mean Cmax and AUC were 34% and 52% higher, respectively (see CLINICAL PHARMACOLOGY,Pharmacokinetics in Special Populations, and DOSAGE AND ADMINISTRATION).

Are there any potential serious side effects for Levitra?

Phase 3 clinical trials included more than 834 elderly patients, and no differences in safety or effectiveness of LEVITRA 5, 10, or 20 mg were noted when these elderly patients were compared to younger patients. However, due to increased vardenafil concentrations in the elderly, a starting dose of 5 mg LEVITRA should be considered in patients ≥65 years of age. LEVITRA was administered to over 4430 men (mean age 56, range 18-89 years; 81% White, 6% Black, 2% Asian, 2% Hispanic and 9% Other) during controlled and uncontrolled clinical trials worldwide. Over 2200 patients were treated for 6 months or longer, and 880 patients were treated for at least 1 year. In placebo-controlled clinical trials, the discontinuation rate due to adverse events was 3.4% for LEVITRA compared to 1.1% for placebo. Vardenafil HCl (Levitra) 10mg tablets are supplied in bottles of 2, 4, 6, 12 and 18 tablets per bottle.Vardenafil HCl (Levitra) 20mg tablets are supplied in bottles of 2, 3, 4, 6, 12 and 18 tablets per bottle. Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F) [see USP Controlled Room Temperature]. Bayer HealthCare Pharmaceuticals Inc.Wayne, NJ 07470 LEVITRA is a registered trademark of Bayer Aktiengesellschaft and is used under license by GlaxoSmithKline and Schering Corporation.

What Side Effects Can You Expect From These Medications?

In a corresponding 1-month rat toxicity study, this dose produced an AUC value for unbound vardenafil 200 fold greater than AUC in humans at the MRHD of 20 mg. There was no effect on sperm motility or morphology after single 20 mg oral doses of vardenafil in healthy volunteers. LEVITRA is not indicated for use in women, newborns, or children. Vardenafil was secreted into the milk of lactating rats at concentrations approximately 10-fold greater than found in the plasma. Following a single oral dose of 3 mg/kg, 3.3% of the administered dose was excreted into the milk within 24 hours.

Can I use Levitra or Viagra while pregnant?

It is not known if vardenafil is excreted in human breast milk. No evidence of specific potential for teratogenicity, embryotoxicity or fetotoxicity was observed in rats and rabbits that received vardenafil at up to 18 mg/kg/day during organogenesis. This dose is approximately 100 fold (rat) and 29 fold (rabbit) greater than the AUC values for unbound vardenafil and its major metabolite in humans given the MRHD of 20 mg. In the rat pre-and postnatal development study, the NOAEL (no observed adverse effect level) for maternal toxicity was 8 mg/kg/day. Retarded physical development of pups in the absence of maternal effects was observed following maternal exposure to 1 and 8 mg/kg possibly due to vasodilatation and/or secretion of the drug into milk. ©2008 Bayer HealthCare Pharmaceuticals Inc.Printed in U.S.A. Repackaged by: APHENA PHARMA SOLUTIONS - TN Cookeville, TN 3850620111027AW Read the Patient Information about LEVITRA before you start taking it and again each time you get a refill. You may also find it helpful to share this information with your partner.

• Levitra 10mg is a popular choice due to fewer side effects.
• It should be used with caution in high blood pressure patients.
• The medication is available in blister packs for convenience.
• Do not use if allergic to vardenafil.
• Seek emergency care if adverse reactions occur.
• The tablet should be taken as needed, not daily.
• Avoid grapefruit or grapefruit juice while taking Levitra.
• Use caution if combining with recreational drugs.
• The medication may cause mild indigestion.
• Levitra 10mg has a fast acting formula.
• Always keep the medication out of children's reach.

This leaflet does not take the place of talking with your doctor. You and your doctor should talk about LEVITRA when you start taking it and at regular checkups.

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When LEVITRA was taken as recommended in placebo-controlled clinical trials, the following adverse events were reported (see Table 5). Back pain was reported in 2.0% of patients treated with LEVITRA and 1.7% of patients on placebo. Placebo-controlled trials suggested a dose effect in the incidence of some adverse events (headache, flushing, dyspepsia, nausea, rhinitis) over the 5 mg, 10 mg, and 20 mg doses of LEVITRA. The following section identifies additional, less frequent events (<2%) reported during the clinical development of LEVITRA. Excluded from this list are those events that are infrequent and minor, those events that may be commonly observed in the absence of drug therapy, and those events that are not reasonably associated with the drug.

How Long Do They Last?

Most, but not all, of bayer levitra buy these patients had underlying anatomic or vascular risk factors for development of NAION, including but not necessarily limited to: low cup to disc ratio (“crowded disc”), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors, to the patient’s underlying vascular risk factors or anatomical defects, to a combination of these factors, or to other factors (see PRECAUTIONS, Information for Patients). Visual disturbances including vision loss (temporary or permanent), such as visual field defect, retinal vein occlusion, and reduced visual acuity, have also been reported rarely in post-marketing experience. It is not possible to determine whether these events are related directly to the use of LEVITRA. Seizure, seizure recurrence and transient global amnesia have been reported post-marketing in temporal association with LEVITRA. If you do not understand the information, or have questions, talk with your doctor or pharmacist. WHAT IMPORTANT INFORMATION SHOULD YOU KNOW ABOUT LEVITRA?

• Levitra 10mg is primarily used for male erectile dysfunction.
• The medication works by relaxing penile muscles.
• It helps increase blood flow during sexual arousal.
• Generic versions of Levitra may be available.
• Do not crush or break the tablet.
• Use caution if you have kidney or liver problems.
• Levitra 10mg does not protect against sexually transmitted infections.
• The medication is not intended for use in women.
• Side effects include dizziness and nasal congestion.
• Report any prolonged or painful erections to a doctor.
• Always follow your healthcare provider’s dosage instructions.