How should this medicine be used?

Vardenafil comes as a tablet to take by mouth. It is usually taken as needed, with or without food, 60 minutes before sexual activity. Vardenafil usually should not be taken more often than once every 24 hours. If you have certain health conditions or are taking certain medications, your doctor may tell you to take vardenafil less often. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take vardenafil exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor will probably start you on an average dose of vardenafil and increase or decrease your dose depending on your response to the medication. Tell your doctor if vardenafil is not working well or if you are experiencing side effects.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking vardenafil,

• tell your doctor and pharmacist if you are allergic to vardenafil or any other medications.

• do not take vardenafil if you are taking alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin (Hytrin); or if you are taking or have recently taken nitrates such as isosorbide dinitrate (Isordril, Sorbitrate), isosorbide mononitrate (Imdur, ISMO), and nitroglycerin (Nitro-BID, Nitro-Dur, Nitroquick, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, sprays, patches, pastes, and ointments. Ask your doctor if you are not sure if any of your medications contain nitrates.

• Do not take street drugs containing nitrates such as amyl nitrate and butyl nitrate ('poppers') while taking vardenafil.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: amiodarone (Cordarone); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delaviradine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); disopyramide (Norpace); erythromycin (E.E.S. , E-Mycin, Erythrocin); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir); isoniazid (INH, Nydrazid); medications for high blood pressure or irregular heartbeat; metronidazole (Flagyl); other medications or treatments for erectile dysfunction; nefazodone (Serzone); paroxetine (Paxil); procainamide (Procanbid, Pronestyl); quinidine (Quinidex); sotalol (Betapace); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate).Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had an erection that lasted more than 4 hours; a condition that affects the shape of the penis such as angulation, cavernosal fibrosis, or Peyronie's disease; high or low blood pressure; irregular heartbeat; a heart attack; angina (chest pain); a stroke; ulcers in the stomach or intestine; a bleeding disorder; blood cell problems such as sickle cell anemia (a disease of the red blood cells), multiple myeloma (cancer of the plasma cells), or leukemia (cancer of the white blood cells); and liver, kidney, or heart disease. Also tell your doctor if you or any of your family members have or have ever had retinitis pigmentosis (an eye disease) or long QT syndrome (a heart condition). Tell your doctor if you have ever been advised by a health care professional to avoid sexual activity for medical reasons.

• you should know that vardenafil is only for use in males. Women should not take vardenafil, especially if they are or could become pregnant or are breast-feeding. If a pregnant woman takes vardenafil, she should call her doctor.

• if you are having surgery, including dental surgery or any dental procedure, tell the doctor or dentist that you are taking vardenafil.

What special dietary instructions should I follow?

Talk to your doctor about drinking grapefruit juice while taking this medicine.

What side effects can this medication cause?

Vardenafil may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache ,upset stomach ,heartburn , bloating, burping , dizziness, flushing , stuffy or runny nose , flu-like symptoms

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• erection that lasts longer than 4 hours

• vision changes (seeing blue tinge on objects; difficulty telling the difference between blue and green; or difficulty seeing at night)

• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

• hoarseness

• difficulty breathing or swallowing

• blurred vision

• fainting

• hives

• rash