Drug Uses

Levitra is an oral therapy for the treatment of erectile dysfunction.

How Taken

Levitra comes as a tablet to take it orally. It should be taken, as needed about 1 hour before sexual activity. Some form of sexual stimulation is needed for an erection to occur with Levitra. Levitra should not be taken more than once a day. Levitra can be taken with or without food.

Warnings/Precautions

Before taking Levitra, tell your doctor if you currently have or have ever had a heart attack, stroke, irregular heartbeats, angina (chest pain), or congestive heart failure; high or low blood pressure; if you have a personal or family history of a rare heart condition known as prolongation of the QT interval (long QT syndrome); liver problems or kidney problems; have ever had blood problems, including sickle cell anemia, multiple myeloma, or leukemia; have a bleeding or blood clotting disorder; have a stomach ulcer; a family history of degenerative eye disease (e.g., retinitis pigmentosa); or if you have a physical deformity of the penis such as Peyronie's disease. You may not be able to take Levitra, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Although women do not indicate Levitra for use, it is in the FDA pregnancy category B. This means that Levitra is not expected to be harmful to an unborn baby. Women should not take Levitra. It is not known whether Levitra passes into breast milk. If you are over 65 years of age, you may be more likely to experience side effects from Levitra. Your doctor may prescribe a lower dose of the medication.

Missed Dose

Levitra is used as needed, so you are not likely to miss a dose.

Possible Side Effects

The most common side effects with Levitra are:
-Headaches
-Flushing
-Stuffy or runny nose
Levitra may uncommonly cause: an erection that will not go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections. Vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green. These are not all the side effects of Levitra. For more information, ask your doctor or pharmacist.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Keep Levitra and all medicines out of the reach of children.

Overdose

Seek emergency medical attention if an overdose is suspected. Symptoms of a Levitra overdose are not known, but are likely to include chest pain, back pain, dizziness, an irregular heartbeat, abnormal vision, and swelling of the ankles or legs.

More Information

Do not take Levitra if you:
-Take any form of medication known as "nitrates" (Type of medicine used to relieve chest pain that can occur as a result of heart disease). Taking Levitra in combination with nitrates may result in serious side effects.
-Take medicines called "alpha-blockers" (sometimes prescribed for prostate problems or high blood pressure). Taking Levitra with alpha-blockers may drop your blood pressure to an unsafe level.
-Your doctor determines that sexual activity poses a health risk for you.
You have a known sensitivity or allergy to any component of Levitra. The use of Levitra offers no protection against sexually transmitted diseases. Counseling of patients about protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), should be considered.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Erectile Dysfunction
Also called: ED, Impotence
Erectile dysfunction (ED) is when you have trouble getting or keeping an erection. ED becomes more common as you get older. But it is not a natural part of aging.
Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated.
Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight or stopping smoking may also help.
Erectile dysfunction, sometimes called "impotence," is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.
Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.
In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging.
ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED; however, urologists accounted for only 25 percent of Viagra mentions in 1999.
How does an erection occur?
The penis contains two chambers called the corpora cavernosa, which run the length of the organ (see figure 1). A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.
Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.
What causes erectile dysfunction (ED)?
Since an erection requires a precise sequence of events, ED can occur when any of the events is disrupted. The sequence includes nerve impulses in the brain, spinal column, and area around the penis, and response in muscles, fibrous tissues, veins, and arteries in and near the corpora cavernosa.
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases?such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease?account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience ED.
Lifestyle choices that contribute to heart disease and vascular problems also raise the risk of erectile dysfunction. Smoking, being overweight, and avoiding exercise are possible causes of ED.
Also, surgery (especially radical prostate and bladder surgery for cancer) can injure nerves and arteries near the penis, causing ED. Injury to the penis, spinal cord, prostate, bladder, and pelvis can lead to ED by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.
In addition, many common medicines?blood pressure drugs, antihistamines, antidepressants, tranquilizers, appetite suppressants, and cimetidine (an ulcer drug)?can produce ED as a side effect.
Experts believe that psychological factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to 20 percent of ED cases. Men with a physical cause for ED frequently experience the same sort of psychological reactions (stress, anxiety, guilt, depression). Other possible causes are smoking, which affects blood flow in veins and arteries, and hormonal abnormalities, such as not enough testosterone.
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How is ED diagnosed?
Patient History
Medical and sexual histories help define the degree and nature of ED. A medical history can disclose diseases that lead to ED, while a simple recounting of sexual activity might distinguish among problems with sexual desire, erection, ejaculation, or orgasm.
Using certain prescription or illegal drugs can suggest a chemical cause, since drug effects account for 25 percent of ED cases. Cutting back on or substituting certain medications can often alleviate the problem.
Physical Examination
A physical examination can give clues to systemic problems. For example, if the penis is not sensitive to touching, a problem in the nervous system may be the cause. Abnormal secondary sex characteristics, such as hair pattern or breast enlargement, can point to hormonal problems, which would mean that the endocrine system is involved. The examiner might discover a circulatory problem by observing decreased pulses in the wrist or ankles. And unusual characteristics of the penis itself could suggest the source of the problem?for example, a penis that bends or curves when erect could be the result of Peyronie's disease.
Laboratory Tests
Several laboratory tests can help diagnose ED. Tests for systemic diseases include blood counts, urinalysis, lipid profile, and measurements of creatinine and liver enzymes. Measuring the amount of free testosterone in the blood can yield information about problems with the endocrine system and is indicated especially in patients with decreased sexual desire.
Other Tests
Monitoring erections that occur during sleep (nocturnal penile tumescence) can help rule out certain psychological causes of ED. Healthy men have involuntary erections during sleep. If nocturnal erections do not occur, then ED is likely to have a physical rather than psychological cause. Tests of nocturnal erections are not completely reliable, however. Scientists have not standardized such tests and have not determined when they should be applied for best results.
Psychosocial Examination
A psychosocial examination, using an interview and a questionnaire, reveals psychological factors. A man's sexual partner may also be interviewed to determine expectations and perceptions during sexual intercourse.

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