nclude nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called “poppers” also contain nitrates, such as amyl nitrate and butyl nitrate. Do not use LEVITRA if you are using these drugs. Ask your doctor or pharmacist if you are not sure if any of your medicines are nitrates. • Take riociguat, a guanylate cyclase stimulator, a medicine that treats pulmonary arterial hypertension and chronic-throembolic pulmonary hypertension. • Have been told by your healthcare provider to not have sexual activity because of health problems. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
WHAT SHOULD YOU DISCUSS WITH YOUR DOCTOR BEFORE TAKING LEVITRA?
Before taking LEVITRA, tell your doctor about all your medical problems, including if you:
• Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your doctor if it is safe for you to have sexual activity. • Have low blood pressure or have high blood pressure that is not controlled. • Have pulmonary hypertension. • Have had a stroke. • Have had a seizure. • Or any family members have a rare heart condition known as prolongation of the QT interval (long QT syndrome). • Have liver problems. • Have kidney problems and require dialysis. • Have retinitis pigmentosa, a rare genetic (runs in families) eye disease • Have ever had severe vision loss, or if you have an eye condition called non-arteritic anterior ischemic optic neuropathy (NAION). • Have stomach ulcers. • Have a bleeding problem. • Have a deformed penis shape or Peyronie’s disease. • Have had an erection that lasted more than 4 hours. • Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia. • Have hearing problems.
CAN OTHER MEDICATIONS AFFECT LEVITRA?
Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. LEVITRA and other medicines may affect each other. Always check with your doctor before starting or stopping any medicines. Especially tell your doctor if you take any of the following:
• Medicines called nitrates (see “What important information should you know about LEVITRA?”). • Ketoconazole or itraconazole (such as Nizoral ® or Sporanox ®). • Ritonavir (Norvir ®) or indinavir sulfate (Crixivan ®) saquinavir (Fortavase ® or Invirase ®) or atazanavir (Reyataz ®). • Erythromycin or clarithromycin. • Medicines called alpha-blockers. These include Hytrin ® (terazosin HCl), Flomax ® (tamsulosin HCl), Cardura ® (doxazosin mesylate), Minipress ® (prazosin HCl), Rapaflo® (silodosin) or Uroxatral ® (alfuzosin HCl). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients the use of PDE5 inhibitor drugs, including LEVITRA, with alpha-blockers can lower blood pressure significantly leading to fainting. You should contact the prescribing physician if alpha-blockers or other drugs that lower blood pressure are prescribed by another healthc
