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What is vardenafil?

Vardenafil relaxes muscles and increases blood flow to particular areas of the body.
Vardenafil is used to treat erectile dysfunction (impotence).
Vardenafil may also be used for purposes other than those listed in this medication guide.

What should I discuss with my doctor before taking vardenafil?

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 serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
A small number of patients have had a sudden loss of eyesight after taking vardenafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether vardenafil is the actual cause of such vision loss. Sudden vision loss with vardenafil use has occurred most often in people with 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.
Before taking vardenafil, tell your doctor if you have:
- heart disease or heart rhythm problems;
- a recent history (in the past 6 months) of a heart attack, angina (chest pain), or congestive heart failure;
- a history of stroke or blood clots;
- 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;
- 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.
If you have any of these conditions, you may not be able to use vardenafil or you may need a dosage adjustment or special tests during treatment.
FDA pregnancy category B: Although vardenafil is not for use in women, this medication is not expected to be harmful to an unborn baby. Do not use vardenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
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.
You may need a lower dose of this medication if you are older than 65. Follow your doctor's instructions.

How should I take vardenafil?

ake each dose with a full glass of water.
Avoid taking High-fat food before taking Levitra as it may cause the medicine to take more time to start working.
Vardenafil is usually taken only when needed, 30 - 90 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.
Do not take vardenafil more than once a day. Allow 24 hours to pass between doses.
Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

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

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.
Symptoms of a vardenafil overdose may include back pain, muscle pain, or vision problems.

What should I avoid while taking vardenafil?

Avoid drinking alcohol, which can increase some of the side effects of vardenafil.
Grapefruit and grapefruit juice may interact with vardenafil. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

What are the possible side effects of vardenafil?

If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of vardenafil.
Stop using vardenafil and get emergency medical help if you have sudden vision loss.
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using vardenafil and call your doctor at once if you have any of these serious side effects:
- chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
- irregular heartbeat;
- swelling in your hands, ankles, or feet;
- shortness of breath;
- vision changes;
- feeling light-headed, fainting; or
- penis erection that is painful or lasts 4 hours or longer.
Continue taking vardenafil and talk with your doctor if you have any of these less serious side effects:
- warmth or redness in your face, neck, or chest;
- stuffy nose;
- headache;
- upset stomach; or
- back pain.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with vardenafil?

Do not take vardenafil if you are taking the following medications:

nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally. This includes some recreational drugs called 'poppers' which also contain amyl nitrate and butyl nitrate.

Vardenafil may also interact with the following medications:

alpha blockers such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), tamsulosin (Flomax®), or terazosin (Hytrin®), used to treat high blood pressure or an enlarged prostate.
arsenic trioxide
bosentan
certain antibiotics such as clarithromycin, erythromycin, sparfloxacin, troleandomycin
certain medicines used for seizures such as carbamazepine, phenytoin, and phenobarbital
certain medicines for the treatment of HIV infection or AIDS
certain medicines to control the heart rhythm (e.g., amiodarone, disopyramide, dofetilide, flecainide, ibutilide, quinidine, procainamide, propafenone, sotalol)
chloroquine
cisapride
diltiazem
grapefruit juice
medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
methadone
nicardipine
pentamidine
pimozide
rifabutin, rifampin, or rifapentine
some medicines for treating depression or mood problems (amoxapine, maprotiline, fluoxetine, fluvoxamine, nefazodone, pimozide, phenothiazines, tricyclic antidepressants)
verapamil

The drug information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. This information is generalized and is not intended as specific medical advice. If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist or other healthcare professional.

A HUNGRY AND HURTING: EMOTIONAL AND PHYSICAL ABUSE (MARTHA’S STORY)

MARTHA: "I didn't have a clue about how to connect with people."

Martha, a thirty-seven-year-old Jewish lesbian mother, links the onset of her compulsive eating to emotional abuse she suffered as a child, abuse that made her feel "disconnected from the world." She never learned the basic lesson of "connecting with other people" that she believes comes from allowing children to be themselves and trust others and nurturing them emotionally and physically. Martha describes herself in terms characteristic of abused children, portraying herself as a lost soul who lacked direction, roots, and a sense of belonging to anyone, including herself.4 She was almost always alone when she was a child. She has almost no memories of the time before she was eleven.

Martha grew up in a home in which she was deprived of basic physical and emotional care. There was no touching; she sometimes pretended to be asleep so her father would pick her up and carry her to bed, providing at least a moment of physical contact. Her father was rarely home because he worked nights. One of Martha's sisters treated her as if she were the family's maid. Another was emotionally cruel to her, keeping Martha from her friends and simultaneously telling Martha that any friends she had were a result of her sister's popularity.

Nor did Martha know how to reach out for attention or friends at school. When she made her first friend, in eighth grade, and told her mother about it, her mother said, "Don't get too excited because as high as you will be is as far as you will fall. These people will hurt you." It was a slap in the face, a punch in the chest. Martha cried as she told me the story: "I opened my heart a little and she pulled it down. A lot of emotional abuse and neglect.

The family labeled Martha overly sensitive and teased her incessantly. She cannot remember ever eating a meal with her family when she did not break down and cry because of the teasing. She watched between ten and twelve hours of television each day, even on school days. She knows she was a bright child because she was able to do well in school even though she never studied. There were no books in the house, and she didn't know how to seek them out. She was mildly dyslexic but no one realized it when she was growing up. She was repeatedly told by the members of her family that she was fat and ugly and had no personality. She had no sense of her body size or whether or not she was attractive.

Her mother controlled what Martha and her sisters ate. Even though her sisters were fat and her mother was obese and a compulsive eater, Martha was the one considered to have the biggest problem with food. She was always served last and castigated for eating. Her mother took her to a diet doctor when Martha was eleven and continued to limit her food. Yet her mother also participated in Martha's bingeing. Martha remembers being told by her mother that she could have three cookies each day when she got home from school. Martha would eat three cookies, want more, think about it, and then have more. Then she would struggle to decide whether' to get more and usually did, typically stopping after finishing a dozen cookies. Her mother would come home and ask her how many she ate. Martha would lie and say three. Her mother never questioned this openly, although she was the one who filled the cookie jar every day. Although Martha was obviously compulsively eating and lying, no one said anything.

Eating compulsively was how Martha comforted herself from the pain of not feeling connected to any person or to the rest of the world. Bingeing calmed her, leaving her feeling drugged and dazed. When I asked her if she thinks she ate compulsively out of fear of her feelings, she said it wasn't as if she had feelings and then ate to get rid of them. That would assume she had feelings to begin with. That would assume some connection. She ate from disconnection. No specific feelings triggered eating. Simply being triggered her desire to eat. She ate, felt numb, and watched television. And no one seemed to care.