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LEVITRA (Vardenafil HCl)
Sexual Health Checklist

Your doctor needs to know about your general and sexual health in order to correctly diagnose and treat erectile dysfunction (ED).

LEVITRA is indicated only for the treatment of ED.

These are some of the types of questions your doctor may ask you. You can also check off the answers here and print out the list to take to your doctor appointment. This checklist is completely private. (See our Privacy Statement.)

Sexual Function:

Have you been having any of the symptoms below?

Erections not hard enough for sex
Erections firm enough for sex, but not as hard as they used to be
Losing erections during intercourse
Can't get an erection
Ejaculation problems
Sex not enjoyable or satisfying
Lost desire for sex or less desire
Less confidence in your ability to have erections
Other

Medical Histories:

Personal
Family

High blood pressure
Heart disease
High cholesterol
Diabetes
Heart attack
Stroke
Depression
Prostate cancer
Prostate enlargement - Benign Prostatic Hyperplasia (BPH)
Multiple sclerosis
Spinal cord injury
Thyroid disorders
Hormonal disorders
Penile disorders
Peyronie's disease (scar tissue or hardened tissue on the penis shaft)
Priapism (persistent or undesired erections)
Other medical conditions

Surgical Procedures:
Prostate surgery
Bladder surgery
Other

Lifestyle:
Smoking
Alcohol
Recreational drug use (marijuana, cocaine, etc.)

Medicines and Supplements:

Check any medicine, supplement, or herbal treatment you take regularly.

Prescription medications
Nonprescription medication (pain relievers, cold medicine, etc.)
Vitamins and nutritional supplements
Herbal treatments

    
 
Important Safety and Dosing Information

LEVITRA is a prescription medicine that is used to treat erectile dysfunction (ED). Men taking nitrate drugs, often used to control chest pain (also known as angina), should not take LEVITRA. Such combinations could cause blood pressure to drop to an unsafe level.

As with all ED drugs, there is a rare risk of an erection lasting longer than four hours. To avoid long-term injury, seek immediate medical attention. LEVITRA does not protect against sexually transmitted diseases. In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicine, including LEVITRA) reported a sudden decrease or loss of vision in one or both eyes, or a sudden loss or decrease in hearing, sometimes with ringing in the ears and dizziness. It is not possible to determine whether these events are related directly to these medicines or to other factors. If you experience any of these symptoms, stop taking PDE5 inhibitors, including LEVITRA, and call a doctor right away.

Discuss your medical conditions, including heart problems, and medications, including alpha blockers prescribed for prostate problems or high blood pressure, with your doctor to ensure LEVITRA is right for you and that you are healthy enough for sexual activity. LEVITRA is not recommended for men with uncontrolled high blood pressure.

The starting dose of LEVITRA is 10 mg taken no more than once per day. Your doctor will decide the dose that is right for you. In patients taking alpha blockers, your doctor may start you on a lower dose of LEVITRA. In patients taking certain medications such as ritonavir, indinavir, saquinavir, atazanavir, ketoconazole, itraconazole, erythromycin and clarithromycin, lower doses of LEVITRA are recommended, and time between doses of LEVITRA may need to be extended.

In clinical trials, the most commonly reported side effects were headache, flushing, and stuffy or runny nose. LEVITRA is available in 2.5-mg, 5-mg, 10-mg, and 20-mg tablets.

Please see complete Prescribing Information for 2.5-mg, 5-mg, 10-mg, and 20-mg LEVITRA ® (vardenafil HCl).
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