Administration of LEVITRA with nitrates and nitric oxide donors is contraindicated. Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors, including LEVITRA, may potentiate the hypotensive effects of nitrates

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Recommended dosing

  • LEVITRA can be taken without regard to food
  • The recommended starting dose of LEVITRA is 10 mg. Titrate up to 20 mg or down to 5 mg based on efficacy and side effects
  • LEVITRA is available in 2.5-mg, 5-mg, 10-mg, and 20-mg tablets
  • LEVITRA should be taken approximately 60 minutes prior to sexual activity
  • Sexual stimulation is required to achieve a response
  • The maximum recommended dosing frequency is once daily

Dosing in special ED populations

  • A starting dose of 5 mg should be considered in patients ≥65 years of age
  • A starting dose of 5 mg should be used in patients on stable alpha-blocker therapy because of the potential for an additive effect on blood pressure
  • For patients with mild (CLcr = 50-80 mL/min), moderate (CLcr = 30-50 mL/min), or severe (CLcr <30 mL/min) renal impairment, no dose adjustment is required. LEVITRA has not been evaluated in patients on renal dialysis
  • In patients with moderate hepatic impairment (Child-Pugh B), a starting dose of 5 mg is recommended and the maximum dose in patients with moderate hepatic impairment should not exceed 10 mg. Do not use in patients with severe hepatic impairment (Child-Pugh C)
  • The dosage of LEVITRA may require adjustment in patients receiving potent or moderate CYP3A4 inhibitors

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