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The safety and warning information for vardenafil is crucial for ensuring proper use and minimizing risks. Please read the details below carefully and consult with your healthcare provider if you have any questions or concerns.

• Heart Conditions: Prior to taking vardenafil, inform your healthcare provider if you have any heart-related issues. This medication is not recommended for those with severe heart conditions, recent heart attacks, or strokes, as it may exacerbate heart problems. Avoid use if you have high or low blood pressure or are on medications that prolong the QT interval.

• Blood Pressure Concerns: Using vardenafil in conjunction with other medications that lower blood pressure can lead to dangerously low levels. Exercise caution if you're taking alpha blockers or medications for hypertension. Always stand up gradually from sitting or lying positions to prevent dizziness and falls. Vardenafil should not be used with nitrate medications or Adempas (riociguat) due to the risk of significant blood pressure drops.

• Prolonged Erection (Priapism): Rarely, vardenafil may cause erections lasting more than 4 hours. This condition can result in permanent penile damage if not treated promptly. Individuals with penile conditions, sickle cell anemia, multiple myeloma, or leukemia are at heightened risk. Seek immediate medical attention if you experience an erection lasting longer than 4 hours or painful erections.

• Vision Changes: Sudden changes in vision in one or both eyes require immediate medical attention, as they could indicate serious eye damage. Although rare, this risk is increased if you have a "crowded" optic disc. Ensure your healthcare provider is aware of your complete medical history before starting vardenafil.

• Hearing Loss: Some users have reported hearing loss, tinnitus, or dizziness while taking vardenafil. Discontinue use and consult your healthcare provider if you notice any changes in your hearing.

• Drug Interactions: Vardenafil can interact severely with certain medications. It is vital to disclose all medications you are currently taking to your healthcare provider. Avoid using vardenafil with nitrate medications, as this can cause a dangerous drop in blood pressure. Caution is also advised with blood pressure medications, alpha blockers, certain antifungals, and antiviral drugs, as these can increase the risk of side effects like headaches, flushing, and vision changes.

Contraindications: Do not use vardenafil if you are taking nitrate medications for chest pain or guanylate cyclase stimulators like Adempas (riociguat), as these combinations can pose serious health risks. Always consult your healthcare provider if you are uncertain about any potential interactions or contraindications.

When taking this medication, you might experience some common side effects, including headaches, flushing, stuffy or runny nose, and dizziness. These are generally mild, but if they persist or worsen, it's important to speak with your healthcare provider. Other side effects that some individuals may encounter involve indigestion, back pain, nausea, sinus inflammation, and flu-like symptoms. Again, these are usually not serious, but it's wise to consult a professional if they cause concern.

There are rare but serious side effects that require immediate medical attention. These include a dangerously low blood pressure, which might make you feel faint, dizzy, or confused, and could also cause blurry vision. If you experience an erection that lasts more than four hours, sudden vision loss, or a sudden decrease or loss of hearing, you should stop taking the medication and seek urgent medical help. Additionally, sexual activity might strain your heart, especially if you have pre-existing heart conditions. Severe dizziness, fainting, or chest pain during sexual activity necessitates stopping and getting medical assistance immediately.

Rarely, this medication can cause sudden decreased vision, including permanent blindness in one or both eyes, or a painful, prolonged erection. If these occur, stop the medication and seek urgent care. Other very serious reactions, such as seizures or temporary memory loss, require immediate medical attention. Although allergic reactions are uncommon, be alert for symptoms like rash, severe dizziness, swelling, or trouble breathing and seek help if they occur. If you notice any other unusual effects, consult your healthcare provider.

Certain drugs can interact with vardenafil, and it is important to be aware of these to avoid adverse effects. Riociguat and vericiguat are two such drugs that should be noted. Vardenafil can significantly lower blood pressure if taken with nitrates, like those used for chest pain or angina, such as nitroglycerin and isosorbide. This interaction may cause dizziness, fainting, and in rare cases, a heart attack or stroke. Recreational drugs known as "poppers," which contain amyl or butyl nitrite, should also be avoided.

If you are taking alpha blockers, like doxazosin or tamsulosin, to manage an enlarged prostate or high blood pressure, combining them with vardenafil could further lower your blood pressure, leading to dizziness or fainting. Your healthcare provider might prescribe a lower initial dose of vardenafil to reduce this risk.

Additionally, some medications can interfere with how vardenafil is cleared from the body, potentially altering its effectiveness. These include azole antifungals, such as itraconazole and ketoconazole, macrolide antibiotics like clarithromycin and erythromycin, and ritonavir.

Lastly, do not use vardenafil in conjunction with other similar medications for erectile dysfunction or pulmonary hypertension, such as sildenafil or tadalafil, as this can increase the risk of side effects. Always consult with your healthcare provider before starting or stopping any medication.