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Take this medication by mouth with or without food as directed by your doctor.

There are two ways that this drug may be prescribed and taken. It may be taken as needed, or it may be taken once a day every day. Your doctor will determine which is the best way for you to take this drug. Follow your doctor’s directions exactly.

If used regularly every day, your doctor will prescribe a low dose (usually 2.5 to 5 milligrams per day). When this drug is taken only as needed, the dosing may need to be higher. Never take more of this drug than prescribed because you may experience serious side effects. Your doctor will adjust your dosage based on your response and other medications you may be taking (see also Drug Interactions section). Consult your doctor or pharmacist for more details.

When taken as needed, take this drug at least 30 minutes before sexual activity; or use as directed by your doctor. This medication’s effect on sexual ability may last up to 36 hours. Therefore, do not take more than once daily as needed.

When taken regularly every day, you may attempt sexual activity at any time between your doses. Do not take more than one dose each day.

Avoid eating grapefruit or drinking grapefruit juice while being treated with this medication unless your doctor instructs you otherwise. Grapefruit juice can increase the amount of certain medications in your bloodstream. Consult your doctor or pharmacist for more details.

Viagra, Levitra and Cialis are approved for use in the treatment of erectile dysfunction, or impotence. All work by blocking an enzyme called PDE5. PDE5 is involved in holding blood in the penis, which creates an erection. A similar enzyme, PDE6, is involved in vision, especially color vision. The most common side effects of Viagra are headache and flushing. Many patients, especially those taking high doses of Viagra, will have changes to their eyesight including blurred vision and changes in color vision. These all go away in a few hours with Levitra and Viagra. They may last a bit longer with Cialis.

There are some drug interactions to worry about. The most notable is the interaction between nitrates and these drugs that can cause very low blood pressure. Although nitrates are normally used by people with coronary artery disease, amyl nitrate (also known as poppers, liquid gold, stud and other colorful names) is used as a recreational drug. The combination of amyl nitrate and Viagra, Cialis or Levitra is likely to cause a big drop in blood pressure.

Viagra, Levitra and Cialis are too frequently used as party drugs. For example, they are sometimes combined with club drugs like ecstasy (the combination is known as Sextasy). The danger is a higher likelihood of unprotected sex, increasing the risk of HIV and other sexually transmitted diseases.

Viagra, Levitra and Cialis are all approved by the U.S. Food and Drug Administration for the treatment of erectile dysfunction, or male impotence. These drugs target an enzyme system that enhances the ability of the penis to engorge with blood and hold the blood.

However, erectile dysfunction is only one component of sexual dysfunction. Other major contributing factors may include a persistent reduction in the sex drive, difficulty in arousal, inability to reach orgasm, and pain during intercourse. Hormone changes, stress, fatigue, and depression are some of the potential causes. Viagra, Levitra, and Cialis will not be helpful for these types of issues.

According to some surveys, up to 50 percent of women in the United States have some form of sexual dysfunction. A number of drugs have been tried to relieve these symptoms in women. Viagra and Levitra have been tried in both pre- and postmenopausal women with sexual dysfunction. The results were not very encouraging.

Because sexual dysfunction can have many causes, I recommend that men and women who have sexual problems speak candidly with their doctors. While drugs like Levitra may not be the answer for women at the moment, other therapies are available.