Film-coated tablet: 10 mg PO ~1 hour before sexual activity; may be increased to 20 mg or reduced to 5 mg, depending on effectiveness and tolerance; not to exceed 1 dose/day Orally disintegrating tablet (ODT): 10 mg PO placed on tongue ~1 hour before sexual activity; not to exceed 1 dose/day 10-mg ODT not interchangeable with 10-mg film-coated tablet; ODT provides higher systemic exposure at same dose; if higher or lower doses are required, film-coated tablet should be prescribed Anatomic deformation of penis, cardiovascular disease, left ventricular outflow obstruction, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, conditions predisposing to priapism, concomitant use of CYP3A4 inhibitors Avoid in patients with congenital QT prolongation or those taking class IA or III antiarrhythmics Use in combination with other treatment for erectile dysfunction has not been studied and is not recommended Not to be taken with other phosphodiesterase (PDE)-5 inhibitors (eg, sildenafil, tadalafil) Concomitant use of alpha blockers increases risk of hypotension May increase risk of rare sudden vision loss attributed to nonarteritic ischemic optic neuropathy; if vision problems arise, discontinue, and contact physician Risk of sudden hearing loss Sexual stimulation causes nitric oxide to be released in corpus cavernosum, and nitric oxide activates guanylate cyclase, which in turn increases cyclic guanosine monophosphate (c GMP), thus causing smooth-muscle relaxation; PDE-5 inhibitors enhance smooth muscle-relaxing effects of nitric oxide in corpus cavernosum by inhibiting degradation of c GMP The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. ciprofloxacin stds Some men with erectile dysfunction, or ED, find they can return to an active sex life by treating an underlying condition, such as high blood pressure, or with counseling and lifestyle changes. But others find they may need medication to get and keep an erection. The FDA has approved several prescription drugs you take orally to treat ED. These medications all work similarly to each other. However, there are subtle differences in how long they stay effective and how quickly they begin to work. Levitra takes about 30 minutes to start working and the effects last a little longer than Viagra, about 5 hours. It contains the same active ingredient as Levitra and can begin working in about 15 minutes. Viagra takes around 30 minutes to become effective and lasts about 4 hours. 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