• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Treating type 2 diabetes in certain patients. It is used along with diet and exercise. It may be used alone or with other antidiabetic medicines.

Pioglitazone is a thiazolidinedione antidiabetic. It lowers blood sugar by making the cells of the body more sensitive to the action of insulin.

Do NOT use Pioglitazone if:

• you are allergic to any ingredient in Pioglitazone
• you have moderate to severe heart failure
• you have type 1 diabetes
• you have a history of liver problems, including jaundice (yellowing of the skin or eyes), during therapy with a similar medicine called troglitazone

Contact your doctor or health care provider right away if any of these apply to you.

Before using Pioglitazone :

Some medical conditions may interact with Pioglitazone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have diabetic ketoacidosis (a severe problem associated with diabetes)
• if you have a history of liver problems, abnormal liver function tests, heart problems (eg, congestive heart failure), or eye or vision problems
• if you have swelling problems (edema)

Some MEDICINES MAY INTERACT with Pioglitazone. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Gemfibrozil, insulin, or oral antidiabetic medicines (eg, glipizide) because the risk of low blood sugar may be increased
• Rifampin because it may decrease Pioglitazone ’s effectiveness, resulting in high blood sugar
• Anticoagulants (eg, warfarin) because their effectiveness may be decreased or the risk of their side effects may be increased by Pioglitazone

This may not be a complete list of all interactions that may occur. Ask your health care provider if Pioglitazone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Pioglitazone :

Use Pioglitazone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Pioglitazone by mouth with or without food.
• Continue to take Pioglitazone even if you feel well. Do not miss any doses. Taking Pioglitazone at the same time each day will help you remember to take it.
• If you miss a dose of Pioglitazone , take it as soon as possible. If it almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Pioglitazone.

Important safety information:

• Carry an ID card at all times that says you have diabetes.
• Proper diet, regular exercise, and regular blood sugar testing are important for best results with Pioglitazone. Follow the diet and exercise program given to you by your health care provider.
• Check your blood sugar levels as directed by your doctor. If they are often higher than they should be and you take Pioglitazone exactly as prescribed, tell your doctor.
• It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. Talk with your doctor about how to control your blood sugar if any of these occur. Do not change the dose of your medicine without checking with your doctor.
• Do NOT take more than the recommended dose without checking with your doctor.
• Pioglitazone may lower your blood sugar levels when it is used along with insulin or other oral diabetic medicines. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
• Pioglitazone may cause ovulation in women who have not reached menopause but do not ovulate. Be sure to use effective birth control while using Pioglitazone.
• Tell your doctor or dentist that you take Pioglitazone before you receive any medical or dental care, emergency care, or surgery.
• Pioglitazone may be associated with an increased risk of bladder cancer. Discuss any questions or concerns with your doctor.
• Lab tests, including fasting blood sugar, hemoglobin A_1c, eye examinations, and liver function, may be performed while you use Pioglitazone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
• Pioglitazone should not be used in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Pioglitazone while you are pregnant. It is not known if Pioglitazone is found in breast milk. Do not breast-feed while taking Pioglitazone.

Possible side effects of Pioglitazone :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Headache; muscle aches; sore throat; weight gain.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; symptoms of heart failure (eg, shortness of breath; sudden unexplained weight gain; swelling of the hands, ankles, or feet); symptoms of liver problems (eg, dark urine; yellowing of the skin or eyes; unexplained nausea, vomiting, or loss of appetite; stomach pain); symptoms of low blood sugar (eg, anxiety, increased sweating, dizziness or drowsiness, headache, chills, tremors, increased hunger); unusual tiredness or weakness.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Drug Name

Zetia (Ezetimibe)

Drug Uses

Zetia treats high blood cholesterol along with a low-fat, low-cholesterol diet. It is also used to treat high blood sitosterol and campesterol along with diet therapy.

How Taken

Use Zetia as directed by your doctor.

Take Zetia by mouth with or without food.

Taking Zetia at the same time each day will help you remember to take it.

If you also take a bile acid sequestrant (eg, cholestyramine, colesevelam, colestipol), do not take it within 4 hours before or 2 hours after taking Zetia . Check with your doctor if you have questions.

Continue to use Zetia even if you feel well. Do not miss any doses.

Ask your health care provider any questions you may have about how to use Zetia.

Drug Class and Mechanism

Zetia is an antihyperlipidemic agent. It works by reducing the amount of cholesterol or other sterols that your body absorbs from your diet.

Missed Dose

If you miss a dose of Zetia , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage

Store Zetia at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Zetia out of the reach of children and away from pets.

Warnings/Precautions

Do not use Zetia if:

• you are allergic to any ingredient in Zetia;
• you have moderate to severe liver problems.

Contact your doctor or health care provider right away if any of these apply to you.

Important:

Do not drive or perform other possibly unsafe tasks until you know how you react to it.

For best results, Zetia should be used along with exercise, a low-cholesterol and low-fat diet, and a weight loss program if you are overweight.

If you experience unexplained muscle pain, weakness, or tenderness, contact your doctor.

Lab tests, including liver function, and cholesterol levels, may be performed while you use Zetia . These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.

Zetia should not be used in children younger than 10 years old; safety and effectiveness in these children have not been confirmed.

Pregnancy and breast-feeding If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Zetia while you are pregnant. It is not known if Zetia is found in breast milk. If you are or will be breast-feeding while you use Zetia, check with your doctor. Discuss any possible risks to your baby.

Possible Side Effects

Check with your doctor if any of these most common side effects persist or become bothersome:

• diarrhea;
• dizziness;
• headache;
• joint pain;
• sinus inflammation;
• sore throat;
• stomach pain;
• tiredness.

Seek medical attention right away if any of these severe side effects occur:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue);
• chest pain;
• dark urine;
• unexplained muscle pain, tenderness, or weakness;
• yellowing of the eyes or skin.

More Information

Zetia is to be used only by the patient for whom it is prescribed. Do not share it with other people.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

What is/are Vytorin Tablets?

EZETIMIBE; SIMVASTATIN blocks the body’s ability to absorb and make cholesterol. It is used to lower cholesterol. It is only for patients whose cholesterol level is not controlled by diet. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

frequently drink alcoholic beverages kidney or liver disease muscle aches or weakness other medical condition an unusual or allergic reaction to ezetimibe, simvastatin, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take this medicine in the evening with or without food. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

certain antibiotics like clarithromycin, erythromycin, and telithromycin medicines for fungal infections like itraconazole and ketoconazole medicines for HIV, AIDS nefazodone other medicines to lower cholesterol or triglycerides red yeast rice

This medicine may also interact with the following:

amiodarone cyclosporine danazol digoxin grapefruit juice niacin verapamil warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue dark yellow or brown urine depression fever muscle pain, tenderness, cramps, or weakness redness, blistering, peeling or loosening of the skin, including inside the mouth trouble passing urine or change in the amount of urine unusually weak or tired yellowing of the skin or eyes

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

constipation gas headache heartburn indigestion stomach pain

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular check-ups. You may need regular tests to make sure your liver is working properly.

Tell you doctor or health care professional right away if you get any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever and tiredness.

This drug is only part of a total heart-health program. Your doctor or a dietician can suggest a low-cholesterol and low-fat diet to help. Avoid alcohol and smoking, and keep a proper exercise schedule.

Do not use this drug if you are pregnant or breast-feeding. Serious side effects to an unborn child or to an infant are possible. Talk to your doctor or pharmacist for more information.

If you are going to have surgery tell your health care professional that you are taking this drug.

Some drugs may increase the risk of side effects from this medicine. If you are given certain antibiotics or antifungals, your doctor or health care professional may stop this medicine for a short time. Check with your doctor or pharmacist for advice.

Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

FENOFIBRATE can help lower blood fats and cholesterol for people who are at risk of getting inflammation of the pancreas (pancreatitis) from having very high amounts of fats in their blood. This medicine is only for patients whose blood fats are not controlled by diet. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

gallbladder disease heart disease kidney disease liver disease an unusual or allergic reaction to fenofibrate, gemfibrozil, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Do not take chipped or broken tablets. Take your medicine at regular intervals. Do not take it more often than directed. Do not stop taking except on your doctor’s advice.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

ezetimibe statin-type cholesterol lowering drugs like atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, or simvastatin red yeast rice

This medicine may also interact with the following:

cholestyramine or colestipol cyclosporine warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue dark urine lower back or side pain muscle pain, tenderness, or weakness skin-bruising stomach pain trouble passing urine or change in the amount of urine unusually weak or tired yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

constipation headache nausea

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress. Your blood fats and other tests will be measured from time to time. Do not stop taking this medicine except on the advice of your doctor or health care professional.

This medicine is only part of a total cholesterol-lowering program. Your health care professional or dietician can suggest a low-cholesterol and low-fat diet that will reduce your risk of getting heart and blood vessel disease. Avoid alcohol and smoking, and keep a proper exercise schedule.

If you are diabetic, close regulation and monitoring of your blood sugars can help your blood fat levels. This medicine may change the way your diabetic medication works, and sometimes will require that your dosages be adjusted. Check with your doctor or health care professional.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

This medicine can make you more sensitive to the sun. Keep out of the sun. If you cannot avoid being in the sun, wear protective clothing and use sunscreen. Do not use sun lamps or tanning beds/booths.

Where should I keep this medicine?

Keep out of the reach of children.

Store the tablets in the original container at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Reducing high lipid levels and high cholesterol, with diet and exercise. It is also used to prevent certain heart problems, including slowing down the progression of hardening of the arteries in patients with heart disease. It may also be used to treat other conditions as determined by your doctor.

Pravastatin is a beta-hydroxy-beta-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin). It works by lowering the blood levels of triglycerides and low-density lipoprotein (LDL) (bad) cholesterol by reducing their production by the liver. They also increase the blood levels of high-density lipoprotein (HDL) (good) cholesterol.

Do NOT use Pravastatin if:

• you are allergic to any ingredient in Pravastatin
• you are pregnant or breast-feeding
• you have liver disease or abnormal liver tests
• you are taking fibric acids (eg, gemfibrozil, fenofibrate)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Pravastatin :

Some medical conditions may interact with Pravastatin. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, plan to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines or other substances
• if you abuse alcohol or have a history of alcohol abuse
• if you have low blood pressure; a muscle disease; a blood infection; a metabolic, endocrine, or electrolyte problem; uncontrolled seizures; a severe infection; had a recent surgery, trauma, or organ transplant; or a high level of a creatine phosphokinase in your blood

Some MEDICINES MAY INTERACT with Pravastatin. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Cyclosporine or fibric acids (eg,gemfibrozil ,fenofibrate) because side effects such as severe muscle destruction may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if Pravastatin may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Pravastatin :

Use Pravastatin as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Pravastatin may be taken with or without food.
• Try to take Pravastatin at the same time each day.
• Take Pravastatin 1 hour before or 4 hours after taking bile-acid reducing resins (eg, cholestyramine, colestipol).
• If you miss a dose of Pravastatin , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Pravastatin.

Important safety information:

• Pravastatin may cause dizziness or blurred vision. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Pravastatin. Using Pravastatin alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• For best results, Pravastatin should be used along with exercise, a low-cholesterol/low-fat diet, and a weight loss program if you are overweight.
• Carefully follow the cholesterol-lowering diet given to you by your health care provider.
• Before having any kind of surgery, tell your doctor that you are taking Pravastatin.
• LAB TESTS, including liver function, kidney function, blood pressure, and blood cholesterol, may be performed to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.
• PREGNANCY and BREAST-FEEDING: Do not use Pravastatin if you are pregnant. If you suspect that you could be pregnant, contact your doctor immediately. Pravastatin is excreted in breast milk. Do not breast-feed while taking Pravastatin.

Possible side effects of Pravastatin :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Common cold; constipation; cough; diarrhea; dizziness; flu-like symptoms; gas; headache; heartburn; muscle aches; nausea; pain; rash; runny nose; soar throat; stomach pain; tiredness; urination problems (difficult or painful urination. frequent urination, frequent urination at night); unusual bleeding or bruising; vomiting; yellowing of skin or eyes.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; hoarseness; muscle cramps; muscle pain, tenderness, or weakness (especially when associated with fever and a general feeling of discomfort); sore throat; swelling of hands, eyes, or throat; unusual bleeding or bruising; yellowing of skin or eyes.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

LOVASTATIN is known as a HMG-CoA reductase inhibitor or ’statin’. It lowers the level of cholesterol in the blood. This drug may also reduce the risk of heart attack or other health problems in patients with risk factors for heart disease. Diet and lifestyle changes are often used with this drug. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• frequently drink alcoholic beverages
• kidney disease
• liver disease
• muscle aches or weakness
• other medical condition
• an unusual or allergic reaction to lovastatin, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take with food. Take your doses at regular intervals. Do not take your medicine more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 10 years of age for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

Note: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What may interact with this medicine?

Do not take this medicine with any of the following:

• clarithromycin
• delavirdine
• erythromycin
• grapefruit juice
• herbal medicines like red yeast rice
• protease inhibitors used to treat HIV infection
• medicines for fungal infections like itraconazole, ketoconazole
• mibefradil
• nefazodone
• other medicines for cholesterol
• telithromycin
• troleandomycin

This medicine may also interact with the following:

• alcohol
• amiodarone
• cyclosporine
• danazol
• diltiazem
• fenofibrate
• gemfibrozil
• fluconazole
• mifepristone, RU-486
• niacin
• St. John’s wort
• verapamil
• voriconazole
• warfarin

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• dark urine
• fever
• joint pain
• muscle cramps, pain
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• trouble passing urine or change in the amount of urine
• unusually weak or tired
• yellowing of the eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• constipation
• gas
• heartburn
• indigestion
• stomach pain

This list may not describe all possible side effects.

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular check-ups. You may need regular tests to make sure your liver is working properly.

Tell you doctor or health care professional right away if you get any unexplained muscle pain, tenderness, or weakness, especially if you also have a fever and tiredness.

This drug is only part of a total heart-health program. Your doctor or a dietician can suggest a low-cholesterol and low-fat diet to help. Avoid alcohol and smoking, and keep a proper exercise schedule.

Do not use this drug if you are pregnant or breast-feeding. Serious side effects to an unborn child or to an infant are possible. Talk to your doctor or pharmacist for more information.

If you are going to have surgery tell your health care professional that you are taking this drug.

Some drugs may increase the risk of side effects from lovastatin. If you are given certain antibiotics or antifungals, your doctor or health care professional may stop lovastatin for a short time. Check with your doctor or pharmacist for advice.

Where should I keep this medicine?

Keep out of the reach of children.

Store at room temperature between 5 and 30 degrees C (41 and 86 degrees F). Protect from light. Keep container tightly closed. Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

What is vardenafil?

• Vardenafil relaxes muscles and increases blood flow to particular areas of the body.
• Vardenafil is used to treat erectile dysfunction (impotence).
• Vardenafil may also be used for purposes other than those listed in this medication guide.

What should I discuss with my doctor before taking vardenafil?

• Do not take vardenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking vardenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
• A small number of patients have had a sudden loss of eyesight after taking vardenafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether vardenafil is the actual cause of such vision loss. Sudden vision loss with vardenafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
• Before taking vardenafil, tell your doctor if you have:
  • heart disease or heart rhythm problems;
  • a recent history (in the past 6 months) of a heart attack, angina (chest pain), or congestive heart failure;
  • a history of stroke or blood clots;
  • a personal or family history of “Long QT syndrome”;
  • high or low blood pressure;
  • liver disease;
  • kidney disease (or if you are on dialysis);
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie’s disease); or
  • if you have been told you should not have sexual intercourse for health reasons.
• If you have any of these conditions, you may not be able to use vardenafil or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category B: Although vardenafil is not for use in women, this medication is not expected to be harmful to an unborn baby. Do not use vardenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
• Although vardenafil is not for use in women, it is not known if vardenafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
• You may need a lower dose of this medication if you are older than 65. Follow your doctor’s instructions.

How should I take vardenafil?

• ake each dose with a full glass of water.
• Avoid taking High-fat food before taking Levitra as it may cause the medicine to take more time to start working.
• Vardenafil is usually taken only when needed, 30 – 90 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
• Do not take vardenafil more than once a day. Allow 24 hours to pass between doses.
• Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

• Since vardenafil is used as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine.
• Symptoms of a vardenafil overdose may include back pain, muscle pain, or vision problems.

What should I avoid while taking vardenafil?

• Avoid drinking alcohol, which can increase some of the side effects of vardenafil.
• Grapefruit and grapefruit juice may interact with vardenafil. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

What are the possible side effects of vardenafil?

• If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of vardenafil.
• Stop using vardenafil and get emergency medical help if you have sudden vision loss.
• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using vardenafil and call your doctor at once if you have any of these serious side effects:
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • vision changes;
  • feeling light-headed, fainting; or
  • penis erection that is painful or lasts 4 hours or longer.
• Continue taking vardenafil and talk with your doctor if you have any of these less serious side effects:
  • warmth or redness in your face, neck, or chest;
  • stuffy nose;
  • headache;
  • upset stomach; or
  • back pain.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with vardenafil?

Do not take vardenafil if you are taking the following medications:

• nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally. This includes some recreational drugs called ‘poppers’ which also contain amyl nitrate and butyl nitrate.

Vardenafil may also interact with the following medications:

• alpha blockers such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), tamsulosin (Flomax®), or terazosin (Hytrin®), used to treat high blood pressure or an enlarged prostate.
• arsenic trioxide
• bosentan
• certain antibiotics such as clarithromycin, erythromycin, sparfloxacin, troleandomycin
• certain medicines used for seizures such as carbamazepine, phenytoin, and phenobarbital
• certain medicines for the treatment of HIV infection or AIDS
• certain medicines to control the heart rhythm (e.g., amiodarone, disopyramide, dofetilide, flecainide, ibutilide, quinidine, procainamide, propafenone, sotalol)
• chloroquine
• cisapride
• diltiazem
• grapefruit juice
• medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
• methadone
• nicardipine
• pentamidine
• pimozide
• rifabutin, rifampin, or rifapentine
• some medicines for treating depression or mood problems (amoxapine, maprotiline, fluoxetine, fluvoxamine, nefazodone, pimozide, phenothiazines, tricyclic antidepressants)
• verapamil

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is tadalafil?

• Tadalafil relaxes muscles and increases blood flow to particular areas of the body.
• Tadalafil is used to treat erectile dysfunction (impotence).
• Tadalafil may also be used for purposes other than those listed in this medication guide.

What should I discuss with my doctor before taking tadalafil?

• Do not take tadalafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking tadalafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
• A small number of patients have had a sudden loss of eyesight after taking tadalafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether tadalafil is the actual cause of such vision loss. Sudden vision loss with tadalafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
• Before taking tadalafil, tell your doctor if you have:
  • heart disease or heart rhythm problems;
  • a recent history a heart attack (within the past 90 days);
  • a recent history of stroke or congestive heart failure (within the past 6 months);
  • angina (chest pain);
  • high or low blood pressure;
  • liver disease;
  • kidney disease (or if you are on dialysis);
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie’s disease); or
  • if you have been told you should not have sexual intercourse for health reasons.
• If you have any of these conditions, you may not be able to use tadalafil or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category B: Although tadalafil is not for use in women, this medication is not expected to be harmful to an unborn baby. Do not use tadalafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
• Although tadalafil is not for use in women, it is not known if tadalafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
• You may need a lower dose of this medication if you are older than 65. Follow your doctor’s instructions.

How should I take tadalafil?

• Take each dose with a full glass of water.
• Avoid taking High-fat food before taking Viagra as it may cause the medicine to take more time to start working.
• Tadalafil is usually taken only when needed, 30 – 60 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
• Do not take tadalafil more than once a day. Allow 24 hours to pass between doses.
• Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

• Since tadalafil is used as needed, you are not likely to be on a dosing schedule.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine.
• Symptoms of a tadalafil overdose may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

What should I avoid while taking tadalafil?

• Avoid drinking alcohol, which can increase some of the side effects of tadalafil.
• Grapefruit and grapefruit juice may interact with tadalafil. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
• Do not use any other drug to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), unless your doctor tells you to.

What are the possible side effects of tadalafil?

• If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of tadalafil.
• Stop using tadalafil and get emergency medical help if you have sudden vision loss.
• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using tadalafil and call your doctor at once if you have any of these serious side effects:
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • vision changes;
  • feeling light-headed, fainting; or
  • penis erection that is painful or lasts 4 hours or longer.
• Continue taking tadalafil and talk with your doctor if you have any of these less serious side effects:
  • warmth or redness in your face, neck, or chest;
  • stuffy nose;
  • headache;
  • upset stomach; or
  • back pain.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with tadalafil?

Do not take tadalafil if you are taking the following medications:

• nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally

Tadalafil may also interact with the following medications:

• alpha blockers, such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), or terazosin (Hytrin®), used to treat high blood pressure or an enlarged prostate.
• bosentan
• certain antibiotics such as clarithromycin, erythromycin, troleandomycin
• certain drugs used for seizures such as carbamazepine, phenytoin, and phenobarbital
• cimetidine
• cisapride
• diltiazem
• grapefruit juice
• medicines for fungal infections (fluconazole, itraconazole, ketoconazole, voriconazole)
• mibefradil
• nicardipine
• certain medicines for the treatment of HIV infection or AIDS
• quinidine
• rifabutin, rifampin or rifapentine
• some drugs for treating depression, anxiety or other mood problems (examples: fluoxetine, fluvoxamine, nefazodone)
• verapamil

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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What is sildenafil?

• Sildenafil relaxes muscles and increases blood flow to particular areas of the body.
• Sildenafil under the name Viagra is used to treat erectile dysfunction (impotence) in men. Another brand of sildenafil is Revatio, which is used to treat pulmonary arterial hypertension and improve exercise capacity in men and women.
• Sildenafil may also be used for purposes other than those listed here.

What should I discuss with my doctor before taking sildenafil?

• Do not take sildenafil if you are also using a nitrate drug for chest pain or heart problems. This includes nitroglycerin (Nitrostat, Nitrolingual, Nitro-Dur, Nitro-Bid, and others), isosorbide dinitrate (Dilatrate-SR, Isordil, Sorbitrate), and isosorbide mononitrate (Imdur, ISMO, Monoket). Nitrates are also found in some recreational drugs such as amyl nitrate or nitrite (“poppers”). Taking sildenafil with a nitrate medicine can cause a serious decrease in blood pressure, leading to fainting, stroke, or heart attack.
• A small number of patients have had a sudden loss of eyesight after taking sildenafil. This type of vision loss is caused by decreased blood flow to the optic nerve of the eye. It is not clear whether sildenafil is the actual cause of such vision loss. Sudden vision loss with sildenafil use has occurred most often in people with heart disease, diabetes, high blood pressure, high cholesterol, or certain pre-existing eye problems, and in those who smoke or are over 50 years old.
• Before taking sildenafil, tell your doctor if you have:
  • heart disease or heart rhythm problems;
  • a recent history (in the past 6 months) of a heart attack, stroke, or heart rhythm disorder;
  • congestive heart failure;
  • high or low blood pressure;
  • coronary artery disease;
  • liver disease;
  • kidney disease;
  • a blood cell disorder such as sickle cell anemia, multiple myeloma, or leukemia;
  • a bleeding disorder such as hemophilia;
  • a stomach ulcer;
  • retinitis pigmentosa (an inherited condition of the eye);
  • a physical deformity of the penis (such as Peyronie’s disease); or
  • if you have been told you should not have sexual intercourse for health reasons.
• If you have any of these conditions, you may not be able to use sildenafil or you may need a dosage adjustment or special tests during treatment.
• FDA pregnancy category B: This medication is not expected to be harmful to an unborn baby. Do not use sildenafil without telling your doctor if you are pregnant or plan to become pregnant during treatment.
• It is not known if sildenafil passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take sildenafil?

• Take each dose with a full glass of water.
• Avoid taking High-fat food before taking Viagra as it may cause the medicine to take more time to start working.
• Sildenafil is usually taken only when needed, 30 – 90 minutes before sexual activity. The medication can help achieve an erection when sexual stimulation occurs. An erection will not occur just by taking a pill.
• Do not take sildenafil more than once a day. Allow 24 hours to pass between doses.
• Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

• Viagra is used as needed, so you are not likely to miss a dose.
• If you miss a dose of Revatio, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

• Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a sildenafil overdose may include chest pain, nausea, irregular heartbeat, and feeling light-headed or fainting.

What should I avoid while taking sildenafil?

• Avoid drinking alcohol, which can increase some of the side effects of sildenafil.
• Avoid using other medicines to treat impotence, such as alprostadil (Caverject, Muse, Edex) or yohimbine (Yocon, Yodoxin, others), without first talking to your doctor.

What are the possible side effects of sildenafil?

• If you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw during sexual activity, stop and call your doctor right away. You could be having a serious side effect of sildenafil.
• Stop using sildenafil and get emergency medical help if you have sudden vision loss.
• Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
• Stop using sildenafil and call your doctor at once if you have any of these serious side effects:
  • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
  • irregular heartbeat;
  • swelling in your hands, ankles, or feet;
  • shortness of breath;
  • vision changes;
  • feeling light-headed, fainting; or
  • penis erection that is painful or lasts 4 hours or longer.
• Continue taking sildenafil and talk with your doctor if you have any of these less serious side effects:
  • warmth or redness in your face, neck, or chest;
  • stuffy nose;
  • headache;
  • upset stomach; or
  • back pain.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What drug(s) may interact with ?

Do not take sildenafil if you are taking the following medications:

• nitroglycerin-type drugs for the heart or chest pain such as amyl nitrite, isosorbide dinitrate, isosorbide mononitrate, nitroglycerin, even if these are only taken occasionally

Sildenafil may also interact with the following medications:

• alpha blockers, used for high blood pressure or an enlarged prostate. NOTE: Do not take doses of sildenafil higher than 25 mg within 4 hours of taking alpha blockers, such as alfuzosin (UroXatral®), doxazosin (Cardura®), prazosin (Minipress®), or terazosin (Hytrin®).
• bosentan
• certain drugs used for seizures such as carbamazepine, phenytoin, and phenobarbital
• certain drugs used for fungal or yeast infections, such as fluconazole, ketoconazole, and voriconazole
• certain drugs for the treatment of HIV infection or AIDS
• cimetidine
• cisapride
• clarithromycin
• diltiazem
• erythromycin
• grapefruit juice
• mibefradil
• nitroprusside
• rifabutin
• rifampin
• quinidine
• some drugs for treating depression, anxiety or other mood problems (examples: fluoxetine, fluvoxamine, nefazodone)
• verapamil

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

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