Simultaneous use of these two drug classes can lower blood pressure considerably causing symptomatic hypotension (e.g., fainting) in some patients. Concomitant treatment should be initiated only if the patient is stable on his alpha blocker therapy. In those patients who are stable on alpha-blocker therapy, levitra should be initiated at a dose of 5 mg.

If you have mild hepatic impairment (Child-Pugh A), and you want to take levitra, you can take it without any adjustment in the dose. But patients who have moderate hepatic impairment (Child-Pugh B) eliminate vardenafil in decreased amount. If you have this condition you need a starting dose of 5 mg of this drug. You should not take more than 10 mg at any cost. The consequence of taking this pill has not been assessed in patients with severe hepatic impairment (Child-Pugh C).

If you have mild (CLcr = 50-80 ml/min), moderate (CLcr = 30-50 ml/min), or severe (CLcr<30 ml/min) renal problem, you need no dose adjustment. This medication has not been studied in patients who require renal dialysis.