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It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors see Adverse Reactions 6.2.
PDE5 inhibitors, including Levitra, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. In some patients, concomitant use of these two drug classes can lower blood pressure significantly leading to symptomatic hypotension for example, fainting see Drug Interactions 7.1 and Clinical Pharmacology 12.2. Consideration should be given to the following: patients should be stable on alpha-blocker therapy prior to initiating a pde5 inhibitor. Patients who demonstrate hemodynamic instability on alpha-blocker therapy viagra use in hindi language alone are at increased risk of viagra use in hindi language symptomatic hypotension with concomitant use of PDE5 inhibitors. In those viagra use in hindi language patients already taking an optimized dose of PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose.
Stepwise viagra use in hindi language increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitor.
Safety of combined use of PDE5 inhibitors viagra use in hindi language and alpha-blockers may be viagra use in hindi language affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs.