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trouble in holding or releasing urine troubled breathing trouble in sleeping weight increased or decreased After you stop using this medicine your body may need time to adjust The length of time this takes depends on the amount of medicine you were using and how long you used it During this period of time check with your doctor if you notice any of the following side effects Anxiety body aches diarrhea fast heartbeat fever runny nose or sneezing gooseflesh high blood pressure increased sweating increased yawning loss of appetite nausea or vomiting nervousness restlessness or irritability shivering or trembling stomach cramps trouble in sleeping unusually large pupils weakness Other side

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ADMINISTRATION Vardenafil has not been evaluated in patients with severe Child-Pugh C hepatic impairment Pharmacodynamics Effects on Blood Pressure In a clinical pharmacology study of patients with erectile dysfunction single doses of vardenafil 20 mg caused a mean maximum decrease in supine blood pressure of 7 mmHg systolic and 8 mmHg diastolic compared to placebo accompanied by a mean maximum increase of heart rate of 4 beats per minute The maximum decrease in blood pressure occurred between 1 and 4 hours after dosing Following multiple dosing for 31 days similar blood pressure responses were observed on Day 31 as on Day 1 Vardenafil may add to the blood pressure lowering effects of antihypertensive agents see PRECAUTIONS Drug Interactions Effects on Blood Pressure and Heart Rate when Levitra is Combined with Nitrates A study was conducted in which the blood pressure and heart rate response to mg nitroglycerin NTG sublingually was evaluated in 18 healthy subjects following pretreatment with Levitra 20 mg at various times before NTG administration Levitra 20 mg caused an additional time-related reduction in blood pressure and increase in heart rate in association with NTG administration The blood pressure effects were observed when Levitra 20 mg was dosed 1 or 4 hours before NTG and the heart rate effects were observed when 20 mg was dosed or 8 hours before NTG

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medication unless otherwise directed by your doctor What happens if I overdose Seek emergency medical attention if an overdose is suspected Symptoms of a acamprosate overdose may include diarrhea What should I avoid while taking acamprosate Use caution when driving operating machinery or performing other hazardous activities Acamprosate may cause dizziness or drowsiness If you experience dizziness or drowsiness avoid these activities Acamprosate side effects If you experience any of the following serious side effects stop taking acamprosate and contact your doctor immediately or seek emergency medical treatment an allergic reaction difficulty breathing closing of the throat swelling of the lips tongue or face or hives an irregular heartbeat or pulse low blood pressure dizziness weakness high blood pressure severe headache blurred vision chills or fever unusual bleeding or bruising a rash or hives If you experience any of the following less serious side effects continue taking acamprosate and talk to your doctor headache tremor nervousness or anxiety stomach pain constipation increased appetite weight gain amnesia abnormal thinking tremor flushing abnormal vision difficulty tasting or decreased sex drive or impotence Side effects other than those

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Cialis and each time the prescription is renewed or refilled Drug Interactions Effects of Other Drugs on Cialis Cytochrome P450 Inhibitors Cialis is a substrate of and predominantly metabolized by CYP3A4 Studies have shown that drugs that inhibit CYP3A4 can increase tadalafil exposure see PRECAUTIONS and DOSAGE AND ADMINISTRATION Ketoconazole Ketoconazole 400 mg daily a selective and potent inhibitor of CYP3A4 increased tadalafil 20 mg single dose exposure AUC by 312 and Cmax by 22 relative to the values for tadalafil 20 mg alone Ketoconazole 200 mg daily increased tadalafil 10 mg single dose exposure AUC by 107 and Cmax by 15 relative to the values for tadalafil 10 mg alone HIV Protease inhibitor Ritonavir 500 mg or 600 mg twice daily at steady state an inhibitor of CYP3A4 CYP2C9 CYP2C19 and CYP2D6 increased tadalafil 20 mg single dose exposure AUC by 32 with a 30 reduction in Cmax relative to the values for tadalafil 20 mg alone Ritonavir 200 mg twice daily increased tadalafil 20 mg single dose exposure AUC by 124 with no change in Cmax relative to the values for tadalafil 20 mg alone Although specific interactions have not been studied other HIV protease inhibitors would likely increase tadalafil exposure see DOSAGE AND ADMINISTRATION Based upon these results in patients taking concomitant potent CYP3A4 inhibitors the dose of Cialis should not exceed 10 mg and Cialis should not be taken more frequently than once in every 72 hours see DOSAGE AND ADMINISTRATION Other cytochrome P450

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■ 北海道セレクト様　 ト・・・

北海道セレクト様　
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