Drug Uses

Levitra is an oral therapy for the treatment of erectile dysfunction.

How Taken

Levitra comes as a tablet to take it orally. It should be taken, as needed about 1 hour before sexual activity. Some form of sexual stimulation is needed for an erection to occur with Levitra. Levitra should not be taken more than once a day. Levitra can be taken with or without food.

Warnings/Precautions

Before taking Levitra, tell your doctor if you currently have or have ever had a heart attack, stroke, irregular heartbeats, angina (chest pain), or congestive heart failure; high or low blood pressure; if you have a personal or family history of a rare heart condition known as prolongation of the QT interval (long QT syndrome); liver problems or kidney problems; have ever had blood problems, including sickle cell anemia, multiple myeloma, or leukemia; have a bleeding or blood clotting disorder; have a stomach ulcer; a family history of degenerative eye disease (e.g., retinitis pigmentosa); or if you have a physical deformity of the penis such as Peyronie's disease. You may not be able to take Levitra, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Although women do not indicate Levitra for use, it is in the FDA pregnancy category B. This means that Levitra is not expected to be harmful to an unborn baby. Women should not take Levitra. It is not known whether Levitra passes into breast milk. If you are over 65 years of age, you may be more likely to experience side effects from Levitra. Your doctor may prescribe a lower dose of the medication.

Missed Dose

Levitra is used as needed, so you are not likely to miss a dose.

Possible Side Effects

The most common side effects with Levitra are:
-Headaches
-Flushing
-Stuffy or runny nose
Levitra may uncommonly cause: an erection that will not go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections. Vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green. These are not all the side effects of Levitra. For more information, ask your doctor or pharmacist.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Keep Levitra and all medicines out of the reach of children.

Overdose

Seek emergency medical attention if an overdose is suspected. Symptoms of a Levitra overdose are not known, but are likely to include chest pain, back pain, dizziness, an irregular heartbeat, abnormal vision, and swelling of the ankles or legs.

More Information

Do not take Levitra if you:
-Take any form of medication known as "nitrates" (Type of medicine used to relieve chest pain that can occur as a result of heart disease). Taking Levitra in combination with nitrates may result in serious side effects.
-Take medicines called "alpha-blockers" (sometimes prescribed for prostate problems or high blood pressure). Taking Levitra with alpha-blockers may drop your blood pressure to an unsafe level.
-Your doctor determines that sexual activity poses a health risk for you.
You have a known sensitivity or allergy to any component of Levitra. The use of Levitra offers no protection against sexually transmitted diseases. Counseling of patients about protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), should be considered.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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What Is Breast Cancer in Men?
Breast cancer is a malignant tumor that has developed from cells of the breast. The disease occurs primarily in women but occasionally occurs in men. Many people do not realize that men have breast tissue and that they can develop breast cancer.
Normal Breast Structure
The breast is made up mainly of lobules (milk-producing glands in women), ducts (tiny tubes that carry the milk from the lobules to the nipple in women), and stroma (fatty tissue and connective tissue surrounding the ducts and lobules, blood vessels, and lymphatic vessels).
Until puberty, young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola (area around the nipple). At puberty, a girl's ovaries produce female hormones, causing breast ducts to grow, lobules to form at the ends of ducts, and the amount of stroma to increase. On the other hand, male hormones produced by the testicles prevent further growth of breast tissue. Men's breast tissue contains ducts, but only a few if any lobules.
Like all cells of the body, a man's breast duct cells can undergo cancerous changes. Because women have many more breast cells than men do and perhaps because their breast cells are constantly exposed to the growth-promoting effects of female hormones, breast cancer is much more common in women.
Many types of breast disorders can affect both men and women. Most breast disorders are benign (not cancerous). Benign breast tumors do not spread outside of the breast and are not life threatening. Other tumors are malignant (cancerous) and may become life threatening. Benign tumors, such as papillomas and fibroadenomas, are common in women but are extremely rare in men.
As in most tissues of the body, fluids are circulated to and from the breast by 2 main forms of channels. Blood vessels carry blood to and from the breast. Lymphatic vessels carry lymph instead of blood. Lymph is a clear fluid that contains tissue fluid and waste products and immune system cells (cells that are important in fighting infections). Lymph nodes are small, bean-shaped collections of immune system cells that are found along lymphatic vessels. This is important in cancer, because cancer cells can enter lymphatic vessels and spread to lymph nodes. This becomes important when we talk about staging (see ?Staging? section).
Most lymphatic vessels in the breast connect to lymph nodes under the arm (axillary lymph nodes). Some lymphatic vessels connect to lymph nodes inside the chest (internal mammary nodes) and either above or below the collarbone (supraclavicular or infraclavicular nodes).
Knowing if the cancer cells have spread to lymph nodes is important because that lets us know that there is a higher chance that the cells could have gotten into the bloodstream and spread to other sites in the body. This is why it is important to find out if breast cancer has spread to your axillary lymph nodes when you are choosing a treatment. The more lymph nodes that are involved with the breast cancer, the more likely it is that the cancer will eventually be found in other organs as well. However, not all men with lymph node involvement develop metastases, and it is not unusual for a man to have negative lymph nodes and later develop metastases.
Benign Breast Conditions
Gynecomastia is the most common male breast disorder. It is not a tumor but rather an increase in the amount of a man's breast tissue. Usually, men have too little breast tissue to be felt or noticed. A man with gynecomastia has a button-like or disk-like growth under his nipple and areola, which can be felt and sometimes seen. Gynecomastia, common among teenage boys, is due to changes in hormone balance during adolescence. The same condition is also common in older men and is also due to changes in their hormone balance.
Rarely, gynecomastia occurs because tumors or diseases of certain endocrine (hormone-producing) glands cause a man's body to produce more estrogen (the main female hormone). Although men's glands normally produce some estrogen, it is not enough to cause breast growth. Diseases of the liver, which is an important organ in male and female hormone metabolism, can change a man's hormone balance and lead to gynecomastia. Obesity may be another cause of elevated estrogens in men.
Many commonly prescribed medicines can sometimes cause gynecomastia, too. These include some drugs used to treat ulcers and heartburn, high blood pressure, and heart failure. Men with gynecomastia should ask their doctors about whether any medicines they are taking might be causing this condition.
Klinefelter syndrome, a rare genetic condition, can lead to gynecomastia and increase a man's risk of developing breast cancer. This condition is discussed further in the section on risk factors for male breast cancer.
Types of Breast Cancer
Adenocarcinoma: Nearly all breast cancers start in the ducts or lobules of the breast. Because this is glandular tissue, they are called adenocarcinomas, a term applied to cancers of glandular tissue anywhere in the body. The 2 main types of breast adenocarcinomas are ductal carcinomas and lobular carcinomas.
Ductal carcinoma in situ (DCIS): DCIS is an uncommon type of breast adenocarcinoma in men (about 10%). Cancer cells fill the ducts but do not invade through the walls of the ducts into the fatty tissue of the breast or spread outside the breast. It is almost always curable with surgery.
In situ is the term used for the early stage of cancer, when it is confined to the immediate area where it began. Specifically in breast cancer, in situ means that the cancer remains confined to ducts (ductal carcinoma in situ) or lobules (lobular carcinoma in situ). It has not invaded surrounding fatty tissues in the breast nor spread to other organs in the body.
Infiltrating (or invasive) ductal carcinoma (IDC): Starting in a duct of the breast, this type of adenocarcinoma breaks through the wall of the duct and invades the fatty tissue of the breast. At this point, it can metastasize (or spread) to other parts of the body. IDC (alone or mixed with other types of invasive or in situ breast cancer) accounts for 80% to 90% of male breast cancers.
Lobular breast cancers in men are very rare, accounting for only 2% of adenocarcinomas. This is because men do not usually have lobular tissue, the milk-producing glands.
Paget disease of the nipple: This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple. It may also spread to the areola (the dark circle around the nipple). The skin of the nipple usually appears crusted, scaly, and red, with areas of itching, oozing, burning, or bleeding. Using the fingertips, a lump may be detected within the breast. If no lump can be felt, the prognosis (outlook for survival) is generally good. Paget disease may be associated with in situ carcinoma or with infiltrating breast carcinoma. It accounts for about 1% of female breast cancers and a higher percentage of male breast cancers. Because the male breast is much smaller than the female breast, all male breast cancers start relatively close to the nipple, so spread to the nipple is more likely.

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