Hypertension medication interaction with herbal ED supplement

Patient

Q: I am considering taking a herbal supplement for ED. It contains Vitamin E 60 IU, Zinc Aspartate 30 mg, L-Carnitine 500 mg, Maca 400 mg, Pine Bark Extract 300 mg, L-Arginine HCL 350 mg, L-Lysine 250 mg, Catuaba 200 mg, Epimedium Sagittatum 150 mg, Muira Puama 100 mg, Hawthorne 50 mg, Cranberry Extract 50 mg, Tribulus Terrestris 50 mg, and Avena Sativa Extract 50 mg. I currently take 80 mg Micardis and a baby aspirin a day. Am I okay? My Interal Medicain physican has previously prescribed 20 mg levitra before, no adverses side effects.

Doctor

A:   LEVITRA® (vardenafil  hcl) is an oral therapy for the treatment of erectile dysfunction(ED). The side effects: Headache, flushing, nasal stuffiness, stomach upset, heartburn, runny nose, dizziness, or nausea may occur. Vision changes such as increased sensitivity to light, blurred vision, or impaired blue/green color discrimination may also occur. If any of these effects persist or worsen, notify your doctor or pharmacist ASAP. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: nitrates (e.g., nitroglycerin, isosorbide), nitroprusside (or any "nitric oxide donor" drugs), recreational drugs called "poppers" containing amyl or butyl nitrite. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: alpha-blocker medication (e.g., doxazosin, prazosin, terazosin, or doses greater than 0.4 milligrams daily of tamsulosin), other medications for impotence, drugs that affect certain liver enzymes (CYP 3A4 substrates, inhibitors and inducers, e.g., cimetidine, rifamycins, St. John's wort, certain anti-seizure drugs), high blood pressure medicines.  I strongly recommend that you do not take this drug with any other herbal product used to treat ED, tell your doctor or pharmacist of all the products you use because may be other drugs or herbal products that can interact negatively with Vardenafil.

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