Zhewitra 40 Mg (vardenafil) is usually taken at home or another private, comfortable place, because it is intended to be taken before planned sexual activity. It does not need to be taken in a clinic or hospital. General guidance includes: Take it about 30–60 minutes before sexual activity, or as directed by your healthcare provider. Swallow the tablet whole with a glass of water. It may be taken with or without Zhewitra 40 Mg , but a heavy or high-fat meal can delay how quickly it starts working. Do not take more than one dose in 24 hours unless your doctor instructs otherwise. Important precautions Do not take Zhewitra 40 Mg if you: Use nitrate medications for chest pain. Take riociguat for pulmonary hypertension. Have been advised by your doctor to avoid sexual activity because of certain heart conditions. If you experience chest pain, sudden vision or hearing changes, or an erection lasting longer than 4 hours, seek immediate medical attention.