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Levitra (vardenafil) is a PDE5 inhibitor used for treating erectile dysfunction in men.
How does it work?
Penis erection is essentially a hemodynamic process, which is based on the relaxation of the smooth muscles of the cavernous body and the arteries located in it. During sexual arousal, nitric oxide is produced from the nerve endings of the cavernous bodies, which stimulates the guanitlate cyclase enzyme, which increases the concentration of cyclic guanosine monophosphate in the cavernous body. As a result, the smooth muscles of the cavernous bodies relax, which in turn is the cause of blood flow into the penis. By blocking the special type 5 phosphodiesterase involved in the decomposition of cyclic guanosine monophosphate, Levitra enhances the local action of endogenous nitric oxide in the cavernous body during intimate arousal. This mechanism explains the ability of the drug to increase the strength of the reaction to sexual arousal.
Weak potency (inability to achieve and maintain an erection required for a full sexual intercourse).
- hypersensitivity to the components of the drug;
- aortic stenosis or idiopathic hypertrophic subaortic stenosis;
- use of nitrates or agents serving as nitric oxide donors;
- bleeding and exacerbation of peptic ulcer;
- use of HIV protease inhibitors such as ritonavir and indinavir;
- inherited degenerative diseases of the retina;
- use by women and children;
- unstable angina pectoris;
- a congenital extended OT interval;
- recent myocardial infarction and stroke;
- men with anatomical deformation of the penis (cavernous fibrosis, curvature, Peyronie’s disease);
- arterial hypotension;
- diseases that contribute to priapism (multiple myeloma, sickle cell anemia, leukemia);
- kidney disease in the terminal stage;
- severe liver dysfunction. For men with minor impairments, dosage adjustment is not required; with moderate impairments, an initial dose is 5 mg / day, then the dose can be increased to 10 mg if the drug is tolerated well.
Dosage and administration
- The initial dose of the drug is 10 mg;
- The drug is taken 30-60 minutes before the planned sex. The duration of action is 4-5 hours;
- Do not use the drug more often than once a day;
- During treatment, the dose can be increased to 20 mg or reduced to 5 mg per day;
- The maximum dose recommended by doctors is 20 mg once a day;
- A dose of 5 mg is recommended for patients over 65 years of age;
- A dose of 20 mg is recommended for men with severe ED (prostatectomy, diabetes mellitus), when a small dose of 10 mg does not produce the desired effect;
- Food and alcohol do not reduce the effectiveness of Levitra;
- The drug begins to work only with the necessary level of sexual arousal.
The drug is most often well tolerated, adverse effects are usually mild/moderate and temporary. Headache, rhinitis, facial flushing, dizziness, dyspepsia, and nausea are more common. Less common side effects are facial edema, glaucoma, photosensitivity, nosebleeds, lower back pain, increased muscle tone, arterial hypertension, syncope, changes in functional “liver” tests, postural hypotension, myocardial ischemia, increased GGTP, arterial hypotension, angina pectoris, anaphylactic reactions (including laryngeal edema), increased creatine kinase levels, priapism, myalgia, watery eyes, drowsiness, blurred vision, dyspnea.
The use of Levitra at a dose of up to 80 mg per day did not cause severe adverse reactions. However, patients who took a dose of 40 mg twice a day sometimes experienced lumbar pain without severe toxicosis in the nervous and muscular systems.
Interaction with other drugs
- The dosage of vardenafil cannot exceed 5 mg when interacting with erythromycin, itraconazole, ketoconazole. The dose of the latest drugs in this case varies up to 200 mg;
- The simultaneous use with ritonavir and indinavir is contraindicated;
- The use in combination with nitrates and nitric oxide donors is contraindicated due to the risk of arterial hypotension;
- Combined treatment with alpha-blockers can cause arterial hypotension; therefore, vardenafil should be taken no earlier than six hours after the use of alpha-blockers and its dosage cannot be higher than 5 mg. However, in the treatment of tamsulosin, the time of drug administration may be the same.
Keep the drug out of the reach and sight of children. Store it in a cool, dry place, away from direct heat, light and moisture. Do not use the expired medication.