Levitra

Levitra is intended for erectile dysfunction treatment in adult men. It effectively and quickly increases potency in men with a weak genital response to sexual stimulation. Levitra 10 mg fights erectile dysfunction of various origins and degrees of development. A stable positive result is achieved with regular long-term use.

Brief description of the drug:

release form: tablets for oral administration, coated with a smooth shell in the appearance of beige color. In one blister, 10 tablets;
main active ingredient (the composition of the drug): vardenafil, which is a selective PDE-5 inhibitor.

What Levitra is used for?

Levitra is used for erectile dysfunction.

What are the contraindications of Levitra?

Hypersensitivity to any of the drug components;
Simultaneous use with nitrates or drugs that are donors of nitric oxide;
Concomitant use with moderately active and potent CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, erythromycin, and clarithromycin;
Medications for erectile dysfunction treatment should not be used in men who are contraindicated sexual activity (for example, patients with concomitant cardiovascular diseases such as unstable angina or acute heart failure.

The safety of Levitra has not been studied and until the relevant data have been obtained, its use is not recommended in patients with the following conditions:

severe liver dysfunction,end-stage kidney diseases requiring hemodialysis;
arterial hypotension;
recent stroke or myocardial infarction (within the last 6 months);
unstable angina pectoris, as well as hereditary degenerative diseases of the retina, for example, retinitis pigmentosa.

How to take Levitra?

Levitra is taken orally, regardless of food intake. At the beginning of treatment, the recommended dose of Levitra is 10 mg approximately 25-60 minutes before sexual contact. Levitra is effective for 4-5 hours before sexual intercourse. The maximum frequency of taking the drug is 1 time per day. Depending on the treatment effectiveness and tolerability, the dose can be increased to 20 mg or reduced to 5 mg per day. The maximum recommended dose is 20 mg once a day. Sexual stimulation is needed to provide an adequate response to treatment.

What if I miss a dose?

This does not apply. However, do not take double or extra doses.

What are the possible interactions of Levitra (Vardenafil)?

CYP inhibitors

Vardenafil is metabolized primarily with the participation of hepatic enzymes of the cytochrome P450 (CYP) system, namely, the ZA4 isoform, as well as with some participation of the CYP3A5 and CYP2C isoforms. Inhibitors of these enzymes may decrease vardenafil clearance.
Cimetidine (400 mg 2 times a day): this non-specific inhibitor of cytochrome P450 does not affect the value of the PPK and SCHc values of Levitra (20 mg) when used simultaneously.
Erythromycin (500 mg 3 times a day): this CYP ZA4 inhibitor causes a 4-fold (300%) increase in PPK and a 3-fold (200%) increase in Cmax of Levitra (5 mg).
Ketoconazole (200 mg): being a potent inhibitor of CYP ZA4, ketoconazole causes a 10-fold increase (900%) in AUC and a 4-fold increase (300%) in Cmax of Levitra (5 mg).
With the combined use of Levitra (10 mg) and the HIV protease inhibitor indinavir (800 mg 3 times a day), a 16-fold (1500%) increase in AUC and a 7-fold (600%) increase in Cmax vardenafil are noted.
24 hours after administration, the concentration of vardenafil in the plasma is approximately 4% of its Cmax-Ritonavir (600 mg 2 times a day): it increases Levitra (5 mg) by 13 times and Cmax its total daily PPK by 49 times. The interaction is due to the fact that ritonavir, as a potent inhibitor of CYP3A4 and CYP2C9, blocks the hepatic metabolism of this ED drug. Ritonavir significantly lengthens T/2 of vardenafil (up to 25.7 hours).
Nicorandil is an activator of potassium channels and contains a nitro group. The presence of a nitro group in the composition of nicorandil causes a high probability of its interaction with vardenafil.
With the combined use of Levitra with ketoconazole, itraconazole, indinavir, and ritonavir (potential CYP3A4 inhibitors), a significant increase in the concentration of vardenafil in the blood plasma can be expected.

Nitrates, nitric oxide donors:

Taking Levitra (10 mg) from 24 hours to 1 hour before taking nitroglycerin (0.4 mg sublingually) does not increase its hypotensive effect. At a dose of 20 mg 1 to 4 hours before the use of nitrates (0.4 mg sublingually), Levitra enhances their hypotensive effect, but if it is prescribed for 24 hours, then the hypotensive effect does not increase.

However, there is insufficient information on the potential antihypertensive effects of vardenafil when used concomitantly with nitrates. In this regard, this combination is contraindicated.

What are the side effects of taking Levitra?

Central nervous system and peripheral nervous system: ≥10% – headache; ≥1% – dizziness; ≥0.1% – <1% – drowsiness; ≥0.01% – <0.1% – anxiety, fainting.
Cardiovascular system: ≥10% – hot flashes (periodic sudden redness of the face, sensation of heat); ≥0.1% – <1% – increased blood pressure, decreased blood pressure, orthostatic hypotension; ≥0.01% – <0.1% – angina pectoris, myocardial ischemia.
Digestive system: ≥1% – <10% – dyspepsia, nausea; ≥0.1% – <1% – change in liver function tests (increased ALT, AST, GGTP).
Respiratory system: ≥1% – <10% – congestive hyperemia of the nasal mucosa (swelling of the mucosa, rhinitis, rhinorrhea); ≥0.1% – <1% – shortness of breath, nosebleeds; ≥0.01% – <0.1% – laryngeal edema.
The organ of vision: ≥0.1% – <1% – increased lacrimation, visual impairment (brightness of vision); ≥0.01% – <0.1% – increased intraocular pressure.
Dermatological reactions: ≥0.1% – <1% – facial edema, photosensitivity.
Musculoskeletal system: ≥0.1% – <1% – myalgia, back pain, increased CPK; ≥0.01% – <0.1% – increased muscle tone. Reproductive system:> 0.01% – <0.1% – prolonged erection or painful erection, priapism.
Other: ≥0.01% – <0.1% – hypersensitivity reactions.

Can you overdose on Levitra?

Symptoms: there are known cases of taking Levitra at a dose of 80 mg 1 time/day and 40 mg 1 time/day for more than 4 weeks without the development of severe adverse reactions. However, at the same time, when applied at a dose of 40 mg 2 times/day, severe lower back pain is observed without signs of toxic effects on the muscle and nervous system.

Treatment: symptomatic and supportive therapy. Since vardenafil is highly bound to plasma proteins, and only a small amount of the drug is excreted by the kidneys, the effectiveness of hemodialysis is unlikely.