Levitra (Vardenafil)

Common Use

Levitra is an oral drug used to treat erectile dysfunction. Sexual stimulation causes the production and release of nitric oxide from the nerve endings of the cavernous bodies of the penis, thereby activating the enzyme guanylate cyclase. Guanylate cyclase is responsible for the production of cyclic guanosine monophosphate (cGMP). The cGMP causes widening and relaxation of the blood vessels carrying blood to the penis. Levitra prevents phosphodiesterase-5 enzyme from destroying cGMP and thus helps to support blood flow to the penis.

Dosage and Direction

The recommended dose of Levitra is 10 mg per day taken an hour before intercourse. If no side effects are experienced, the dosage can be increased up to 20 mg. In case of adverse effects, the dose is reduced to 5 mg daily. Do not take more than one tab of Levitra a day.

Precautions

Levitra has not been studied in people with cardiovascular disease, so it is preferable to avoid Levitra in patients who have had a stroke, heart failure, or a heart attack in the last six months. Before taking Levitra, inform your doctor if you have:

• Kidney or liver problems
• A bleeding disorder
• Stomach ulcer
• An inherited retinal disorder such as retinitis pigmentosa
• Allergic reactions to this medicine or any other medicines
• Deformation of the penis such as angulation or cavernous fibrosis (Peyronie's disease)
• Diseases that contribute to the development of priapism (e.g., sickle-cell anemia, multiple myeloma, leukemia)

Contraindications

Levitra is contraindicated in patients with:

• Hypersensitivity to its ingredients
• Organic nitrates
• Patients under 16 years old
• HIV protease inhibitors such as indinavir and ritonavir

Side Effects

Side effects of Levitra (Generic) might include:

• Stuffy nose
• Dizziness, headache, or feeling light-headed
• Nausea and/or diarrhea
• Rarely hyper- or hypotension, back pain, watery eyes, myalgia, priapism (a prolonged and painful erection that must be reported to a doctor if it does not disappear for more than 4 hours, otherwise it may cause damage to the penis)

To decrease the risk of developing side effects, it is required that your doctor authorize usage of Levitra (Generic) if you:

• Are under 16
• Are taking HIV protease inhibitors containing indinavir or ritonavir
• Are taking medications containing organic nitrates and those containing erythromycin, itraconazole, ketoconazole, or terazosin
• Suffer from cardiovascular diseases, priapism, kidney/liver/blood conditions, stomach ulcer, retinal disorders (e.g., retinitis pigmentosa), multiple myeloma, leukemia, or sickle-cell anemia
• Are allergic to vardenafil or any other medications, foods, or substances
• Have your penis deformed due to angulation or cavernous fibrosis

Drug Interaction

Levitra's metabolism is inhibited by:

• Erythromycin
• Ketoconazole (Nizoral)
• Itraconazole (Sporanox)
• Indinavir (Crixivan)
• Ritonavir (Norvir)

Levitra reduces the concentration of ritonavir and indinavir. In patients treated with nitrates, Levitra may aggravate chest pain by increasing heart rate and lowering blood pressure. Levitra is able to exaggerate the blood pressure-lowering effects of alpha-blocking drugs (e.g., terazosin or Hytrin). Levitra should never be administered to patients who are treated with organic nitrates.

Missed Dose

Levitra is taken when needed but not more often than once daily, so missed dose is not supposed.