Understanding Levitra: Key Information and Uses

Inform patients of the increased risk of NAION in individuals who have already experienced NAION in one eye and discuss the increased risk of NAION among the general population in patients with a "crowded" optic disc, although evidence is insufficient to support screening of prospective users of PDE5 inhibitor, including vardenafil, for this uncommon condition. Advise patients to stop treatment and seek prompt medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including vardenafil. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors. The use of vardenafil offers no protection against sexually transmitted diseases. Counseling of patients about protective measure necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), should be considered.

Learn more, stress less when doctors come together

In a single dose study in 25 normal males, vardenafil 40 mg, twice the maximum daily recommended dose, did not alter visual acuity, intraocular pressure, fundoscopic and slit lamp findings. In another double blind, placebo controlled clinical trial, at least 15 doses of 20 mg vardenafil were administered over 8 weeks versus placebo to 52 males. Thirty-two (32) males (62%) of the patients completed the trial. Retinal function was measured by ERG and FM-100 test 2, 6 and 24 hours after dosing. The trial was designed to detect changes in retinal function that might occur in more than 10% of patients.

Which erectile dysfunction drug is best?

Vardenafil did not produce clinically significant ERG or FM-100 effects in healthy men compared to placebo. Two patients on vardenafil in the trial reported episodes of transient cyanopsia (objects appear blue). There was no effect on sperm motility or morphology after single 20 mg oral doses of vardenafil in healthy volunteers. The pharmacokinetics of vardenafil are approximately dose proportional over the recommended dose range. Absorption: Vardenafil is rapidly absorbed with absolute bioavailability of approximately 15%. Advise patients that the disintegrating tablet (Staxyn) is not interchangeable with the film-coated tablet (Levitra).

Product	Dosage	Quantity + Bonus	Price
Levitra Generic	40mg	30 + 2 Pills	93.58€ 89.12€	Buy
Levitra Generic	60mg	60 + 4 Pills	198.85€ 189.38€	Buy
Levitra Generic	20mg	10 Pills	31.49€ 29.99€	Buy
Levitra Generic	40mg	270 + 10 Pills	561.89€ 535.13€	Buy
Levitra Generic	10mg	60 + 6 Pills	112.98€ 107.60€	Buy
Levitra Generic	60mg	20 Pills	81.30€ 77.43€	Buy
Levitra Soft Tabs	20mg	180 + 10 Pills	398.14€ 379.18€	Buy
Levitra Generic	10mg	270 + 10 Pills	338.09€ 321.99€	Buy
Levitra Soft Tabs	20mg	120 + 8 Pills	288.52€ 274.78€	Buy
Levitra Generic	60mg	30 + 2 Pills	109.43€ 104.22€	Buy
Levitra Original	20mg	76 + 4 Pills	344.39€ 327.99€	Buy
Levitra Generic	20mg	90 + 8 Pills	180.78€ 172.17€	Buy
Levitra Generic	40mg	360 + 10 Pills	704.99€ 671.42€	Buy
Levitra Professional	20mg	360 + 6 Pills	914.63€ 871.08€	Buy
Levitra Generic	60mg	180 + 10 Pills	501.43€ 477.55€	Buy

General Notes: May be taken with or without food. (Tablet) Place on tongue to disintegrate; take without liquid and immediately upon removal from blister. Approval Status: Approved for marketing by the U.S. FDA on August 19, 2003. Chemical/Biological Nature: LEVITRA is a small molecule chemical compound, with a molecular weight of 579.1 daltons. Administration: LEVITRA is taken orally 60 minutes before sexual activity. For most patients, the recommended starting dose is 10 mg. Depending on an individual’s response, the dose may be adjusted higher to 20 mg or lower to 5 mg.

Next Steps

Maximum observed plasma concentrations after a single 20 mg dose in healthy volunteers are usually reached between 30 minutes and 2 hours (median 60 minutes) after oral dosing in the fasted state. Two food-effect studies were conducted which showed that high-fat meals caused a reduction in Cmax by 18%-50%. Distribution: The mean steady-state volume of distribution (Vss) for vardenafil is 208 L, indicating extensive tissue distribution. Vardenafil and its major circulating metabolite, M1, are highly bound to plasma proteins (about 95% for parent drug and M1). This protein binding is reversible and independent of total drug concentrations.

Helpful Links

Following a single oral dose of 20 mg vardenafil in healthy volunteers, a mean of 0.00018% of the administered dose was obtained in semen 1.5 hours after dosing. Metabolism: Vardenafil is metabolized predominantly by the hepatic enzyme CYP3A4, with contribution from the CYP3A5 and CYP2C isoforms. The major circulating metabolite, M1, results from desethylation at the piperazine moiety of vardenafil. The plasma concentration of M1 is approximately 26% that of the parent compound. This metabolite shows a phosphodiesterase selectivity profile similar to that of vardenafil and an in vitro inhibitory potency for PDE5 28% of that of vardenafil. The recommended maximum dosing frequency is no more than once daily. Mechanism of Disease: Penile erection is a hemodynamic event. There are many abnormalities that could lead to erectile dysfunction.

• Levitra may interact with other medications like alpha-blockers for prostate issues.
• Use caution when combining Levitra with other vasodilators.
• Patients should avoid excessive alcohol when taking Levitra to prevent adverse effects.
• It is important to stay hydrated and avoid dehydration during treatment.
• Levitra's effectiveness can be reduced by certain health conditions, like obesity.
• Men with certain eye conditions should have medical clearance before use.
• Levitra may cause dizziness; patients should stand slowly from sitting or lying.
• Overdose symptoms include prolonged erections and cardiovascular symptoms; seek immediate help.

Normally, the signal transduction events mediated by cyclic guanosine monophosphate (cGMP) lead to the relaxation of the smooth muscle of blood vessels that supply blood to the penis when there is sexual stimulation. The lack of, or insufficient sustained levels of, cGMP result in erectile dysfunction. Mechanism of Drug Action: During sexual stimulation, nitric oxide is released from nerve cells and subsequently from the endothelial cells in the corpus cavernosum of the penis.

Connect globally

Therefore, M1 accounts for approximately 7% of total pharmacologic activity. Elimination: The total body clearance of vardenafil is 56 L/h, and the terminal half-life of vardenafil and its primary metabolite (M1) is approximately 4-5 hours. After oral administration, vardenafil is excreted as metabolites predominantly in the feces (approximately 91-95% of administered oral dose) and to a lesser extent in the urine (approximately 2-6% of administered oral dose). Pediatrics: Vardenafil is not indicated for use in pediatric patients. Vardenafil trials were not conducted in the pediatric population.

What should I do if I miss a dose of vardenafil?

Geriatric: In a healthy volunteer study of elderly males (≥65 years) and younger males (18-45 years), mean Cmax and AUC were 34% and 52% higher, respectively, in the elderly males. Hepatic Impairment: In volunteers with mild hepatic impairment (Child-Pugh A), the Cmax and AUC following a 10 mg vardenafil dose were increased by 22% and 17%, respectively, compared to healthy control subjects. In volunteers with moderate hepatic impairment (Child- Pugh B), the Cmax and AUC following a 10 mg vardenafil dose were increased by 130% and 160%, respectively, compared to healthy control subjects. Vardenafil has not been evaluated in patients with severe (Child-Pugh C) hepatic impairment. Renal Impairment: In male volunteers with ClCr= 50-80 mL/min, the pharmacokinetics of vardenafil were similar to those observed in a control group with ClCr >80 mL/min. Nitric oxide activates guanylate cyclase, which catalyzes the synthesis of cGMP from guanosine triphosphate (GTP).

• Levitra may cause visual disturbances such as blurred vision in rare cases.
• Men taking medication for prostate issues should discuss Levitra with a doctor.
• It is essential to inform a doctor of any underlying health conditions before use.
• Levitra does not protect against sexually transmitted infections.
• Alcohol can increase the risk of side effects such as dizziness when using Levitra.
• Sexual health education complements medication therapy for ED.
• Levitra's safety profile has been established through numerous clinical trials.
• Use Levitra as directed; misuse can lead to serious health complications.

cGMP causes the smooth muscle to relax, allowing increased blood flow into the penis, leading to an erection.

Proper Use

It should be explained that sexual stimulation is required for an erection to occur after taking vardenafil. It should be taken approximately 60 minutes before sexual activity. Patients should be counseled regarding the dosing of vardenafil especially regarding the maximum daily dose. Patients should be advised to contact their healthcare provider for dose modification if they are not satisfied with the quality of their sexual performance with vardenafil or in the case of an unwanted effect. Inform patients that there have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for vardenafil and this class of compounds. Because of its importance, the level of cGMP is tightly regulated. The balance is maintained by production and degradation.

• Levitra can improve quality of life for men with erectile dysfunction.
• The medication has a high success rate in restoring erectile function.
• Certain foods and beverages can influence Levitra's effectiveness.
• The medication is generally well tolerated but requires professional oversight.
• Levitra's rapid onset makes it convenient for spontaneous sexual activity.
• Side effects can sometimes indicate allergic reactions requiring immediate attention.
• Levitra is part of a broader treatment plan, including lifestyle changes.
• Always inform your doctor of any side effects or concerns during treatment.

As mentioned above, production of cGMP is initiated after nitric oxide is released.

Conditions treated by Levitra and Viagra

In male volunteers with ClCr = 30-50 mL/min or ClCr <30 mL/min renal impairment groups, the AUC of vardenafil was 20-30% higher compared to that observed in a control group with ClCr >80 mL/min). Vardenafil pharmacokinetics have not been evaluated in patients requiring renal dialysis. Advise patients of the contraindication of vardenafil with regular and/or intermittent use of organic nitrates. Patients should be counseled that concomitant use of vardenafil with nitrates could cause blood pressure to suddenly drop to an unsafe level, resulting in dizziness, syncope, or even heart attack or stroke. Inform patients of the potential cardiac risk of sexual activity for patients with preexisting cardiovascular risk factors.

Approved as Treatment by the FDA

Inform patients that in some patients concomitant use of PDE5 inhibitors, including vardenafil, with alpha-blockers can lower blood pressure significantly leading to symptomatic hypotension (for example, fainting). Patients prescribed vardenafil who are taking alpha-blockers should be started on the lowest recommended starting dose. Patients should be advised of the possible occurrence of symptoms related to postural hypotension and appropriate countermeasures. Patients should be advised to contact the prescribing physician if other anti-hypertensive drugs or new medications that may interact with vardenafil are prescribed by another healthcare provider. Discuss with patients the appropriate use of vardenafil and its anticipated benefits. There are numerous types of PDEs, with each type being preferentially expressed in different tissues.

• Levitra is not suitable for men with severe liver or kidney impairment.
• Do not take Levitra with other medications containing nitrates for chest pain.
• Older adults should use Levitra with caution due to potential side effects.
• Levitra is sometimes used in clinical trials for other conditions.
• Keep Levitra out of reach of children due to potential toxicity.
• Store Levitra in a cool, dry place and away from direct sunlight.
• Patients should inform their healthcare provider about all current medications.
• Levitra can cause priapism, a prolonged erection requiring medical attention.

The predominant type expressed in the penis is PDE type 5 (PDE5). LEVITRA binds selectively to PDE5 and inhibits the enzymatic function of PDE5. Less cGMP is degraded, tilting the balance to a higher level of cGMP, thus enhancing penile erection.

Does Levitra prevent pregnancy?

In the event that an erection persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result. Advise patients to stop treatment and seek medical attention in the event of sudden loss of vision in one or both eyes. Such an event may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION), a cause of decreased vision, including permanent loss of vision, that has been reported rarely post-marketing in temporal association with the use of all PDE5 inhibitors. It is not possible to determine whether these events were related directly to the use of PDE5 inhibitors or to levitra 5mg online other factors. It was demonstrated by in vitro studies that LEVITRA inhibits PDE5 selectively.

Aspect	Description
Drug Name	Levitra
Generic Name	Vardenafil
Drug Class	Phosphodiesterase type 5 inhibitor
Approved Uses	Erectile dysfunction