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Show / Hide Product Info »

Levitra (Vardenafil)

Brand name of drug: Levitra

Generic name: Vardenafil

Dosage form: tablets, coated

Ingredients: Levitra 5 mg, 10 mg and 20 mg.

Each tablet contains 5 mg, 10 mg or 20 mg vardenafil
(5.926 mg, 11,852 mg or 23,705 mg of vardenafil hydrochloride trihydrate, respectively).

Registration number: P No. 015037/01-2003

Pharmacological properties

Pharmacodynamics

Penile erection is a hemodynamic process, based on the relaxation of smooth muscles of cavernous bodies and located there arterioles. During sexual stimulation of the nerve endings of the corpus cavernosum released nitric oxide (N0), activating the enzyme guanylate cyclase, which leads to an increase in content in the cavernous bodies of cyclic guanosine monophosphate (cGMP). The result is relaxation of smooth muscles of cavernous bodies, which increases blood flow to the penis.

By blocking specific phosphodiesterase fifth type (PDE5), which participates in the cleavage of cGMP, Levitra thereby contributes to the local action of endogenous nitric oxide (N0) in the cavernous bodies during sexual stimulation. This effect causes the ability to Levitra enhance response to sexual stimulation.

Pharmacokinetics

After ingestion Levitra is quickly absorbed and starts to act within 15 minutes (the majority of men after 25 minutes), duration of action is 4-5 hours.

Indications for Use

Erectile dysfunction (inability to attain or maintain an erection necessary for sexual intercourse).

Contraindications

Hypersensitivity to any component of the drug.
The simultaneous use of nitrates or drugs, which are nitric oxide donators.
Combination with HIV protease inhibitors such as indinavir or ritonavir.
Levitra is not indicated for women and children up to age 16.
Caution should be used in patients:

with congenital prolongation of;
with anatomical deformation of the penis (curvature, cavernous fibrosis, Peyronie's disease);
with diseases predisposing to priapism (sickle cell anemia, multiple myeloma, leukemia);
with severe hepatic impairment. Patients with impaired liver function minor changes in dosage regimen is not required. In patients with moderate hepatic impairment initial dose is 5 mg per day. In the future, depending on the efficacy and tolerability of treatment dose can be increased to a maximum of 10 mg;
with kidney disease in the terminal stage. In patients with low, moderate and severe decreased kidney function changes in dosage regimen is not required;
with arterial hypotension (systolic blood pressure at rest below 90 mm Hg. Art.)
with recent stroke and myocardial infarction, with unstable angina;
with inherited retinal degenerative diseases (eg, retinitis pigmentosa);
with a tendency to bleeding and exacerbation of peptic ulcer disease;
with aortic stenosis and idiopathic hypertrophic subaortalnym stenosis.
Dosing and Administration

The initial dose is 10 mg.
Taken for 25-60 minutes before sexual intercourse.
Levitra duration of action is 4-5 hours.
The maximum recommended dosing frequency - 1 time per day. Depending on the efficacy and tolerability of treatment dose can be increased to 20 mg or decreased to 5 mg per day.
The maximum recommended dose is 20 mg 1 time per day.
Dose of 5 mg is recommended for older patients (over 65 years).
20mg dose is assigned in cases of severe ED (diabetes, prostatectomy) when the starting dose of 10 mg is not effective enough.
Eating and drinking do not affect the performance of Levitra.
Levitra is effective only when a sufficient level of sexual stimulation.

Side effects

Levitra is generally well tolerated, side effects, usually slightly or moderately expressed and are transient in nature.

The most common (1-10%): headache, facial flushing, indigestion, nausea, dizziness, rhinitis.

Atypical and rare (0,1-1%): facial swelling, photosensitivity, pain, hypertension, changes in functional "liver" tests, increased GGT, increased levels of creatine kinase, myalgia, drowsiness, dyspnea, blurred vision, watery eyes , priapism, anaphylactic reaction (including laryngeal edema), angina pectoris, hypotension, myocardial ischemia, postural hypotension, syncope, increased muscle tone, nasal bleeding, glaucoma.

Overdose

Aware of cases taking Levitra 80 mg per day, which is not accompanied by the development of serious adverse reactions. However, at the same time, when used in doses of 40 mg twice a day, there are marked back pain without evidence of toxic effects on the muscular and nervous system.

Interaction with other drugs

Dose of Levitra should not exceed 5 mg when it is combined with erythromycin, ketoconazole, itraconazole. The dose of ketoconazole and itraconazole at the same time should not exceed 200 mg. Combination with indinavir and ritonavir is contraindicated.
Nitrates, nitric oxide donator: Combined assignment of Levitra and nitrates is contraindicated because of the risk of arterial hypotension.
Combined therapy of alpha-blockers and Levitra can be accompanied by the development of arterial hypotension. Levitra should be applied no earlier than 6 hours after administration of alpha-adrenergic blockers, and the dose should not exceed 5 mg. However, when combined with alpha-blocker tamsulosin, taking medication on time can be the same.