Levitra (20 and 40 mg): instructions for use

Levitra (vardenafil) - a drug that is used to treat erectile dysfunction in men, refers to the analogues of Viagra.

The effectiveness of a drug produced by a well-known pharmaceutical company Bayer is confirmed by international certificates and clinical trials. This drug is characterized by prolonged action and a smaller number of contraindications compared to analogues.

The action of the medication begins already in 20-30 minutes after taking the pill and is maintained for 6 to 12 hours. If the drug is taken simultaneously with fatty and heavy food, then its absorption slows down and the effect comes later. In this case, the result should be expected no earlier than 2-3 hours after the use of the tablet. The active substance vardenafil is metabolized in the liver, is excreted from the body through the intestines and kidneys.

Clinical and pharmacological group

The drug used for erectile dysfunction.

Conditions of leave from pharmacies

It is released on prescription.

Price list

How much is Levitra in pharmacies? The price depends on the packing and the concentration of the active substance in the preparation. You can buy Levitra in a pharmacy at the following prices:

1. Levitra 5 mg (1 piece) - from 800 rubles;
2. Levitra 20mg (1pc) - from 950 rubles;
3. Levitra 10mg (2pcs) - from 1300 rubles.

Form of issue and composition

Tablets Levitra have a round shape, biconvex smooth surface and light yellow color.

The active substance of Levitra is vardenafil hydrochloride trihydrate, in 1 tablet:

• , 26 mg, equivalent to 5 mg of vardenafil;
• 1, 52 mg, which is equivalent to 10 mg of vardenafil;
• 2, 05 mg, which is equivalent to 20 mg of vardenafil.

Auxiliary components: magnesium stearate, crospovidone, silicon dioxide colloidal anhydrous, microcrystalline cellulose.

Additionally in the composition of the shell: hypromellose, macrogol 400, titanium dioxide, iron oxide red, iron oxide yellow.

Pharmacological effect

Enzyme PDE-5 prevents the expansion of the vessels of the penis and thus weakens the erection. Vardenafil blocks the action of this enzyme, which helps to relax the smooth muscles of blood vessels and increase blood flow to them to the tissues of the penis.

As a result, there comes a long and strong erection. But the erection comes only when there is sexual stimulation, because only during sexual arousal of the nerve endings occurs the release of nitric oxide, which activates the enzyme guanylate cyclase, which is responsible for the chain of processes necessary to eliminate erectile dysfunction.

It is important to remember the main principle of Levitra's action - it does not create an erection, it strengthens it against the background of sexual stimulation. The action of Levitra is seen already after 20-25 minutes after administration and in most cases remains up to 5-6 hours.

Indications for use

As indicated in the instructions to Levitra, this drug is intended for the therapy of erectile dysfunction, i.e. the inability of a man to achieve and / or maintain an erection necessary for the sexual act.

Contraindications

In some cases it is recommended to stop using Levitra. Contraindications for admission are as follows:

1. Vascular and cardiac muscle pathologies;
2. Disorders of amino acid metabolism;
3. Peptic ulcer disease;
4. Congenital deformity of the penis;
5. Predisposition to frequent bleeding;
6. Diseases of the eye retina;
7. Hypersensitivity to the components of tablets;
8. Adolescence;
9. Postponed diseases requiring sexual rest, for example, heart attack or stroke;
10. Combination with medicines containing nitrates, and directed to HIV treatment;
11. Combination with similar means aimed at improving erection.

Dosage and route of administration

The instructions for use indicate: Levitra tablets are taken orally regardless of food intake.

1. The initial recommended dose is 10 mg for 25-60 minutes before sexual contact.
2. You can also take in the period from 4-5 hours to 25 minutes before sexual activity.

The maximum frequency of reception is 1 time / day. To achieve efficiency, a sufficient level of sexual stimulation is needed.

• Depending on the effectiveness and tolerability, the dose can be increased to 20 mg or reduced to 5 mg / day. The maximum daily dose is 20 mg.

Correction of the dosing regimen in elderly patients is not required.

In patients with mild hepatic insufficiency, correction of the dosing regimen is not required. In patients with moderate hepatic insufficiency, the initial dose is 5 mg per day. Further, depending on the effectiveness and tolerability of treatment, the dose can be increased to 10 mg and then to 20 mg.

In patients with mild to moderate renal dysfunction, correction of the dosing regimen is not required.

Side effects

As a rule, if the dosage is maintained, Levitra does not cause side effects. The instructions give side effects that can be observed in men:

• tinnitus;
• bleeding from the nose;
• stomach ache;
• rash, erythema;
• allergic reactions;
• shortness of breath, nasal congestion;
• increased sweating and a feeling of heat;
• conjunctivitis;
• decreased visual acuity;
• sleep disturbances and headache;
• general malaise;
• dry mouth, nausea, abdominal pain, vomiting;
• palpitation, tachycardia, angina pectoris.

The listed side effects manifest themselves in a mild form and eventually pass. However, it is worth remembering a possible overdose. In this case, symptomatic therapy is performed.

Overdose

Studies conducted in patients to whom Levitra was administered at a dosage of 40 mg once a day and 80 mg once a day for 4 weeks, showed no significant adverse reactions in the process treatment. However, when the drug is administered in a dosing regimen of 40 mg twice a day, severe pain in the lumbar region, not accompanied by toxic effects on the nervous and muscular system.

As a treatment, supportive and symptomatic therapy is prescribed. Since vardenafil is largely bound to plasma proteins and only a small amount of substance is excreted through the kidneys, the effectiveness of hemodialysis appears to be negligible.

special instructions

Prior to the appointment of Levitra (as well as other drugs used to treat erectile dysfunction), the doctor must evaluate the state of the cardiovascular system, since there is a risk of developing complications from the heart during sexual activity.

1. Vardenafil has vasodilating properties, which can be accompanied by a slight or moderate decrease in blood pressure.
2. In men who are not shown sexual activity, due to concomitant cardiovascular disease, drugs for the treatment of erectile dysfunction are not prescribed.
3. Patients with left ventricular outflow obstruction, for example, with aortic stenosis, idiopathic hypertrophic subaortic stenosis, may be sensitive to the action of vasodilators, including inhibitors of PDE5.
4. The safety and effectiveness of vardenafil in combination with other drugs for the treatment of erectile dysfunction has not been studied, so their joint use is not recommended.
5. Since Levitra in therapeutic doses (10 mg) causes prolongation of the QT interval, the drug should not be administered to patients with congenital prolongation of the QT interval and those taking antiarrhythmic drugs of class IA (quinidine, procainamide) or class III (amiodarone, sotalol).
6. Against the background of Levitra and other PDE5 inhibitors, cases of transient loss of vision and non-arterial ischemic neuropathy of the optic nerve were recorded. In the event of a sudden loss of vision, the patient should stop taking Levitra and consult a doctor immediately.
7. The safety of vardenafil has not been investigated and its use is not recommended in the following groups of patients: severe impairment of function liver, kidney disease in the terminal stage, requiring hemodialysis, arterial hypotension (systolic pressure at rest? 0 mm Hg. st.), a recent stroke or myocardial infarction (within the last 6 months), unstable angina, as well as hereditary degenerative diseases of the retina, for example, pigmentary retinitis.
8. The dose of Levitra should not exceed 5 mg when it is combined with erythromycin, ketoconazole, itraconazole. The dose of ketoconazole and itraconazole should not exceed 200 mg.
9. The combination with indinavir and ritonavir is contraindicated.
10. Since vardenafil was not used in patients with a tendency to bleeding and in patients with exacerbation of ulcerative disease, its purpose in these cases is possible only after a thorough assessment of the relationship between benefit and risk therapy.
11. Vardenafil does not increase platelet aggregation, caused by various drugs. In a higher therapeutic concentration, vardenafil causes a slight increase in the antiplatelet effect of sodium nitroprusside, which is a donator of nitric oxide.
12. The effect of vardenafil and heparin with simultaneous application on the duration of bleeding has not been studied.
13. Vardenafil does not affect the duration of bleeding, nor does it affect this index when combined with acetylsalicylic acid.
14. The effect of vardenafil on the hypotensive effect of nitrates in patients is not known, therefore the combined use of Levitra and nitrates is contraindicated.
15. Combined therapy with alpha-adrenoblockers and vardenafil may be accompanied by the development of arterial hypotension with an appropriate clinical picture, because these drugs have vasodilating effect. The combined use of Levitra and alpha-blockers is acceptable only if there are stable indices of blood pressure in the background reception of alpha-adrenoblockers, with Levitra should be prescribed in the minimum recommended dose of 5 mg. Do not take Levitra at the same time with alpha-blockers, with the exception of tamsulosin, the reception of which may coincide with the administration of vardenafil. In case of taking a selected dose of Levitra, alpha-blockers should be started at the lowest dose. A gradual increase in the dose of alpha-blockers to patients receiving drugs from the group of PDE5 inhibitors may lead to a further decrease in blood pressure.

Before prescribing the drug, patients who drive vehicles and work with mechanisms need to find out their individual response to Levitra.

Drug Interactions

Before you start taking the drug, you need to get information with other medicines.

Some features of taking Levitra with other medicines:

1. Levitra is incompatible with Nicorandil;
2. Rionavir disrupts the metabolism of liver cells and almost doubles half-life. Therefore, the recommended dose of Levitra is not more than 10 mg;
3. It is not recommended to take simultaneously with Erythromycin, as it doubles the concentration of vardenafil;
4. The process of removing vardenafil is significantly slowed down by the use of drugs that suppress HIV protease;
5. Levitra is not recommended for use with ketoconazole, since it increases the concentration of the components fourfold.

Careful studies of the compatibility of vardenafil and nitrates have not been conducted, therefore it is forbidden to take Levitra and its analogs with nitrates.

Reviews

We picked up some reviews of men taking Levitra:

1. Arseny. In my opinion Levitra is the best drug for eliminating impotence. I tried different means, but some of them did not give the desired effect, and others - caused unwanted side reactions. In comparison with the same Viagra, Levitra has fewer side effects, and the drug is tolerated more easily. With the task of coping on "excellent allows you to achieve a persistent and prolonged erection. Thanks to this drug, my wife and I had a good sex life and peace and harmony prevailed in the family.
2. Taras. It's not the first year I've been using Levitra, the effect is much better than that of Viagra and longer) A couple of times I've also come across a dummy, later advised the store 24viagra.ru, all orders coming of excellent quality and the price is lower than in pharmacies. If someone does not like the pill, you can try Cialis or Viagra as a gel

Analogues

Viagra and Cialis are the main alternatives to the medicament Levitra. Analogs also contain type 5 phosphodiesterase inhibitors.

Before using analogues, consult your doctor.

Storage conditions and shelf life

Shelf life is 3 years, if the storage conditions recommended by the manufacturer are observed - protected from the sun, dry and cool (at a temperature not exceeding 30 ° C).

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