Product Name: Generic Levitra
Active Ingredients: Vardenafil
Price: $0.94 per pill
Generic Levitra is a drug intended for the erectile dysfunction treatment. It contains vardenafil. This drug is released in 10 and 20 mg. It provides an effect within 40-50 minutes. Take the drug on an empty stomach. Not combinable with alcohol.
Generic Levitra is a drug for the treatment of erectile dysfunction, a PDE5 inhibitor. An erection is a hemodynamic process, which is based on the relaxation of the cavernous bodies smooth muscles and the arterioles located in it. During sexual stimulation, nitric oxide (NO) is released from the nerve endings of the cavernous bodies, activating the guanylate cyclase enzyme, which leads to an increase in cyclic guanosine monophosphate (cGMP) in the cavernous bodies. As a result, the smooth muscles of the cavernous bodies relax, which contributes to an increase in blood flow to the penis. The main component of Levitra is vardenafil. It stimulates an erection for 5-6 hours in the case of sexual stimulation.
In what cases is Levitra applied?
It is applied in erectile dysfunction. This disease is characterized by inability to achieve and maintain an erection necessary for sexual intercourse.
Dosage and mode of application
The drug is taken orally, regardless of food intake. The initial recommended dose is 10 mg taken 25-60 minutes before sexual intercourse. It can also be taken from 4-5 hours to 25 minutes before sexual activity. The maximum frequency of admission is 1 time/day. Sexual stimulation is required to achieve effectiveness.
The dose can be increased to 20 mg or reduced to 5 mg/day. The maximum daily dose is 20 mg.
Correction of the dosage regimen in elderly patients is not required.
In patients with mild hepatic insufficiency, correction of the dosage regimen is not required. In patients with moderate liver failure, the initial dose is 5 mg per day. Subsequently, 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 and moderate renal impairment, dosage adjustment is not required.
- The central nervous system and peripheral nervous system: ≥10% – headache; ≥1% – dizziness; ≥0.1% – <1% – drowsiness; ≥0.01% – <0.1% – anxiety, fainting.
- The 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.
- The digestive system: ≥1% – <10% – dyspepsia, nausea; ≥0.1% – <1% – change in liver function tests.
- The 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.
- The musculoskeletal system: ≥0.1% – <1% – myalgia, back pain, increased CPK; ≥0.01% – <0.1% – increased muscle tone. The reproductive system:> 0.01% – <0.1% – prolonged erection or painful erection, priapism.Other: ≥0.01% – <0.1% – hypersensitivity reactions.
- Simultaneous therapy with nitrates or drugs that donate nitric oxide;
- Combination with HIV protease inhibitors such as indinavir or ritonavir;
- Hypersensitivity to the drug components;
- The drug is not intended for use in children and adolescents under the age of 16.
Symptoms: there are known cases of taking Levitra at a dose of 80 mg 1 time/day and 40 mg 1 time/day for over 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 diagnosed 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 ineffective.
Vardenafil, Levitra main component, is metabolized mainly with the participation of hepatic enzymes of the cytochrome P450 system, namely, the 3A4 isoform, as well as with 3A5 and 2C9 isoforms. Inhibitors of these enzymes may decrease vardenafil clearance.
Cimetidine (400 mg 2 times / day): a non-specific inhibitor of cytochrome P450 does not affect the values of AUC and Cmax of vardenafil (20 mg) when used simultaneously.
Levitra is contraindicated in combination with moderately active or potent CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, indinavir, erythromycin, and clarithromycin. With the combined use of Levitra with ketoconazole, itraconazole, indinavir and ritonavir (potential CYP3A4 inhibitors), a significant increase in the concentration of vardenafil in plasma can be expected.
Nitrates, donors of nitric oxide: the administration of vardenafil (10 mg) for a period of 24 hours to 1 hour, prior to the administration of nitroglycerin (0.4 mg sublingually), does not increase its hypotensive effect when taken in healthy subjects. At a dose of 20 mg for 1-4 hours before taking nitrates (0.4 mg sublingually), vardenafil enhances their hypotensive effect, but if vardenafil is prescribed for 24 hours, then the increase in the hypotensive effect of nitrates does not occur when taken in healthy middle-aged subjects.
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.
However, there is insufficient information on the potential antihypertensive effects of vardenafil when used concomitantly with nitrates. In this regard, this combination is contraindicated.
Vardenafil (20 mg) does not change the AUC and Cmax values of glibenclamide (glyburide at a dose of 3.5 mg) when used together. It is also shown that the pharmacokinetics of vardenafil does not change when it is used simultaneously with glibenclamide.
For more interactions, consult your doctor.