Generic Levitra (Vardenafil) is a potent and highly selective PDE5 inhibitor. This effect determines the property of this ED drug to improve the natural response to sexual stimulation. Taking vardenafil at a dose of 20 mg in some men causes an erection sufficient for penetration within 15 minutes. A firm erection was achieved within 25 minutes.
Indications for use
The main Canadian Pharmacy Levitra indication is erectile dysfunction (the inability to achieve and maintain an erection necessary for intercourse).
Mode of application and dosage
Oral administration irrespective of the meal. At the beginning of treatment, the recommended dose is 10 mg (approximately 25-60 minutes before sexual intercourse). However, there is an evidence that generic analog is effective when taken 4-5 hours before sexual intercourse. The maximum frequency of drug reception is 1 time per day. Depending on the efficacy and tolerability, the dose can be increased to 20 or reduced to 5 mg per day. The maximum recommended dose is 20 mg once a day. Sexual stimulation is mandatory to ensure an adequate response to sexual stimulant.
Generic Levitra is a drug that is contraindicated in the following cases:
- hypersensitivity to any component of the drug;
- severe liver dysfunction;
- kidney disease in the terminal stage, requiring hemodialysis;
- arterial hypotension;
- a recent stroke or myocardial infarction (within the last 6 months);
- unstable angina pectoris, as well as hereditary degenerative diseases of the retina, such as retinitis pigmentosa.
The drug should be used with caution in patients with anatomical deformity of the penis (curvature, cavernous fibrosis, Peyronie’s disease), with diseases that predispose to priapism (sickle cell anemia, multiple myeloma, leukemia). This drug should be prescribed only after assessing the benefit-risk ratio for patients with a tendency to bleeding and with exacerbation of peptic ulcer disease.
- Infectious and parasitic diseases: rarely – conjunctivitis.
- Immune system disorders: infrequently – allergic edema and angioedema; rarely – allergic reactions.
- Mental disorders: infrequently – sleep disorders.
- Nervous system disorders: very often – headache; often – dizziness; infrequently – paresthesia and dysesthesia, drowsiness; rarely – fainting, amnesia, convulsions.
- The organ of vision: infrequently – visual impairment, hyperemia of the conjunctiva of the eyeball, color perception disorders, pain in the eyeballs and a feeling of discomfort in the eyes, photophobia; rarely – increased IOP.
- Hearing disorders and labyrinthine disorders: infrequently – ringing in the ears, vertigo.
- Heart disorders: infrequently – palpitations, tachycardia; rarely – angina pectoris, myocardial infarction, ventricular tachyarrhythmias.
- Vascular disorders: often – vasodilation; rarely, hypotension.
- Respiratory system, chest and mediastinal organs: often – nasal congestion; infrequently – shortness of breath, congestion of the paranasal sinuses.
- Gastrointestinal disorders: often – dyspepsia; infrequently – nausea, abdominal pain, dry mouth, diarrhea, gastroesophageal reflux disease, gastritis, vomiting.
- The liver and biliary tract: infrequently – increased activity of transaminases.
- Skin and subcutaneous tissue disorders: infrequently – erythema, rash.
- Musculoskeletal and connective tissue disorders: infrequently – back pain, increased creatinphosphokinase levels, increased muscle tone and cramps, myalgia.
- Violations of the genitals and mammary gland: infrequently – increased erection; rarely priapism.
- General disorders and disorders at the injection site: infrequently – feeling unwell; rarely – chest pain.
- Cimetidine (400 mg 2 times a day): this nonspecific inhibitor of cytochrome P450 does not affect the AUC and Cmax of vardenafil (20 mg) when used in combination.
- Erythromycin (500 mg 3 times a day): this CYP3A4 inhibitor causes a 4-fold (300%) increase in the AUC and a 3-fold (200%) increase in Cmax of this ED drug (5 mg).
- Ketoconazole (200 mg): being a potent inhibitor of CYP3A4, ketoconazole causes a 10-fold (900%) increase in AUC and a 4-fold (300%) increase in Cmax of vardenafil (5 mg).
- Ritonavir (600 mg 2 times a day): 13 times increases the Cmax of the described drug (5 mg) and 49 times its total daily AUC. The interaction is due to the fact that ritonavir, being a potent inhibitor of CYP3A4 and CYP2C9, blocks the hepatic metabolism of vardenafil. Ritonavir significantly lengthens the T1 / 2 of vardenafil (up to 25.7 hours).
- Nitrates, nitric oxide donors. Taking this generic medication (10 mg) for a time from 24 hours to 1 hour before taking nitroglycerin (0.4 mg sublingually) does not increase its hypotensive effect. At a dose of 20 mg 1–4 hours before the use of nitrates (0.4 mg sublingually), vardenafil enhances their hypotensive effect, but if administered 24 hours before, the hypotensive effect does not increase.
What are the symptoms of an overdose?
In a study in healthy volunteers, vardenafil was tested in single doses up to 120 mg per day. Single doses of vardenafil up to 80 mg and multiple doses of vardenafil up to 40 mg given once daily for 4 weeks were tolerated without severe side effects. However, when using vardenafil at a dose of 40 mg 2 times a day, severe pain in the lower back was noted without signs of toxic effects on the muscular and nervous systems.
How to overcome an overdose of medicine?
Standard supportive therapy should be carried out. Since vardenafil is highly bound with plasma proteins and only a small amount of the drug is excreted by the kidneys, hemodialysis is unlikely to be effective.
What affects the speed of drug’s onset?
Mainly, the pharmaceutical form affects the speed of the drug’s onset. This ED drug in terms of speed of action has the following characteristics:
- the form of tablets begin to act within 30-60 minutes;
- soft pills act within 15-20 minutes;
- jelly pills begin to work within 10-15 minutes.
How to take pills for potency correctly?
Every man should follow the rules of use to achieve the desired result from taking erectile dysfunction medications:
- The drugs are taken about an hour before the planned sexual intercourse. Take it with water or juice.
- It isn’t recommended to mix the drug with alcohol, although some forms of release allow such a combination (soft).
- You cannot mix several remedies for potency at the same time. You should also avoid taking one drug repeatedly during the day. Choose one and take it.
- Use with caution when taken with other medications. Consult your physician to clear out this aspect.
- Do not use tablets after the expiration date.
Which remedy to choose?
You can consult a specialist or try all types of ED drug and find the best option for you. This method is justified, since even the standard causes of sexual dysfunction have individual characteristics. Also, the choice is made by the personal preferences of the man. To facilitate the selection procedure, you can make your own rating of drugs for potency, taking into account the following characteristics:
- safety and efficiency;
- reaction to simultaneous application with other drugs;
- the speed of the effect onset after administration and its duration;
- cost per piece, blister, packaging.
Also, when searching, you should take into account how long it will take you between taking the drug and the immediate onset of sexual intercourse. For a quick result, “soft” tablets or jelly are suitable; with prolonged prelude, the standard form of drug release is quite effective.
Table: Comparison of ED drugs
|ED Drug||The Effect Onset and Duration||Contraindiations|
|Cialis Oral Jelly||10-15 after administration. The duration is up to 36 hours.||Hypersensitivity to tadalafil. 6 months after cardac arrest or blood stroke. Cardiac, renal or hepatic impaired function. Prohibition to sexual intercourse. Penile deformaties.|
|Viagra Oral Jelly||10-15 after administration. The duration is 4-6 hours.||Nitrate-based drugs. Viral infections and hypertension. Take with caution in renal к hepatic disorders, penile deformaties, banned on sexual life because of cardiac disorders.|
|Levitra Soft||15-20 min after administration. The duration is up to 12 hours.||Hypersensitivity to vardenafil. Penile deformaties, predisposition to priapism. Pulmonary hypertension. Shifts in blood pressure. Severe cardiovascular diseases.|
|Levitra||20-30 min after administration. The effect curation is up to 12 hours.||Hypersensitivity to vardenafil. Heart failure in the acute stage, angina pectoris, arterial hypotension. Hepatic and renal failure. Chronic diseases of the urinary system. Stomach ulcer. Benign prostatic hyperplasia.|
|Cialis Soft||15-20 min after administration. The duration is up to 36 hours||Renal failure. Chronic diseases of blood vessels and heart. High blood pressure. The first six months after a heart attack or stroke. Combined reception with medications, which include nitrogen donors, nitrates, alpha-blockers. Priapism. Penile deformities.|
|Cialis||20-40 min before sexual intercourse. The duration is up to 36 hours.||Hypersensitivity to tadalafil or another component. Contraindications to sexual activity. Cardiovascular diseases, ischemic stroke in the last 6 months. Loss of vision due to ischemic neuropathy. Concomitant use of doxazosin, treatment of erectile dysfunction with other agents. Lactose intolerance, lactase deficiency. Frequent use for chronic renal failure.|
|Viagra Soft||20-30 min after administration. The duration is up to 4 hours.||Increased sesitivity to active ingredients. Medical prohibition on sexual activity. Heart failure, up to 6 months after stroke and heart attack. Renal and hepatic impairment. Chronic diseases of the cardiovascular system and gastrointestinal tract. Hereditary pathology of the retina. Penile trauma.|
|Viagra||30-50 min after administration. The duation is up to 4 hours.||Hypersensitivity to sildenafil or another ingredient. Combined use with nitric oxide donors. Diseases of the cardiovascular system. Recent stroke or heart attack, low blood pressure. Hereditary eye diseases. Liver problems.|
Generic Levitra and alcohol
This drug has been tested in the United States at the request of the local pharmaceutical market regulator. In the course of research, it was found that compatibility of Levitra and alcohol is permissible but only in small quantities. The maximum allowable amount of alcoholic beverages with a strength of 40°, which can be consumed after taking vardenafil, is approximately 150 ml.
How to combine Levitra with alcohol?
In fact, you can combine these two substances. But only if you follow one condition: not abuse. Here’s what the order of your actions should be if you nevertheless decide to drink a little during a romantic dinner, and then take a Levitra pill and have sex:
- decide in advance how much you will drink not exceeding this amount;
- the maximum allowable dose of alcohol when combined with vardenafil is approximately 150 ml, the strength of which does not exceed 40 °if you weigh at least 70 kg;
- when deciding whether vardenafil can be taken with alcohol, discuss it your partner;
- try to choose lower fat meals as a snack. Fatty foods can slow down the action of vardenafil by half an hour or more;
- the tablet should be taken with plenty of water. Never wash it down with alcoholic or hot drinks;
- it is recommended to stop drinking alcohol after you have taken this sexual stimulator;
- do not forget that the next pill of the drug can be taken no earlier than 24 hours after the previous one.
Why was the new form of Levitra created?
Phosphodiesterase type 5 inhibitors are recommended as first-line drugs for the treatment of ED. Currently, the market is represented by four of them: sildenafil, udenafil, vardenafil and tadalafil. These compounds are available in tablet form that are rapidly absorbed from the gastrointestinal tract. But the researchers did not stop at creating Levitra in the form of a coated tablet, and a new form of this drug was created – ODT – orally dispersible tablets. This was due to the fact that both patients and medical practitioners believe that rapid onset of action, higher bioavailability (compared to coated tablets) and ease of use are important attributes of oral pharmacotherapy for ED.
The pill dissolves under the tongue in a matter of seconds and does not require drinking water, which allows men more flexible control over their sexual activity, provides ease of administration and high efficiency.