Levitra

• Structure
• Release form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications to use
• Contraindications
• Side effects
• Application instruction of Levitra (way and dosage)
• Overdose
• Interaction
• Terms of sale
• Storage conditions
• Period of validity
• Analogs
• Responses

Structure

Tablets with a film cover contain active agent – vardenafit which quantity depending on a dosage of drug differs and can make 5, 10 and 20 mg. Among excipients – krospovidon, magnesium stearate, MKTs; silicon dioxide colloid.

The film cover consists of a macrogoal 400, gipromelloza, titanium dioxide and dyes — iron oxide yellow and red.

Release form

Tablets are round, biconvex light orange color, there can be a grayish shade, there are engravings from the different parties — a corporate cross of Bayer and designation of a dosage of drug - "5", "10", "20" respectively. Levitra of 20 mg and 10 mg is issued in blisters on 1 or 4 tablets which are sealed in cardboard boxes or sliding packagings like "Burgopack". For a dosage of 5 mg there are additional packagings – 5 blisters on 4 tablets.

Pharmacological action

Drug improves erectile function.

Pharmacodynamics and pharmacokinetics

The most known FDE — specific FDE-5, participates in splitting by hydrolysis of tsGMF that is one of the parties of regulation of the tsGMF level in the course of a penis erection. Vardenafil blocks FDE-5 and strengthens local effect of nitrogen oxide (endogenous NO), vydelyayushchegsyao nerve terminations of cavernous bodies at sexual stimulation. NO is necessary for activation of the enzyme of guanylate cyclase increasing the maintenance of a cyclic guanozinmonofosfat (abbr. tsGMF) and leading to relaxation of unstriated muscles in cavernous bodies and in a consequence — to increase in inflow of blood to a generative organ. Thus, Levitra is capable to strengthen natural reaction to sexual stimulation.

It is established that the average concentration necessary for FDE-5 inhibition — 0,7 nany, that is vardenafit - it is powerful and high-selection inhibitor. 20 mg of a vardenafil later cause 15 min. the erection level sufficient for penetration in some men. It is necessary for the full answer that there passed 25 min.

Attention! There is Levitr's generic software which differs in the speed of occurrence of effect. Tablets can be chewed and rassasyvat under language, thereby accelerating occurrence of effect (comes usually in 10 minutes).

Data of researches of pharmacokinetics

Absorption

Absorption at oral administration fast, on an empty stomach the maximum concentration can come in 15 minutes, but most often (in 90%) — in 60 minutes. If to accept together with fat food, then the speed of absorption decreases on average by 20%. Level of absolute bioavailability — about 15%. The stationary volume of distribution — 208 l. Level linkng of main main (M1) with plasma blood proteins – no more than 95% (process reversible), in 90 minutes to 0,00012% of a dose can be observed in sperm of healthy men.

Metabolism and removal

Happens mainly to participation of systems of cytochrome and liver enzymes. The average time of semi-removal — 4–5 h, and the main metabolite which is formed by a dezetilirovaniye of piperazinovy part in a molecule — about 4 h. Metabolites are removed mainly through a digestive tract (about 91-95%), the rest — kidneys.

Changes of AUC and other indicators at different groups of patients

• at elderly persons of AUC usually increases by 52%;
• at a heavy renal failure of AUC increases approximately by 21%, and the maximum concentration decreases by 23%;
• at abnormal liver functions the clearance decreases in proportion to the level of disturbance of work of a liver.

Indications to use

As well as ordinary Levitra, Levitra software and Levitra odt – potentiality regulators which should be accepted at erectile dysfunction — inability to reach and keep the erection which is required for commission of full sexual intercourse at the necessary level.

Contraindications

• patients with hypersensitivity to any component of drug;
• persons, the accepting nitratosoderzhashchy means or donators of nitrogen oxide, and also CYP3A4 inhibitors (for example: Ritonavir, Indinavir, Ketokonazol, Itrakonazol, Erythromycin, Klaritromitsin);
• therapy by drugs from erectile dysfunction;
• men to whom sexual activity is not recommended, including existence of such accompanying cardiovascular diseases as an acute form of heart failure or unstable stenocardia;
• heavy disturbances of work of a liver;
• hemodialysis at an initial stage of a disease of kidneys;
• arterial hypotension (with the ABP at rest less than 90 mm hg);
• recent stroke or myocardial infarction (till 6 months);
• hereditary degenerative diseases of a retina, for example, pigmental retinitis;
• women, newborns and children.

With care it is necessary to apply, estimating advantage risk

• at anatomically the deformed generative organ, including various curvatures, cavernous fibrosis and Peyroni's illness;
• predisposition to a priapism, for example, multiple myeloma, sickemia, leukemia;
  tendency to bleedings;
• aggravation of a peptic ulcer.

Side effects

The Undesirable Reactions (UR) arising at Levitra's use are given below (at transfer their force of manifestation is specified as reduction):

• Infectious diseases: conjunctivitis.
• Disturbances from mentality and TsNS: sleep disorders, headache.
• Organs of sight: disturbance of visual acuity and color perception, conjunctiva hyperemia, sensation of discomfort and eye pains, photophobia, increase of VGD.
• Acoustic organs: vertigo, sudden deafness, a ring in ears.
• Immune system: allergic or Quincke's disease, allergic reactions.
• From heart and vessels: heartbeat, stenocardia, tachycardia, myocardial infarction, ventricular tachyarrhythmia, vazodilatation, hypotension.
• Gastrointestinal tract: dyspepsia, nausea, an abdominal pain, diarrhea, dryness in a mouth, gastritis, a gastroesophageal reflux disease, vomiting.
• Respiratory system and bodies of a thorax, mediastinum: a nose congestion, an asthma, the stuffed-up okolonosovy bosoms.
• Liver and zhelchevyvodyashchy ways: superactivity of transaminases.
• Skin and hypodermic fabrics: erythema, rash.
• Skeletal and muscular and connecting fabrics: dorsodynias, the increased KFK level, increase of a muscle tone, a mialgiya.
• Generative organs and mammary glands: strengthening of an erection, priapism.
• The general: feeling sick, stethalgias.

Application instruction of Levitra (way and dosage)

Usually to take a pill orally, in independence of a diet, in 25–60 minutes prior to sexual intercourse.

Standard scheme of reception

The initial recommended dose — 10 mg (approximately in 25–60 min. prior to sexual contact). The maximum frequency of use of drug — once at 24 o'clock. Considering efficiency and portability of treatment, increase in a daily dose of 20 mg or decrease to 5 mg is possible.

The application instruction of Levitra at disturbances of work of a liver

The initial recommended dose — 5 mg which can be increased during therapy to 10 mg.

Overdose

If the dose of a vardenafil in the amount of 40 mg two times per day is accepted, then at the patient the expressed pains in a waist without signs of toxic influence on nervous and muscular systems can be observed.

Overdose treatment

Standard maintenance therapy. The hemodialysis is ineffective.

Interaction

• With CYP-inhibitors decrease in clearance of a vardenafil is possible.
• With Erythromycin in sutochn. to a dose of 1500 mg there is a quadruple increase in PPK and triple increase in the maximum concentration of Levitra (5 mg).
• To Ketokonazol in a dose of 200 mg there is a tenfold increase in PPK and quadruple increase in the maximum concentration of Levitra (5 mg) that demands correction of their dosage.
• Simultaneous use of Levitra with HIV inhibitors of proteases of active agent — an indinavira (a daily dose of 2400 mg) is observed sixteenfold increase of PPK and sevenfold increase in the maximum concentration of a vardenafil.
• With Ritonavir (sutochn. dose of 1200 mg): thirteenfold increase of the maximum concentration of Levitra in a dose of 5 mg and by 49 times increase of a total daily indicator of PPK, and also considerable lengthening (about 26 h) of T1/2 of a vardenafil is observed.
• With Nitrates and donators of nitrogen oxide the potentsiation of their effects is observed, however – if the interval of 24 h is sustained, then medicinal interaction does not happen.
• Supertherapeutic doses of a vardenafil with Sodium nitroprussidum cause insignificant strengthening of antiagregantny effect.
• Between Levitra's reception and alpha adrenoblockers it is necessary to observe a time interval and to apply only at stable indicators of the ABP. For example, Terazozin demands a 6-hour interval between receptions.

Terms of sale

For acquisition of drug it is necessary to show the recipe.

Storage conditions

The dry place with a temperature not above +30 °C.

Drug is contraindicated to children therefore it is necessary to store — in the unavailable place.

Period of validity

Till 36 months.

Levitr's analogs

Analogs of drug, differ in active agent (Sildenafil Sildenafil is used), but the automatic telephone exchanges matching on a code:

• Adamaks;
• Viagra;
• Dzhenagra.

It is possible to buy structural analog of drug on various platforms of worldwide network, for example, Levitra to ODT or not less known generic — Lovevitra (contains 40 mg of a vardenafil) from the Indian company Delta Enterprises became available to the general public recently.

About Levitre

Drug proved as available means for improvement of erectile function. Responses at forums positive: men praise and recommend Levitra, note a possibility of administration of drug with alcohol, aged from 18 and till 75 flyings even with some cardiovascular diseases.

Levitra, responses of doctors: Levitr's generic of ODT and Levitr of production of the German company Bayer are modern regulators of a potentiality which allow to strengthen natural reaction to sexual stimulation to the level necessary for penetration and commission of full sexual intercourse.