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Levitra (Vardenafil) is a new impotence drug. Vardenafil is in a class of medications known as PDE-5 inhibitors, which are used to treat male impotence (erectile dysfunction, ed). Up to 80% of patients who take Vardenafil experience an improvement in their erections. Vardenafil has proved highly successful in clinical trials and is generating major interest as a real alternative to Viagra.
Penile erection is caused by the engorgement of the penis with blood. This engorgement occurs when the blood vessels delivering blood to the penis increase in size and increase the delivery of blood to the penis. At the same time, the blood vessels carrying blood away from the penis decrease in size and decrease the removal of blood from the penis. Sexual stimulation that leads to the engorgement and erection causes the production and release of nitric oxide in the penis. Nitric oxide then activates the enzyme, guanylate cyclase to produce cyclic guanosine monophosphate (cGMP). The cGMP is primarily responsible for increasing and decreasing the size of the blood vessels carrying blood to and from the penis, respectively. Levitra prevents an enzyme called phosphodiesterase-5 from destroying cGMP so that cGMP persists longer. The longer cGMP persists, the more prolonged the engorgement of the penis.
HOW DOES IT WORKS?
Levitra acts in the same way as Viagra. Levitra blocks an enzyme called phosphodiesterase-5, or PDE-5. This helps the smooth muscles in the penis relax and widen, which allows for more blood to enter. As a result, you gain erections faster and easier with Vardenafil. There is currently no direct evidence to compare the effectiveness of treatments such as Vardenafil, against others such as Viagra. However, findings do indicate that Levitra may be especially effective in treating specific types of ED, such as ED resulting from prostate surgery. In clinical trials, Vardenafil was shown to work quickly as early as 16 minutes. More importantly, Levitra was shown to improve the sexual response for the majority of men the first time they took it, and it worked consistently over time.
For most individuals, the recommended dose of Levitra is 10 mg per day taken 60 minutes before intercourse. If there is no response or side effects, the dose may be increased to 20 mg or, if there are side effects, it may be reduced to 5 mg. Individuals 65 years of age or older should begin therapy with 5 mg. Individuals who are taking medications that increase the blood levels of vardenafil should start treatment with 2.5 to 5 mg of Levitra.
The breakdown and elimination of Vardenafil from the body is inhibited by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). Therefore, these drugs increase the concentration of Vardenafil in the blood. If these drugs are being used at the same time as Levitra, the dose of Levitra should be reduced in order to avoid side effects from Levitra. Vardenafil reduces the concentration of ritonavir and indinavir and may reduce the effect these drugs. Levitra increases the heart rate and also exaggerates the blood pressure lowering effects of nitrates (e.g. nitroglycerine). In patients who take nitrates for chest pain (angina), vardenafil could cause chest pain by increasing heart rate and lowering blood pressure. Therefore, patients with angina should not use vardenafil. Vardenafil also exaggerates the blood pressure lowering effects of alpha-blocking drugs, e.g. terazosin (Hytrin), and should not be used by individuals who also use alpha-blockers.
The most common side effects of Levitra are facial flushing (reddening), headaches, stomach upset, diarrhea, flu like symptoms and nausea. Vardenafil also may cause chest pain, low blood pressure, blurred vision and changes in color vision, abnormal ejaculation and priapism (painful erection). Rare cases of sudden loss of hearing have been reported with phosphodiesterase inhibitors such as vardenafil, sometimes associated with ringing in the ears and dizziness. If changes in hearing occur, patients should discontinue their Levitra and seek immediate medical attention.