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Gettting started with Vardenafil (Levitra™️)
What is Vardenafil?
Vardenafil is the active ingredient in Levitra. Vardenafil is a prescribed drug that is used primarily to treat erectile dysfunction (ED), also known as impotence, which is the inability to get or maintain an erection satisfactory for intercourse.
Clinical studies have found Vardenafil to be highly effective for the treatment of ED in patients who have diabetes, hypertensions, and dyslipidemia (high cholesterol). Further studies revealed that men with low testosterone as well as ED respond well to Vardenafil in combination with a testosterone replacement regimen.
How does an erection occur?
The process of achieving an erection is complex. The first step is for a man to experience sexual arousal or an erotic stimulus. This arousal signals a cascade of events that relaxes cavernosal artery smooth muscles in the phallus. Parasympathetic nerves in the phallus release nitric oxide (N.O.), which increases cyclic GMP (cGMP), decreases intracellular calcium levels, and enhances smooth muscle relaxation. The relaxation of smooth muscle in the phallus allows for an influx of arterial blood, increased intracavernosal pressure, and erectile expansion and rigidity. Increased venous outflow, a passive process, maintains the phallus in an erect state.
When arousal has subsided, sympathetic nerves release norepinephrine, which stimulates alpha-adrenergic receptors. The resulting smooth muscle contraction causes the erection to reduce in size in rigidity.
How is phosphodiesterase (PDE) important for erectile function?
Nitric oxide and cGMP are essential components for smooth muscle relaxation in the phallus and vascular dilation. Without enough nitric oxide or cGMP, not enough blood can flow to the phallus for an erection.
Phosphodiesterase (PDE) enhances the breakdown of nitric oxide (N.O) and reduces the presence of cGMP. There are several types of PDE enzymes, but PDE-5 is the primary PDE enzyme in the male phallus. By preventing or inhibiting PDE-5, cGMP can maintain blood flow by increasing N.O. to the phallus, promoting an erection.
All oral ED medications, including Vardenafil (Levitra), are PDE-5 inhibitors.
What causes erectile dysfunction?
Erectile dysfunction is the inability to obtain or maintain an erection that is strong enough for sexual activity, including sexual intercourse. Approximately 52% of men older than 40 years old and 26% of men less than 40 years old have some degree of erectile dysfunction.
Many situations can interfere with a normal erectile function, including stress, depression, anxiety, low testosterone, smoking, physical inactivity, and the use of alcohol and/or drugs.
Other causes for ED can include an underlying cardiovascular condition or atherosclerosis. For example, obstructed or narrowed blood vessels can make it difficult for an erection to occur.
How does Vardenafil work?
The purpose of Vardenafil is to relax restricted or narrowed blood vessels and relax smooth muscles in the phallus in order for an erection to be achieved. Vardenafil specifically aims to address blood vessel-related erectile dysfunction by enhancing blood flow, relaxing cavernosal smooth muscle and increasing intracavernosal pressure resulting in a firm, rigid, and natural erection.
Vardenafil is one example of a type of drug known as a PDE-5 inhibitor (phosphodiesterase). PDE-5 inhibitors prevent the breakdown of nitric oxide, a potent vasodilator that is necessary to maintain a rigid and firm erection. Taking Vardenafil typically results in increased NO in the penile cavernosal tissue and muscles, which ensures a prolonged, stronger, more easily attained erection.
What is the difference between Vardenafil and Levitra?
Vardenafil is the active ingredient in Levitra. (There are several inactive ingredients, too.) Levitra is a brand name of the drug, whereas Vardenafil is the generic ingredient that can often be obtained in compound or at a more affordable price. Levitra is specifically marketed for the on-demand treatment of ED.
What is the best way to use Vardenafil for ED?
Swallow the medication whole or allow it to dissolve underneath your tongue, with or without food. Vardenafil takes effect quickly, as soon as 10 minutes of taking a dose, though more typically within 30 minutes. For maximum benefit, take your dose within 30-60 minutes of sexual activity. The effects of Vardenafil can last up to eight (8) hours, though in rare instances in may last for up to 12 hours.
How does Vardenafil differ from other ED medications?
There are four types of oral PDE-5 inhibitors that help treat ED and are currently approved by the U.S. Food and Drug Administration (FDA). These PDE-5 inhibitors work along the same pathway in the penis to promote smooth muscle relaxation and blood vessel dilation by increasing nitric oxide in the penis.
These drugs work in the same way, but differ in immediacy of action, half-life, side effect profile, and other characteristics. These slight differences may benefit some men and be ineffective for others.
Vardenafil (Levitra) was approved in 2003 for the U.S. market. It is known for its fast onset–Vardenafil can start working as quickly as 10 minutes after taking a dose. For maximum benefit, wait 30-60 minutes before sexual activity. Typically, Vardenafil stops working about eight (8) hours after taking a full dose, though its effects can last for up to 12 hours in some men.
The biggest different between Vardenafil and other PDE-5 inhibitors is that Vardenafil can increase QT prolongation, which can lead to irregular heartbeats. If you have prolonged QTc or are currently taking Class 1 or Class 3 antiarrhythmics, you may consider a different ED drug. Let your healthcare provider know about any cardiac history before starting any ED medication.
A doctor will assess your current health and your potential side effects when considering what type of ED medication is best for you. You may also have some input when choosing.
What are the common side effects of Vardenafil?
Vardenafil can cause a sudden drop in blood pressure. When combined with other specific medications, your blood pressure can drop to particularly unsafe levels, resulting in dizziness, fainting, and even a heart attack or stroke. Seek immediate medical help if this occurs.
Other common side effects include:
- Indigestion or Dyspepsia (uncomfortable feeling in the uppermiddle part of your stomach)
- Runny or stuffy nose
- Flulike symptoms
These side effects generally decrease over time, going away altogether within a few hours.
You may also experience back or muscle aches within 12-24 hours of taking Vardenafil. These aches typically go away completely within two (2) days.
Sexual activity can strain your heart, particularly if previous heart issues such as heart disease or a heart attack have already weakened your heart. If you experience chest pains, dizziness, or nausea during sexual activity, stop right away and seek professional medical help immediately.
What are the uncommon side effects of Vardenafil?
Uncommon side effects of Vardenafil may include, but are not limited to, the following:
- An erection lasting longer than four (4) hours. Known as priapism, an erection that won’t go away must be treated as soon as possible to avoid longterm damage, including the inability to have an erection.
- Changes in color vision. You may see a blue hue or have difficulty differentiating between blue and green colors.
- Sudden decrease in or loss of vision. In particularly rare instances, men taking Vardenafil or other ED medications may have a sudden decrease in or loss of vision in one or both eyes. If you experience a sudden vision decrease or loss, stop taking Vardenafil and seek immediate medical help.
- Sudden decrease in or loss of hearing. Ringing in your ears and/or dizziness may accompany a sudden decrease in or loss of hearing, though it is rare. If you experience a sudden hearing decrease or loss, stop taking Vardenafil and seek immediate medical help.
What should I avoid while taking Vardenafil?
Combining alcohol with Vardenafil may cause side effects, especially if you are drinking more than the recommended amount.
Combining grapefruit or grapefruit juice with Vardenafil can result in unwanted side effects.
How long does Vardenafil stay active in my body?
One dose of Vardenafil contains active ingredients that typically stay in your body for up to eight (8) hours. The effects of Vardenafil can last up to eight (8) hours, though in rare instances in may last for up to 12 hours.
Other medications you may take, especially for kidney or liver health, can cause the active ingredients to linger longer than 12 hours.
Who should not take Vardenafil?
Vardenafil is not right for everyone. Only your healthcare provider and you can decide if Vardenafil is right for you.
Women and children under the age of 18 should not take Vardenafil. Only those who have specifically been prescribed Vardenafil should take it. Never share Vardenafil with others, even if their symptoms are similar, as it may cause serious harm.
Who should I contact if I have a reaction to Vardenafil?
If you experience serious side effects such as fainting, heart attack, loss of vision or hearing, or significant allergic reaction, seek immediate medical help.
Contact your physician or professional health care provider if you have questions about Vardenafil.
What is the best way to store Vardenafil?
Keep Vardenafil at room temperature, between 59°F and 85°F (15-30°C). Always store Vardenafil and all medications out of reach from children.
What medications interfere with (are contraindicated) Vardenafil?
Do not take Vardenafil if you are currently taking other ED medicines or treatments, including Levitra.
Do not take Vardenafil if you are currently taking any medications known as “nitrates”. Nitrates are often used to treat angina, a symptom of heart disease, that can result in pains in your jaw, chest, or arm. Ask your physician or healthcare provider if any of your other medications are nitrates. Nitrates may also be found in medicines including:
- Isosorbide dinitrate
- Isosorbide mononitrate
- Recreational drugs known as “poppers”, which often contain nitrites called amyl nitrite or butyl nitrite
Do not take Vardenafil if take any medication known as “guanylate cyclase stimulators”, which include Riociguat (Adempas), a drug that treats pulmonary hypertension and chronic-thromboembolic pulmonary hypertension.
Other medications that can affect how you handle Vardenafil include:
- Medicines known as “alpha blockers”, which can be prescribed for prostate problems and/or high blood pressure, among other issues. Combining alpha blockers with Vardenafil can result in dizziness or fainting. Alpha blockers may include, but are not limited to the following:
- Cardura, aka doxazosin mesylate
- Flomax, aka tamsulosin HCl
- Hytrin, also known as (aka) terazosin HCl
- Jalyn, aka dutasteride or tamsulosin HCl
- Minipress, aka prazosin HCl
- Rapaflo, aka silodosin
- Uroxatral, aka alfuzosin HCl
- Medicines that treat abnormal heartbeat, including:
- Antiretroviral drugs, including:
- Ritonavir, aka Norvir
- Indinavir sulfate, aka Crixivan
- Satuinavir, aka Fortavase and Invirase
- Atazanavir, aka Reyatax
- Some types of antibiotics, including:
- Biaxin, aka clarithromycin
- Erythromycin, aka several brand names
- Medicines known as “HIV protease inhibitors”, such as Norvir or Kaletra, aka ritonavir
- Some types of antifungals, including:
- Nizoral, aka ketoconazole
- Sporanox, aka itraconazole
Can I take Vardenafil if I am allergic to Levitra?
No. If you have had an allergic reaction to Levitra, do not take Vardenafil. Allergic reactions can include:
- Swelling of your lips, throat, or tongue
- Difficulty breathing or swallowing
What does my healthcare provider need to know before I take Vardenafil?
Vardenafil is not right for everyone. Only your healthcare provider and you can decide if Vardenafil is right for you. Your physician or healthcare provider must know all medications and non-prescription drugs or medicines you are currently taking.
Ask your healthcare provider if your heart is healthy enough for you to have sexual activity. You should not take Vardenafil if your healthcare provider has told you not to engage in sexual activity due to health problems. Before taking Vardenafil, tell your healthcare provider about all your medical problems, particularly if you have ever had:
- Previous heart issues, such as irregular heartbeats, angina, heart failure, or heart attack
- Low blood pressure
- Rare heart condition known as long QT syndrome prolongation of the QT interval (this applies to family members as well)
- High blood pressure that is not currently under control
- Pulmonary hypertension
- Liver problems
- Kidney problems and/or required dialysis
- Retinitis pigmentosa (a rare eye disease)
- Severe vision loss, including a condition known as NAION
- Stomach ulcers
- Bleeding problems
- Deformed penis shape and/or Peyronie’s disease
- History of priapism (an erection that’s lasted for longer than four (4) hours)
- Blood cell problems, such as multiple myeloma, sickle cell anemia, or leukemia
- Hearing problems
In the case of an emergency medical situation related to your heart, you must disclose the last time you took Vardenafil.
Warning for Airplane Pilots
The U.S. Federal Aviation Authority approves the use of Vardenafil (Levitra) for the treatment of ED in its pilots. However, pilots may not use Vardenafil within eight (8) hours of pilot duties.
The FAA also restricts the use of other ED medications for pilots.
Can I take Vardenafil for ED?
Yes. Vardenafil is used for the treatment of ED and should be taken one (1) hour prior to sexual activity for best results. For most patients, the starting dose is 10 milligrams (mg), up to once a day. Increase to 20 mg or decrease to 5 mg based on efficacy and tolerability.
Can I take Vardenafil for BPH?
No. Only Tadalafil (Cialis) has been approved for BPH.
Can I take Vardenafil if I have Liver problems?
In patients with moderate hepatic impairment (Child-Pugh B), the recommended starting dose of Vardenafil is 5 mg. The maximum dose in patients with moderate hepatic impairment should not exceed 10 mg.
How should I take Vardenafil?
Take Vardenafil exactly as prescribed by your physician or healthcare professional. A dose of 10 mg is standard, though your physician may increase dosage up to 20 mg or decrease as low as 2.5 mg based on your health and age, as well as your initial and longer-term tolerability and efficacy.
Do not take Vardenafil more than one (1) tablet in a 24-hour period. Do not break or split a Vardenafil tablet unless instructed by your health care provder; swallow it in its entirety, unless otherwise instructed by your healthcare provider. Do not use other ED medicines or treatments while taking Vardenafil.
Vardenafil is typically prescribed for use as needed. In this situation, you may take your prescribed dose of Vardenafil tablet within 10 minutes to eight (8) hours of sexual activity, though one (1) hour before sexual activity is ideal.
Never share Vardenafil with others, even if their symptoms are similar, as it may cause serious harm.
When is the best time to take Vardenafil before sex?
If you are taking Vardenafil on an as-needed basis, you may take one tablet before expected sexual activity. Generally, Vardenafil can help you have sex within 30 minutes and up to eight (8) hours after taking one dose.
Despite taking Vardenafil as prescribed, sexual stimulation is still necessary for an erection.
Can Vardenafil improve my sexual desire?
Vardenafil will not improve your desire for sexual activity or cure ED. A man’s sexual desire is only one of the many functions of testosterone. A low testosterone level can decrease a man’s desire for sexual activity. Vardenafil does not protect from sexually transmitted diseases (STDs), including HIV. Vardenafil is not a form of birth control for men.
Should I take Vardenafil with food?
You can take Vardenafil with or without food.
Can I take Vardenafil and drink alcohol?
Taking Vardenafil with alcohol is not recommended. Drinking too much alcohol can increase your odds of a headache, dizziness, elevated heart rate, or lower blood pressure.
The Centers for Disease Control and Prevention generally recommend no more than two (2) drinks per day for men. One drink is generally defined as 12 ounces of a regular beer (approximately 5% ABV), 5 ounces of wine, or 1.5 ounces of distilled spirits (such as vodka, whiskey, gin, tequila, etc.).