Levitra

Levitra is an inhibitor fosfodiestrady fifth type - PDE5 and serves as already mentioned for the treatment of erectile dysfunction in males . If an erection occurs hemodynamic process that rasslyablyaet smooth muscles of cavernous bodies of the penis and arterioles located in it. Occurs release of nitric oxide (NO) of the first endings pescherestyh bodies during sexual stimulation and increased cyclic guanzinmonofosfat (cGMP ) . This is accompanied by muscle relaxation of corpus cavernosum , resulting in blood flow to the penis increases. Function Levitra ( vardenafil ) is blocking PDE5 , which breaks down cGMP , endogenous NO in the corpora cavernosa increases during sexual stimulation and the effect of the drug enhances the response to sexual stimulation .

Administration and dosage of Levitra :


Levitra taken orally with or without food . For the action of the drug is needed sexual stimulation . Levitra acted to take the recommended dose should be 10 mg 25-60 minutes before intercourse . If the positive effect of such dosage does not cause , it shall be increased to 20 mg ( a dose usually prescribed sprostatektomiey and diabetes ) If the patient is taking other medications dose of Levitra is selected in 2.5 - 5 mg. Patients over 65 years old , the recommended dose is 5 milligrams . Your doctor may increase the dose to 10 mg usual , depending on individual tolerance and effekivnosti effects of Levitra . Also recommended dose of 5 mg should be administered to patients with moderate hepatic impairment . Do not take Levitra more than once a day. Maksimalnayach receiving a dose of 20 milligrams Levira night .

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Cautions


To be effective, treatment requires a sufficient level of sexual stimulation.

Prior to the appointment of drugs used to treat erectile dysfunction , the physician must evaluate the cardiovascular system of the patient , because of the risk of cardiac events during sexual activity . Vardenafil has vasodilating properties, which may be accompanied by minor or moderate blood pressure reduction . Patients with obstruction of the outflow tract of the left ventricle ( eg aortic stenosis , idiopathic hypertrophic subaortal stenosis ) can be sensitive to the action of vasodilators including PDE5 inhibitors . Males , which is not shown sexual activity due to concomitant cardiovascular disease , drugs for treatment of erectile dysfunction should not be used.

Since Levitra at therapeutic doses (10 mg) causes a lengthening of the interval QT, patients with congenital QT prolongation and those who accept antiarrhythmics class IA ( quinidine, procainamide ) or Class III ( amiodarone , sotalol ) , this drug should not be administered buy Levitra Online Without Prescription. Although myocardial infarction is associated in time with the use of vardenafil and with sexual activity , but not yet established whether the associated emergence of this disease directly with vardenafil or sexual activity , or comorbidities , or a combination of these factors. Preparations for the treatment of erectile dysfunction should be used with caution in patients with anatomical deformation of the penis ( curved, cavernous fibrosis or Peyronie's disease ) , as well as in patients with diseases predisposing to the development of priapism ( sickle- cell anemia, multiple myeloma, or leukemia ) Viagra without prescription.

Safety and efficacy of vardenafil in combination with other drugs to treat erectile dysfunction has not been studied , so their combined use is not recommended. Safety of vardenafil has not been studied and its use is not recommended in the following patient groups : severe liver , kidney disease in the terminal stage , requiring dialysis , hypotension (Sad at rest - < 90 mm Hg. Tbsp. ) , Recent stroke or heart attack infarction ( within the last 6 months) , unstable angina, as well as hereditary retinal degenerative diseases (such as retinitis pigmentosa ) . On the intake of Levitra and other PDE5 inhibitors have been reported cases of transient vision loss and nearteriitnoy ischemic optic neuropathy . Upon the occurrence of a sudden loss of vision should stop taking Levitra and immediately consult a doctor .

Combined therapy of alpha -blockers and vardenafil may be accompanied by the development of arterial hypotension with appropriate clinical picture , because these drugs have a vasodilating effect . Combined appointment of vardenafil and alpha-blockers permitted only at presence of stable BP values ​​in patients receiving alpha-blockers , with vardenafil should be appointed to the minimum recommended dose - 5 mg.

Should not take vardenafil same time with alpha -blockers , except tamsulosin , which may be the same reception time with the reception of vardenafil . If you receive a selected dose of vardenafil alpha- blocker therapy should be started at the minimum dose . The gradual increase in the dose of alpha-blockers in patients receiving drugs from the group of PDE5 inhibitors , may be accompanied by a further reduction in blood pressure.

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Vardenafil dose should not exceed 5 mg when it is combined with erythromycin , ketoconazole , itraconazole . The dose of ketoconazole and itraconazole thus should not exceed 200 mg. Combination with indinavir and ritonavir is contraindicated .Since vardenafil has not been used in patients with a tendency to bleeding in patients with exacerbation of peptic ulcer , his appointment in these cases only after a thorough assessment of the benefit - risk.

Vardenafil not affect the duration of bleeding , including the combined use with acetylsalicylic acid . Vardenafil does not increase platelet aggregation induced by various drugs . At concentrations above the therapeutic , vardenafil causes slight increase antiplatelet action of sodium nitroprusside , which is a donor of nitric oxide.

Effect of combined purpose of vardenafil and heparin on the duration of bleeding has not been studied . Effect of vardenafil on the hypotensive effect of nitrates in patients has not been studied , so the combined purpose of vardenafil and nitrates is contraindicated . Due to the fact that the cardiac activity is associated with a degree of cardiac risk , before being administered for treatment of erectile dysfunction , a physician must estimate the state of the cardiovascular system of a patient .

Combination with indinavir and ritonavir is contraindicated buy Levitra Online Without Prescription. Since vardenafil has not been used in patients with a tendency to bleeding in patients with exacerbation of peptic ulcer , his appointment in these cases only after a thorough assessment of the benefit - risk.

Vardenafil not affect the duration of bleeding , including the combined use with acetylsalicylic acid . Vardenafil does not increase platelet aggregation induced by various drugs . At concentrations above the therapeutic , vardenafil causes slight increase antiplatelet action of sodium nitroprusside , which is a donor of nitric oxide.

Effect of combined purpose of vardenafil and heparin on the duration of bleeding has not been studied . Effect of vardenafil on the hypotensive effect of nitrates in patients has not been studied , so the combined purpose of vardenafil and nitrates is contraindicated . Due to the fact that the cardiac activity is associated with a degree of cardiac risk , before being administered for treatment of erectile dysfunction , a physician must estimate the state of the cardiovascular system of a patient .