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What Is Levitra 40 MG (Vardenafil 40MG)

Levitra (vardenafil) is an oral medication indicated for the treatment of erectile dysfunction in men. Levitra relaxes muscles and increases blood flow to specific areas of the body thereby enhancing erectile function. As a result of the mechanism of action of Levitra, sexual stimulation is required to activate the pathway by which the medication exhibits its effect in the body and to achieve a therapeutic response. Levitra has no effect in the absence of sexual stimulation.

In most patients, the usual adult starting dose of Levitra, for the treatment of erectile dysfunction, is 10 mg administered approximately 60 minutes prior to sexual activity. The dose may be increased to a maximum dose of 20 mg or decreased to 5 mg based on efficacy and adverse reactions. The maximum recommended frequency of dosing and administration is once daily. Patients are advised to separate doses of Levitra by at least 24 hours. Levitra may be taken without regard to food and sexual stimulation is required for a therapeutic response to treatment.

The recommended starting dose in the geriatric population, in those patients 65 years of age and older, should be 5 mg administered once daily. The most commonly reported adverse reactions associated with Levitra include headache, flushing, stuffy or runny nose, indigestion, upset stomach or dizziness. The adverse reactions typically resolve after a few hours. Patients are advised to contact their physician if unpleasant or bothersome adverse reactions occur or if adverse reactions do not resolve. Less common side effects possible with treatment may include priapism (painful erection lasting for more than four hours which may lead to permanent damage if left untreated) or color vision changes, including seeing a blue tinge or having difficulty differentiating between blue and green.

Rarely, patients taking Levitra have reported experiencing a sudden decrease or loss of vision in one or both eyes. Patients are instructed to discontinue use of Levitra and contact their physician immediately if they experience a sudden decrease or loss of vision or sudden decrease or loss of hearing. Treatment with Levitra is contraindicated in patients currently being treated with nitrates. The concomitant use of Levitra with nitrates can cause an unsafe and sudden decrease in blood pressure and lead to dizziness, fainting, heart attack or stroke. Levitra is not intended for use in women or the pediatric population.

Levitra Dosage

Before taking this medication must remember that for maximum efficiency requires a sufficient level of sexual stimulation. Vardenafil 40 mg is taken orally, regardless of meal. The initial recommended dose is 10 mg for 25-60 minutes before sexual contact. Maximum frequency of reception 1 time per day. Efficacy and tolerability of the drug is individual and depending on this, the dose may be increased to 20 mg or reduced to 5 mg. Maximum daily dose of 20 mg. Correction mode of taking the drug and dosing in older men is not required. In addition, those men who suffer from moderate hepatic insufficiency, the initial dose should not exceed 5 mg a day. For minor violations of the liver and kidneys correction of ingestion dosage is not required.

Doctors advise their patients to use this medicine orally 1 hour before their planned sexual intercourse. However, it’s allowed to take Levitra only once a day to avoid overdosing. The right dosage of men depends on their overall health condition, age and other important factors. They need to avoid eating fatty meals and drinking grapefruit juice when taking this medication because of increased side effects and reduced effectiveness. There are certain symptoms that indicate overdosing, such as abnormal vision, severe vomiting and muscle pain.

When you receive a dose of 40 mg 2 times per day the subjects observed significant pain in the lumbar region without evidence of toxic effects on the nervous and muscular system. In the event of such symptoms it is recommended that a reduced dosage.Pregnancy and lactation .The drug is not intended for use in women. Drug interaction with alcohol.

Common Side Effects(Levitra 40 MG):

  1. Dizziness
  2. Headache
  3. Upset stomach
  4. Nosebleeds
  5. Flushing
  6. Back Pain

Levitra Side Effects

Some men may develop certain symptoms while taking Levitra, and the most widespread ones include:

  • Flushing andheadaches;
  • Dizziness and stuffy nose;
  • Vision and hearing changes;
  • Increased sensitivity to the light;
  • Vomiting and nausea;
  • Diarrhea.

To decrease a possible risk of lightheadedness and dizziness, it’s advisable to get up slowly from lying and sitting positions. Besides, patients should understand that sexual activities can put more strain on their hearts, so they need to be careful when taking Levitra if they have any pre-existing heart conditions. Once they notice such signs as fainting, arm pain and severe dizziness, men need to go to the hospital immediately. In very rare cases they may develop serious adverse effects.

Some side effects of Levitra such as stuffy nose, sneezing, and a warm feeling or redness in the face, neck, arms, and upper chest may go away as your body adjusts to the medicine. While these side effects do not usually need medical attention, talk to your doctor if they become bothersome.

Severe Side Effects of Levitra

Check in with your doctor right away if you notice any of these side effects while taking Levitra:

  • Pain in the arm, back, or jaw
  • Hearing loss
  • Blindness, blurry vision, or decreased vision
  • Pain, discomfort, or tightness in the chest
  • Chills, cold sweats
  • Dizziness, lightheadedness or faintness
  • Racing, pounding heartbeat pr pulse
  • Nausea, vomiting
  • Hives, itching
  • Skin rash or puffiness or swelling of eyelids, face, lip, tongue, eyes
  • Unusual tiredness or feeling of weakness

Rare Side Effects of Levitra

Some Levitra side effects are less common, including:

  • Ejaculating abnormally
  • Pain in the back or other areas
  • “Pins and needles” sensation of the skin
  • Sour stomach
  • Diarrhea
  • Dry, sore throat
  • Fever
  • Heartburn, indigestion
  • Priapism and seizures;
  • Allergicreactions;
  • Memory loss;
  • Irregular heartbeats.

Levitra Drug Interactions

These medications are not usually taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

  • CGMP SPECIFIC PDE TYPE-5 INHIBITORS/NITRATES
  • VARDENAFIL (>2.5 MG)/STRONG CYP3A4 INHIBITORS
  • VARDENAFIL/SELECTED PROTEASE INHIBITORS
  • VARDENAFIL (> 5 MG)/SELECTED CYP3A4 INHIBITORS
  • PDE INHIBITORS/RIOCIGUAT

Serious Interactions

These medications may interact and cause very harmful effects. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

  • VARDENAFIL/CLASS IA AND III ANTIARRHYTHMICS
  • POSSIBLE QT PROLONGING AGENTS/DOMPERIDONE
  • POSSIBLE QT PROLONGING AGENTS/ANAGRELIDE
  • POSSIBLE QT PROLONGING AGENTS/AMIFAMPRIDINE
  • POSSIBLE QT PROLONGING AGENTS/DRONEDARONE
  • POSSIBLE QT PROLONGING AGENTS/ARTEMETHER-LUMEFANTRINE
  • POSSIBLE QT PROLONGING AGENTS/CISAPRIDE
  • SELECTED QT PROLONGING AGENTS/ZIPRASIDONE
  • POSSIBLE QT PROLONGING AGENTS/SERTINDOLE
  • POSSIBLE QT PROLONGING AGENTS/DROPERIDOL
  • POSSIBLE QT PROLONGING AGENTS/LEVOMETHADYL
  • POSSIBLE QT PROLONGING AGENTS/SPARFLOXACIN
  • POSSIBLE QT PROLONGING AGENTS/HALOFANTRINE
  • POSSIBLE QT PROLONGING AGENTS/PIMOZIDE
  • POSSIBLE QT PROLONGING AGENTS/BEPRIDIL
  • POSSIBLE QT PROLONGING AGENTS/THIORIDAZINE

Precautions (Vardenafil 40 MG)

  1. Women should avoid taking Levitra 40 mg as it is not approved for them.
  2. One should not take Levitra 40 mg if they are taking any kind of nitrate.
  3. People who are taking medications to treat STD’s should not take Levitra 40 mg or Vardenafil 20mg/Vardenafil 40 mg simultaneously.
  4. People who have cardiovascular disease or significant heart disease should avoid taking Levitra or Vardenafil Tablets.

The evaluation of erectile dysfunction should include a medical assessment, a determination of potential underlying causes and the identification of appropriate treatment.

Before prescribing LEVITRA, it is important to note the following:

Cardiovascular Effects

General

Physicians should consider the cardiovascular status of their patients, since there is a degree of cardiac risk associated with sexual activity. Therefore, treatment for erectile dysfunction, including LEVITRA, should not be used in men for whom sexual activity is not recommended because of their underlying cardiovascular status.

There are no controlled clinical data on the safety or efficacy of vardenafil in the following patients; and therefore its use is not recommended until further information is available: unstable angina; hypotension (resting systolic blood pressure of <90 mmHg); uncontrolled hypertension (>170/110 mmHg); recent history of stroke, life-threatening arrhythmia, or myocardial infarction (within the last 6 months); severe cardiac failure.

Left Ventricular Outflow Obstruction

Patients with left ventricular outflow obstruction, (for example, aortic stenosis and idiopathic hypertrophic subaortic stenosis) can be sensitive to the action of vasodilators including PDE5 inhibitors.

Blood Pressure Effects

LEVITRA has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of 7 mmHg systolic and 8 mmHg diastolic) [see CLINICAL PHARMACOLOGY]. While this normally would be expected to be of little consequence in most patients, prior to prescribing LEVITRA, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects.

Potential For Drug Interactions With Potent Or Moderate CYP3A4 Inhibitors

Concomitant administration with potent CYP3A4 inhibitors (such as ritonavir, indinavir, ketoconazole) or moderate CYP3A4 inhibitors (such as erythromycin) increases plasma concentrations of vardenafil. Dosage adjustment is necessary when LEVITRA is administered with certain CYP3A4 inhibitors [see DOSAGE AND ADMINISTRATION , DRUG INTERACTIONS].

Long-term safety information is not available on the concomitant administration of vardenafil with HIV protease inhibitors.

Risk Of Priapism

There have been rare reports of prolonged erections greater than 4 hours and priapism (painful erections greater than 6 hours in duration) for this class of compounds, including vardenafil. In the event that an erection persists longer than 4 hours, the patient should seek immediate medical assistance. If priapism is not treated immediately, penile tissue damage and permanent loss of potency may result.

LEVITRA should be used with caution by patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie’s disease) or by patients who have conditions that may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia).

Effects On The Eye

Physicians should advise patients to stop use of all phosphodiesterase type 5 (PDE5) inhibitors, including LEVITRA, and seek medical attention in the event of sudden loss of vision in one or both eyes. Such an event may be a sign of nonarteritic anterior ischemic optic neuropathy (NAION), a rare condition and a cause of decreased vision, including permanent loss of vision, that has been reported rarely postmarketing in temporal association with the use of all PDE5 inhibitors. Based on published literature, the annual incidence of NAION is 2.5–11.8 cases per 100,000 in males aged ≥50.

An observational case-crossover study evaluated the risk of NAION when PDE5 inhibitor use, as a class, occurred immediately before NAION onset (within 5 half-lives), compared to PDE5 inhibitor use in a prior time period. The results suggest an approximate 2-fold increase in the risk of NAION, with a risk estimate of 2.15 (95% CI 1.06, 4.34). A similar study reported a consistent result, with a risk estimate of 2.27 (95% CI 0.99, 5.20). Other risk factors for NAION, such as the presence of “crowded” optic disc, may have contributed to the occurrence of NAION in these studies.

Neither the rare postmarketing reports, nor the association of PDE5 inhibitor use and NAION in the observational studies, substantiate a causal relationship between PDE5 inhibitor use and NAION [see ADVERSE REACTIONS].

Physicians should consider whether their patients with underlying NAION risk factors could be adversely affected by use of PDE5 inhibitors. Individuals who have already experienced NAION are at increased risk of NAION recurrence. Therefore, PDE5 inhibitors, including LEVITRA, should be used with caution in these patients and only when the anticipated benefits outweigh the risks. Individuals with “crowded” optic disc are also considered at greater risk for NAION compared to the general population, however, evidence is insufficient to support screening of prospective users of PDE5 inhibitors, including LEVITRA, for this uncommon condition.

LEVITRA has not been evaluated in patients with known hereditary degenerative retinal disorders, including retinitis pigmentosa, therefore its use is not recommended until further information is available in those patients.

Sudden Hearing Loss

Physicians should advise patients to stop taking all PDE5 inhibitors, including LEVITRA, and seek prompt medical attention in the event of sudden decrease or loss of hearing. These events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to the intake of PDE5 inhibitors, including vardenafil. It is not possible to determine whether these events are related directly to the use of PDE5 inhibitors or to other factors [see ADVERSE REACTIONS].

Alpha-Blockers

Caution is advised when PDE5 inhibitors are co-administered with alpha-blockers. PDE5 inhibitors, including LEVITRA, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects. When vasodilators are used in combination, an additive effect on blood pressure may be anticipated. In some patients, concomitant use of these two drug classes can lower blood pressure significantly leading to symptomatic hypotension (for example, fainting) [see DRUG INTERACTIONS and CLINICAL PHARMACOLOGY]. Consideration should be given to the following:

Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor. Patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors.

In those patients who are stable on alpha-blocker therapy, PDE5 inhibitors should be initiated at the lowest recommended starting dose [see DOSAGE AND ADMINISTRATION].

In those patients already taking an optimized dose of PDE5 inhibitor, alpha-blocker therapy should be initiated at the lowest dose. Stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitor.

Safety of combined use of PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs.

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