Levitra
Vardenafil (in the form of the monohydrochloride trihydrate) 5 mg per tablet. Other ingredients: crospovidone, magnesium stearate, microcrystalline cellulose, colloidal anhydrous silica, polyethylene glycol (macrogol 400), hypromellose (hydroxypropyl methylcellulose), titanium dioxide (E171), iron oxide yellow (E172), iron oxide red (E172).
The pharmacological action of the drug Levitra
Levitra - a drug for the treatment of erectile dysfunction, try it to buy levitra online phosphodiesterase inhibitor type 5 (PDE5).
Penile erection is a hemodynamic process based on the relaxation of smooth muscles of cavernous bodies and located in its arterioles. During sexual stimulation of the nerve endings of the cavernous bodies released nitric oxide (of NO), activates the enzyme guanylate cyclase, which leads to higher content in the cavernous bodies of cyclic guanosine monophosphate (cGMP). The result is relaxation of smooth muscles of cavernous bodies, which increases blood flow to the penis.
The drug Levitra blocks PDE-5, which takes place under the influence of the splitting of cGMP, as a result of this action of endogenous NO in the cavernous bodies during sexual stimulation is enhanced, resulting in the ability of Levitra enhances the natural response to sexual stimulation.
The clinical effect of the drug Levitra is realized before reaching Cmax. After oral drug Levitra in doses of 20 mg and 10 mg of onset of action - 10 min, which allows an erection sufficient for penetration and successful completion of intercourse in 34% and 40% of patients with mild to moderate erectile dysfunction, respectively. After 25 minutes, the effect occurs respectively in 53% and 50% of patients, which coincides with the beginning of the appearance of the drug in the blood and a rapid increase of its concentration. Duration - 8-12 hours.
Pharmacokinetics in special clinical situations
In healthy older men (65 years and older) compared to younger (45 years old and younger) not observed a significant reduction in hepatic clearance of vardenafil. In men older AUC increased on average by 52%. In clinical studies, there was no difference between the efficacy and safety of the elderly and young individuals.
Patients with minor (QC 80-50 mL / min), moderate (creatinine clearance 50-30 ml / min) and severe (creatinine clearance <30 mL / min) renal dysfunction vardenafil pharmacokinetic parameters were comparable to those in healthy subjects. There was no significant correlation between QA and the concentration of vardenafil in the plasma (AUC and Cmax).
In patients on hemodialysis, the pharmacokinetics of vardenafil has not been studied.
In patients with mild and moderate hepatic impairment the clearance of the drug Levitra is reduced in proportion to the degree of liver dysfunction. Compared with healthy men, patients with minor hepatic impairment may increase in AUC and Cmax of 1.2 times and at moderate hepatic dysfunction - in 2.6 times.
In patients with severely impaired hepatic function The pharmacokinetics of the drug Levitra has not been studied.
Special instructions for use of the drug Levitra:
Be wary of the drug Levitra 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).
Safety Levitra has not been studied, and the use of the drug is not recommended in patients with severe hepatic impairment; in renal disease in the terminal stage, requiring dialysis; arterial hypotension (systolic blood pressure at rest of less than 90 mm Hg); recent stroke or myocardial infarction (within the last 6 months); unstable angina; with hereditary degenerative retinal disorders (for example, retinitis pigmentosa).
Because Levitra has not been used in patients with a tendency to bleeding, and in patients with acute exacerbation of peptic ulcer disease, use of the drug in these cases is possible only after a careful assessment of risk-benefit of treatment.
In studies in humans, while the use of the drug Levitra as monotherapy were not observed changes krovotecheniya.v time Due to the fact that the sexual activity is associated with a certain degree of cardiac risk before prescribing the drug Levitra for erectile dysfunction is necessary to assess the state of the cardiovascular system patient.