Levitra is a medicine that contains the active substance called Vardenafil. The medication is used for erectile dysfunction and belongs to the pharmacological group type 5 phosphodiesterase blockers. Vardenafil can be distinguished from the whole group precisely for its selectivity for the enzyme PDE5, which has a beneficial effect on reducing side effects. Levitra is available in dosages of 10, 20, 40, and 60 mg.
Erection is a process based on the relaxation of the muscles of the cavernous bodies due to blood flow. It is directly related to the accumulation of an active substance called cGMP. It participates in the relaxation of smooth muscle cells and blood flow, respectively - erection. Moreover, the concentration of the medication is controlled by its synthesis and cleavage with the participation of the enzyme phosphodiesterase. In the cavernous bodies, cGMP-PDE5 predominates. Therefore, when the PDE5 enzyme is blocked, degradation and release of cGMP occur. Taking the medication does not cause an erection without sexual arousal, which is very important.
It is taken internally. Absorption occurs quickly from 15 minutes to an hour. Absorption decreases when the medication is taken together with fatty foods. Levitra binds to plasma proteins, both the medication itself and its metabolite. Metabolism takes place in the liver. The average elimination half-life is 4-5 hours. The drug is excreted to a greater extent in feces up to 95%, the rest with urine.
The medication is suitable for both young and mature. The main indication is the inability of a man to achieve and maintain an erection necessary for intercourse, in medical terminology - for men with erectile dysfunction.
The effect of the tablets does not depend on food intake, excluding fatty foods. Meals and foods rich in fats reduce the absorption and maximum concentration of the medication. The medication should be taken at least half an hour before sexual intercourse. Individual prescription of the dose of the medicine should start with 10 mg. In the future, either increase to 20 or decrease to 5 mg. Therapy will only be considered adequate if sexually stimulated.
It is forbidden to use the medication with an expired shelf life.
The medication is taken orally with a bit of water.
The maximum dose of Levitra is 60 mg. If the patient responds to less dosage, it is necessary to keep it at a reduced dosage.
Among the side effects, the development of PINZN was noted - anterior ischemic neuropathy of the optic nerve, which led to a loss of vision or its persistent impairment. However, it should be noted that there is no clear established relationship between taking the medication. This complication since all patients from this group has concomitant diseases, such as diabetes mellitus, arterial hypertension, ischemic heart disease, or an anatomical defect of the optic nerve, an increase in the fraction of LDL-low-density lipoproteins, with a decrease in HDL-high density lipoproteins, as well as a history of long-term smoking, which can also lead to this complication. Among the subjects, the most common side effects were the appearance of headaches, more than 10%. Priapism, hearing loss, and lengthening of the QT interval occurred in a small percentage of patients treated.
If a person is diagnosed with coronary artery disease exertional angina and takes nitrates, taking vardenafil is prohibited. Joint administration has a powerful effect on the hypotensive effect, leading to the development of hypotensive shock. In addition, the impact on the heart rate is enhanced.
Safety has not been determined in relation to such severe conditions and diseases as severe liver dysfunction, renal failure in the terminal stage, patients on hemodialysis, hypotension, recent heart attack, or stroke. Research is underway, and taking the drug with the related listed conditions is also undesirable.
The drug is taken with caution and risk assessment in case of anatomical deformity of the penis, including curvature, fibrosis, Peirrney's disease, myeloma, sickle cell anemia, leukemia, in persons prone to bleeding and exacerbation of gastric ulcer.
• Since the liver enzyme cytochrome P450 metabolizes Levitra, any inhibitors of these enzymes lead to a decrease in the clearance of vardenafil and an increase in its half-life. The inhibitors include cimetidine, ketoconazole, erythromycin, and drugs used in the treatment of HIV - ritonavir, indinavir.
• Joint intake with nitrogen donors - nitrates, almost doubles the effect of lowering blood pressure and medicines containing a nitro group in their composition: nicorandil.
• Reception with alpha-blockers is permissible only if there is a stable result of treatment and in the minimum dosage of Levitra 5 mg.
According to the studies, information is available on taking the medication in a single dosage of 120 mg. Taking this dose caused pain in the lower back, muscles, and visual disturbances. Dosages below: 80 mg once a day, 40 mg twice a day did not lead to significant consequences.
As for the treatment of overdose, it should be noted that dialysis does not significantly increase the clearance of the medication since vardenafil has a high degree of binding to plasma proteins. Therefore, the treatment remains only supportive.
Sexual activity is a physical activity associated with certain cardiac risks, and therefore, before prescribing the medication, the doctor should refer to the examination of the cardiovascular system. With cardiovascular diseases and restrictions of sexual activity, it makes no sense to treat with vardenafil.
Vardenafil has the property of a systemic vasodilator, which should be considered in patients undergoing treatment for hypertension.
For liver diseases, namely liver failure, at least Child-Pugh class B, the recommended dose is 5 mg.
In the group of people over 65 years old, when taking the usual dosage, an increase in the concentration of the drug in the plasma was observed in comparison with the younger group (18-45). Therefore, a minimum dose of 5 mg is required in the treatment of elderly patients.
Erectile dysfunction (ED) is an inability to enjoy intercourse due to a lack of erection. Moreover, it may be the impossibility of both achieving and maintaining this state. The disappearance of spontaneous morning erection is also possible.
Among the main reasons leading to erectile dysfunction, several groups should be distinguished:
• vascular diseases; • neurological; • hormonal disorders; • psychological; • infections of the genitourinary system; • taking certain medications.
What exactly is included in each group.
Vascular changes may include atherosclerosis, impaired blood outflow from the penis, diabetes mellitus, high blood pressure, hyperlipidemia.
Neurological includes injuries of intervertebral discs, trauma, multiple sclerosis, stroke, Parkinson's disease, CNS tumors, polyneuropathy with alcohol.
The mental ones include stress, depression, constant conflicts with the other half, or simply emotional emptiness, neuroses.
Infections of the genitourinary system include syphilis, gonorrhea, chlamydia, and others.
Hormonal - an increase in female hormones in relation to male and a decrease in male hormones, hypogonadism, both an excess and a deficiency of thyroid hormones, an excess of prolactin.
Medicines group is the one that lower blood pressure, antidepressants, narcotic drugs, and others.
More than 50% of men have impotence between the ages of 40-70, with an increase in % with age. And only 10% of the male population turns to a specialist for help at the first sign. This usually leads to a complete loss of erection.
• A man ceases to experience sexual attraction to the opposite sex • A man experiences sexual desire but is not able to achieve a full erection • A man is not able to experience an orgasm • Accelerated ejaculation • Lack of morning erection
Erection is divided into organic and psychogenic. Organic is associated with somatic pathology. Psychogenic differs from the first preservation of a spontaneous erection in the morning and an erection with ejaculation during unconventional intercourse.
To identify and diagnose, a doctor needs not only to interview a man about sexual activity but also to conduct examinations, including complete blood count (CBC), general urine examination (GUE), blood for hormones, fasting blood glucose, ultrasound with a Doppler pelvic organ, smears for sexually transmitted diseases, a vasoactive test.
Impotence is not a verdict.
Alternative methods include herbs.
Herbal Viagra is called ginseng. Several studies were conducted, among which it was found that a daily intake of 600-1000 grams up to 3 times a day of ginseng leads to an improvement in erectile dysfunction and the elimination of some symptoms. The treatment of metabolic syndrome and hyperlipidemia has proven especially good.
DHEP (dehydroepiandrosterone is a natural hormone produced by the adrenal glands, further converted into estrogens and testosterone. It is especially effective for impotence associated with diabetes mellitus).
L-arginine is an amino acid that promotes nitric oxide - a substance involved in relaxing the muscular walls of blood vessels and improving blood flow. It contributes to the emergence of a full erection. Studies have been carried out regarding this amino acid, and its effect on erectile dysfunction and the following results have been obtained - daily intake of 5 grams of amino acid led to 30% detection, and if the reception was combined with pycnogenol - 92% within 3 months. L-arginine is well tolerated when combined with other medicinal substances, which can also be used in traditional medicine.
Alternative medicine can also include the intake of foods with a high zinc content, a substance necessary for the synthesis of testosterone. More zinc is found in meat, pumpkin seeds, legumes, eggs, natural yogurt, etc. This method is also one of the areas of traditional medicine. Diet - nutritional recommendations are available for every medical condition, including erectile dysfunction. It should also highlight other foods recommended by doctors as prophylaxis - food rich in water and fat-soluble vitamins. These include olive, sunflower, sesame, corn, rose hips, nuts, currants, cereals, and redfish.
Regarding herbs, medicine cannot turn phytotherapy away, but no controlled, long-term studies can track the results and consequences if any. That is why doctors do not always approve of these methods. DHEP, L-arginine, is used as an additional treatment to existing procedures.
As a preventive measure worth recommending:
• Refusal of bad habits • Lack of excess weight • Regular physical activity • Sleeping schedule • Visiting a urologist at least once a year • Minimization of stressful situations • Permanent sexual partner • Timely solutions to health problems and their prevention
Erectile dysfunction is a condition that always leads to psycho-emotional dissatisfaction, which is a big problem affecting the quality of life. The increase in life expectancy has led to the statistics that we have now, and there is increased growth of this pathology among young people.
Lack of sexual activity in men leads to stagnant and inflammatory diseases of the urogenital tract, which leads to the appointment of permanent antibiotics and the development of resistance.
The success of therapy doubles at the initial stages of the disease and the correct determination of the etiology. With psychogenic disorders, it is possible to achieve success and complete recovery with the help of a psychotherapist by identifying actual problems and ways to solve them what is not so easy to achieve with somatics, especially those associated with surgical interventions and late stages of diseases. However, there is a need for complete qualified help from a specialist with the prescription of an examination and treatment, particularly medications - PDE5 blockers. A doctor is the one who can help stop the progression of the disease and prevent irreversible consequences.
Nowadays, science does not stand in one place, and knowledge is updated daily. There are combinations of medications, surgical and therapeutic techniques that can solve many of the problems associated with erectile dysfunction. In medical practice for the treatment of ED, physiotherapy is widely used to improve blood flow - negative pressure treatment, shock wave therapy (ESWT). Even though vasculogenic pathology remains the main cause of ED, many specialists classify surgical treatment in revascularization and venous surgery as experimental medicine, the effectiveness of which ranges from 30 to 95%.
When choosing a treatment, pay attention to age, associated diseases, degree of dysfunction, and etiology.
In the hands of andrologists and urologists, many certified, modern medicines fully meet the latest advances in this area and can restore erectile dysfunction completely or replace the pharmacologically lost mechanisms of the links of this process.
Active advertising of medicines on the market has led to the fact that today everyone can name medication for impotence. But doctors strongly recommend not to use drugs and refrain from self-medication until examination and identification of the cause is identified.
Only qualified consultation and optimal diagnostics can guarantee the effectiveness of pharmacological drugs and minimize side effects.