Levitra Extra Dosage (vardenafil hydrochloride) is a high-potency prescription medication specifically formulated for the management of moderate to severe erectile dysfunction (ED) in adult men. This enhanced formulation builds upon the established efficacy of standard Levitra, offering a more robust pharmacological profile for patients who may require a stronger therapeutic response. It functions as a potent and selective inhibitor of phosphodiesterase type 5 (PDE5), facilitating increased blood flow to the penile tissue upon sexual stimulation. Treatment should be undertaken under the strict supervision of a qualified healthcare provider following a comprehensive medical evaluation to ensure suitability and safety.

Features

• Active Pharmaceutical Ingredient: Vardenafil hydrochloride trihydrate, equivalent to vardenafil 20 mg.
• Pharmacological Class: Selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).
• Onset of Action: Typically observed within 25-60 minutes post-administration.
• Duration of Efficacy: The therapeutic window can extend for up to 5 hours.
• Administration: For oral use. Can be taken with or without food, though a high-fat meal may delay absorption.
• Bioavailability: Approximately 15%.

Benefits

• Achieves a firmer and more sustainable erection adequate for satisfactory sexual intercourse.
• Provides a prolonged window of opportunity, reducing performance anxiety related to timing.
• Offers a reliable treatment option for men who have experienced suboptimal results with other ED therapies.
• Enhances overall sexual confidence and quality of life for both the patient and their partner.
• The higher dosage strength is specifically indicated for cases requiring a more potent therapeutic effect.

Common use

Levitra Extra Dosage is indicated for the treatment of erectile dysfunction, the recurrent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is not indicated for use by women, children, or adolescents. It is crucial to understand that this medication is not an aphrodisiac and will not result in an erection without direct sexual stimulation. Its use should be limited to a maximum of one tablet per 24-hour period.

Dosage and direction

The recommended dose is one 20 mg tablet taken orally approximately 25 to 60 minutes before anticipated sexual activity. The tablet should be swallowed whole with a glass of water. Dosage must be individualized based on efficacy and tolerability. The maximum recommended dosing frequency is once per day. For patients with hepatic impairment (moderate cirrhosis) or severe renal impairment (creatinine clearance <30 mL/min), a starting dose of 5 mg is recommended, with a potential increase to 10 mg based on patient response and tolerability. Concomitant use with certain medications (see Drug Interactions) necessitates strict dosage limitations or is contraindicated.

Precautions

• Prior to initiation, a thorough medical history and physical examination should be conducted to diagnose ED, identify potential underlying causes, and assess cardiovascular health. Sexual activity poses a cardiac risk; therefore, patients must be evaluated for cardiovascular suitability.
• Use with caution in patients with anatomical deformation of the penis (e.g., angulation, cavernosal fibrosis, Peyronie’s disease), or conditions that may predispose them to priapism (e.g., sickle cell anemia, multiple myeloma, leukemia).
• Non-arteritic anterior ischemic optic neuropathy (NAION) has been reported post-marketing in association with PDE5 inhibitor use. Patients who have experienced NAION in one eye are at increased risk of NAION in the other eye.
• Sudden decrease or loss of hearing has been reported. Patients should seek immediate medical attention if these symptoms occur.
• Use with caution in patients with bleeding disorders or active peptic ulceration.

Contraindications

• Concomitant administration with any form of organic nitrates (e.g., nitroglycerin, isosorbide mononitrate or dinitrate) or nitric oxide donors in any form.
• Concomitant administration with guanylate cyclase stimulators, such as riociguat.
• Known hypersensitivity to vardenafil or any of the tablet’s excipients.
• Patients for whom sexual activity is inadvisable due to underlying cardiovascular status.

Possible side effect

Like all medicines, this medicine can cause side effects, although not everybody gets them. Very common (≥1/10) and common (≥1/100 to <1/10) side effects include headache, flushing, nasal congestion, indigestion, and dizziness. Uncommon (≥1/1,000 to <1/100) side effects include palpitations, tachycardia, nausea, increased creatinine kinase, blurred vision, eye pain, photophobia, erections lasting more than 4 hours (priapism), and hypotension. Rare (≥1/10,000 to <1/1,000) side effects include syncope, myocardial infarction, and serious cardiovascular events. Very rare (<1/10,000) side effects include NAION and sudden hearing loss.

Drug interaction

• Nitrates: Concomitant use is contraindicated due to the risk of profound hypotension.
• Alpha-blockers: Concomitant use can lead to symptomatic hypotension. This combination should be avoided. If co-administration is necessary, it should only occur after the patient has been stabilized on alpha-blocker therapy, and the PDE5 inhibitor should be initiated at the lowest dose.
• Potent CYP3A4 inhibitors: Drugs such as ketoconazole, itraconazole, ritonavir, indinavir, and clarithromycin significantly increase vardenafil plasma concentrations. Concomitant use is not recommended. If unavoidable, a maximum single dose of 5 mg vardenafil in a 24-hour period should not be exceeded.
• Other antihypertensives: Additive blood pressure-lowering effects may occur when administered with other antihypertensive medications.
• Guanylate cyclase stimulators (e.g., riociguat): Concomitant use is contraindicated due to additive hypotensive effects.

Missed dose

Levitra Extra Dosage is not intended for chronic daily dosing. It is taken on an as-needed basis prior to sexual activity. Therefore, the concept of a “missed dose” does not apply. Do not take a double dose to make up for a missed one.

Overdose

In cases of overdose, standard supportive measures should be adopted as required. Given the vasodilatory effects of vardenafil, renal dialysis is not expected to accelerate clearance. The primary expected symptom of overdose would be severe hypotension. Cardiovascular support and management of hypotension are the primary treatment goals.

Storage

Store in the original package below 30°C (86°F) to protect from moisture and light. Keep out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and blister. The expiry date refers to the last day of that month.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. It is not a substitute for a consultation with a qualified healthcare professional. Always read the accompanying patient information leaflet provided with your medication. Do not initiate or alter any treatment regimen without the direct advice of your doctor. The brand name “Levitra” is a registered trademark.

Reviews

• “As a urologist with over 20 years of experience, I reserve Levitra Extra Dosage for patients with more challenging ED cases who have not achieved desired results with first-line therapies. The pharmacokinetic profile is excellent, and the higher dose provides a reliable option. It is imperative, however, to strictly screen patients for cardiovascular risk and contraindications.” – Dr. A. Reynolds, MD.
• “After trying standard doses of other medications with limited success, my physician recommended we try this formulation. The difference was significant and reliable. The extended duration alleviated the pressure of a narrow window, which was a major factor in my performance anxiety.” – Patient, 58.
• “The efficacy is undeniable, but so is the potential for side effects. Patients must be thoroughly counseled on the increased risk of headache and flushing at this dosage and the absolute prohibition against use with nitrates. It is a powerful tool that demands respect and careful patient selection.” – Clinical Pharmacist Review.
• “For my husband, this was the solution that finally worked consistently. It has positively impacted our relationship and intimacy. The key was working closely with his doctor to ensure it was safe for him to use.” – Partner Review.