levitra
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.02 | $40.17 (0%) | 🛒 Add to cart |
| 20 | $2.76 | $80.34 $55.23 (31%) | 🛒 Add to cart |
| 30 | $2.34 | $120.50 $70.29 (42%) | 🛒 Add to cart |
| 60 | $1.67 | $241.01 $100.42 (58%) | 🛒 Add to cart |
| 90 | $1.45 | $361.51 $130.55 (64%) | 🛒 Add to cart |
| 120 | $1.34 | $482.02 $160.67 (67%) | 🛒 Add to cart |
| 180 | $1.23 | $723.03 $220.92 (69%) | 🛒 Add to cart |
| 270 | $1.12 | $1084.54 $301.26 (72%) | 🛒 Add to cart |
| 360 | $1.00
Best per pill | $1446.05 $361.51 (75%) | 🛒 Add to cart |
| Product dosage: 20mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.52 | $45.19 (0%) | 🛒 Add to cart |
| 20 | $3.26 | $90.38 $65.27 (28%) | 🛒 Add to cart |
| 30 | $2.85 | $135.57 $85.36 (37%) | 🛒 Add to cart |
| 60 | $2.34 | $271.13 $140.59 (48%) | 🛒 Add to cart |
| 90 | $2.23 | $406.70 $200.84 (51%) | 🛒 Add to cart |
| 120 | $2.01 | $542.27 $241.01 (56%) | 🛒 Add to cart |
| 180 | $1.84 | $813.40 $331.39 (59%) | 🛒 Add to cart |
| 270 | $1.64 | $1220.11 $441.85 (64%) | 🛒 Add to cart |
| 360 | $1.39
Best per pill | $1626.81 $502.10 (69%) | 🛒 Add to cart |
Synonyms | |||
Similar products
Let me walk you through what we’ve observed with Levitra over the years - not the polished marketing version, but what actually happens in clinical practice. Vardenafil hydrochloride, that’s the active pharmaceutical ingredient in Levitra, belongs to the PDE5 inhibitor class alongside sildenafil and tadalafil. But it’s got its own unique characteristics that make it particularly interesting for certain patient populations.
I remember when we first started prescribing this back in 2003 after FDA approval - there was a lot of skepticism about whether we really needed another ED medication when Viagra was already dominating the market. But the pharmacokinetic profile told a different story. The thing about vardenafil is its higher selectivity for PDE5 compared to PDE6 - that’s what reduces those visual disturbances some patients experience with sildenafil.
Key Components and Bioavailability of Levitra
The molecular structure of vardenafil hydrochloride gives it some distinct advantages in terms of absorption and metabolism. Unlike sildenafil which is significantly affected by high-fat meals, Levitra maintains reasonable bioavailability even with food intake - though we still recommend taking it on an empty stomach for optimal results.
The standard tablets come in 5mg, 10mg, and 20mg strengths, but what’s interesting is the orally disintegrating tablet formulation that came later. That was a game-changer for patients who had trouble swallowing conventional tablets or wanted more discretion. The sublingual absorption bypasses first-pass metabolism to some extent, leading to slightly faster onset.
Bioavailability sits around 15% for the standard tablet, which seems low until you consider that the drug is highly protein-bound and has a volume of distribution that suggests good tissue penetration. The liver metabolizes it primarily through CYP3A4, which becomes crucial when we’re talking about drug interactions.
Mechanism of Action: Scientific Substantiation
The mechanism seems straightforward on paper - phosphodiesterase type 5 inhibition leading to increased cyclic GMP and smooth muscle relaxation in the corpus cavernosum. But the clinical reality is more nuanced.
What we’ve observed is that Levitra’s higher PDE5 selectivity translates to what patients describe as a “more natural” erection quality compared to sildenafil in some cases. The onset typically within 25-60 minutes gives patients better planning flexibility than the stricter timing requirements of sildenafil.
The duration of action around 4-5 hours hits that sweet spot for many couples - long enough to allow spontaneous intimacy but short enough to minimize side effect duration. I’ve had patients who switched from tadalafil specifically because the 36-hour window was actually too long for their comfort.
Indications for Use: What is Levitra Effective For?
Levitra for Erectile Dysfunction
This is the primary indication, and it works across various etiologies - psychogenic, organic, mixed. What’s interesting is the response rate in diabetic patients - we’ve seen better results with vardenafil in this population compared to other agents in some studies.
Levitra for Pulmonary Arterial Hypertension
This is off-label but we’ve used it successfully in patients who couldn’t tolerate sildenafil or tadalafil. The hemodynamic effects are similar, though the dosing needs careful titration.
Levitra for Benign Prostatic Hyperplasia
Again off-label, but the relaxation of smooth muscle in the prostate and bladder neck does provide symptomatic relief for some men with BPH. We typically use lower doses for this indication.
Instructions for Use: Dosage and Course of Administration
The standard starting dose is 10mg taken about 60 minutes before sexual activity, though some younger patients do well with 5mg. For older patients or those with hepatic impairment, we start lower.
| Patient Population | Starting Dose | Timing | Special Instructions |
|---|---|---|---|
| General ED | 10mg | 60 min before activity | Empty stomach preferred |
| Elderly (>65) | 5mg | 60-90 min before | Monitor for hypotension |
| Hepatic impairment | 5mg | 90 min before | Avoid in severe impairment |
| Diabetic patients | 10mg | 45-60 min before | May require dose adjustment |
The maximum dosing frequency is once daily, though in practice we often recommend patients take “drug holidays” to maintain medication efficacy and reduce tolerance development.
Contraindications and Drug Interactions
This is where things get clinically messy. The absolute contraindications include concurrent nitrate use - and I can’t stress enough how dangerous this combination is. We’ve had patients who “forgot” to mention their angina medication and ended up in the ED with profound hypotension.
The relative contraindications include recent MI, unstable angina, hereditary degenerative retinal disorders, and severe hepatic impairment. The drug interaction profile is extensive due to CYP3A4 metabolism - azole antifungals, HIV protease inhibitors, and macrolide antibiotics can significantly increase vardenafil levels.
What’s often overlooked is the alpha-blocker interaction. We need at least 6 hours between alpha-blocker administration and vardenafil dosing to minimize orthostatic hypotension risk.
Clinical Studies and Evidence Base
The pivotal trials showed about 80% improvement in erectile function across all severity levels of ED. The recovery time after ejaculation appears shorter with vardenafil compared to other agents based on patient reports.
The VARDEN trial specifically looked at diabetic patients and found significant improvement in IIEF scores with 20mg dosing. Another study in spinal cord injury patients showed good efficacy, which was surprising given the neurogenic component.
What the trials don’t capture well is the individual variation in response. Some patients respond dramatically better to one PDE5 inhibitor over others for reasons we don’t fully understand.
Comparing Levitra with Similar Products and Choosing Quality Medication
The comparison inevitably comes down to three factors: onset, duration, and side effect profile. Levitra sits between sildenafil and tadalafil in terms of duration, with potentially fewer visual side effects than sildenafil and less duration-related anxiety than tadalafil.
The cost difference between brand and generic is significant, but the bioavailability studies show the generics are equivalent. We’ve had good results with the authorized generics in terms of patient satisfaction.
The choice often comes down to individual patient factors - their specific comorbidities, medication regimen, sexual habits, and even psychological preferences. Some patients simply feel more confident with one medication over another.
Frequently Asked Questions about Levitra
What is the recommended course of Levitra to achieve results?
Most patients see optimal results within 2-3 doses as they learn the timing and their individual response pattern. We recommend at least 4-6 attempts before considering a medication ineffective.
Can Levitra be combined with blood pressure medications?
Yes, with careful monitoring. The additive hypotensive effects are usually modest with proper dosing intervals, but we check orthostatic vital signs during initial use.
How does alcohol affect Levitra efficacy?
Moderate alcohol consumption (1-2 drinks) doesn’t significantly impact efficacy, but heavy drinking can both impair sexual function and increase side effect risk.
Is Levitra safe for patients with heart disease?
In stable, treated cardiovascular disease, yes. But we typically get cardiology clearance for patients with recent cardiac events or unstable symptoms.
Conclusion: Validity of Levitra Use in Clinical Practice
The risk-benefit profile favors Levitra for many patients, particularly those who’ve failed other agents or have specific comorbidities like diabetes. The clinical evidence supports its efficacy and safety when used appropriately.
I’ve been working with this medication long enough to see patterns emerge that weren’t in the original trials. There’s an art to matching the right PDE5 inhibitor to the right patient.
I’ll never forget Mr. Henderson, 58-year-old architect with well-controlled type 2 diabetes who came in frustrated after sildenafil gave him blue-tinted vision that scared him off ED meds entirely. His A1c was 6.8, lipids decent, but his marriage was suffering from the sexual dysfunction. We started him on 10mg Levitra and the difference was immediate - no visual issues, reliable response within 40 minutes. What surprised me was his wife’s comment at follow-up: “It’s not just the physical effect, it’s that he’s not anxious about side effects anymore.”
Then there was the learning curve with the sublingual formulation. We had a 72-year-old retired teacher with Parkinson’s who struggled with pill swallowing - the ODT version was perfect theoretically. But his tremor made handling the blister pack nearly impossible until his daughter found a weekly pill organizer with individual compartments that worked. Small practical details that never make it into clinical trials.
The toughest case was probably David, 45 with spinal cord injury at T10 - we expected limited response but vardenafil worked better than anticipated. His sensation was incomplete but the mechanical function returned enough for sexual activity. We had to coordinate with his urologist because he was on intermittent catheterization, but the quality of life improvement was significant.
What we didn’t anticipate was how many patients would use it situationally for performance anxiety rather than regular ED. The shorter duration actually became a feature for them - “I don’t want to be medicated all weekend” as one patient put it.
The longitudinal follow-up has been revealing too. We’ve got patients who’ve used it successfully for over a decade without dose escalation, others who needed periodic breaks. The diabetics generally need more careful dose adjustment over time as their neuropathy progresses.
The real testament comes from patients like Robert, who told me after 2 years of use: “I don’t take it every time anymore - knowing I can perform when I want to took the pressure off enough that half the time I don’t even need it.” That psychological benefit never shows up in the IIEF scores but it’s every bit as important as the pharmacological effect.