Drug Uses

Levitra is an oral therapy for the treatment of erectile dysfunction.

How Taken

Levitra comes as a tablet to take it orally. It should be taken, as needed about 1 hour before sexual activity. Some form of sexual stimulation is needed for an erection to occur with Levitra. Levitra should not be taken more than once a day. Levitra can be taken with or without food.

Warnings/Precautions

Before taking Levitra, tell your doctor if you currently have or have ever had a heart attack, stroke, irregular heartbeats, angina (chest pain), or congestive heart failure; high or low blood pressure; if you have a personal or family history of a rare heart condition known as prolongation of the QT interval (long QT syndrome); liver problems or kidney problems; have ever had blood problems, including sickle cell anemia, multiple myeloma, or leukemia; have a bleeding or blood clotting disorder; have a stomach ulcer; a family history of degenerative eye disease (e.g., retinitis pigmentosa); or if you have a physical deformity of the penis such as Peyronie's disease. You may not be able to take Levitra, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Although women do not indicate Levitra for use, it is in the FDA pregnancy category B. This means that Levitra is not expected to be harmful to an unborn baby. Women should not take Levitra. It is not known whether Levitra passes into breast milk. If you are over 65 years of age, you may be more likely to experience side effects from Levitra. Your doctor may prescribe a lower dose of the medication.

Missed Dose

Levitra is used as needed, so you are not likely to miss a dose.

Possible Side Effects

The most common side effects with Levitra are:
-Headaches
-Flushing
-Stuffy or runny nose
Levitra may uncommonly cause: an erection that will not go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections. Vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green. These are not all the side effects of Levitra. For more information, ask your doctor or pharmacist.

Storage

Store at 25°C (77°F); excursions permitted to 15-30°C (59-86°F). Keep Levitra and all medicines out of the reach of children.

Overdose

Seek emergency medical attention if an overdose is suspected. Symptoms of a Levitra overdose are not known, but are likely to include chest pain, back pain, dizziness, an irregular heartbeat, abnormal vision, and swelling of the ankles or legs.

More Information

Do not take Levitra if you:
-Take any form of medication known as "nitrates" (Type of medicine used to relieve chest pain that can occur as a result of heart disease). Taking Levitra in combination with nitrates may result in serious side effects.
-Take medicines called "alpha-blockers" (sometimes prescribed for prostate problems or high blood pressure). Taking Levitra with alpha-blockers may drop your blood pressure to an unsafe level.
-Your doctor determines that sexual activity poses a health risk for you.
You have a known sensitivity or allergy to any component of Levitra. The use of Levitra offers no protection against sexually transmitted diseases. Counseling of patients about protective measures necessary to guard against sexually transmitted diseases, including the Human Immunodeficiency Virus (HIV), should be considered.

Disclaimer

This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.

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Penis Disorders
Problems with the penis can cause pain and affect a man's sexual function and fertility. Penis disorders include
* Erectile dysfunction - inability to get or keep an erection
* Priapism - a painful erection that does not go away
* Peyronie's disease - bending of the penis during an erection due to a hard lump called a plaque
* Balanitis - inflammation of the skin covering the head of the penis, most often in men and boys who have not been circumcised
* Penile cancer - a rare form of cancer, highly curable when caught early
Erectile Dysfunction
On this page:
* How does an erection occur?
* What causes erectile dysfunction (ED)?
* How is ED diagnosed?
* How is ED treated?
* Hope Through Research
* Points to Remember
* For More Information
Erectile dysfunction, sometimes called "impotence," is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word "impotence" may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.
Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.
In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging.
ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED. Urologists, who specialize in problems of the urinary tract, have traditionally treated ED; however, urologists accounted for only 25 percent of Viagra mentions in 1999.
How does an erection occur?
The penis contains two chambers called the corpora cavernosa, which run the length of the organ (see figure 1). A spongy tissue fills the chambers. The corpora cavernosa are surrounded by a membrane, called the tunica albuginea. The spongy tissue contains smooth muscles, fibrous tissues, spaces, veins, and arteries. The urethra, which is the channel for urine and ejaculate, runs along the underside of the corpora cavernosa and is surrounded by the corpus spongiosum.
Erection begins with sensory or mental stimulation, or both. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the spaces. The blood creates pressure in the corpora cavernosa, making the penis expand. The tunica albuginea helps trap the blood in the corpora cavernosa, thereby sustaining erection. When muscles in the penis contract to stop the inflow of blood and open outflow channels, erection is reversed.
How is ED treated?
Most physicians suggest that treatments proceed from least to most invasive. For some men, making a few healthy lifestyle changes may solve the problem. Quitting smoking, losing excess weight, and increasing physical activity may help some men regain sexual function.
Cutting back on any drugs with harmful side effects is considered next. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.
Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.
Psychotherapy
Experts often treat psychologically based ED using techniques that decrease the anxiety associated with intercourse. The patient's partner can help with the techniques, which include gradual development of intimacy and stimulation. Such techniques also can help relieve anxiety when ED from physical causes is being treated.
Drug Therapy
Drugs for treating ED can be taken orally, injected directly into the penis, or inserted into the urethra at the tip of the penis. In March 1998, the Food and Drug Administration (FDA) approved Viagra, the first pill to treat ED. Since that time, vardenafil hydrochloride (Levitra) and tadalafil (Cialis) have also been approved. Additional oral medicines are being tested for safety and effectiveness.
Viagra, Levitra, and Cialis all belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Taken an hour before sexual activity, these drugs work by enhancing the effects of nitric oxide, a chemical that relaxes smooth muscles in the penis during sexual stimulation and allows increased blood flow.
While oral medicines improve the response to sexual stimulation, they do not trigger an automatic erection as injections do. The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. Levitra is also available in a 2.5 mg dose.
None of these PDE inhibitors should be used more than once a day. Men who take nitrate-based drugs such as nitroglycerin for heart problems should not use either drug because the combination can cause a sudden drop in blood pressure. Also, tell your doctor if you take any drugs called alpha-blockers, which are used to treat prostate enlargement or high blood pressure. Your doctor may need to adjust your ED prescription. Taking a PDE inhibitor and an alpha-blocker at the same time (within 4 hours) can cause a sudden drop in blood pressure.
Oral testosterone can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage. Patients also have claimed that other oral drugs?including yohimbine hydrochloride, dopamine and serotonin agonists, and trazodone?are effective, but the results of scientific studies to substantiate these claims have been inconsistent. Improvements observed following use of these drugs may be examples of the placebo effect, that is, a change that results simply from the patient's believing that an improvement will occur.
Many men achieve stronger erections by injecting drugs into the penis, causing it to become engorged with blood. Drugs such as papaverine hydrochloride, phentolamine, and alprostadil (marketed as Caverject) widen blood vessels. These drugs may create unwanted side effects, however, including persistent erection (known as priapism) and scarring. Nitroglycerin, a muscle relaxant, can sometimes enhance erection when rubbed on the penis.
A system for inserting a pellet of alprostadil into the urethra is marketed as Muse. The system uses a prefilled applicator to deliver the pellet about an inch deep into the urethra. An erection will begin within 8 to 10 minutes and may last 30 to 60 minutes. The most common side effects are aching in the penis, testicles, and area between the penis and rectum; warmth or burning sensation in the urethra; redness from increased blood flow to the penis; and minor urethral bleeding or spotting.
Research on drugs for treating ED is expanding rapidly. Patients should ask their doctor about the latest advances.

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