Drug Name
Levitra Super Active+

Drug Uses
Levitra Super Active+ are soft gelatin capsules for oral use, which are used for treatment of erectile dysfunction.

How to use
The recommended starting dose of Levitra Super Active+ is 10 mg taken as needed approximately 2 minutes before sexual activity. In clinical tests Levitra Super Active+ was shown to be efficacious when taken up to 4-5 hours before sexual activity.
Levitra Super Active+ can be taken with or without food. Sexual stimulation is required for a natural response to treatment.
For patients, who are older than 65 years, Levitra Super Active+ clearance is reduced. A starting dose of 5 mg should be considered for those patients.
Levitra Super Active+ is used only for oral use.
Levitra Super Active+ is not indicated for use in children.


Drug Class and Mechanism
Penile erection is a hemodynamic process based on the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, from nerve ends in the corpus cavernosum nitric oxide (NO) is released, which activates the enzyme guanylate cyIase resulting in an increased level of cyclic guanosine monophosphate (cGMP) in the corpus cavernosum. This in turn triggers smooth muscle relaxation, allowing increased inflow of blood into the penis.
By inhibiting PDE5, the enzyme responsible for cGMP degradation in the corpus cavemosum, Levitra Super Active+ potently enhances the effect of endogenous NO, locally released in corpus cavernosum upon sexual stimulation.
Levitra Super Active+ thus potentiates the natural response to sexual stimulation.



Missed Dose
If you miss a dose of Levitra Super Active+, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Storage
Store Levitra Super Active+ at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Keep Levitra Super Active+ out of the reach of children and away from pets.

Warnings/Precautions
Levitra Super Active+ has vasodilator properties which may result in mild and transient decreases in blood pressure. Patients with left ventricular outflow obstruction, e.g., aortic stenosis and idiopathic hypertrophic subaortic stenosis, can be sensitive to the action of vasodilators including Type 5 phosphodiesterase inhibitors.
In men for whom sexual activity is not recommendable because of their underlying cardiovascular status, agents for the treatment of erectile dysfunction should generally not be used.
In a study of the effect of Levitra Super Active+ on QT interval in 59 healthy males, therapeutic (10 mg) and supratherapeutic (80 mg) doses of Levitra Super Active+ produced increases in QTc interval. This observation should be considered in clinical decisions when prescribing Levitra Super Active+. Patients with congenital QT prolongation (long QT syndrome) and those taking Class IA (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications should avoid using Levitra Super Active+.
Agents for the treatment of erectile dysfunction should generally be used with caution in patients with anatomical deformation of the penis (such as angulation, cavernosal fibrosis or Peyronie's disease) or in patients who have conditions which may predispose them to priapism (such as sickle cell anaemia, multiple myeloma or leukaemia).
The use of Levitra Super Active+ is also not recommended until further information is available: severe hepatic impairment, end stage renal disease requiring dialysis, hypotension (resting systolic blood pressure of < 90 mmHg), recent history of stroke or myocardial infarction (within last 6 months), unstable angina, and known hereditary degenerative retinal disorders such as retinitis pigmentosa.
Patients should be aware of how they react to VOLKENO-20 before driving or operating machinery.

Possible Side Effects
Even the highest dosage tested (80 mg per day) was tolerated without producing senous adverse side effects. This was confirmed in a study with 40 mg once daily doses over 4 weeks. When 40 mg was administered twice daily, cases of severe backpain were observed. No muscle or neurological toxicity was identified, however.
In cases of overdose, standard supportive measures should be taken as required. Renal dialysis is not expected to accelerate clearance as Levitra Super Active+ is highly bound to plasma proteins and not significantly eliminated in the urine.

More Information
Levitra Super Active+: Each Soft Gelatin Capsule contains 20 mg of Levitra Super Active+ (23,705 mg of Vardenafil monohydrochloride trihydrate).
Further constituents: crospovidone, magnesium stearate, microoystalline cellulose, colloidal silicon dioxide (silica colloidal anhydrous), polyethylene glycol, hypromellose (hydroxy-propyl-methylcellulose), titanium dioxide, ferric oxide yellow, ferric oxide red.