Dosage and Administration
It is recommended to take an oral dose of LEVITRA 25 mins to 1 hour before engaging in sexual acts. 10 mg is the advsed starting dose for LEVITRA. A patient can commence with sex acts as early as 15 minutes post taking LEVITRA and as late as 4-5 hours.
It is advised not to take more than one LEVITRA dose per day.
Take LEVITRA with or without eating.
In order to gain a natural response to the treatment, sexual excitement is required.
LEVITRA can be administered in as small a dose as 5 mg and as large a dose as 20 mg weighing heavily on effectiveness of the drug and tolerability of the patient. It is ill-advised to take more than 20 mg of LEVITRA per day.
Vardenafil’s plasma levels can expect a boost if taken with potent cytochrome P450 (CYP) inhibitors, ritonavir, itraconazole, indinavir, ketoconazole. If LEVITRA use is to be combined with erythromycin, ketoconazol, or itraconazole the maximum dose of LEVITRA should not be more than 5 mg as concomitant use not only up efficacy but also increases incidents of adverse reactions. Avoid using LEVITRA with HIV protease inhibitors indinavir or ritonavir.
Dose adjustment is not needed for Elderly (65 years and older) patients.
Vardenafil is not to be used in Children (16 years and younger).
Patients possessing mild hepatic impairment (Child-Pugh A) do not require a dose adjustment.
Patients possessing moderate hepatic impairment (Child-Pugh B) require a lowered clearence for Vardenafil. They are to be started with a dose of 5 mg then, based on tolerability and efficacy, their dose can gradually be raised up to 20 mg.
Patients with severe hepatic impairment (Child-Pugh C) should refrain from using vardenafil, as the pharmacokinetics of vardenafil in patients needing dialysis has yet to be studied.
Patients with renal impairment do not require a dose adjsutment, whether it be mild (CLcr> 50-80 ml/min), moderate (CLcr> 30-50 ml/min), or even severe (CLcr> 30ml/min) impairment.
Patients requiring dialysis should refrain from using vardenafil, as the pharmacokinetics of vardenafil in patients in this condition has yet to be studied.
Doses of vardenafil as large as 80 mg per day were administered during a single dose volunteer study. For the most part, there were no heavy adverse reactions to even the highest tested dosage (80 mg/day). Studying 40 mg per day for more than a month confirmed this fact.
Though it could not be attributed to muscle or neurological toxicity, 40 mg, twice per day, induced serious back pain in some cases.
Take the required standard supportive measures in case of overdose on generic vardenafil. Vardenafil is intensely bound to plasma proteins and is not greatly disposed of through urine, so it is not expected that renal dialysis will accelerate clearance.