Pharmacokinetics

Absorption
After being applied orally, Vardenafil (Levitra) is quickly absorbed. 90% of patients reach Cmax, on an empty stomach, between 30 to 120 mins (median 1 hour) after oral dosing, but Cmax has been achieved as soon as 15 minutes in others.
Observed pharmacokinetic parameters have a substantial intra-subject and inter-subject variability caused by vardenafil’s ample first-pass metabolism. A 10mg dose of vardenafil has a mean absolute bioavailability of about 15%. Within the recommended dose range of 5mg-20mg of vardenafil, there almost a proportional increase of Cmax and AUC, after oral dosing.
Though the mean AUC went unaffected, the mean Cmax (rate of absorption) suffered an approximate 20% reduction and there was an approximate 60min delay in median tmax when vardenafil was taken with a high fat meal of approximately 57% fat. Pharmacokinetic parameters were not notably affected after consuming a ‘regular meal’ of approximately 30% fat. These results should prove that food is not required to take cheap vardenafil.
Distribution
Vardenafil’s mean steady state volume of distribution (Vss) is ~2.5 L/kg, referring to tissue distribution.
Plasma proteins are strongly bound to both vardenafil medication and it main circulating metabolite (M1) (~95% for M1 or parent drug). Total drug concentration is not dependent on this reversable protein binding. A maximum of only 0.0002% of a given dose of vardenafil is traceable in patient’s semen. This was taken from healthy subjects, an hour and a half post dosing.
Metabolism
Hepatic enzymes via CYP3A4 mostly metabolize vardenafil, but CYP3A5 and CYP2C9 isoforms make a few contributions. It takes about from 4 to 5 hours for the mean terminal elimination half-life from plasma.
The desethylation at the piperazine moiety of vardenafil produces human beings main circulating metabolite, M1, which may undergo further metabolism. The metabolite M1 has a terminal plasma elimination half-life of ~4 hours, equivalent to the parent drug. M1 appears in systemic circulation as it glucuronide-conjugated form (glucuronic acid). Non-glucuronidated M1 has a plasma concentration of only 26% of the parent compound. M1 has an efficacy contribution of about 7%, which means it has almost the same phosphodiesterase selectivity profile as vardenafil pills and an in vitro inhibitory potency for PDE5 of ~28%, in comparison to canadian vardenafil.
Excretion
Vardenafil drug has a 56 L/hour total body clearance, giving it a terminal half-life of between 4 and 5 hours. Generic Vardenafil is mostly excreted in the fecal matter (about 91 – 95% of given oral dose) and partially during urination (only about 2 – 6 % of given oral dose).

The haemodynamic process of erecting a penis is grounded in the relaxation of smooth muscle in the corpus cavernosum and its allied arterioles. Nitric oxide (NO) is released from the corpus cavernosum’s nerve ends during sexual arousal. This triggers the enxyme guanylate cyclase causing the corpus cavernosum’s cyclic guanosine monophosphate (cGMP) levels to increase. This is what causes relaxation in the smooth muscle and allows freer blood flow into the penis, causing an erect penis. The rate of degradation via cGCP hydrolyzing phosphodiesterases (PDEs) and the rate of synthesis via the guanylate cyclase are the two factors that actually regulates the cGMP level. The cGMP specific phosphodiesterase type 5 (PDE5) is the main PDE in the corpus cavernosum of a human.
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