Vardenafil - use, indications, action, contraindications

Vardenafil primarily functions as a potent and selective inhibitor of the enzyme phosphodiesterase type 5 (PDE5), the enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP). By inhibiting PDE5, vardenafil leads to an increase in the levels of cGMP in the corpus cavernosum of the penis.

This significant increase in cGMP levels leads to smooth muscle relaxation in the corpus cavernosum, which in turn promotes increased blood flow to the penis. The enhanced blood flow aids in achieving and maintaining an erection sufficient for satisfactory sexual performance.

It's worth noting that sexual stimulation is required for vardenafil to produce its beneficial therapeutic effects. This is because the nitric oxide released during sexual stimulation is what triggers the production of cGMP in the first place. Without sexual stimulation, there would be no nitric oxide, and thus, no increase in cGMP levels, regardless of the presence of vardenafil or other PDE5 inhibitors.

Furthermore, the duration of action of vardenafil is typically between 4 to 5 hours, although this can vary based on individual factors such as age, overall health status, and the presence of other underlying medical conditions.

In summary, the action of vardenafil is a complex process involving several biochemical and physiological events. Its primary effect of facilitating erections is achieved through the selective inhibition of PDE5 and subsequent increase in cGMP levels in the penis, leading to smooth muscle relaxation and enhanced blood flow.

Vardenafil is primarily indicated for the treatment of erectile dysfunction (ED), a common sexual problem in men. Erectile dysfunction is a condition in which a man is unable to achieve or maintain an erection sufficient for satisfactory sexual performance. This can be a result of various health issues ranging from psychological problems to physical conditions.

Some of the specific indications of Vardenafil include:

• Treatment of erectile dysfunction in adult men. It is particularly useful in those cases where the ED is due to physical causes such as diabetes, high blood pressure, and high cholesterol.
• It may also be indicated for use in men who have had prostate surgery or have experienced a spinal cord injury.
• Vardenafil can also be used to manage ED that has not responded to other treatments.
• It is sometimes used off-label for the treatment of premature ejaculation, although this is not a widely accepted use.

It is worth noting that Vardenafil does not cure erectile dysfunction or increase sexual desire. Instead, it aids in achieving and maintaining an erection by increasing blood flow to the penis during sexual stimulation. This allows men with ED to have a satisfactory sexual experience.

Despite its benefits, Vardenafil is not suitable for everyone and should only be used under the guidance of a healthcare professional. It is not intended for use in women or children and should not be used by men who are not suffering from ED. It is also contraindicated in certain conditions, which are discussed in the 'Vardenafil - Contraindications' section.

Although Vardenafil can be a highly effective medication for the treatment of erectile dysfunction, it is not suitable for everyone and has multiple contraindications that need to be considered before use.

First and foremost, people with hypersensitivity to vardenafil or any other ingredients of the preparation should not use this treatment. Similarly, those using nitrate medications or nitric oxide donors, like amyl nitrite, are contraindicated as the combination can lead to a significant drop in blood pressure.

Patients with serious heart conditions, such as severe heart failure or unstable angina, are also advised against using Vardenafil. It can be problematic in people who have suffered a stroke or heart attack in the recent past (within the last 6 months).

Other contraindications include end-stage kidney disease requiring dialysis, severe liver problems, and certain hereditary degenerative retinal disorders. Furthermore, it is not recommended for individuals with low blood pressure (hypotension) or those who have recently experienced significant blood loss or dehydration.

Lastly, Vardenafil is contraindicated in people for whom sexual activity is inadvisable, for example, men with underlying cardiovascular conditions. Also, it should not be used in men with anatomical deformation of the penis, such as angulation, cavernosal fibrosis, or Peyronie's disease.

These contraindications aim to prevent adverse effects and ensure the safe use of Vardenafil. It is always essential to consult with a healthcare professional before starting any new medication.

Vardenafil, like other medications, can cause some side effects, although not everyone gets them. They are usually mild and do not last long. However, you should inform your doctor if they persist or become bothersome.

The common side effects of Vardenafil include:

• Headaches
• Dizziness
• Flushing
• Nasal congestion
• Dyspepsia (indigestion)

These side effects should resolve on their own with time. But, if they persist or worsen, contact your healthcare provider immediately.

Uncommon or rare side effects can be:

• Changes in vision or sudden loss of vision
• Sudden decrease or loss of hearing
• Prolonged and painful erection (priapism)
• Severe allergic reactions (rash, itching, difficulty breathing, swelling of the face, lips, or tongue)

If you experience any of these, seek medical attention immediately. These are serious side effects and need immediate medical attention.

Remember, this is not a comprehensive list of all the possible side effects of Vardenafil. Always consult your doctor or pharmacist for more detailed information and advice tailored to your health condition.

Vardenafil is an oral medication, and its dosage recommendations are specific to address different conditions. However, it's always essential to follow the instructions provided by your healthcare provider. It's typically started at a dose of 10mg, taken approximately 60 minutes before sexual activity. Yet, the dose can range from 5mg to 20mg depending on efficacy and tolerability.

For elderly patients (aged 65 years and above), a starting dose of 5mg may be considered. The maximum dose frequency is once per day. In men with hepatic impairment (moderate and severe hepatic insufficiency), the dose should not exceed 5mg. In patients with renal impairment, the dose adjustments are not necessary, but caution is advised when Vardenafil is prescribed to patients with severe renal insufficiency.

Patients taking certain protease inhibitors such as Ritonavir, Indinavir, Ketoconazole, Itraconazole, and Erythromycin, the dose of Vardenafil should not exceed a maximum single dose of 2.5mg in a 24-hour period.

Always remember, the dose of Vardenafil should be personalized to the minimum effective dose, which should be kept as low as possible. Your doctor will determine the right dosage for you based on your medical history, current health status, and the severity of the condition being treated.

Vardenafil is primarily used for treating erectile dysfunction (ED) in men. It operates by increasing the blood flow to the penis during sexual stimulation. This enhanced blood flow allows men to get and maintain an erection adequate for sexual activity.

It is important to note that Vardenafil doesn't provide an automatic erection. Sexual stimulation is necessary to activate the drug's effects. Therefore, its usage must be coordinated to align with planned sexual activity.

Vardenafil tablets are usually taken as needed, about one hour before sexual activity. The dosage depends on the individual's medical condition, response to treatment, and possible interaction with other medications.

Moreover, it is essential not to take more than one dose within a 24-hour period unless directed by a healthcare professional. Doing so can lead to unwanted side effects or worsen existing conditions.

Vardenafil can also be used in the treatment of premature ejaculation. However, this should only be done under the guidance of a healthcare professional.

While Vardenafil is generally safe, it is important to take certain precautions to avoid unwanted side effects or interactions. Here are the key precautions that you need to keep in mind:

• Vardenafil should not be used if you are allergic to it.
• If you have a history of heart problems, it’s crucial to consult with your doctor before starting this medication.
• Vardenafil is not recommended for use in people with severe liver disease.
• If you are taking medication for high blood pressure, consult with your doctor as Vardenafil can potentially lower your blood pressure.
• It is not advisable to take Vardenafil if you are using any kind of nitrate medication for chest pain or heart problems.
• If you are using recreational drugs known as 'poppers', avoid taking Vardenafil as it can lead to a serious drop in blood pressure.
• Alcohol can increase the risk of certain side effects of Vardenafil. Limit your alcohol consumption while on this medication.
• Vardenafil may cause dizziness. Do not drive or operate machinery until you know how this medication affects you.
• Do not take Vardenafil more than once a day unless instructed by your doctor.

When taking Vardenafil, interactions with other medications can occur. These interactions can change how Vardenafil works, or increase the risk of serious side effects. It is therefore important to keep a list of all the products you use, including prescription/nonprescription drugs and herbal products, and share the list with your doctor or pharmacist.

Some of the medications that can interact with Vardenafil include:

• Nitrates, such as nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Combining these drugs with Vardenafil can cause a dangerous drop in blood pressure.
• Alpha blockers, such as prazosin, terazosin, and doxazosin. These drugs can also lower blood pressure, and taking them with Vardenafil can increase that effect.
• Other medications for erectile dysfunction, such as sildenafil and tadalafil. Taking these drugs with Vardenafil can cause an overdose.
• Certain heart medications, such as amiodarone, diltiazem, and verapamil. These drugs can increase the concentration of Vardenafil in the blood, increasing the risk of side effects.
• Some antifungals, such as ketoconazole and itraconazole, and certain antibiotics, such as erythromycin and clarithromycin. These medications can also increase the concentration of Vardenafil in the blood.

It is also worth noting that consumption of grapefruit or grapefruit juice can increase the levels of Vardenafil in your blood, which can increase the risk of side effects.

Always consult your healthcare provider before starting or stopping any medication.

The price of Vardenafil can vary significantly depending on the brand, dosage, and the pharmacy where it is purchased. More commonly, the cost may range from $15 to $20 per tablet for the brand name product and $1 to $3 for generic versions. It is important to note that this is a prescription medication, so your health insurance may cover part or all of the cost.

There are also a number of online pharmacies that sell Vardenafil, often at a reduced price. However, caution must be exercised when buying medications online to ensure the pharmacy is reputable and the product is genuine. Look for online pharmacies that are accredited by the National Association of Boards of Pharmacy (NABP) to ensure they meet stringent standards for quality and safety.

In some cases, pharmaceutical companies offer patient assistance programs that provide medications at a lower cost or even for free for those who cannot afford their medications. Some pharmacies also offer discount programs or coupons for prescription medications.

Finally, the price of Vardenafil can also be affected by the country in which it is purchased, with prices typically lower in Canada and other countries with government-regulated healthcare systems.

Substitutes for Vardenafil include other phosphodiesterase-5 (PDE5) inhibitors, such as Sildenafil (Viagra) and Tadalafil (Cialis). These medications work in a similar way to Vardenafil by enhancing nitric oxide effects, which increases blood flow to the penis and supports erection.

It's important to note that while these medications serve as substitutes, individual responses may vary. Factors such as pre-existing conditions, tolerance, and personal preference may influence the choice of medication. Furthermore, the onset and duration of effect differ amongst these medicines. Sildenafil typically takes 30 to 60 minutes to start working and lasts about four hours. Tadalafil can start working in as little as 15 minutes, and its effects can last up to 36 hours.

Other substitutes can include Alprostadil, a medicine that can be injected into the penis or inserted as a pellet into the urethra. Penile implants and pumps are also alternatives for those who cannot take or do not respond to PDE5 inhibitors.

Before considering a substitute, it's crucial to consult a healthcare provider. They can provide advice based on individual health status and needs. Self-medication or change of medication without professional advice can lead to serious health risks.