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Erection of the penis is a haemodynamic process, basing on relaxation of smooth muscles of cavernous bodies and arterioles which are situated in them. During sexual stimulation oxide of nitrogen evolves an activating ferment guanylate ciclase from nervous endings of cavernous bodies, which results in increase of cyclic guanosine monophospate. It results in relaxaion of smooth muscles of cavernous bodies, which favors the increase of blood reflux to the penis.

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Levitra is not indicated for women and children younger than 12 years old.

Dosage form: tablets

It should be used with care in patients:

* With native prolongation of the interval of OT;
* With anatomic deformation of the penis (contortion, cavernous fibrosis, Peironi disease);
* With diseases predisposing for priapism (crescent-cell anemia, multiple myeloma, leukemia);
* With hereditary degenerative retinopathy (for instance pigmented retinitis);
* With predisposing to bleeding and aggravation of ulcer disease;
* With aortal stenosis and idiopathic hypertrothic subaortal stenosis.


Mode of application and doses :

* The primary dose is 10 mg.
* It is taken 25-60 minutes before a sexual intercourse.
* Duration of action of Buy Levitra without prescription is 4-5 hours.
* Maximum recommended frequency of intake once in 24 hours. In relation to efficiency and tolerance the dose may be increased up to 20 mg or decreased to 5 mg in 24 hours.
* Maximum recommended dose is 20 mg once in 24 hours.
* A dose of 5 mg is recommended to senior patients (over 65 years old).
* A dose of 20 mg is administered in cases of severe ED (diabetes, prostatectomy) when a starting dose of 10 mg shows little efficiency.
* Meals and alcoholic beverages do not affect the efficiency of Buy Levitra without prescription .
* Buy Levitra without prescription acts only with a sufficient level of sexual stimulation.


Side effects:

The most typical are (1-4%): headache, redness of the face, dyspepsia, nausea, faintness, rhinitis.

Non-typical and rare (0,1-1%): hydrops of the face, photosensitization, aches in the lumbus, arterial hypertension, change of functional "liver" tests, increase of the level of GGTP, increase of the level of creatine kinase, myalgia, drowsiness, dyspnoea, vision disturbance, runny eyes, priapism, anaphylactic reactions (including laryngeal edema), cardiac angina, arterial hypotension, myocardial ischemia, postural hypotension, syncopal states, increase of muscle tonus, nose bleeding, glaucoma.


Overdosing:

The cases of an intake of Buy Levitra without prescription in a dose of 80 mg. are known, but serious side effects have not developed. But at the same time with an intake of 40 mg. two times in 24 hours there have been witnessed marked pains in the lumbus without any signs of toxic action on the muscular and nervous systems.


Interaction with other medications :

A dose of Levitra without prescription should not exceed 5 mg. with its combination with erythromycin, ketoconazol, itraconasol. While doses of ketoconazol and itraconasol should not exceed 200 mg. Combinations with indinavir and ritonavir are counter indicated.

Nitrates, donators of oxide of nitrogen: combined administration of Levitra and nitrates is counter indicated because of the hazard of development of arterial hypotension.

Combined therapy of alpha-adrenergic blockers and Buy Levitra without prescription may be accompanied by the development of arterial hypotension. Buy Levitra without prescription can be taken not earlier than after 6 hours after an intake of alpha-adrenergic blockers, and the dose should not exceed 5 mg. But in coupling with alpha-blocker tamsulosine the intake time of the medications may coincide.

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