Levitra is an oral drug therapy for the treatment of erectile dysfunction. I have taken it on several occasions and it does work to enhance erectile function, usually within a few hours, for me. Also known by the chemical name vardenafil, it is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Like impotence drugs Viagra and Cialis, Levitra is a phosphodiesterase-5 inhibitor (PDE-5). All of these drugs function in essentially the same way. In smooth muscle cells, cGMP (cyclic guanosine monophosphate) mediates smooth muscle relaxation. The more cGMP, the more the muscles can relax, the more blood can flow in, and the better the erection. PDE-5 breaks down cGMP, so PDE-5 inhibitors keep this from happening, helping to maintain high levels of cGMP. A possible advantage of Levitra is that it is very selective in attacking PDE-5 without affecting other isoenzymes. This allows a smaller dose to have the same effect as a larger dose of Viagra (an average Levitra dose is 10mg while an average Viagra dose is 50mg), even though the two drugs essentially work the same way.

Aging Male 2014.  The real-life perception of efficacy, attitude, satisfaction and safety of vardenafil therapy (REPEAT): a prospective, non-interventional, observational study. This study assessed the improvement in relationship quality, effectiveness and safety associated with Levitra for the treatment of erectile dysfunction (ED). The study was conducted in 1433 centres across 21 countries and comprised a baseline patient visit and up to four follow-up visits during an observational period of 1 year. Relationship quality, happiness, satisfaction with treatment, and safety and tolerability were assessed by physician interviews and patient and partner questionnaires. Relationship quality, assessed by a relationship questionnaire, was improved at last observation carried forward, compared with baseline, in both patients and partners and satisfaction with the effectiveness of treatment was high. Levitra was well tolerated and adverse events were consistent with the known safety profile of phosphodiesterase type 5 inhibitors.

Viagra Cialis Levitra danger, safety, toxicity
A small number of men have lost eyesight in one eye some time after taking Viagra, Cialis or Levitra. This type of vision loss is called non-arteritic anterior ischemic optic neuropathy (NAION). People who have a higher chance for NAION include those who have pre-existing eye problems, heart disease, are over 50 years old, have diabetes, have high blood pressure, have high cholesterol, or smoke. FDA has approved new labels for Viagra, Cialis and Levitra to include information on possible eyesight loss (NAION). Stop using them if you have reduced vision or loss in your eyesight. Get medical help right away.

Alternative to Levitra, natural aphrodisiacs
There are sexual enhancement alternatives to Viagra Cialis and Levitra. There are herbal supplements that support healthy stamina, libido, sensation, and sexuality in men and women. In recent years science has made breakthroughs in the understanding of sexual dysfunction. But, for hundreds of years, civilizations around the world have known about locally grown herbs that achieve wonderful results with far fewer side effects than prescription drugs. The potent herbal extracts that enhance sexual pleasure include ashwagandha, catuaba, cnidium monnieri, coleus forskohlii, horny goat weed, maca, mucuna pruriens, muira puama, passion flower, pfaffia paniculata, rhodiola, shilajit, tribulus terrestris extract, and tongkat ali.

Viagra Cialis Levitra alternative - herbs in a natural formula called Passion Rx include ashwagandha herb, Catuaba, Cnidium, Muira Puama, Tribulus Terrestris extract with saponins, Tongkat ali, and  Yohimbe.

Levitra side effects, risk, toxicity, is it safe?
The side effects of Levitra are many.  The most common side effects are stuffy nose or runny nose, flushing, muscle aches and a headache. Less frequent side effect include priapism, an erection that won't go away. A serious Levitra side effect is that involving eyesight. Vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green can occur, along with a potentially serious loss of vision, particularly in those who have vascular disease.

Use for spinal cord Injury
The impotence drug Levitra is helpful for men who have erectile dysfunction caused by spinal cord injury. Researchers evaluated the efficacy and tolerability of 12 weeks of treatment with Levitra versus placebo in 418 men with erectile difficulties due to a traumatic spinal injury. Erectile function improved with Levitra, known chemically as vardenafil, whereas there was little improvement in erectile function in the placebo group. Men treated with Levitra had a 76 percent success rate for penetration (versus 41 percent with placebo) and a higher success rate for maintaining the erection.

Levitra Research for ED
Levitra is a synthetic, highly selective, and potent inhibitor of phosphodiesterase-5 which competitively inhibits cyclic guanosine monophosphate (cGMP) hydrolysis and thus increases cGMP levels. It is clinically approved for treatment of erectile dysfunction in men, including diabetic and post prostate surgery patients.

Vardenafil for erectile dysfunction: a systematic review and meta-analysis of clinical trial reports.
Markou S. 1Akrata Medical Center, Greece.
Trials of the efficacy and safety of Levitra in the treatment of male erectile dysfunction (ED) were meta-analysed. Trials were eligible if they included men with ED, compared Levitra with placebo, were randomized, were at least of 12 weeks duration, and assessed clinically relevant outcomes. Two reviewers independently evaluated study quality and extracted data in a standardized fashion. Nine trials (6809 men) met the inclusion criteria. In results pooled from seven fixed-dose trials, Levitra increases the Erectile Function domain of the International Index of Erectile Function questionnaire by 6 units (weighted mean difference (WMD)). Levitra also increases the percentage of erections firm enough to allow vaginal penetration and the percentage of sexual attempts that were successful per participant . The percentage of men agreeing with the statement that 'the treatment they have been taking over the past 4 weeks improved their erections', is also in favor of Levitra. These efficacy variables appeared greater at higher doses, although there are no significant differences between 10 and 20 mg dose. Specific adverse events with Levitra included flushing, dyspepsia, headache, and rhinitis. The drug was not significantly associated with serious cardiovascular events or death. Levitra, in all treatment regimens, shows to possess superior efficacy to placebo in the treatment of patients with erectile dysfunction.

Levitra not only enables men with erectile dysfunction (ED) to engage successfully in sexual intercourse, it also significantly improves partner satisfaction. Dr. Edwards of White House Surgery, Chipping Norton, UK, and his colleagues randomly assigned 260 men with erectile dysfunction to Levitra or an inactive "placebo" pill. Every 4 weeks over the 12-week study. When the effects of treatment for men and their partners were considered, Levitra significantly improved satisfaction scores compared with placebo orgasm satisfaction (60 percent vs 32 percent for men, 56 percent vs 32 percent for partners), pleasure (67 percent vs 44 percent for men; 64 percent vs 38 percent for partners), ease of erection (64 percent vs 41 percent for men and 60 vs 37 percent for partners), satisfaction with erection (60 percent vs 28 percent for men; 58 percent vs 27 percent for partners), satisfaction with the medication (62 percent vs 31 percent for men; 58 percent vs 30 percent for partners).

J Sex Medicine. 2011. Efficacy and safety of vardenafil for the treatment of erectile dysfunction in men with metabolic syndrome: results of a randomized, placebo-controlled trial. This is the first study to assess the efficacy and safety of vardenafil, taken alone, for ED therapy in a population of men who all had metabolic syndrome. Although baseline erectile function in these patients was low, vardenafil treatment was associated with significant improvements in erectile function and rates of successful intercourse, and was well tolerated.

Raynaud's phenomenon
Arch Intern Med. 2012. Vardenafil for the treatment of raynaud phenomenon: a randomized, double-blind, placebo-controlled crossover study.

Testimonial sent by email
I just wanted you (and maybe your subscribers) to know that I've tried Viagra & Cialis & Levitra. For me, and though they all work similarly, I prefer Levitra far more than the others, mainly because it is the only one that does not cause me a headache. I also don't seem to get that red-skin-flush appearance (or feeling) with it.

Questions, reports
I read in a Levitra forum online that results come in a few hours. Can it be mixed with alcohol?
   The results occur within several hours. I would not recommend mixing alcohol and Levitra unless the alcohol is kept to one drink only.

Q. I heard Levitra can cause blindness. Is that true?
   A. There have been several cases reported of an association between Cialis, Levitra and blindness. If you have a 20 mg pill, only use a portion to avoid the adverse reactions. Dosing with a smaller amount reduces side effects. High doses pose a danger if a person takes it who has heart disease or is on heart medicines.

Q. I read in a Levtria brochure that Levitra is better than Viagra. Is that true?
   A. Some people prefer Levitra, others Cialis, and still others Viagra. It's a personal preference.

Q. Is Levitra sold online pill ? I want to order Levitra but don't know who to trust.
   A. Yes, you can order or buy Levitra online but a prescription is needed. You can buy Levitra at an online pharmacy but make sure they are legitimate and require a prescription.

Q. What's your opinion on cheapest generic Levitra?
   A. I would be surprised if a generic Levitra sold on an online pharmacy site would be effective. If you buy generic Levitra, you may be wasting your money. You are better off to purchase it from a reliable pharmacy even if the cost is higher, Get a Levitra prescription from your doctor.

Q. Do you have a Levitra testimonial on your site?
   A. We focus mostly on natural Levitra alternatives, but we have heard that it works in 60 to 80 percent of users.

Q. I tried a Levitra sample my doctor gave me, and it did not work but gave me a headache.
   A. Not all drugs, medicines, or supplements work in everyone. The dosage can make a difference, too.

Q. Does a Levitra pill work in a woman?
   A. I doubt if women find it to be of benefit.

History and background Information
2004 - German drug maker Bayer won approval to sell a new impotence drug across the European Union that it hopes will win business from Pfizer's breakthrough blockbuster Viagra. Bayer expects Levitra, which it is marketing with Britain's GlaxoSmithKline, to bring in up to 1 billion euros ($1.1 billion) a year, once it secures approval in the United States. Bayer said the round, orange pills would go on sale in Germany later this month. U.S. approval is expected later this year. ``This is an extremely important step for our pharmaceuticals business,'' chief executive Werner Wenning said. ``We believe that Levitra has the potential to become a new blockbuster,'' The battle for dominance in a condition that affects about one in five men is expected to be fierce. Cialis, a drug from Eli Lilly & Co. and Icos Corp. won European approval last year and is also expected to hit pharmacies in the United States later this year. All the drugs work in the same manner so some doctors believe it may be difficult for Levitra and Cialis to establish themselves when Viagra has been around for five years. Other say the drugs are an option for those whose conditions aren't helped by Viagra. Sales of Pfizer's blue, diamond-shaped Viagra pills totaled $1.7 billion last year. It is the only significant prescription product for erectile dysfunction. ``We think the competition will expand the overall market. Erectile dysfunction is still underdiagnosed,'' said a Pfizer spokeswoman. ``But in the end, we think patients will choose Viagra because it has a track record.'' Leverkusen-based Bayer has a lot riding on Levitra. It is still suffering from the 2001 withdrawal of the cholesterol lowering drug Lipobay, marketed in the United States as Baycol, after it was linked to dozens of deaths. Bayer Gets OK for New Impotence Drug.

Marketing
Bayer initially developed Levitra and manufactures the drug. The orange/yellow Levitra pill has the "Bayer cross" trademark on it, Bayer registered the "Levitra" trademark, owns the Levitra.com domain, etc. Since GlaxoSmithKline has a better marketing infrastructure for prescription drugs, Bayer joined with GlaxoSmithKline to market the drug jointly. The two companies describe the relationship this way: Levitra is "co-developed and co-promoted by Bayer and GlaxoSmithKline".

More questions
Q. Can Levitra be taken with horny goat weed, lipoic acid, vinpocetine, or the mind booster acetylcarnitine?
   A. We prefer impotence drugs to be taken on days when herbs are not being used.

Q. I purchased Passion Rx recently and have a question about its use if a patient also uses ED medications. I saw some disclaimer info for this Viagra-alternative and among the usual drugs it warned against using with Levitra was yohimbe. Do you know why Yohimbe might have a negative interaction with this class of ED drugs and is there enough Yohimbe in the Passion Rx formula developed by developed Dr. Sahelian to be of any concern. You advise to take the supplement first thing in morning and if I was to use Levitra the same day it would be 12 hours or more after.
   A. Yohimbe is a potent herb and Passion Rx is a potent combination. Usually the positive effects of many sex herbs is delayed for a day or two, One option is to take Passion Rx the day before the use of Levitra, but not the same day. This way you can have some of the benefit of the Passion Rx but it won't be too hard on your body taking the herbal combination and Levitra the same day. Another option is to take the Passion Rx 2 days in a row and then the third day take Levitra. Be very careful and use much lower amounts if you have heart problems or blood pressure problems and have approval by your doctor. In some people herbal Viagra alternatives work so well that they may not need Levitra or Viagra, or may use them in lower dosages and less frequently.

Q.  Sir, is it safe to take arginine with Levitra for erectile dysfunction? I am 30 years old and I am healthy. The only medical condition I am currently being treated for is GERD (acid reflux disease). My doctor prescribed me Nexium and Famotidine. If it is safe to combine the two, how much arginine would be safe with a 10 mg dose of Levitra. I would ask my own doctor but not two many doctors are familiar with herbs and dietary supplements.
   A. We can only provide general information on Levitra and arginine. It is up to the consumer and their doctor to determine whether to mix drugs and supplements. We are not very impressed with the ability of arginine to be effective for impotence.

Q. Can I take passion Rx and use Viagra or Levitra the same day?
   A. Not the same day. Passion Rx can be taken the day before and perhaps a little lower dosage of the pharmaceutical drug the day of intimacy. And, we suggest medical approval.

Q. I have an erectile dysfunction prescription for Levitra. I have had this prescription for a more than 2 years at the 20 mg. dose. My empty prescription bottles would likely fill a brown grocery bag more than halfway. On some occasions, I have doubled my dose, which I now realize to be a grand mistake. I am 43 years old, and in otherwise excellent physical condition, however, Lately, I have had increased chest pressure surrounding my heart. I have not done enough cardio-vascular exercise, I eat badly, and heart disease runs in my family tree. How much of factor is Levitra on my heart? And What is the factor of a double dose on my heart? And lastly, What is the long term effect of this drug? I need to schedule a full physical and make changes to my diet and exercise, Is it still safe to take this drug?
   A. Heart disease is something that is important to rule out before using Levitra on a regular basis. It is impossible for us to know whether Levitra had an influence on your chest pains. Those with erectile dysfunction are more likely to have heart disease than those that do not have ED. Your decision to seek a full physical evaluation is wise.

Q. If my husband's doctor prescribed Cialis and Levitra after my husband's prostate removal --is it correct to assume that Passion Rx might be able to help in the same way, without the negative side effects of those drugs? My husband gets a mild, all day headache and dry mouth from those drugs. not very conducive to motivation to have sex. His robotic prostate operation was supposed to be nerve sparing. But it has been 7 months and he is still not able to have anything close to an erection, even with the use of those drugs. (He didn't start them till 6 months out, due to problems with urinary incontinence. ) His doc says have sex every other day! But the desire is not really there, even with the drug, and so far they have no impact.
   A. It is difficult to predict in any one person how they will respond to Passion Rx or any herbal or pharmaceutical sexual enhancer. Passion Rx does help improve desire and performance in the majority of users and most people who take this natural herbal formula like the effects.