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levitra is a prescription medicine that is used to treat erectile dysfunction (ED). Men taking nitrate drugs, often used to control chest pain (also known as angina), should not take levitra. Such combinations could cause blood pressure to drop to an unsafe level.

As with all ED drugs, there is a rare risk of an erection lasting longer than four hours. To avoid long-term injury, seek immediate medical attention. levitra does not protect against sexually transmitted diseases.

Discuss your medical conditions, including heart problems, and medications, including alpha blockers prescribed for prostate problems or high blood pressure, with your doctor to ensure levitra is right for you and that you are healthy enough for sexual activity.

The starting dose of levitra is 10 mg taken no more than once per day. Your doctor will decide the dose that is right for you. In patients taking alpha blockers, your doctor may start you on a lower dose of levitra. In patients taking certain medications such as ritonavir, indinavir, ketoconazole, itraconazole, and erythromycin, lower doses of levitra are recommended, and time between doses of levitra may need to be extended.

In clinical trials, the most commonly reported side effects were headache, flushing, and stuffy or runny nose. levitra is available in 2.5-mg, 5-mg, 10-mg, and 20-mg tablets.


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levitra was developed by Bayer and GlaxoSmithKline and is scheduled for U.S. launch in 2003.


Viagra, produced by Pfizer Inc., revolutionized the treatment of male sexual dysfunction, allowing men for the first time to pop a pill to get an erection -- rather than trying various devices, having a drug injected into the penis, or having a pellet inserted into it.


By some estimates, some degree of ED affects more than 50% of men over the age of 40. In the U.S., alone 30 million men are affected.


However, statistics show that only about 10% of men seek help. So 90% of men out there still aren't getting treated for impotence, says Irwin Goldstein, MD, director of the Institute for Sexual Medicine at the Boston University Medical Center and a leader of the Massachusetts Male Aging Study.



 

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"In the early days of Viagra, many men got turned off -- largely because reports of heart attacks that were shown later not to be related to the drug," Goldstein tells WebMD. Today, Viagra carries only an advisory for people with high blood pressure who are taking particular types of blood pressure-lowering medication, and patients with angina or heart disease who take nitrates.


The preliminary data on levitra:


A phase III clinical trial enrolled 440 men with erectile dysfunction between 44 and 77 years old, most of whom had undergone nerve sparing prostatectomies six or more months before entering the study. (About a third of men who have had a prostatectomy -- removal of the prostate gland -- develop ED.) After 12 weeks of levitra, 71% of the men had improved erections. And a subset of men experiencing depression related to their impotence reported fewer symptoms of depression after taking levitra.


In a 26-week phase III trial of 805 men, about 74%-77% of men taking 10-20 mg of levitra reported successful penetration on their first attempt, compared with 46% of men taking placebo. Also, the men who were successful the first time reported successful penetration in about 85%-91% of subsequent attempts, compared with 77% of those taking placebo. Side effects were mild to moderate headache, flushing, and nasal congestion -- "mild stuff," says Goldstein.


Both Viagra and levitra work by inhibiting the PDE5 enzyme. "That means that if you take a pill, then have sexual stimulation, the drug can magnify the natural erectile response. It allows the reaction to be more like sex should be."


The biochemical differences between the two drugs mark the difference, he says. "levitra contains a more efficient enzyme inhibitor, so only a very small amount of the drug is necessary," Goldstein tells WebMD. "That's the thing that's cool about levitra -- it's biochemical potency is distinctly different from Viagra and Cialis [another impotence treatment drug being developed by Lilly]."


All three drugs -- plus several more still in development -- have their place in a physician's armamentarium, says Goldstein. "Several other companies are also working on drugs with PDE5 inhibitors."


When it starts to work and how long it lasts are big issues in impotence medicine: Viagra takes effect in about 30 minutes and the effects last about 4 hours. Cialis reaches maximum concentration in 24 hours, and the effects last for about 3 days, says Goldstein. levitra is faster-acting, reaching maximum concentration in 30 to 40 minutes, with the effects lasting about 16 hours.





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