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About Vardenafil

How does vardenafil work?

During sexual arousal, the penis becomes erect because it fills with blood. To become erect the penile blood vessels need to dilate (expand) and the muscle relax. This process relies on a chemical called nitric oxide.

Vardenafil belongs to a group of drugs called phosphodiesterase inhibitors (PDE5 inhibitors). PDE5 inhibitors exert their effects by increasing levels of nitric oxide within penile tissues.

Why choose vardenafil?

Vardenafil provides an alternative choice for the treatment of erectile dysfunction. Studies have shown vardenafil is safe and effective, and usually works well to improve erections and overall sexual performance.

Side effects are possible with all the PDE5 inhibitors but these are no more common with vardenafil than with any of the others.

Vardenafil needs to be taken around 30-60 minutes before sexual intercourse, and is effective for around 4-5 hours. It will not work without any sexual stimulation.

Other options for treating erectile dysfunction include Viagra/sildenafil, Cialis/tadalafil, and Spedra/avanafil. These all work in a similar way, but there are small differences in how to take them. See tablet differences for further details.

How to take vardenafil

The first time you take vardenafil, start with one 10mg tablet. Depending on the response, this dose can subsequently be increased to 20mg, or reduced to 5mg. Most commonly men find the 10mg dose works well.

It should be taken 30-60 minutes before sexual intercourse with or without food. However a fatty meal delays absorption and should be avoided.

It may be taken with a small amount of alcohol, but alcohol reduces all aspects of sexual performance.

Vardenafil should not be taken more than once in 24 hours.

It is important to understand that vardenafil and the other PDE5 inhibitors may not be effective the first time you use them. Try to stay open minded and be prepared to try several times. As a general rule, stick with the same dose you took last time before increasing the dose, and only go up to the higher strength if vardenafil has not worked as well as you had hoped on several occasions.

Contraindications and interactions

Before buying vardenafil tablets online, all men with erectile dysfunction should consult a doctor for a face to face medical consultation. This is to ensure that any possible medical reasons for erectile dysfunction have been addressed, and that there are no specific concerns about your suitability for vardenafil.

A past history of heart disease and stroke would mean vardenafil is unlikely to be a safe choice. There are some types of medication which interact with vardenafil and the other PDE5 inhibitors, for example drugs used to treat angina and heart disease such as nitrates. Your doctor will perform basic checks, and assess your overall eligibility for vardenafil and the other PDE5 inhibitors, and if you are not suitable, will discuss alternatives.

When purchasing vardenafil from Dr Fox, all men are required to complete an online assessment. This is to be sure vardenafil is a suitable and safe choice.

Men should not take vardenafil without further assessment from their GP when the following apply:

• Low or high blood pressure
• Allergies or reactions to past ED treatments
• Recent heart attack (within 6 weeks) or suffer from angina (heart pain on exertion) or any form of heart disease
• History of strokes or mini-strokes (transient ischaemic attack)
• History of vision problems caused by circulation problems
• History in the family of rare degenerative eye disease
• Serious kidney (renal) or liver disease
• Peyronie's disease – angulation or deformity of the penis
• Leukaemia, multiple myeloma or sickle cell disease
• Bleeding disorders (such as haemophilia)
• Current active stomach ulcers (peptic ulcer or gastric ulcer)

There is a very rare theoretical risk of abnormal heart rhythm if vardenafil is taken at the same time as some other medications - please check this list.

How effective is vardenafil?

Studies show vardenafil is very effective in treating erectile dysfunction. In clinical trials, 76% of men using vardenafil at the 10mg dose achieved erections suitable for penetration, over a 3 month period.

Side effects of vardenafil

The commonest side effect, affecting up to 1 in 10 men is headache. The next most common side effects are dizziness, facial flushing, indigestion, and a stuffy nose.

A complete list of side effects can be found in the manufacturer's patient information leaflet.

If you feel dizzy after taking vardenafil or any of the PDE5 inhibitors, you should not drive or operate heavy machinery.

When might side effects from vardenafil be an emergency?

Severe adverse reactions to vardenafil are rare, affecting between 1 in 1000 to 1 in 10,000 men.

These include allergic reactions, chest pains, and/or fits.

Priapism is the name for painful erections which last for 2 hours or more. This is a rare serious side effect of vardenafil and the other PDE5 inhibitors, and if it occurs you must seek urgent medical help straight away.

Are there any other medicines which might interact with vardenafil?

The most important drugs to avoid when taking vardenafil or any PDE5 inhibitors are nitrates such as isosorbide mononitrate, isosorbide dinitrate, or glyceryl trinitrate (GTN) as these may cause a sudden drop in blood pressure.

Other medicines that can interact with vardenafil include:

• Drugs to treat heart arrhythmias, e.g. quinidine, procainamide, amiodarone, sotalol
• Anti-HIV drugs, e.g. ritonavir, indinivir
• Antifungal agents, e.g ketoconazole, itraconazole
• Antibiotics, e.g. erythromycin, clarithromycin
• Alpha blockers used to treat high blood pressure and benign prostatic hyperplasia, e.g doxazocin, terazocin, tamsulosin
• Riociguat – a treatment for pulmonary hypertension

You should not stop taking medicines without first discussing with your doctor.

What causes erectile dysfunction (ED)?

The vast majority of men with ED have no identifiable medical disease. However ED is very common - affecting 50% of men at some time in their lives.

In general ED is thought to be due to a combination of factors including the natural effects of ageing, psychological stress, anxiety, and lifestyle factors which can all disturb blood circulation.

Some lifestyle factors have a major effect on the blood circulation and can be associated with ED. These include smoking, excess alcohol, lack of exercise, and obesity.

Medical conditions associated with ED include diabetes, heart disease, high blood pressure, and also following prostate surgery or from spinal injuries. Sometimes ED can be a side effect of certain medicines.

Alternative ED treatments

Unfortunately not all men will respond to vardenafil, although it is important to try using it several times, and to try a higher dose before admitting defeat. However if there are significant physiological reasons why erections are not taking place, vardenafil or indeed any of the other PDE5 inhibitors may not be successful.

It is very important to see a doctor for a face to face consultation, to be sure any underlying causes for PDE5 have been identified and managed appropriately. Without doing this, your health and sexual function may continue to suffer.

Alternative treatments may be tried. These include alprostadil – such as Vitaros cream, MUSE (Medical Urethral System for Erections), or the use of vacuum pumps.

Specialist counselling with a sexual therapist may be very beneficial, especially if there is underlying stress and anxiety.

Manufacturers and brands of vardenafil

Different pharmacy companies produce their own vardenafil tablets. Dr Fox supplies only UK licensed tablets supplied from UK registered pharmacies.

Dr Fox will usually supply the same brand of vardenafil each time, although this may not always be possible. From time to time manufacturers may have stock shortages, and brand switching is unavoidable. Most men find no difference between brands. Patients may request specific brands if they have a preference.

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