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Levitra (Vardenafil) is a PDE5 inhibitor used for treating impotence (erectile dysfunction). Levitra (Vardenafil) indications and contra-indications are the same as with other PDE5 inhibitor; it is closely related in function to sildenafil (Viagra) and tadalafil (Cialis). Structurally, the difference between a vardenafil molecule and the others is a methyl group and a nitrogen atom's position. Vardenafil's relatively short effective time is comparable to sildenafil's.

For most patients, the recommended starting dose of Levitra is 10 mg, taken orally approximately 60 minutes before sexual activity. The dose may be increased to a maximum recommended dose of 20 mg or decreased to 5 mg based on efficacy and side effects. The maximum recommended dosing frequency is once per day. Levitra can be taken with or without food. Sexual stimulation is required for a response to treatment.

Penile erection is a hemodynamic process initiated by the relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in the corpus cavernosum. Nitric oxide activates the enzyme guanylate cyclase resulting in increased synthesis of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the corpus cavernosum. The cGMP in turn triggers smooth muscle relaxation, allowing increased blood flow into the penis, resulting in erection. The tissue concentration of cGMP is regulated by both the rates of synthesis and degradation via phosphodiesterases (PDEs). The most abundant PDE in the human corpus cavernosum is the cGMP-specific phosphodiesterase type 5 (PDE5); therefore, the inhibition of PDE5 enhances erectile function by increasing the amount of cGMP. Because sexual stimulation is required to initiate the local release of nitric oxide, the inhibition of PDE5 has no effect in the absence of sexual stimulation.

Levitra Best Competitor for Viagra

Levitra was approved by FDA in the year 2003 after that this drug has created a good reputation in the erectile dysfunction market. This can also contributes to good advertisements rule handles by Bayer.
In 2005, Bayer offered patient a refund if they are not satisfied with their drug levitra. By thing opportunity more and more people try to have Levitra drug and when taken most of people find it successful drug to treat erectile dysfunction.
In disparity, the sales ranking of Viagra fell precipitously from ninth place in 2005 to 19th during the previous year. It also noticeable the first time that Viagra has trailed behind Reductil in Taiwan's top-20 best-selling medications list.
Urologists credited uninspiring of Viagra to domestic financial slowdown .This may be due to its higher cost which discouraged less serious impotence patients from using the drug, and is not qualified for national health insurance coverage.
There can be another reason for fall in viagra sales and that is up coming of other erectile dysfunction drugs, such as Cialis and Levitra.