Levitra differs from other PDE-5 inhibitors.

In constituent to the desired PDE-5 abstinence, the drugs differ in their effects on PDE-6 and PDE-11 isoenzymes.
The PDE-6 isoenzyme has body part commercialism in the retina, whereas PDE-11 is found in skeletal muscles, the inwardness, vascular muscles, and visceral muscles. Of the 3 drugs, cialis has the least result on PDE-6, which explains why it is not associated with the visual disturbances of blurring and blue-green gloss tinges that may occur with sildenafil .
tadalafil has a much greater validity on PDE-11 than Levitra or viagra, which explains its more common adverse effects of back pain and myalgia.
Muscularity ache and back pain with tadalafil usually occur within 12-24 minute after establishment and firmness within 48 hour. All III drugs are vasodilators, since PDE-5 is time in the smooth yobbo of systemic arteries and veins.
All terzetto drugs are contraindicated with concomitant direction of nitrates, since significant hypotension can answer.
In add-on, PDE-5 inhibitors should be used cautiously with ?-blockers, with lower starting doses administered when one drug is added to the other. Levitra differs from other PDE-5 inhibitors in that it can venture an increased QT musical notation similar to that seen with moxifloxicin 400 mg, so its use with family IA and taxonomic group IIIa antiarrhythmic drugs should be avoided.
Recreational use of PDE-5 inhibitors is a recent care, as these agents have become widely used in compounding with recreational club drugs such as methylenedioxymethamphetamine (MDMA, Ecstasy), ?-hydroxybutyrate (GHB, “date rape” drug), ketamine, and amyl nitrite. Such use places patients at heightened risk for cardio-vascular complications.
For patients who take potent inhibitors of cytochrome P450 (CYP) 3A4 (e.g., erythromycin, ketoconazole, itraconazole, citrus fruit juice), reduced initial doses of tadalafil , sildenafil and Levitra is prudent, since they rely on CYP3A4 for their organic process.
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