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Levitra

Levitra is a powerful medication used for the treatment of all kinds of erectile dysfunction (impotence). Levitra helps men achieve and keep a strong erection in response to a sexual stimulation. Levitra can be taken by men who suffer from type 1 or type 2 diabetes, high blood pressure or high cholesterol.

Other names for this medication:

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Also known as:  Vardenafil.

Description

Levitra is an ideal preparation in the treatment of different forms of erectile dysfunction (ED). Levitra allows the user to achieve and maintain a hard erection. Levitra can be taken by men who suffer from type 1 or type 2 diabetes, high blood pressure or high cholesterol.

The active ingredient Vardenafil, a phosphodiesterase type 5 inhibitor (PDE-5 inhibitor), stimulates the release of nitric oxide (NO) in the corpus cavernosum in response to sexual stimulation. Nitric oxide activates the lyase enzyme which results in increased levels of cyclic guanosine monophosphate (cGMP). This relaxes smooth muscles in blood vessels of the corpus cavernosum, increasing blood flow and thus inducing an erection. The action of Levitra may last up to 6 hours.

Levitra effectively prolongs sexual performance but can be indicated as a remedy to prevent premature ejaculation only along with the treatment of ED.

Levitra is also known as Vardenafilum, Vivanza, Vardif®, Vilitra.

Levitra doesn't protect you or your partner from sexually transmitted diseases (including HIV) or from pregnancy.

Dosage

Take Levitra orally with a full glass of water 30-60 minutes before sexual intercourse.

Avoid fatty foods as this may affect the effectiveness of the medication.

The effect lasts for 4-6 hours.

The dosage depends on the overall health.

You should take Levitra when it is suitable for you and your partner.

Levitra must not be taken more than once a day.

Overdose

If you take an overdose of Levitra, you should seek emergency medical attention or contact your healthcare provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) and away from excess moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Levitra are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Levitra if you are allergic to any of Levitra’s components.

Do not take Levitra if you are also using organic nitrates, nitrate drugs for chest pain or heart condition (e.g., nitroglycerin, isosorbide dinitrate and isosorbide mononitrate), nitrates as amyl nitrate or nitrite ("poppers").

Do not take Levitra if you take other medications to treat erectile dysfunction or pulmonary arterial hypertension, such as riociguat (Adempas).

Do not take Levitra if you are taking erythromycin, alpha-blockers, ketoconazole, itraconazole (Sporanox or Nizoral), ritonavir (Norvir) or indinavir (Crixivan).

Do not consume alcohol while using Levitra, as it can lower your blood pressure, causing dizziness and rapid heart rate (tachycardia).

Do not drive or operate machinery while taking the medication.

Contact you doctor or health care professional right away if your erection lasts longer than 4 hours or if it becomes painful.

Levitra does not protect you or your partner from sexually transmitted diseases or pregnancy.

Levitra can be dangerous for children and women.

Levitra can be taken by men who suffer from type 1 or type 2 diabetes, high blood pressure or high cholesterol.

levitra generic reviews

To assess the pharmacodynamic effects of coadministered vardenafil and tamsulosin in patients with benign prostatic hyperplasia (BPH) undergoing stable tamsulosin therapy.

levitra name brand

This study assessed the improvement in relationship quality, effectiveness and safety associated with vardenafil 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 vardenafil treatment, and safety and tolerability were assessed by physician interviews and patient and partner questionnaires. Overall, 7496 patients were enrolled in the study, of which 7430 were included in the safety analyses and 6470 in the effectiveness analyses. Relationship quality, assessed by a relationship questionnaire (partnerschaftsfragebogen [PFB]), was improved at last observation carried forward, compared with baseline, in both patients and partners and satisfaction with the effectiveness of vardenafil treatment was high. Vardenafil was well tolerated and adverse events were consistent with the known safety profile of phosphodiesterase type 5 inhibitors. These results confirm the well-established effectiveness and safety profiles of vardenafil. This study is the first to demonstrate improvements in relationship quality following vardenafil therapy, in both patients and partners, using the PFB questionnaire.

levitra 2 tablet

Vardenafil treatment significantly improved LUTS, EF, and QoL in men with BPH/LUTS. Vardenafil may be considered a promising treatment option for men with symptoms secondary to BPH.

levitra generic

Erectile dysfunction (ED) is a sexual disorder mainly caused by decrease in cellular concentration of cyclic guanosine monophosphate (cGMP), which is degraded by phosphodiesterase type-5 (PDE-5). As a potent therapeutic target, inhibitors such as Viagra , Cialis, and Levitra have already been developed to target PDE-5 for treating ED; traditional Chinese medicine, Epimedium sagittatum, also has shown prominent results as well. To developed new PDE-5 inhibitors, we performed a virtual screening of traditional Chinese medicine (TCM) database and docking analyses to identify candidates. Known PDE-5 inhibitors were used to construct a three dimensional quantitative structure-activity relationship (3D QSAR) model by HypoGen program. From docking analyses, isochlorogenic acid b was identified as the most potential inhibitory compound. De novo evolution designed 47 derivatives. Of the 47 derivatives, seven were able to map into the pharmacophore model, and these seven compounds were suggested to be the most promising leads for inhibiting PDE-5. An analysis of the hydrogen bond interactions formed between the docked ligands and PDE-5 identified ASN662, SER663 and GLN817 as the most frequently interacting residues. A total of eight novel leading compounds were identified to have favorable interaction with PDE-5. These compounds all had hydrogen bond interactions with three key residues that could be further investigated for understanding of PDE-5 and ligands interaction.

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NCT01130532.

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Primary outcome measure was the percentage of subjects with an IIEF-EF score of > or =22 after the 2-mo washout period. Secondary variables included mean per-patient success rates for Sexual Encounter Profile (SEP) questions 2 and 3.

levitra ratings reviews

We studied a therapeutic effect of long-term and regular use of vardenafil which is an inhibitor of phosphodiesterase-5 (PDE-5) in patients with erectile dysfunction (n=32, mean age 35.7 +/- 6.8 years). They received the drug daily for 1 month in a dose 10 mg in the evening without direct sexual realization of the drug action. Before the treatment, upon 1 and 2 months of therapy the patients filled in questionnaire International Index of Erectile Function Scale (IIEFS) and underwent pharmacoechodopplerography of the penis. The erection scores by IIEFS after 1 month of vardenafil therapy increased from 17.8 +/- 4.5 to 23.7 +/- 5.3 (p < 0.01). On posttreatment day 30 this parameter went down to 21.9 +/- 5.6 scores (p < 0.01). However, this value was significantly better than the baseline (p < 0.01). The same dynamics was observed in objective indices of penile hemodynamics. Thus, routine daily intake of vardenafil produces a significant and persistent improvement of erectile function.

daily levitra dose

The number of circulating EPCs and progenitor cells (PCs) in HH patients was evaluated after acute vardenafil administration at baseline and after 6 months of T supplementation.

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Significant gating was only found for the N1 component in rats while all three peaks P1, N1 and P2 showed gating in humans, i.e. the response to the second sound click was decreased as compared with the first for these deflections. Administration of vardenafil did neither have an effect on sensory gating in rats nor in humans.

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Inflammatory markers in lungs of F508del-CF and wild-type mice were monitored in response to lipopolysaccharide from Pseudomonas aeruginosa (LPS). The effect of pretreatment with vardenafil (0.14 mg/kg) was evaluated.

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The therapeutic approach in patients with sphincter of Oddi (SO) dysfunction (SOD) aims to reduce the resistance to the flow of bile or pancreatic juice. Vardenafil inhibits the activity of phosphodiesterase type 5 (PDE-5), which degrades cyclic guanossine monophosphate (cGMP) and results in relaxation of smooth muscle.

levitra normal dosage

This study is registered as PROSPERO CRD42013005289.

levitra 5mg reviews

Patients who were initially prescribed sildenafil were significantly more likely to refill their medication and significantly less likely to switch medications during the study period compared with patients who were initially prescribed vardenafil or tadalafil. These findings may indicate greater treatment satisfaction in patients receiving sildenafil, although future prospective evaluation is required.

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One of the most often reported cognitive deficits of acute cannabis administration is an impaired recall of previously learned information.

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The aim of this paper was to investigate whether vardenafil-induced cGMP accumulation reduces RhoA/ROCK signaling in bladder.

levitra 5mg online

Cardiovascular and metabolic conditions are risk factors for ED and are common among men with ED. The purpose of this study was to assess the safety and effectiveness of, and notably patient satisfaction with, vardenafil treatment in a general population of men with ED, including those with underlying conditions, over a period of 3-12 months. A prospective, multicenter, noninterventional study was carried out in Germany between July 2005 and January 2007. Men aged > or =18 years (n=7088) who were prescribed vardenafil for ED, irrespective of previous ED treatment or underlying conditions, were eligible for inclusion. Safety, effectiveness and patient satisfaction data were collected by physician case report forms (CRFs) after 3 months, with optional self-completed patient questionnaires at baseline, 3, 6, 9 and 12 months. The intent-to-treat population included 6474 patients, and 1331 patients returned at least one questionnaire. No serious adverse events were related to vardenafil use. CRF data showed that 93.0% of patients reported improved erections after 3 months, with similar rates of improvement among men with underlying conditions. High levels of patient satisfaction with vardenafil regarding effectiveness of treatment, time to onset and duration of action were sustained throughout the study.

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The role of testosterone in erectile dysfunction (ED) is increasingly recognized. It is suggested that assessment of testosterone deficiency in men with ED and symptoms of hypogonadism, prior to first-line treatment, may be a useful tool for improving therapy.

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International Index of Erectile Function (IIEF) domain scores; Sexual Encounter Profile (SEP) questions 2-5.

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Erectile dysfunction (ED) usually exists in combination with depression in men. The comorbidity of the two diseases may bring more troubles to patients, so it is important to find an effective treatment. Recently, DRIVER (Depression Related Improvement with Vardenafil for Erectile Response) trials showed that, phosphodiesterase 5 (PDE 5) inhibitor vardenafil could improve not only erectile function but also depressive symptoms and quality of life in men with ED and depression. Vardenafil was generally safe and well tolerated.

levitra soft tabs

Trials of the efficacy and safety of vardenafil in the treatment of male erectile dysfunction (ED) were meta-analysed. All available databases were searched (January 1, 2001-November 30, 2003). Trials were eligible if they included men with ED, compared vardenafil 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, vardenafil increases the Erectile Function domain of the International Index of Erectile Function questionnaire by 6.18 units (weighted mean difference (WMD)). Vardenafil also increases the percentage of erections firm enough to allow vaginal penetration (WMD: 26) and the percentage of sexual attempts that were successful per participant (WMD: 29.8). 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 favour of vardenafil (relative risk (RR): 3). These efficacy variables appeared greater at higher doses, although there are no significant differences between 10 and 20 mg dose. The same results were extracted for the two flexible 'as needed' dosing trials. Discontinuations are greater at the vardenafil groups compared to placebo (RR: 2.25). Specific adverse events with vardenafil included flushing, dyspepsia, headache, and rhinitis. Vardenafil was not significantly associated with serious cardiovascular events or death. Vardenafil, in all treatment regimens, shows to possess superior efficacy to placebo in the treatment of patients with erectile dysfunction. More data is needed on patients' subgroups.

levitra reviews

To investigate whether the results of the ultrasonographic (US) measurement of post-occlusive changes in the diameters of cavernosal arteries after administering phosphodiesterase type 5 (PDE-5) inhibitor vardenafil could be associated with the response to vardenafil in patients with erectile dysfunction (ED), as currently there are no reliable methods for predicting the success rate of oral PDE-5 inhibitors.

levitra low dose

Sildenafil was administered to 28 of the patients, tadanafil to 25, and vardenafil to 22. Of the total number of patients, 61 (81.3%) achieved effective erection, but no significant differences were observed in the rate of effectiveness among the sildenafil (24 cases, 85.7%), tadanafil (20 cases, 80.0%) and vardenafil (17 cases, 77.3%) groups (P > 0.05). After medication, 53 (70.7%) of the patients successfully ejaculated, but there were no remarkable differences in the success rate among the sildenafil (21 cases, 75.0%), tadanafil (17 cases, 68.0%) and vardenafil (15 cases, 68.2%) groups (P > 0.05). Of the 75 patients, 37 received the recommended initial dose and 38 the maximum recommended dose of PDE5 inhibitors, but no significant differences were found in the rate of successful sperm retrieval between the former (28 cases, 75.7%) and the latter group (25 cases, 65.8%) (P > 0.05). Mild adverse events, including transient flush and dizziness, occurred in 5 cases (6.7%).

levitra 80 mg

Organ bath studies were used.

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levitra generic cost 2015-12-25

In normal rats, vardenafil relaxed carbachol- and inhibited buy levitra EFS-induced contractions of detrusor preparations with and without urothelium, and in PUO rats with urothelium. Relaxations were accompanied by increases in both cAMP and cGMP content. It is proposed that vardenafil-induced relaxation of rat detrusor, also in obstructed and mucosa-denuded preparations, is mediated via cAMP.

levitra generic online 2015-05-20

The pattern and extent of adulteration buy levitra of male erectile dysfunction health products with sildenafil, tadalafil, and vardenafil as well as their structurally modified analogues.

buy cheap levitra 2015-03-29

Least-squares mean baseline IIEF-EF domain scores (vardenafil 14.6, placebo 13.4) were consistent with moderate ED. After 12 weeks, vardenafil treatment was associated with significant increases from the baseline in IIEF-EF domain scores compared with the placebo (22.4 vs. 14.3; P<0.001). Vardenafil was associated with significant improvements from baseline in least squares (LS) mean success rates buy levitra for SEP-2 (vardenafil 82.2 vs. placebo 43.6; P<0.001) and SEP-3 (vardenafil 66.1 vs. placebo 24.0; P<0.001). Positive GAQ responses were reported by 81.8% of vardenafil recipients vs. 24.3% of placebo recipients. Adverse events were reported by 25.4% of the vardenafil group, the majority mild and transient.

vardenafil levitra online 2016-03-06

These findings highlight a buy levitra potential role for vardenafil in the treatment of diabetic nephropathy.

levitra generic canada 2016-04-18

Wistar rats were orally administered saline or a protein-carbohydrate mixture with or without tryptophan (TRP). TRP-depleted animals additionally received an oral vehicle injection or the PDE inhibitors BAY 60-7550 or vardenafil at a dose known to improve object buy levitra memory performance.

levitra 1 mg 2017-02-18

Ureteral rings from human, porcine and ovine ureters underwent the same organ bath protocol. After stimulation with KCl, ureters were subjected to different doses of vardenafil buy levitra . Basic contractility and ureteral response to vardenafil were analyzed.

levitra generic 2017-12-22

The results suggest that PDE5i may increase sexual arousal by acting in the central nervous system. This effect may be buy levitra mediated (at least in part) by the activation of mesolimbic dopaminergic neurons.

levitra drug 2015-04-22

This open-label, prospective study, conducted in 6,740 U.S. centers, included an initial visit and one or two buy levitra follow-up visits within a 2-month period of the first vardenafil dose. Vardenafil was administered in 5-20 mg doses.

levitra pill 2015-02-03

Action buy levitra of Ang II and AT1 receptor antagonist, as well as SOD and DPI on CCSM function.

levitra k7 pill 2015-11-19

Many men with erectile dysfunction (ED) also have associated underlying buy levitra cardiovascular and metabolic conditions, for which they are likely to be taking medication. Therefore, cardiovascular safety and potential drug interactions are two of the major concerns when using PDE-5 inhibitors in these patients. The PDE-5 inhibitor, vardenafil, is characterized by a rapid onset of action, increased duration of erection, high rates of first-dose success and reliable efficacy that can be maintained with continued use. In both clinical trials and real-life observational studies, vardenafil has demonstrated a favorable efficacy and safety profile in men with ED, including those with associated underlying conditions such as diabetes, hypertension and dyslipidemia. Importantly, the concomitant use of medication for these conditions is not associated with any noteworthy changes in the efficacy and safety of vardenafil. The evidence presented in this review supports the use of vardenafil as a first-line treatment for men with ED, including those with underlying conditions.

levitra 5mg reviews 2015-07-20

Based on the syndromes of Traditional Chinese Medicine, 124 ED patients were divided into Groups A (kidney-yang deficiency, n=44), B (kidney-yin deficiency, buy levitra n=41) and C (liver-qi stasis, n = 39). All the patients were treated with vardenafil at 5 mg daily for 8 weeks, and the therapeutic effects were evaluated by comparing the scores on IIEF-5 and Erection Quality Scale (EQS) before and after the treatment.

levitra buy canada 2016-12-24

A prospective, randomized, double-blind, parallel-group, at-home study of 732 men with ED (mean age 55.5 years) was conducted at 64 sites in North America and Europe. Following a 4-week run-in period, patients were randomized to either vardenafil 10 (N = 237) or 20 mg (N = 248) or placebo (N = 247) to buy levitra be taken on demand over 4 weeks. Using a stopwatch, patients recorded the elapsed time from dosing to attainment of an erection perceived to be adequate for penetration that led to intercourse completion. Earliest time of onset was defined as the fastest time among the first four doses for each patient. Time points from 25 to 5 minutes were tested for significance (alpha = 0.025) using a backward stepping procedure.

levitra headache remedy 2017-04-15

Approximately two-thirds of PDE5I-naïve, Latin American men with ED were persistent and adherent after 6 months of therapy. Factors like education level, ED severity, and ED duration were associated with persistence and buy levitra adherence; additional study is warranted to investigate the predictive value of these factors.

levitra 10mg dosage 2015-12-05

To evaluate if platelet cyclic guanosine monophosphate (cGMP) buy levitra could represent a valuable marker for PDE5-I activity in ED.

levitra dosage reviews 2015-11-01

In the vardenafil group, 24 patients had their ED improved and the efficacy rate was 80%, as compared with Seroquel 20 Mg 27% in the sertraline group. There was significant difference between the two groups (P < 0.05). Twenty patients had their PE improved in vardenafil group, with an efficacy rate of 67% as compared with 40% in the sertraline group. The difference was significant between the two groups (P < 0.05). In both of the two groups, a significantly higher rate of PE improvement was found in patients with improved ED than in those without. Only mild side effects were recorded, and none withdrew from the treatment.

levitra 100mg pills 2015-07-16

This was a double-blinded, randomized, placebo controlled crossover trial. Patients with benign prostatic hyperplasia and erectile dysfunction treated with the doxazosin gastrointestinal therapeutic system on a regular basis, with no other antihypertensive events, were recruited. Subjects took 10 mg vardenafil or placebo in a randomized crossover fashion with a washout period of at least 7 days between each treatment. The supine and standing blood pressure of Viagra Gold Reviews the subjects was recorded from 1 hour before to 6 hours after the administration of vardenafil or placebo. The primary outcome of the study was the maximal change in standing systolic blood pressure of the subjects from 1 half hour before to 6 hours after the administration of drugs.

generic levitra 2015-03-05

Endothelium-intact and denuded artery rings were suspended in order to record isometric Zyloprim Drug Card tension. In the rings with or without endothelium, the concentration-response curves for vardenafil were generated. In the rings without endothelium the contractile response induced by phenylephrine (Phe) or KCl was assessed in the presence or absence of vardenafil. In the last set of experiments, pulmonary artery rings were exposed to calcium-free isotonic depolarizing solution and the contractile response induced by the addition of calcium was evaluated in the presence or absence of vardenafil, nifedipine, verapamil or 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ).

levitra mg information 2015-08-19

Our results have demonstrated that PDE inhibitors can reverse the adrenergic tension of human SV tissue and increase levels of cyclic nucleotides. This outlines the potential significance of cAMP and cGMP in the control of Prednisone Drug Interactions SV smooth muscle function. These findings might be of importance with regard to the pharmacologic treatment of premature ejaculation.

levitra recommended dosage 2015-09-28

In this 12-week, multicenter, randomized, flexible-dose, parallel-group, double-blind study, 280 men with erectile dysfunction for at least 6 months and untreated mild major depression received Indocin 50mg Capsules placebo or vardenafil, 10 mg/day, for 4 weeks, with the option to titrate to 5 mg/day or 20 mg/day after each of two consecutive 4-week intervals. Endpoints included International Index of Erectile Function erectile function domain and 17-item Hamilton Depression Rating Scale (HAM-D) scores.

levitra soft tabs 2016-08-25

Several small studies and a number of case reports have described the use of PDE5 inhibitors in patients with either primary or secondary Raynaud's phenomenon. The data Generic Coreg Cr from the best designed study show a reduced attack frequency and duration, reduced Raynaud Condition Score, and increased capillary blood flow in patients with secondary Raynaud's phenomenon.

levitra dosage maximum 2017-09-19

To Clomid Medication Fertility investigate the gastroprotective effect of vardenafil against indomethacin-induced gastric damage.

levitra 40mg dose 2017-08-25

A masked version of the emotional Amaryl Pill Stroop task, vaginal pulse amplitude. For subjective measurement, responses were collected continuously with a lever and two self-report measures were used.

levitra tablet 2015-02-21

More TGF-beta1 and less nNOS are expressed when the junction is obstructed. PDE5 inhibitors may be able to regulate these Buy Deltasone Online 2 factors, or other factors that have not been discussed in this experiment, in order to halt the progression of UPJO.

levitra online cheap 2017-05-20

At baseline, Plavix 40 Mg the intention-to-treat population had moderate ED (International Index of Erectile Function-Erectile Function domain score of 13). For SEP-2 (penetration), the first-attempt and subsequent success rate was 44% and 74% for placebo, 71% and 81% for vardenafil 5 mg, 76% and 86% for vardenafil 10 mg, and 76% and 91% for vardenafil 20 mg, respectively. For SEP-3 (maintenance), first-attempt and subsequent success rate was 25% and 56% for placebo, 51% and 76% for vardenafil 5 mg, 65% and 76% for vardenafil 10 mg, and 59% and 84% for vardenafil 20 mg, respectively. For overall satisfaction with the sexual experience, the first-attempt and subsequent success rate was 19% and 48% for placebo, 48% and 68% for vardenafil 5 mg, 57% and 72% for vardenafil 10 mg, and 56% and 79% for vardenafil 20 mg, respectively. The reliability of vardenafil was similar or slightly greater in sildenafil-naive subjects compared with prior sildenafil responders. The most common adverse events were mild-to-moderate headache, flushing, and rhinitis.

levitra mg 2015-10-17

To review the role of PDEs, which Seroquel Generic exist as a superfamily of enzymes comprising 11 distinct families, in the urogenital system, focusing on anatomical locations, functions and dysfunctions, potential disorders that could be treated, and any promising new selective PDE inhibitors under development.

vardenafil levitra reviews 2016-05-18

The study is conducted to show and compare efficacy and safety of the three PDE-5 inhibitors and to assess patient's preference in the treatment of erectile dysfunction. It's still unknown which of the three PDE-5 inhibitors is used the most.

levitra effectiveness reviews 2016-08-26

Available evidence suggests that sildenafil may be associated with improved microcirculation, symptomatic relief, and ulcer healing in patients with secondary Raynaud's phenomenon. Limited information suggests similar effects with tadalafil and vardenafil. Improved blood flow and clinical improvements have also been observed in some patients with primary Raynaud's phenomenon treated with PDE5 inhibitors; however, studies have yielded conflicting results.

levitra 5mg tablets 2017-09-04

To determine whether a causative relationship exists between non-arteritic anterior ischemic optic neuropathy (NAION) and the use of phosphodiesterase-5 (PDE-5) inhibitors for the treatment of erectile dysfunction.

levitra medication 2015-02-23

The aim of this paper was to investigate whether vardenafil-induced cGMP accumulation reduces RhoA/ROCK signaling in bladder.

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Phosphodiesterases (PDEs) play a decisive role in cyclic nucleotide-mediated intracellular signaling. As PDEs are expressed in a variety of tissues, selectivity is a prerequisite for a therapeutically applicable PDE inhibitor. Sildenafil, vardenafil, and tadalafil are selective for PDE5, with vardenafil exhibiting the highest potency and minimal inhibition of other PDEs, with the exception of PDE6. Tadalafil is extremely selective for PDE5, but also potently inhibits PDE11, an enzyme with unknown physiological function. As PDE1 is expressed in the brain, myocardium, and vascular smooth muscle cells, nonselectivity with respect to this enzyme (selectivity: tadalafil>vardenafil>sildenafil) may result in vasodilation and tachycardia. Inhibition of PDE6 (selectivity: tadalafil>vardenafil congruent with sildenafil), which is expressed only in retina and functions in visual transduction, can transiently disturb vision. PDE5 inhibitors may also indirectly inhibit PDE3 by increasing cyclic guanosine monophospate levels, thereby elevating heart rate and vasodilation while inhibiting platelet aggregation.