How does it work?

Carevitra relaxes and smooths out blood vessels because vardenafil selectively inhibits the phosphodiesterase type 5 (PDE5) enzyme that regulates blood flow in penile tissue. By preventing PDE5 from breaking down cyclic guanosine monophosphate (cGMP), Carevitra increases cGMP levels in the corpora cavernosa during sexual stimulation, which leads to smooth-muscle relaxation and vascular dilation — allowing increased blood flow to the penis and enabling erection in response to sexual stimulation.

PDE5 inhibition: Carevitra contains vardenafil, a selective inhibitor of the phosphodiesterase type 5 (PDE5) enzyme.

Increased cGMP levels: Inhibition of PDE5 prevents cGMP breakdown, resulting in elevated cGMP concentrations in the penis.

Smooth muscle relaxation: cGMP mediates smooth muscle relaxation in penile arterioles and trabecular smooth muscle, enabling vasodilation.

Increased blood flow: Vasodilation increases blood inflow to the corpora cavernosa, facilitating erection maintenance during sexual activity.

Dosage

Generally recommended starting dose (typical): 10 mg taken approximately 30–60 minutes before sexual activity. (Some branded vardenafil products list 10 mg as the usual starting dose; dose may be adjusted.)

Dose adjustment: Depending on effectiveness and tolerability, dose may be decreased to 5 mg or increased to 20 mg for some patients, taken no more than once daily. Higher off-label strengths marketed online (e.g., 40 mg, 60 mg) are not standard recommended doses and can increase risk; consult a healthcare provider before using such strengths.

Benefits of using Carevitra

• Carevitra is indicated for the treatment of erectile dysfunction (ED) in men.
• Enhances erectile function, helping men achieve and maintain an erection sufficient for sexual intercourse when sexually stimulated.
• May improve sexual confidence and overall quality of life when used appropriately under medical guidance.

Pharmacokinetics

• Absorption (Tmax): Vardenafil is absorbed with peak plasma concentrations typically reached within 0.5–2 hours after oral dosing; onset may occur sooner if taken on an empty stomach.
• Bioavailability & distribution: Oral bioavailability is limited (approx. low percentage); vardenafil is highly protein-bound (~95%) and widely distributed.
• Metabolism: Metabolized primarily in the liver by CYP3A4 (with minor contribution from CYP3A5 and CYP2C). Active drug levels are increased by strong CYP3A4 inhibitors.
• Elimination half-life: Approximately 4–5 hours.
• Excretion: Eliminated mainly via the biliary route into feces; renal excretion of the unchanged drug is minimal.

Absorption: Tmax ~0.5–2 hours.

Metabolism: Liver (CYP3A4); half-life ~4–5 hours.

Excretion: Primarily biliary (feces), minimal unchanged renal excretion.

Carevitra interactions are classified into several categories:

Drug interactions : 

Nitrates: Contraindicated — concurrent use with nitrates (e.g., nitroglycerin, isosorbide mononitrate/dinitrate) can cause severe, potentially life-threatening hypotension. Do not use Carevitra with any nitrate preparations.

Alpha-blockers: Co-administration may cause symptomatic hypotension; if combined, start with the lowest doses and monitor blood pressure closely. Examples: doxazosin, terazosin, tamsulosin.

Antihypertensives: May potentiate hypotensive effects when used with blood pressure medications (e.g., beta-blockers, calcium channel blockers). Monitor orthostatic effects.

CYP3A4 inhibitors (Protease inhibitors, macrolide antibiotics, azole antifungals): Can substantially increase vardenafil plasma concentrations (e.g., ritonavir, saquinavir, erythromycin, clarithromycin, ketoconazole, itraconazole); dosage adjustments or avoidance may be necessary.

Food interactions

High-fat meals: May delay the onset of action and reduce peak plasma levels — taking Carevitra on an empty stomach can lead to a faster onset.

Grapefruit juice: Can increase vardenafil levels by inhibiting CYP3A4 — avoid or use caution.

Alcohol: Excessive alcohol can increase the likelihood of orthostatic symptoms (dizziness, lightheadedness) and may impair performance.

Disease interactions: 

Cardiovascular disease: Patients with significant cardiac disease, recent myocardial infarction, or unstable angina must consult a physician before use; sexual activity itself can pose cardiac risk in certain patients.

Hepatic impairment: Dose adjustments may be required in patients with moderate hepatic impairment because vardenafil is hepatically metabolized.

Renal impairment: Severe renal impairment can alter pharmacokinetics; use caution and consider dose changes for end-stage renal disease.

Other Interactions

Other ED medications: Do not combine Carevitra with other PDE5 inhibitors or nitrates without a healthcare provider’s clear guidance.

Certain medical conditions: Men with severe cardiovascular disease, hypotension, or retinitis pigmentosa, or who are at increased risk of priapism, should use Carevitra only under specialist advice.

Side effects

• Headache
• Flushing
• Nasal congestion
• Indigestion (dyspepsia).
• Dizziness.

Precautions

• Carevitra should be used cautiously in patients with unstable cardiovascular conditions or those at risk from sexual exertion.
• Never combine with nitrates under any circumstances.
• Use caution in patients at risk of priapism (sickle cell disease, leukemia, multiple myeloma).
• Administer generally 30–60 minutes before expected sexual activity, and no more than once daily unless directed by a physician.
• Use in women, children, and adolescents is not established and is generally not recommended.

Conclusion

Carevitra (vardenafil) is a clinically recognized PDE5 inhibitor for the management of erectile dysfunction when used under medical supervision. When used appropriately — with attention to dosing, interactions, and cardiovascular safety — it can be an effective option to help restore erectile function and improve sexual wellbeing. Always consult a licensed healthcare professional before starting Carevitra to ensure safe and appropriate use.

FAQ’s

1) What is Carevitra used for?

Carevitra is used to treat erectile dysfunction (ED) in adult men by helping increase blood flow to the penis during sexual stimulation.

2) How does Carevitra work?

Carevitra relaxes blood vessels in the penis by inhibiting PDE5, which increases cGMP and causes smooth muscle relaxation and increased blood flow, facilitating erection.

3) What are the common side effects?

Common side effects include headache, flushing, nasal congestion, indigestion, and dizziness. Most are transient; seek medical help for severe or persistent symptoms.

4) Is Carevitra safe for everyone?

Carevitra is not safe for everyone — it is contraindicated with nitrates and should be used cautiously in people with significant heart disease or those taking strong CYP3A4 inhibitors. Always consult a healthcare provider before use.

References

https://pubmed.ncbi.nlm.nih.gov/12027779/

https://www.ncbi.nlm.nih.gov/books/NBK548920/