ZHEWITRA 40

In the treatment of complex forms of erectile dysfunction (ED), where the standard maximum dose of Vardenafil (20 mg) is insufficient, medications with increased concentration may be used. ZHEWITRA 40 is a generic containing 40 mg of Vardenafil. It is intended exclusively for men with pronounced, resistant ED who require a more potent effect.

What is ZHEWITRA 40?

ZHEWITRA 40 is an oral tablet medication containing 40 mg of Vardenafil. Vardenafil is a highly selective PDE5 inhibitor.

1. Indication and dosage warning

It must be strictly understood: the standard maximum daily dose of Vardenafil approved by regulatory bodies is 20 mg. The 40 mg dosage offered by ZHEWITRA 40 doubles this standard.

This medication should never be used as a first or standard dose. It is intended for:

• Patients in whom 20 mg of Vardenafil did not yield the expected therapeutic response (resistance).

• Men with severe coexisting conditions (e.g., severe diabetes) requiring an increased concentration to compensate for vascular impairments.

• Sensible splitting, where the full 40 mg tablet is used as a source for two standard maximum doses of 20 mg.

Detailed mechanism of action of ZHEWITRA 40

The mechanism of action of ZHEWITRA 40 is based on Vardenafil 40 mg providing potent and highly selective inhibition of the PDE5 enzyme.

1. Trigger: Sexual arousal causes the release of nitric oxide (NO).

2. Erectile Cycle: NO stimulates the formation of cyclic GMP (cGMP), which relaxes the smooth muscles of blood vessels, causing blood flow.

3. PDE5 Blockade: Vardenafil blocks the PDE5 enzyme that degrades cGMP. The 40 mg dose ensures powerful inhibition, allowing cGMP to persist longer, enhancing and stabilizing the erection.

Key takeaway: Vardenafil in ZHEWITRA 40 does not cause spontaneous arousal; it only enhances the natural physiological response.

Instructions for using ZHEWITRA 40: Safety rules

Taking a dose as high as 40 mg requires extreme caution and monitoring.

1. Dosing recommendations

• Initial Use: It is strictly forbidden to start treatment with a whole 40 mg tablet. Always start with 1/4 of a tablet (10 mg) or 1/2 of a tablet (20 mg).

• Maximum Daily Dose: 40 mg is the absolute maximum. You must not take more than one ZHEWITRA 40 tablet within 24 hours.

• Practical Splitting: The sensible use of ZHEWITRA 40 is to split it into two maximum standard doses of 20 mg.

• Method: Swallow the tablet whole with water, 30–60 minutes before sexual intercourse.

2. Interaction with food and alcohol

• Food: Vardenafil is less food-dependent than Sildenafil. Nevertheless, for the fastest and strongest effect, taking ZHEWITRA 40 on an empty stomach is recommended.

• Alcohol: Combining 40 mg of Vardenafil and alcohol is not recommended. The high dose of a vasodilator can cause a severe drop in blood pressure, dizziness, and fainting.

Critical contraindications for ZHEWITRA 40

Due to the increased dosage, the risks of interaction are heightened.

• Interaction with Nitrates: Absolutely forbidden! Taking ZHEWITRA 40 with any form of nitrates or nitric oxide donors (e.g., Nitroglycerin) causes a life-threatening drop in blood pressure.

• Severe Cardiovascular Diseases: Recent heart attack or stroke (within 6 months), unstable angina, severe heart failure.

• Blood Pressure: Persistent hypotension (pressure < 90/50 mmHg) or uncontrolled hypertension.

• Liver and Kidneys: Severe hepatic or renal failure.

Side effects of ZHEWITRA 40: Increased Risk

At the 40 mg Vardenafil dosage, the probability and intensity of side effects are significantly higher compared to 20 mg.

• Very Common: Severe headache, pronounced facial flushing, nasal congestion.

• Common: Dizziness, dyspepsia (indigestion), back and muscle pain (myalgia).

• Increased Risk of Serious Effects: Priapism (painful erection lasting longer than 4 hours), sudden loss of vision or hearing, severe hypotension.

Professional advice on using ZHEWITRA 40

1. Splitting is safety and economy: ZHEWITRA 40 is ideal for splitting. By dividing it into two parts, you get two maximum standard doses of 20 mg. This gives maximum efficacy with lower risk.

2. Do not chase the dose: If 20 mg of Vardenafil provides a sufficient effect, switching to 40 mg will not increase the duration of the erection (it remains 4–6 hours) but will increase the risk of adverse reactions.

3. Choice for Diabetics: Vardenafil is known for its high efficacy in men with diabetes. ZHEWITRA 40 may be advisable for this group, but only after gradual dose escalation under control.

ZHEWITRA 40: Extended Q&A section

• How long does ZHEWITRA 40 last? The duration of Vardenafil's action does not depend on the dose. The effect is maintained for 4-6 hours.

• Can I take ZHEWITRA 40 if 20 mg did not work? The transition to 40 mg is only possible after consulting a doctor. Always start with 1/2 tablet (20 mg) to assess tolerability.

• How does Vardenafil differ from Tadalafil? Vardenafil (the active substance in ZHEWITRA 40) acts faster than Tadalafil but has a shorter duration (4-6 hours versus 36).

• Is a doctor's consultation required before taking 40 mg? Yes, it is mandatory. The 40 mg dose exceeds the therapeutic maximum.