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Levitra +: Combination for ED and PE (Vardenafil + Dapoxetine)

The term "Levitra Plus" or Levitra + (or "Super") is a common name for a category of combination generics designed for men who simultaneously face two problems: erectile dysfunction (ED) and premature ejaculation (PE).

These drugs combine two powerful active ingredients with entirely different mechanisms of action in one tablet.

What is in Levitra +?

Usually, when referring to "Super" or "+" drugs, the following standard combination is implied:

1. Vardenafil (20 mg): This is the "Levitra" component. It is a PDE5 inhibitor and is responsible for achieving and maintaining a firm erection.

2. Dapoxetine (60 mg): This is the "+" component. It is a short-acting Selective Serotonin Reuptake Inhibitor (SSRI) and is responsible for control and prolongation of intercourse.

Popular brand names for such drugs include: Super Vilitra, Super Zhewitra, Snovitra Super Power, Super Lovevitra, and others.

Dual Mechanism of Action

The drug acts simultaneously on the vascular and neurochemical systems.

1. How Vardenafil (20 mg) works – "Levitra"

Vardenafil does not cause an erection mechanically. It works only in the presence of sexual stimulation. It blocks the PDE5 enzyme, leading to the relaxation of blood vessels in the penis and a powerful inflow of blood. Vardenafil is known for its high selectivity (fewer visual side effects) and compatibility with food and alcohol.

2. How Dapoxetine (60 mg) works – "The Plus"

Dapoxetine acts on the central nervous system. It temporarily increases serotonin levels in the brain, which has an inhibitory effect on the ejaculation centers. This allows the man to better control the moment of orgasm and significantly prolongs intercourse (by 3-4 times on average).

Key takeaway: Levitra + provides a strong combined effect: Vardenafil guarantees the erection, and Dapoxetine allows it to last significantly longer.

Instructions for Use: Very Important!

Taking a combination drug requires strict adherence to the rules due to the presence of two potent active components.

1. Dosage

• One tablet (20 mg Vardenafil + 60 mg Dapoxetine) is the absolute maximum daily dose. Exceeding it is strictly prohibited.

• Initial Dose: Never start with a whole tablet. It is recommended to start with 1/2 a tablet (10 mg Vardenafil + 30 mg Dapoxetine) to assess tolerability.

2. Time and Method of Intake

• Time of Intake: Take 1–3 hours before planned sexual activity.

• Why so early? Vardenafil starts working in 30-60 minutes, but Dapoxetine needs time (1-2 hours) to reach peak concentration and maximum prolongation effect.

• Method: Swallow the tablet (or its part) whole with a full glass (at least 250 ml) of water.

Critical Contraindications and Warnings

The list of contraindications is amplified due to the summation of risks from the two molecules.

1. ALCOHOL: ABSOLUTE PROHIBITION!

• This is the most important rule. Dapoxetine (the "+" component) is absolutely incompatible with alcohol. Their combination manifold increases the risk of neurocognitive side effects (dizziness, drowsiness) and can lead to fainting (syncope), which is dangerous.

2. INTERACTION WITH NITRATES: FATAL!

• Vardenafil (the "Levitra" component) is strictly forbidden to take with any form of organic nitrates (Nitroglycerin, isosorbide dinitrate – heart medications) or nitric oxide donors ("poppers"). This causes a life-threatening drop in blood pressure.

3. Other Contraindications

• Severe cardiovascular diseases (recent heart attack or stroke).

• Taking antidepressants (other SSRIs) or MAO inhibitors.

• Severe liver or kidney failure.

Side Effects of Levitra +

Side effects can be caused by either of the two components.

• From Vardenafil: Headache, facial flushing, nasal congestion (usually less pronounced than with Sildenafil).

• From Dapoxetine: Nausea (most common effect), dizziness, drowsiness, dry mouth.

Professional Advice on Use

1. Splitting is Safety: Start with 1/2 tablet. If 10 mg of Vardenafil and 30 mg of Dapoxetine provide a sufficient effect, there is no need to take the full dose and increase the risks.

2. Take with Water, While Seated: To minimize the risk of fainting, always take the drug while standing or sitting, with a full glass of water, and avoid standing up abruptly.

3. Not for Daily Use: This is an "on-demand" drug. It is not intended for daily course intake.

Levitra +: Extended Q&A Section

• How long does the effect last? The erection effect (Vardenafil) and prolongation effect (Dapoxetine) last for 4–6 hours.

• What if I only have ED, but not PE? In this case, taking Dapoxetine is unnecessary. Use regular Levitra or its generics (e.g., Vilitra 20).

• What if I only have PE, but not ED? Use pure Dapoxetine (e.g., Vriligy, Poxet).