Zhewitra Oral Jelly

Common use
This is a powerful medicine to treat erectile dysfunctions. It works only if there is sexual stimulation. Sexual arousal releases nitric oxide from the nerves' endings of the cavernous bodies of the penis and activates guanylate cyclase enzyme. Guanylate cyclase in its turn is responsible for production of cyclic guanosine monophosphate (cGMP). Due to cGMP the blood vessels supplying the penis with blood widen and relax.

Dosage and direction
The recommended dose of Zhewitra Oral Jelly contains 20 mg of Vardenafil, it is available in a pack of sachet. Take it an hour before intercourse. Do not exceed the recommended dose. Strictly follow all recommendations of your doctor and never take the drug if it was not prescribed to you.

Precautions
Zhewitra Oral Jelly is not recommended in patients who have a stroke or heart failure, or a heart attack in history and especially within last six month. Before using Zhewitra Oral Jelly inform your doctor if you have serious renal impairment, a bleeding disorder, stomach ulcerations, or an inherited retinal disorder such as retinitis pigmentosa, allergic reaction to this medicine or any other medicines, deformation of the penis such as angulation, cavernous fibrosis (Peyronie's disease), as well as in diseases that contribute to the development of priapism.

Contraindications
Zhewitra-20 Oral Jelly cannot be prescribed in patients who are hypersensitive to its ingredients, ones treated with organic nitrates. Use in individuals who have not reached the age of 16 y.o. is contraindicated. Concomitant use of HIV protease inhibitors such as indinavir and ritonavir with Zhewitra-20 Oral Jelly is prohibited.
Possible side effect
Treatment with Zhewitra-20 Oral Jelly usually does not lead to serious side effects and if any they are mostly transient. The most frequent side effects are: headache, flushing, dizziness, diarrhea, nausea, stuffy nose.

Drug interaction
Metabolism of Zhewitra-20 Oral Jelly is inhibited by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). Zhevitra-20 Oral Jelly also reduces the blood concentration of ritonavir and indinavir. Chest pain may become more acute in patients treated with nitrates as the medication increases heart rate and lowers blood pressure. Zhevitra-20 Oral Jelly never should be administered in patients who are treated with organic nitrates.

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