Super Zhewitra

Super Zhewitra 20/60 mg is often used to treat impotence or erectile dysfunction (ED) in males, when a male loses the ability to get and maintain an erection. Physicians may prescribe this medication to treat other medical conditions such as pulmonary arterial hypertension (PAH), benign prostatic hyperplasia (BPH), and other conditions not listed in this article. While Vardenafil and Dapoxetine are the active ingredients of the Super Zhewitra 20/60 mg, it contains other inactive ingredients such as colloidal silicon dioxide, crospovidone, microcrystalline cellulose, magnesium stearate, and others. This medication belongs to the group of medications called phosphodiesterase type-5 (PDE-5) inhibitors.

Product dosage: 20/60 mg
Package (num)	Per pill	Price	Buy
20	$2.75	$55.00 (0%)	🛒 Add to cart
30	$2.50	$82.50 $75.00 (9%)	🛒 Add to cart
60	$2.20 Best per pill	$165.00 $132.00 (20%)	🛒 Add to cart

Super Zhewitra represents a significant advancement in the pharmacological management of erectile dysfunction (ED), combining two well-established phosphodiesterase type 5 (PDE5) inhibitors—Vardenafil and Sildenafil Citrate—into a single, potent formulation. This dual-mechanism approach is engineered for individuals who have experienced suboptimal results with monotherapy treatments, offering a more robust and reliable solution for achieving and sustaining erections sufficient for sexual activity. Its development is grounded in clinical understanding of varying patient responses, aiming to provide a higher efficacy profile through synergistic action. This product is strictly prescription-only and must be used under direct medical supervision to ensure appropriate patient selection and risk mitigation.

Features

• Active Pharmaceutical Ingredients: Vardenafil 20mg and Sildenafil Citrate 100mg.
• Pharmacological Class: Combined PDE5 inhibitor.
• Mechanism of Action: Potent inhibition of cGMP-specific phosphodiesterase type 5, enhancing the effects of nitric oxide (NO). This inhibition increases cyclic guanosine monophosphate (cGMP) levels in the corpus cavernosum, facilitating smooth muscle relaxation and consequent inflow of blood for an erection.
• Onset of Action: Typically observed within 30-60 minutes post-administration.
• Duration of Effect: The therapeutic window can extend for up to 6-8 hours, though individual duration may vary.
• Administration: Oral tablet, to be taken with or without food, though a high-fat meal may delay absorption.
• Manufacturer: Formulated under strict GMP (Good Manufacturing Practices) guidelines.

Benefits

• Enhanced Efficacy Profile: The synergistic action of two PDE5 inhibitors targets the condition through complementary pathways, potentially offering a more potent and reliable response than single-agent therapy, particularly in cases of prior monotherapy failure.
• Extended Therapeutic Window: Provides a significantly longer duration of opportunity for sexual activity compared to many standard treatments, reducing time-sensitive pressure and contributing to a more natural sexual experience.
• Improved Rigidity and Sustainability: Promotes stronger and more sustainable erections by maximizing blood flow into the penile tissues, which is crucial for satisfactory sexual performance.
• Increased Confidence: Reliable pharmacological support can significantly reduce performance anxiety, a common compounding factor in erectile dysfunction, thereby improving overall psychological well-being related to sexual health.
• Dual-Mechanism Flexibility: Offers a comprehensive approach that may address a broader range of physiological causes of ED within a single treatment protocol.

Common use

Super Zhewitra is exclusively indicated for the treatment of erectile dysfunction (ED) in adult males. It is not intended for use by women, children, or adolescents. It is a therapeutic agent, not an aphrodisiac; sexual stimulation is required for it to facilitate an erection. It is particularly considered for patients who have not achieved desired results with other PDE5 inhibitor monotherapies. It is not approved for daily use and should only be taken as prescribed in anticipation of sexual activity.

Dosage and direction

• Standard Dosage: One tablet (containing Vardenafil 20mg and Sildenafil Citrate 100mg) taken orally approximately 30-60 minutes before anticipated sexual activity.
• Frequency: The dosing should not exceed one tablet in a 24-hour period.
• Administration: Can be taken with or without food. However, consumption with a high-fat meal may delay the time to onset of effect (Tmax).
• Instruction: Swallow the tablet whole with a full glass of water. Do not crush, split, or chew the tablet.
• Dosage Adjustment: Dosage must be individualized based on efficacy and tolerability under the guidance of a prescribing physician. It is not recommended for patients with hepatic severe impairment or severe renal impairment.

Precautions

• Cardiovascular Status: Patients with pre-existing cardiovascular disease (e.g., heart failure, coronary artery disease, arrhythmias) require a thorough cardiovascular evaluation before initiation of therapy, as sexual activity poses a potential cardiac risk.
• Priapism: Prolonged and sometimes painful erections lasting more than 4 hours (priapism) may occur. This is a medical emergency that can lead to permanent tissue damage and impotence if not treated immediately.
• Vision/Hearing Changes: Non-arteritic anterior ischemic optic neuropathy (NAION), causing sudden vision loss, and sudden decrease or loss of hearing have been reported rarely in temporal association with PDE5 inhibitor use. Discontinue use immediately and seek medical attention if such symptoms occur.
• Underlying Causes: ED can be a symptom of underlying medical conditions. A complete medical evaluation is recommended to identify and treat potential causes.
• Alcohol: Excessive consumption of alcohol (e.g., 5 units or more) is not recommended as it may increase the risk of orthostatic hypotension, dizziness, and increased heart rate.

Contraindications

Super Zhewitra is absolutely contraindicated in the following scenarios:

• Concomitant administration with any form of organic nitrate therapy (e.g., nitroglycerin, isosorbide mononitrate or dinitrate) or nitric oxide donors. This combination can cause a severe, life-threatening drop in blood pressure.
• Concomitant use with guanylate cyclase stimulators, such as riociguat.
• Known hypersensitivity to Vardenafil, Sildenafil Citrate, or any other component of the formulation.
• Patients with a history of serious hypersensitivity reactions to other PDE5 inhibitors.
• Men for whom sexual activity is inadvisable due to underlying cardiovascular pathology.

Possible side effect

Like all potent medications, Super Zhewitra can cause side effects, which are often dose-related and typically transient. Common side effects are primarily vascular in nature and include:

• Headache
• Flushing (redness and warmth of the face, neck, or chest)
• Dyspepsia (indigestion)
• Nasal congestion
• Dizziness
• Back pain and myalgia (muscle pain) Less common but more serious side effects require immediate medical attention:
• Priapism (prolonged, painful erection >4 hours)
• Sudden vision loss or changes in vision (NAION)
• Sudden decrease or loss of hearing
• Tinnitus (ringing in the ears)
• Palpitations, arrhythmias
• Severe hypotension (low blood pressure)

Drug interaction

Super Zhewitra has significant and potentially dangerous interactions with several drug classes. A comprehensive review of all concomitant medications with a physician is mandatory.

• Nitrates: ABSOLUTE CONTRAINDICATION. Concomitant use can cause profound hypotension, syncope, stroke, or myocardial infarction.
• Alpha-blockers: Co-administration with alpha-adrenergic blocking agents (e.g., doxazosin, tamsulosin) can potentiate the blood-pressure-lowering effects and is not recommended. A significant time separation may be required if use is deemed necessary.
• Antihypertensives: Additive hypotensive effects may occur when taken with other antihypertensive medications.
• Strong CYP3A4 Inhibitors: Drugs like ketoconazole, itraconazole, ritonavir, atazanavir, clarithromycin, and grapefruit juice can significantly increase the plasma concentration of both active ingredients, increasing the risk of adverse effects. Dose adjustment or avoidance is required.
• Guanylate Cyclase Stimulators (e.g., Riociguat): CONTRAINDICATED due to the risk of symptomatic hypotension.

Missed dose

Super Zhewitra is not intended for scheduled daily dosing. It is taken on an as-needed basis. Therefore, the concept of a “missed dose” does not apply. Simply take one tablet when you plan to engage in sexual activity, ensuring at least 24 hours have passed since any previous dose.

Overdose

In cases of suspected overdose, which would likely manifest as severe manifestations of the drug’s vasodilatory effects (severe headache, profound hypotension, syncope, prolonged priapism), immediate medical attention is required. Standard supportive measures should be employed, including placing the patient in a supine position with the legs elevated to manage hypotension. Priapism requires immediate urological intervention. Dialysis is not expected to be effective due to high protein binding of the active compounds.

Storage

• Store at room temperature (15°-30°C or 59°-86°F).
• Protect from light and moisture.
• Keep in the original blister packaging until the moment of use.
• Keep out of reach of children and pets.
• Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. Do not purchase or use this medication without a valid prescription from a licensed healthcare professional.

Reviews

• “After trying sildenafil alone with inconsistent results, my urologist suggested Super Zhewitra. The difference in reliability and rigidity is notable. The effect lasts long enough to alleviate timing anxiety completely.” – M.K., 54
• “The potency is significant. I experienced the expected flushing and a mild headache, but the efficacy was unparalleled compared to other treatments I’ve tried. It is crucial to follow the doctor’s instructions precisely.” – A.P., 61
• “This is a powerful combination medication that should only be used under strict supervision. For me, it worked effectively where others had failed, but the side effects (mainly nasal congestion) were more pronounced. A worthwhile trade-off for the result.” – R.S., 58