Silvitra 120 Mg (Sildenafil Citrate)

What is Silvitra 120 mg?

How It Works (Mechanism of Action)

Both ingredients act on the same pathway:

Where the two drugs differ:

Property	Sildenafil	Vardenafil
Usual onset	30 to 60 minutes	25 to 60 minutes
Half-life	About 4 hours	About 4 to 5 hours
Duration	4 to 5 hours	4 to 5 hours
Food effect	Delayed by fatty meals	Reduced by fatty meals
Visual side effects	More common	Less common
Heart rhythm effect	Minimal	Greater than sildenafil
Nitrate-free interval	24 hours	24 hours

3. Dosage Guide

Patient Group	Recommended Approach	Maximum Frequency	Key Notes
Adult men, first-time ED treatment	A single agent	–	Never begin with a two-drug combination
Adult men, inadequate response to sildenafil	Try vardenafil alone	–	A different single agent, not both together
Adult men, inadequate response to vardenafil	Try tadalafil alone	–	Switching is standard practice
Adult men prescribed this combination	One tablet	Once in 24 hours	Only on specific medical direction
Adult men, side effects on this product	Single agent	–	Ask your doctor to switch
Any heart rhythm disorder	Contraindicated	–	Vardenafil affects the QT interval
Taking Class IA or III antiarrhythmics	Contraindicated	–	Quinidine, amiodarone, sotalol and similar
Men aged 65 and over	Not recommended	–	Both components need dose reduction
Men over 75 taking ketoconazole or itraconazole	Contraindicated	–	A vardenafil-specific restriction
Mild liver impairment	Not recommended	–	Both drugs are cleared by the liver
Moderate to severe liver impairment	Contraindicated	–	Both must be avoided
Severe kidney impairment or dialysis	Contraindicated	–	Vardenafil is not adequately studied
Taking CYP3A4 inhibitors (ketoconazole, clarithromycin, ritonavir)	Contraindicated	–	Both drugs accumulate dangerously
Taking alpha-blockers (tamsulosin, doxazosin)	Not recommended	–	Additive blood pressure drop
Taking any other PDE-5 inhibitor	Contraindicated	–	Risk of severe hypotension
Absolute limit for any patient	One tablet	One dose per 24 hours	Never take two tablets in a day

How to Take It

Precautions

Absolute Contraindications – Do Not Use If You

Applying to both drugs:

Additional contraindications from the vardenafil component:

Conditions to Disclose to Your Doctor

Tell your doctor before use if you have or had:

Ask specifically whether vardenafil is safe for you. It is not interchangeable with sildenafil in terms of cardiac safety.

Food and Drink Precautions

Item	Effect	Recommendation
High-fat meals	Delay and reduce absorption of both drugs	Take on an empty stomach or after a light meal
Grapefruit and grapefruit juice	Raise blood levels of both drugs	Avoid entirely on dosing days
Alcohol	Adds to the blood pressure drop from both drugs	Avoid or limit strictly
Excess caffeine	May worsen palpitations and headache	Reduce intake around dosing
Water	No interaction	Use a full glass to swallow the tablet
Liquorice in large amounts	Can lower potassium levels	Avoid excessive intake
Seville oranges and pomelo	May affect the same enzyme pathway	Best avoided on dosing days

Before-Use Safety Checklist

Confirm every point below before each dose:

Side Effects

You may experience side effects from either drug, or from both.

Side Effect	Source	Frequency	What To Do
Headache	Both	Very likely	Rest and hydrate
Facial flushing or warmth	Both	Very likely	Settles as the drugs wear off
Indigestion or heartburn	Both	Common	Avoid heavy or spicy meals
Blocked or runny nose	Both	Common	Temporary; no treatment usually needed
Dizziness	Both	Common	Sit or lie down; do not drive
Blurred or blue-tinged vision	Sildenafil	Common	Avoid driving; tell your doctor
Light sensitivity	Sildenafil	Common	Avoid bright screens and sunlight
Nausea	Both	Common	Take with a light snack next time
Back pain or muscle ache	Both	Common	Usually resolves within 24 hours
Low blood pressure symptoms	Both, additive	Increased	Stop use; seek medical advice
Rapid or pounding heartbeat	Both	Less common	Rest; seek advice if it persists
Palpitations or fluttering	Vardenafil	Less common	Report promptly; may signal rhythm change
Nosebleed	Both	Less common	Apply pressure; report if repeated
Sleepiness	Vardenafil	Less common	Do not drive
Ringing in the ears	Both	Less common	Report to your doctor
Skin rash or itching	Both	Less common	Stop use and contact your doctor
Raised liver enzymes	Vardenafil	Uncommon	Your doctor may check liver function
Fainting or near-fainting	Both, additive	Uncommon	Stop use; seek medical care
Chest pain	Both	Rare	Emergency; see section 8
Priapism (erection over 4 hours)	Both	Rare	Emergency; see section 8
Sudden vision loss (NAION)	Both	Rare	Emergency; stop use permanently
Sudden hearing loss	Both	Rare	Emergency; stop use immediately
Serious irregular heartbeat	Vardenafil	Very rare	Emergency; seek immediate care
Seizure	Both	Very rare	Emergency; call for help
Severe skin reaction with blistering	Both	Very rare	Emergency; stop use immediately

Low blood pressure is the effect most changed by combining the drugs. Both lower blood pressure independently. Together the fall is greater.

Palpitations deserve particular attention with this product. The vardenafil component affects heart rhythm. Do not dismiss a fluttering or irregular heartbeat as ordinary.

Drug Interactions – Avoid With

Never combine (dangerous):

Medicines that also lengthen the QT interval use only with specialist advice:

Use only with medical supervision:

May reduce effectiveness:

Always show your doctor a full list of your medicines. Name both sildenafil and vardenafil, and mention any heart rhythm medicine specifically.

Emergency Warning Signs

Stop the medicine and seek emergency care immediately if you experience:

What to Know Before Choosing This Product

This section replaces a standard recommendation, because the evidence does not support one.

What the combination does provide:

What it does not provide:

What it adds:

Standard practice when one drug does not work:

Switching between agents is well established. Stacking two is not.

Storage Instructions

Medical Disclaimer

This content is for information only. It is not medical advice. Silvitra 120 mg contains two PDE-5 inhibitors, sildenafil 100 mg and vardenafil 20 mg, each at its maximum approved single dose. Product labelling for every PDE-5 inhibitor advises against combining it with another drug of the same class, and no such combination is approved by the FDA, EMA, or MHRA. Vardenafil can lengthen the QT interval and is contraindicated with certain heart rhythm medicines. Nitrate medicines must be avoided for at least 24 hours after a dose. Do not take any other erectile dysfunction medicine alongside this product. Use only under a qualified doctor’s supervision and direction. Always read the manufacturer’s package insert before use.