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Extra Super Zhewitra is a medication that contains two active ingredients: vardenafil and dapoxetine. It's primarily used to treat erectile dysfunction (ED) and premature ejaculation (PE) in men. As with any medication, there are certain contraindications—factors that make the use of the medication potentially harmful or dangerous. Here are some contraindications associated with Extra Super Zhewitra:

Hypersensitivity or allergy: Individuals who have a known hypersensitivity or allergy to vardenafil, dapoxetine, or any other ingredients in Extra Super Zhewitra should not take this medication. Allergic reactions can range from mild to severe and may include rash, itching, swelling, or difficulty breathing.

Nitrates: Extra Super Zhewitra should not be taken concomitantly with nitrates or nitric oxide donors, as this combination can lead to a significant drop in blood pressure, resulting in dizziness, fainting, or even cardiovascular collapse. Nitrates are commonly used to treat chest pain (angina) and include medications such as nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate.

Grapefruit juice: Grapefruit juice can interact with vardenafil, one of the active ingredients in Extra Super Zhewitra, and increase the risk of side effects. It's advisable to avoid consuming grapefruit or grapefruit juice while taking this medication.

Severe hepatic impairment: Extra Super Zhewitra is metabolized primarily in the liver, and individuals with severe hepatic impairment (e.g., liver cirrhosis) may have difficulty metabolizing the medication. This can lead to an increased risk of adverse effects or complications. Extra Super Zhewitra should be used with caution in patients with mild to moderate hepatic impairment, and dosage adjustments may be necessary.

Severe renal impairment: Extra Super Zhewitra should be used with caution in individuals with severe renal impairment (e.g., end-stage renal disease) due to the potential accumulation of the medication and its metabolites. Dosage adjustments may be necessary based on the severity of renal impairment.

Cardiovascular conditions: Extra Super Zhewitra should be used with caution in individuals with cardiovascular conditions such as heart disease, stroke, or arrhythmias. The medication can cause a temporary decrease in blood pressure, which may pose a risk to individuals with underlying cardiovascular conditions.

History of priapism: Individuals with a history of priapism (prolonged erection lasting longer than 4 hours) should use Extra Super Zhewitra with caution, as the medication may increase the risk of recurrent priapism.

It's essential to consult with a healthcare provider before taking Extra Super Zhewitra to discuss any potential contraindications or risks associated with the medication. Your healthcare provider can assess your medical history, current medications, and overall health status to determine if Extra Super Zhewitra is suitable for you and provide personalized recommendations for treatment.