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Inhibitors of CYP3A4, such as nicardipine, can reduce vardenafil clearance.
| Condition | Caution | Reason |
|---|---|---|
| Use with Nitrates | Contraindicated | Risk of severe hypotension |
| Severe Liver Impairment | Use with caution | Metabolism may be affected |
| Heart Disease | Consult doctor before use | Potential cardiovascular risks |
| Retinitis Pigmentosa | Avoid | Possible risk of vision loss |
| Hypotension or Hypertension | Caution or avoid | Blood pressure effects |
Increased systemic exposure to vardenafil may result in an increase in vardenafil-induced adverse effects.
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Nelfinavir: (Major) Do not use vardenafil orally disintegrating tablets with nelfinavir due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; nelfinavir is a strong CYP3A4 inhibitor. Netupitant, Fosnetupitant; Palonosetron: (Major) Do not use vardenafil orally disintegrating tablets with netupitant due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; netupitant levitra spray is a moderate CYP3A4 inhibitor. Nicardipine: (Moderate) Vardenafil is metabolized by hepatic cytochrome P450 3A4 and to a lesser extent CYP2C9. Nifedipine: (Moderate) Nifedipine can have additive hypotensive effects when administered with phosphodiesterase inhibitors (PDE 5 inhibitors). The patient should be monitored carefully and the dosage should be adjusted based on clinical response. For example, in patients whose hypertension was controlled with nifedipine, vardenafil produced mean additional supine systolic/diastolic blood pressure reductions of 3 to 4 mmHg (age group 65 to 69 years) and 5 to 6 mmHg (age group 70 to 80 years) compared to placebo. Nilotinib: (Major) Avoid the concomitant use of nilotinib with other agents known to prolong the QT interval, such as vardenafil.
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Sudden death and QT prolongation have occurred in patients receiving nilotinib therapy. Also, nilotinib is a moderate CYP3A4 inhibitor and vardenafil is a primary CYP3A4 substrate; administering these drugs together may result in increased vardenafil concentrations. Do not use vardenafil orally disintegrating tablets with nilotinib due to increased vardenafil exposure.
- Vardenafil requires a prescription; self-medicating is unsafe.
- Take Levitra approximately 60 minutes before intimacy.
- Do not take more than one dose per 24 hours.
- Symptoms like priapism need immediate medical attention.
- Levitra may cause nasal congestion or upset stomach.
- Combining vardenafil with other ED drugs increases risks.
- Alcohol can hinder the effectiveness of Levitra.
- Levitra is designed for occasional use, not daily.
- Precautions include monitoring for vision changes.
- Seek medical advice if you experience allergic reactions.
If use of nilotinib and vardenafil oral tablets is required, do not exceed a single vardenafil oral tablet dose of 5 mg per 24-hour period. Nirmatrelvir; Ritonavir: (Major) Consider withholding vardenafil during receipt of ritonavir-boosted nirmatrelvir. Coadministration may increase vardenafil exposure resulting in increased toxicity. Nitrates: (Contraindicated) Coadministration of phosphodiesterase inhibitors with organic nitrates or nitrites in any dosage formulation is contraindicated. Nitroglycerin: (Contraindicated) Coadministration of phosphodiesterase inhibitors with organic nitrates or nitrites in any dosage formulation is contraindicated.
- Levitra is available in 10 mg and 20 mg tablets.
- The medication is not an aphrodisiac; it enhances ability when sexually stimulated.
- Vardenafil is a PDE5 inhibitor class drug.
- It can be used by men with diabetes-related erectile issues.
- Levitra may cause dizziness; avoid driving after taking.
- The medication is approved by the FDA for ED treatment.
- Do not use if you have severe liver or kidney problems.
- Vardenafil should be stored at room temperature, away from moisture.
- It is not suitable for women or children.
- Consult your doctor for potential drug interactions.
Nitroprusside: (Contraindicated) Concomitant use of nitroprusside and vardenafil is contraindicated due to the risk of additive hypotension. A suitable time interval after vardenafil dosing for the safe administration of nitrates has not been determined. In addition, vardenafil may potentiate the nitric oxide-mediated platelet anti-aggregatory effect of nitroprusside.
Patient characteristics
Leuprolide: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., leuprolide) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Consider taking steps to minimize the risk of QT/QTc interval prolongation and TdP, such as avoidance, electrolyte monit oring and repletion, and ECG monitoring, especially in patients with additional risk factors for TdP. Leuprolide; Norethindrone: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., leuprolide) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Levofloxacin: (Moderate) Concomitant use of levofloxacin and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Levoketoconazole: (Contraindicated) Avoid concomitant use of ketoconazole and vardenafil due to an increased risk for QT/QTc prolongation and torsade de pointes (TdP).
Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: A systematic review and meta-analysis
Lithium: (Moderate) Concomitant use of vardenafil and lithium may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Lonafarnib: (Major) Do not use vardenafil orally disintegrating tablets with lonafarnib due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; lonafarnib is a strong CYP3A4 inhibitor. Loperamide: (Moderate) Concomitant use of vardenafil and loperamide may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Loperamide; Simethicone: (Moderate) Concomitant use of vardenafil and loperamide may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Ofloxacin: (Moderate) Concomitant use of ofloxacin and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
Warnings & Precautions
Methadone: (Major) Concomitant use of vardenafil and methadone increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Metronidazole: (Moderate) Concomitant use of metronidazole and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Midostaurin: (Major) Concomitant use of vardenafil and midostaurin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Mifepristone: (Major) Do not use vardenafil orally disintegrating tablets with mifepristone due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A and mifepristone is a strong CYP3A inhibitor.
How does Levitra help with these illnesses?
Mirtazapine: (Moderate) Concomitant use of vardenafil and mirtazapine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Mobocertinib: (Major) Concomitant use of mobocertinib and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Moxifloxacin: (Major) Concomitant use of vardenafil and moxifloxacin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Nefazodone: (Major) Do not use vardenafil orally disintegrating tablets with nefazodone due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; nefazodone is a strong CYP3A4 inhibitor. Olanzapine: (Moderate) Concomitant use of vardenafil and olanzapine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Olanzapine; Fluoxetine: (Moderate) Concomitant use of vardenafil and fluoxetine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. (Moderate) Concomitant use of vardenafil and olanzapine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
How To Get Vardenafil
Lopinavir; Ritonavir: levitra 100 mg (Major) Concomitant use of vardenafil and lopinavir increases the risk of QT/QTc prolongation and torsade de pointes (TdP). (Major) Do not use vardenafil orally disintegrating tablets with ritonavir due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 72-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; ritonavir is a strong CYP3A4 inhibitor. Coadministration of ritonavir with vardenafil resulted in a 49-fold increase in vardenafil AUC and a 13-fold increase in vardenafil Cmax. Concomitant use may increase the risk of vardenafil-related adverse effects, such as prolonged erection or QT prolongation.
What is tadalafil (Cialis®)?
Lorcaserin: (Moderate) Lorcaserin is a serotonin 2C receptor agonist, and priapism is a potential effect of 5-HT2C receptor agonism. Because there is little experience with the combination of lorcaserin and medications indicated for erectile dysfunction (e.g., phosphodiesterase inhibitors), combined use should be approached with caution. Macimorelin: (Major) Concomitant use of vardenafil and macimorelin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Maprotiline: (Moderate) Concomitant use of vardenafil and maprotiline may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Mefloquine: (Moderate) Concomitant use of vardenafil and mefloquine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Olanzapine; Samidorphan: (Moderate) Concomitant use of vardenafil and olanzapine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
| Side Effect | Frequency | Severity | Notes |
|---|---|---|---|
| Headache | Common | Mild to Moderate | Usually subsides over time |
| Flushing | Common | Mild | Occasionally persistent |
| Nasal Congestion | Common | Mild | Temporary |
| Dizziness | Less Common | Mild | Especially when standing up |
| Dyspepsia | Less Common | Mild | Stomach upset |
Ondansetron: (Major) Concomitant use of ondansetron and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Osilodrostat: (Moderate) Concomitant use of vardenafil and osilodrostat may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
Before Using
Avoid use of lefamulin injection with vardenafil; however, if coadministration of lefamulin injection cannot be avoided, ECG monitoring is recommended during treatment. Vardenafil is a primary CYP3A4 substrate that is associated with QT prolongation. Both therapeutic and supratherapeutic doses of vardenafil can produce an increase in QTc interval. Lefamulin is a moderate CYP3A4 inhibitor that has a concentration-dependent QTc prolongation effect. Coadministration of vardenafil with another moderate CYP3A4 inhibitor increased the AUC of vardenafil by 4-fold.
Does vardenafil interact with other medicines (drug interactions)?
Lenacapavir: (Major) Do not use vardenafil orally disintegrating tablets with lenacapavir due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A; lenacapavir is a moderate CYP3A inhibitor. Lenvatinib: (Major) Concomitant use of vardenafil and lenvatinib increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Letermovir: (Major) Do not use vardenafil orally disintegrating tablets with letermovir due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; letermovir is a moderate CYP3A4 inhibitor.
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