The Efficacy and Safety of Flexible-Dose Vardenafil (Levitra®) in a Broad Population of European Men

Sapropterin: (Moderate) Sapropterin acts as a cofactor in the synthesis of nitric oxide and may cause vasorelaxation. Caution should be exercised when administering sapropterin in combination with drugs that affect nitric oxide-mediated vasorelaxation such as phosphodiesterase inhibitors.

Drug Interactions

PDE5 inhibitors, including vardenafil, may potentiate the hypotensive effects of vericiguat. Vigabatrin: (Major) Vigabatrin should not be used with phosphodiesterase inhibitors, which is associated with serious ophthalmic effects (e.g., retinopathy or glaucoma) unless the benefit of treatment clearly outweighs the risks. Voclosporin: (Moderate) Concomitant use of vardenafil and voclosporin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. The degree of QT prolongation associated with voclosporin is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 3 times the maximum recommended dose. Vonoprazan; Amoxicillin; Clarithromycin: (Major) Do not use vardenafil orally disintegrating tablets with cheap levitra oral jelly online clarithromycin due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets.

What are the most common side effects of vardenafil?

Voriconazole: (Major) Do not use vardenafil orally disintegrating tablets with voriconazole 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; voriconazole is a strong CYP3A4 inhibitor. In addition, voriconazole has been associated with QT prolongation and rare cases of torsade de pointes. Vorinostat: (Moderate) Concomitant use of vardenafil and vorinostat may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Voxelotor: (Major) Do not use vardenafil orally disintegrating tablets with voxelotor due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets.

More common

Vardenafil is primarily metabolized by CYP3A; voxelotor is a moderate CYP3A inhibitor. Ziprasidone: (Major) Concomitant use of ziprasidone and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Levitra/Staxyn/Vardenafil/Vardenafil Hydrochloride Oral Tab: 2.5mg, 5mg, 10mg, 20mgStaxyn Oral Tab Orally Dis: 10mg For regular tablets (e.g., Levitra), 20 mg/day PO. For orally disintegrating tablets (e.g., Staxyn), 10 mg/day PO. The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. When given together these agents may produce an additive reduction in blood pressure. The combination of sapropterin and a phosphodiesterase (PDE5) inhibitor did not significantly reduce blood pressure when administered concomitantly in animal studies. The additive effect of these agents has not been studied in humans. Saquinavir: (Contraindicated) Coadministration of saquinavir boosted with ritonavir is contraindicated with other drugs that may prolong the QT interval and which are primary CYP3A4 substrates, such as vardenafil.

Saquinavir boosted with ritonavir is a strong CYP3A4 inhibitor that increases the QT interval in a dose-dependent fashion. Selpercatinib: (Major) Concomitant use of vardenafil and selpercatinib increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Sertraline: (Moderate) Concomitant use of vardenafil and sertraline may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

Database entry date

Solifenacin: (Moderate) Concomitant use of vardenafil and solifenacin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Sotalol: (Major) Concomitant use of vardenafil and sotalol increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Stiripentol: (Moderate) Consider a dose adjustment of vardenafil when coadministered with stiripentol. Coadministration may alter plasma concentrations of vardenafil resulting in an increased risk of adverse reactions and/or decreased efficacy. In vitro data predicts inhibition or induction of CYP3A4 by stiripentol potentially resulting in clinically significant interactions.

Are you currently using Vardenafil (Levitra, Staxyn)?

Sunitinib: (Moderate) Concomitant use of vardenafil and sunitinib may increase the risk online levitra price of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tacrolimus: (Moderate) Concomitant use of vardenafil and tacrolimus may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tamoxifen: (Moderate) Concomitant use of tamoxifen and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tamsulosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on tamsulosin therapy before initiating therapy with the lowest dose of vardenafil. Telavancin: (Moderate) Concomitant use of vardenafil and telavancin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

Popularity of Levitra and Stendra

Terazosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on alpha-blocker therapy before initiating therapy with the lowest dose of vardenafil. Tetrabenazine: (Major) Concomitant use of vardenafil and tetrabenazine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Thioridazine: (Contraindicated) Avoid concomitant use of vardenafil and thioridazine due to an increased risk for torsade de pointes (TdP) and QT/QTc prolongation. Tipranavir: (Major) Do not use vardenafil orally disintegrating tablets with tipranavir boosted 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. Tolterodine: (Major) Due to the potential for QT prolongation and torsade de pointes (TdP), caution is advised when administering tolterodine with vardenafil. The degree of QT prolongation associated with sertraline is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 2 times the maximum recommended dose. Silodosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on silodosin therapy before initiating therapy with the lowest dose of vardenafil. Conversely, patients already receiving an optimized dose of vardenafil should be started on the lowest dose of silodosin; increases in the alpha-blocker dose should be done in a stepwise fashion. Other variables, such as intravascular volume depletion, concurrent antihypertensive therapy, or evidence of hemodynamic instability with alpha-blocker monotherapy, may affect the safety of concomitant use of vardenafil and silodosin. Siponimod: (Major) Concomitant use of vardenafil and siponimod increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Sodium Stibogluconate: (Moderate) Concomitant use of sodium stibogluconate and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

Solifenacin: (Moderate) Concomitant use of vardenafil and solifenacin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

Prescription Status: Rx-Only vs. OTC

Tolterodine has been associated with dose-dependent prolongation of the QT interval, especially in poor CYP2D6 metabolizers. Therapeutic (10 mg) and supratherapeutic (80 mg) doses of vardenafil also produce an increase in QTc interval (e.g., 4 to 6 msec calculated by individual QT correction). Toremifene: (Major) Concomitant use of vardenafil and toremifene increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Trandolapril; Verapamil: (Major) Do not use vardenafil orally disintegrating tablets with verapamil 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 and verapamil is a moderate CYP3A inhibitor.

Other Interactions

Trazodone: (Major) Concomitant use of vardenafil and trazodone increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Triclabendazole: (Moderate) Concomitant use of triclabendazole and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Trifluoperazine: (Minor) Use vardenafil with caution in buy levitra 60mg combination with trifluoperazine as concurrent use may increase the risk of QT prolongation. Trifluoperazine is associated with a possible risk for QT prolongation. Triptorelin: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., triptorelin) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

Common Side Effects

Tucatinib: (Major) Do not use vardenafil orally disintegrating tablets with tucatinib 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; tucatinib is a strong CYP3A4 inhibitor. Venlafaxine: (Moderate) Concomitant use of vardenafil and venlafaxine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Verapamil: (Major) Do not use vardenafil orally disintegrating tablets with verapamil due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets. Vericiguat: (Contraindicated) Use of vericiguat and vardenafil is contraindicated due to the risk of hypotension. Sotalol: (Major) Concomitant use of vardenafil and sotalol increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Stiripentol: (Moderate) Consider a dose adjustment of vardenafil when coadministered with stiripentol. Coadministration may alter plasma concentrations of vardenafil resulting in an increased risk of adverse reactions and/or decreased efficacy. In vitro data predicts inhibition or induction of CYP3A4 by stiripentol potentially resulting in clinically significant interactions. Sunitinib: (Moderate) Concomitant use of vardenafil and sunitinib may increase the risk online levitra price of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tacrolimus: (Moderate) Concomitant use of vardenafil and tacrolimus may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tamoxifen: (Moderate) Concomitant use of tamoxifen and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tamsulosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on tamsulosin therapy before initiating therapy with the lowest dose of vardenafil.

• 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.

Telavancin: (Moderate) Concomitant use of vardenafil and telavancin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Terazosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on alpha-blocker therapy before initiating therapy with the lowest dose of vardenafil. Tetrabenazine: (Major) Concomitant use of vardenafil and tetrabenazine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Thioridazine: (Contraindicated) Avoid concomitant use of vardenafil and thioridazine due to an increased risk for torsade de pointes (TdP) and QT/QTc prolongation. Tipranavir: (Major) Do not use vardenafil orally disintegrating tablets with tipranavir boosted 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. Tolterodine: (Major) Due to the potential for QT prolongation and torsade de pointes (TdP), caution is advised when administering tolterodine with vardenafil. Tolterodine has been associated with dose-dependent prolongation of the QT interval, especially in poor CYP2D6 metabolizers. Therapeutic (10 mg) and supratherapeutic (80 mg) doses of vardenafil also produce an increase in QTc interval (e.g., 4 to 6 msec calculated by individual QT correction). Toremifene: (Major) Concomitant use of vardenafil and toremifene increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Trandolapril; Verapamil: (Major) Do not use vardenafil orally disintegrating tablets with verapamil 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 and verapamil is a moderate CYP3A inhibitor. Trazodone: (Major) Concomitant use of vardenafil and trazodone increases the risk of QT/QTc prolongation and torsade de pointes (TdP).

Generic Vardenafil: Availability and Manufacturers

Sapropterin: (Moderate) Sapropterin acts as a cofactor in the synthesis of nitric oxide and may cause vasorelaxation. Caution should be exercised when administering sapropterin in combination with drugs that affect nitric oxide-mediated vasorelaxation such as phosphodiesterase inhibitors. When given together these agents may produce an additive reduction in blood pressure. The combination of sapropterin and a phosphodiesterase (PDE5) inhibitor did not significantly reduce blood pressure when administered concomitantly in animal studies. The additive effect of these agents has not been studied in humans.

Specific interventions included in the review

Saquinavir: (Contraindicated) Coadministration of saquinavir boosted with ritonavir is contraindicated with other drugs that may prolong the QT interval and which are primary CYP3A4 substrates, such as vardenafil. Saquinavir boosted with ritonavir is a strong CYP3A4 inhibitor that increases the QT interval in a dose-dependent fashion. Selpercatinib: (Major) Concomitant use of vardenafil and selpercatinib increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Sertraline: (Moderate) Concomitant use of vardenafil and sertraline may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. The degree of QT prolongation associated with sertraline is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 2 times the maximum recommended dose.

Sustained efficacy and tolerability of vardenafil (Levitra®), a highly potent, selective phosphodiesterase-5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial

Silodosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on silodosin therapy before initiating therapy with the lowest dose of vardenafil. Conversely, patients already receiving an optimized dose of vardenafil should be started on the lowest dose of silodosin; increases in the alpha-blocker dose should be done in a stepwise fashion. Other variables, such as intravascular volume depletion, concurrent antihypertensive therapy, or evidence of hemodynamic instability with alpha-blocker monotherapy, may affect the safety of concomitant use of vardenafil and silodosin. Siponimod: (Major) Concomitant use of vardenafil and siponimod increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Sodium Stibogluconate: (Moderate) Concomitant use of sodium stibogluconate and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Triclabendazole: (Moderate) Concomitant use of triclabendazole and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Trifluoperazine: (Minor) Use vardenafil with caution in buy levitra 60mg combination with trifluoperazine as concurrent use may increase the risk of QT prolongation. Trifluoperazine is associated with a possible risk for QT prolongation. Triptorelin: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., triptorelin) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Tucatinib: (Major) Do not use vardenafil orally disintegrating tablets with tucatinib 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; tucatinib is a strong CYP3A4 inhibitor. Venlafaxine: (Moderate) Concomitant use of vardenafil and venlafaxine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Verapamil: (Major) Do not use vardenafil orally disintegrating tablets with verapamil due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets.

Patient characteristics

Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cGMP. Cyclic guanosine monophosphate causes smooth muscle relaxation in the corpus cavernosum thereby allowing inflow of blood; the exact mechanism by which cGMP stimulates relaxation of smooth muscles has not been determined. Phosphodiesterase type 5 is responsible for degradation of cGMP in the corpus cavernosum. Vardenafil enhances the effect of NO by inhibiting PDE5, thereby raising concentrations of cGMP in the corpus cavernosum. Vardenafil has no direct relaxant effect on isolated human corpus cavernosum and, at recommended doses, has no effect in the absence of sexual stimulation. Vericiguat: (Contraindicated) Use of vericiguat and vardenafil is contraindicated due to the risk of hypotension. PDE5 inhibitors, including vardenafil, may potentiate the hypotensive effects of vericiguat.

Vigabatrin: (Major) Vigabatrin should not be used with phosphodiesterase inhibitors, which is associated with serious ophthalmic effects (e.g., retinopathy or glaucoma) unless the benefit of treatment clearly outweighs the risks.

• Levitra is manufactured by Bayer Pharmaceuticals.
• It is available in both tablet and generic forms.
• The drug can be prescribed for men aged 18 and above.
• Levitra's active ingredient is vardenafil hydrochloride.
• It helps achieve erections suitable for sexual activity.
• Taking fatty meals may delay the drug's onset.
• Levitra does not protect against sexually transmitted diseases.
• Use with caution if you have heart conditions.
• It is essential to inform your doctor of all medications.
• Vardenafil does not cure ED; it manages symptoms.

Voclosporin: (Moderate) Concomitant use of vardenafil and voclosporin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

• Vardenafil Levitra is a prescription medication for erectile dysfunction.
• It works by increasing blood flow to the penis.
• Vardenafil is marketed under the brand name Levitra.
• It typically takes about 25-60 minutes to work.
• The effects of vardenafil last up to 4-5 hours.
• It should be taken on an empty stomach for faster results.
• Common side effects include headache and flushing.
• Vardenafil is contraindicated with nitrates.
• Do not consume alcohol with vardenafil.
• Always follow your doctor's dosage instructions.

The degree of QT prolongation associated with voclosporin is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 3 times the maximum recommended dose. Vonoprazan; Amoxicillin; Clarithromycin: (Major) Do not use vardenafil orally disintegrating tablets with cheap levitra oral jelly online clarithromycin due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Voriconazole: (Major) Do not use vardenafil orally disintegrating tablets with voriconazole 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; voriconazole is a strong CYP3A4 inhibitor. In addition, voriconazole has been associated with QT prolongation and rare cases of torsade de pointes. Vorinostat: (Moderate) Concomitant use of vardenafil and vorinostat may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Voxelotor: (Major) Do not use vardenafil orally disintegrating tablets with voxelotor 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; voxelotor is a moderate CYP3A inhibitor. Ziprasidone: (Major) Concomitant use of ziprasidone and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP).

• 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.

Levitra/Staxyn/Vardenafil/Vardenafil Hydrochloride Oral Tab: 2.5mg, 5mg, 10mg, 20mgStaxyn Oral Tab Orally Dis: 10mg For regular tablets (e.g., Levitra), 20 mg/day PO. For orally disintegrating tablets (e.g., Staxyn), 10 mg/day PO. The physiologic mechanism of erection of the penis involves release of nitric oxide (NO) in the corpus cavernosum during sexual stimulation. Nitric oxide then activates the enzyme guanylate cyclase, which results in increased levels of cGMP.

Cyclic guanosine monophosphate causes smooth muscle relaxation in the corpus cavernosum thereby allowing inflow of blood; the exact mechanism by which cGMP stimulates relaxation of smooth muscles has not been determined. Phosphodiesterase type 5 is responsible for degradation of cGMP in the corpus cavernosum. Vardenafil enhances the effect of NO by inhibiting PDE5, thereby raising concentrations of cGMP in the corpus cavernosum. Vardenafil has no direct relaxant effect on isolated human corpus cavernosum and, at recommended doses, has no effect in the absence of sexual stimulation.