Vardenafil is primarily metabolized by CYP3A4/5; clarithromycin is a strong CYP3A4 inhibitor.
Record Status
Patients with mild hepatic impairment (Child-Pugh class A): No dose adjustment is required. Patients with moderate hepatic impairment (Child-Pugh class B): Decrease starting dose to 5 mg/day PO using the regular tablets; the maximum dose should not exceed 10 mg/day PO. Do not use vardenafil orally disintegrating tablets in patients with moderate hepatic impairment.Patients with severe hepatic impairment (Child-Pugh class C): Do not use. CrCl 30 mL/minute or more: No dosage adjustments are needed. HemodialysisDo not use vardenafil in patients requiring dialysis; vardenafil has not been studied in these patients.
The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction
Abarelix: (Major) Avoid use of vardenafil in patients taking abarelix therapy. Abarelix has been associated with QT prolongation and torsade de pointes. Vardenafil is also associated with QT prolongation. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. A decreased pressor effect of phenylephrine might occur. Use of vardenafil with other strong CYP3A4 inhibitors increased the AUC of vardenafil by 10 to16-fold.
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Use of these drugs together may increase the risk for QT prolongation or vardenafil-related side effects.
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.
Clarithromycin has an established risk of QT prolongation and torsade de pointes.
Drug Interactions
Orally disintegrating tablets: Place on tongue where tablet will disintegrate. Administer immediately upon removal from blister packaging. Vardenafil orally disintegrating tablets are not interchangeable with the film-coated tablets; vardenafil orally disintegrating tablets provide higher systemic exposure vs. vardenfil film-coated tablets. 10 mg PO as needed approximately 60 minutes before anticipated sexual activity.
Do you need a prescription for Levitra or generic vardenafil?
May decrease dose to 5 mg or increase dose to 20 mg PO as needed approximately 60 minutes before anticipated sexual activity. Coadministration of certain drugs may need to be avoided or vardenafil dosage adjustments may be necessary; review drug interactions. 5 mg PO as needed approximately 60 minutes before anticipated sexual activity. May increase dose up to 20 mg PO as needed approximately 60 minutes before anticipated sexual activity. Coadministration of certain drugs may need to be avoided or dosage adjustments may be necessary; review drug interactions. Vardenafil may produce an increase in QTc interval at both therapeutic and supratherapeutic doses.
Frequently Asked Questions
Monitor for proper blood pressure when these drugs are used together. Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Acetaminophen; Dextromethorphan; Phenylephrine: (Minor) The therapeutic effect of levitra 40 mg online phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Acetaminophen; Guaifenesin; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Acetaminophen; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors.
What are common drug interactions for vardenafil and tadalafil?
Adagrasib: (Major) Avoid concomitant use of adagrasib and vardenafil due to the potential for increased vardenafil exposure and additive risk for QT/QTc prolongation and torsade de pointes (TdP). If concomitant use is necessary, use vardenafil oral tablets instead of orally disintegrating tablets and do not exceed a single dose of 2.5 mg per 24-hour period. Additionally, consider taking steps to minimize the risk for QT prolongation and TdP, such as electrolyte monitoring and repletion and ECG monitoring. Vardenafil is a CYP3A substrate, adagrasib is a strong CYP3A inhibitor, and both medications have been associated with QT interval prolongation. Coadministration with other strong CYP3A inhibitors increased the AUC of vardenafil by 10- to 16-fold. Anagrelide: (Major) Concomitant use of vardenafil and anagrelide increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
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
Apomorphine: (Moderate) Concomitant use of vardenafil and apomorphine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
Medication
Active Ingredient
Onset of Action
Duration
Typical Dose
Cost
Vardenafil (Levitra)
Vardenafil
25-60 min
Up to 5 hours
10 mg
Moderate
Sildenafil (Viagra)
Sildenafil
30-60 min
4-6 hours
50 mg
Moderate
Tadalafil (Cialis)
Tadalafil
30-60 min
Up to 36 hours
10-20 mg
Higher
Consider taking steps to minimize the risk of QT/QTc interval prolongation and levitra oral jelly uk TdP, such as avoidance, electrolyte monitoring and repletion, and ECG monitoring, especially in patients with additional risk factors for TdP. Aprepitant, Fosaprepitant: (Major) Do not use vardenafil orally disintegrating tablets with aprepitant, fosaprepitant 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; aprepitant is a moderate CYP3A4 inhibitor when administered as a 3-day oral regimen (125 mg/80 mg/80 mg). Coadministration with another moderate CYP3A4 inhibitor increased the AUC of vardenafil by 4-fold. Fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions. Monitor for an increase in vardenafil-related adverse effects for several days after administration of a multi-day aprepitant regimen. Aripiprazole: (Moderate) Concomitant use of vardenafil and aripiprazole may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Arsenic Trioxide: (Major) Concomitant use of vardenafil and arsenic trioxide increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
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
Artemether; Lumefantrine: (Major) Concomitant use of vardenafil and lumefantrine increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
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.
Asenapine: (Major) Concomitant use of vardenafil and asenapine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Atazanavir: (Major) Do not use vardenafil orally disintegrating tablets with atazanavir due to increased vardenafil exposure. Use reduced doses of no more than 2.5 mg every 72 hours of vardenafil oral tablets with increased monitoring for adverse reactions. Vardenafil is primarily metabolized by CYP3A4/5; atazanavir is a strong CYP3A4 inhibitor. Coadministration with other strong CYP3A4 inhibitors increased the AUC of vardenafil by 10 to16-fold. Atazanavir; Cobicistat: (Major) Do not use vardenafil orally disintegrating tablets with atazanavir due to increased vardenafil exposure. (Major) Do not use vardenafil orally disintegrating tablets with cobicistat 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; cobicistat is a strong CYP3A4 inhibitor. Coadministration with other strong CYP3A4 inhibitors increased the AUC of vardenafil by 10 to 16-fold. Atomoxetine: (Moderate) Concomitant use of atomoxetine and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Bedaquiline: (Major) If possible, avoid the use of vardenafil with bedaquiline due to the risk of QT prolongation. Monitor ECGs if bedaquiline is used in patients receiving other drugs that prolong the QTc interval, such as vardenafil.
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Alfuzosin: (Moderate) Due to the potential for symptomatic hypotension, patients should be stable on alfuzosin therapy before initiating therapy with the lowest starting dose of vardenafil. Conversely, patients already receiving an optimized dose of vardenafil should be started on the lowest dose of alfuzosin; 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 alfuzosin. Concurrent use of these medications may also increase the risk for QT prolongation. Alpha-blockers: (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.
What is vardenafil (Levitra®)?
Conversely, patients already receiving an optimized dose of vardenafil should be started on the lowest dose of the alpha-blocker; 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 an alpha-blocker. Amiodarone: (Major) Do not use vardenafil orally disintegrating tablets with amiodarone due to increased vardenafil exposure; do not exceed online levitra store a single dose of 5 mg per 24-hour period of vardenafil oral tablets. Concomitant use also increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Vardenafil is primarily metabolized by CYP3A and amiodarone is a moderate CYP3A inhibitor. Discontinue bedaquiline if evidence of serious ventricular arrhythmia or if a QTcF interval greater than 500 ms occurs. Both therapeutic (10 mg) and supratherapeutic (80 mg) doses of vardenafil produce an increase in the QTc interval.
Authors' conclusions
Coadministration with another moderate CYP3A inhibitor increased the AUC of vardenafil by 4-fold. Amisulpride: (Major) Concomitant use of vardenafil and amisulpride increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Avoid concomitant use if possible, especially in patients with additional risk factors for TdP. Consider taking steps to minimize the risk for QT/QTc interval prolongation and TdP, such as electrolyte monitoring and repletion and ECG monitoring, if concomitant use is necessary. Amoxicillin; Clarithromycin; Omeprazole: (Major) Do not use vardenafil orally disintegrating tablets with clarithromycin due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Berotralstat: (Major) Do not use vardenafil orally disintegrating tablets with berotralstat due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets.
