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Clinical Studies on Vardenafil Efficacy
Dutasteride; 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. Conversely, patients already receiving an optimized dose of vardenafil should be started on the lowest dose of tamsulosin; 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 tamsulosin. Duvelisib: (Major) Do not use vardenafil orally disintegrating tablets with duvelisib 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; duvelisib is a moderate CYP3A4 inhibitor. Efavirenz: (Moderate) Concomitant use of vardenafil and efavirenz may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
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Vardenafil is primarily metabolized by CYP3A4/5; idelalisib is a strong CYP3A4 inhibitor. Iloperidone: (Major) Concomitant use of vardenafil and iloperidone increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Imatinib: (Major) Do not use vardenafil orally disintegrating tablets with imatinib 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; imatinib is a moderate CYP3A4 inhibitor. Indinavir: (Major) Do not use vardenafil orally disintegrating tablets with indinavir due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets.
Other Interactions
Efavirenz; Emtricitabine; Tenofovir Disoproxil Fumarate: (Moderate) Concomitant use of vardenafil and efavirenz may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Eliglustat: (Moderate) Concomitant use of vardenafil and eliglustat may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide: (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. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: (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. Emtricitabine; Rilpivirine; Tenofovir alafenamide: (Moderate) Concomitant use of vardenafil and rilpivirine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Emtricitabine; Rilpivirine; Tenofovir Disoproxil Fumarate: (Moderate) Concomitant use of vardenafil and rilpivirine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Entrectinib: (Major) Concomitant use of vardenafil and entrectinib increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Eribulin: (Major) Concomitant use of vardenafil and eribulin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Erythromycin: (Major) Do not use vardenafil orally disintegrating tablets with erythromycin 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 erythromycin is a moderate CYP3A inhibitor.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Levitra Generic | 10mg | 20 Pills | 46.54€ 44.32€ | |
| Levitra Original | 20mg | 12 Pills | 81.99€ 78.09€ | |
| Levitra Professional | 20mg | 360 + 6 Pills | 914.63€ 871.08€ | |
| Levitra Generic | 10mg | 120 + 10 Pills | 178.59€ 170.09€ | |
| Levitra Soft Tabs | 20mg | 10 Pills | 52.27€ 49.78€ | |
| Levitra Original | 20mg | 76 + 4 Pills | 344.39€ 327.99€ | |
| Levitra Generic | 60mg | 10 Pills | 47.42€ 45.16€ | |
| Levitra Generic | 60mg | 60 + 4 Pills | 198.85€ 189.38€ | |
| Levitra Generic | 40mg | 30 + 2 Pills | 93.58€ 89.12€ | |
| Levitra Original | 20mg | 14 + 2 Pills | 102.27€ 97.40€ | |
| Levitra Original | 20mg | 120 + 8 Pills | 528.19€ 503.04€ | |
| Levitra Generic | 40mg | 360 + 10 Pills | 704.99€ 671.42€ | |
| Levitra Original | 20mg | 8 Pills | 65.05€ 61.95€ | |
| Levitra Generic | 40mg | 20 Pills | 67.56€ 64.34€ | |
| Levitra Generic | 20mg | 360 + 10 Pills | 458.44€ 436.61€ |
Coadministration with erythromycin increased the AUC of vardenafil by 4-fold. Escitalopram: (Moderate) Concomitant use of vardenafil and escitalopram may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
- Levitra was one of the first medications introduced for erectile dysfunction.
- Its mechanism involves relaxation of smooth muscle in penile tissue.
- Men should avoid taking Levitra with heavy meals to ensure rapid action.
- The medication’s safety profile is well-documented in scientific literature.
- Levitra may be prescribed alongside other therapies for ED management.
- Regular medical check-ups are recommended during treatment.
- Patients should be aware of potential drug interactions with Levitra.
- Avoid combining Levitra with recreational drugs, especially stimulants.
Fedratinib: (Major) Do not use vardenafil orally disintegrating tablets with fedratinib 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; fedratinib is a moderate CYP3A4 inhibitor. The safety and efficacy of combinations of tadalafil and other phosphodiesterase 5 (PDE5) inhibitors, such as vardenafil, has not been studied. Fingolimod: (Moderate) Concomitant use of vardenafil and fingolimod may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Flecainide: (Major) Concomitant use of flecainide and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
Proper Use
The degree of QT prolongation associated with fostemsavir is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 4 times the recommended daily dose. Gemifloxacin: (Moderate) Concomitant use of vardenafil and gemifloxacin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Gemtuzumab Ozogamicin: (Moderate) Concomitant use of vardenafil and gemtuzumab ozogamicin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Gilteritinib: (Moderate) Concomitant use of vardenafil and gilteritinib may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Glasdegib: (Major) Concomitant use of vardenafil and glasdegib increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
Drug Interactions
Goserelin: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., goserelin) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Granisetron: (Moderate) Concomitant use of vardenafil and granisetron may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Grapefruit juice: (Major) Grapefruit and grapefruit juice should be avoided during treatment with vardenafil orally disintegrating tablets 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; grapefruit juice is a moderate CYP3A4 inhibitor. Guaifenesin; levitra pastillas Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Fluconazole: (Contraindicated) Avoid concomitant use of vardenafil and fluconazole due to an increased levitra canadian drugs risk for torsade de pointes (TdP) and QT/QTc prolongation.
- Levitra works by blocking PDE5 enzyme, enhancing erectile response.
- Patients should not engage in strenuous activity immediately after taking Levitra.
- It is often prescribed when other ED treatments have failed or are unsuitable.
- Levitra has a rapid onset, with effects usually seen within 30-60 minutes.
- The medication is available in various dosages to tailor treatment.
- Alcohol and high-fat foods can impair the absorption of Levitra.
- Women should not take Levitra as it is not approved for female use.
- Regular follow-up with a healthcare provider helps monitor treatment efficacy.
Concomitant use may also increase vardenafil exposure, further increasing the risk of adverse effects. If concomitant use of fluconazole and vardenafil oral tablets is required, the maximum single dose is 5 mg every 24 hours. Do not use vardenafil orally disintegrating tablets with fluconazole. Vardenafil is primarily metabolized by CYP3A and fluconazole is a moderate CYP3A inhibitor. Fluoxetine: (Moderate) Concomitant use of vardenafil and fluoxetine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Fluphenazine: (Minor) Use vardenafil with caution in combination with fluphenazine due to increased risk of QT prolongation.
| Aspect | Levitra (Vardenafil) | Sildenafil (Viagra) | Tadalafil (Cialis) |
|---|---|---|---|
| Onset of action | 25-30 minutes | 30-60 minutes | 30-60 minutes |
| Duration | Up to 4-5 hours | Up to 4 hours | Up to 36 hours |
| Food interactions | Less affected by food | Delayed if taken after heavy meals | Less affected by food |
| Side effect profile | Similar to others, with possible visual disturbances | Similar, with some headache | Longer-lasting effect |
Fluphenazine is also associated with a possible risk for QT prolongation. Fluvoxamine: (Major) Do not use vardenafil orally disintegrating tablets with fluvoxamine 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; fluvoxamine is a moderate CYP3A4 inhibitor. There may also be an increased risk for QT prolongation and torsade de pointes (TdP) during coadministration. Cases of QT prolongation and TdP have been reported during postmarketing use of fluvoxamine. Both therapeutic and supratherapeutic doses of vardenafil can produce an increase in the QTc interval.
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Halogenated Anesthetics: (Major) Concomitant use of vardenafil and halogenated anesthetics increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Haloperidol: (Moderate) Concomitant use of vardenafil and haloperidol may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. The intravenous route may carry a higher risk for haloperidol-induced QT/QTc prolongation than other routes of administration. Histrelin: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., histrelin) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Consistent with their known effects on the nitric oxide/cGMP pathway, concomitant use of phosphodiesterase inhibitors and nitrates can cause severe hypotension, syncope, or myocardial infarction.
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Deaths have been reported in men who were using sildenafil while taking nitrate or nitrite therapy for angina. Hydroxychloroquine: (Major) Concomitant use of hydroxychloroquine and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Hydroxyzine: (Moderate) Concomitant use of vardenafil and hydroxyzine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Ibutilide: (Major) Concomitant use of vardenafil and ibutilide increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Idelalisib: (Major) Do not use vardenafil orally disintegrating tablets with idelalisib due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Fosamprenavir: (Major) Do not use vardenafil orally disintegrating tablets with fosamprenavir 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; fosamprenavir is a moderate CYP3A inhibitor.
Next Steps
Dutasteride; 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. Conversely, patients already receiving an optimized dose of vardenafil should be started on the lowest dose of tamsulosin; 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 tamsulosin. Duvelisib: (Major) Do not use vardenafil orally disintegrating tablets with duvelisib 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; duvelisib is a moderate CYP3A4 inhibitor.
What are the most common side effects of vardenafil?
Efavirenz: (Moderate) Concomitant use of vardenafil and efavirenz may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Efavirenz; Emtricitabine; Tenofovir Disoproxil Fumarate: (Moderate) Concomitant use of vardenafil and efavirenz may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Eliglustat: (Moderate) Concomitant use of vardenafil and eliglustat may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide: (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. Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate: (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. Foscarnet: (Major) Concomitant use of vardenafil and foscarnet increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Fostemsavir: (Moderate) Concomitant use of vardenafil and fostemsavir may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. The degree of QT prolongation associated with fostemsavir is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 4 times the recommended daily dose. Gemifloxacin: (Moderate) Concomitant use of vardenafil and gemifloxacin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Gemtuzumab Ozogamicin: (Moderate) Concomitant use of vardenafil and gemtuzumab ozogamicin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Gilteritinib: (Moderate) Concomitant use of vardenafil and gilteritinib may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Glasdegib: (Major) Concomitant use of vardenafil and glasdegib increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
| Step | Description |
|---|---|
| PDE5 inhibition | Blocks enzyme PDE5, increasing cGMP levels |
| Increased cGMP | Causes smooth muscle relaxation in corpora cavernosa |
| Erection initiation | Blood flow into the penis increases, facilitating an erection |
Goserelin: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., goserelin) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
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Fluphenazine is also associated with a possible risk for QT prolongation. Fluvoxamine: (Major) Do not use vardenafil orally disintegrating tablets with fluvoxamine 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; fluvoxamine is a moderate CYP3A4 inhibitor. There may also be an increased risk for QT prolongation and torsade de pointes (TdP) during coadministration. Cases of QT prolongation and TdP have been reported during postmarketing use of fluvoxamine.
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Both therapeutic and supratherapeutic doses of vardenafil can produce an increase in the QTc interval. Fosamprenavir: (Major) Do not use vardenafil orally disintegrating tablets with fosamprenavir 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; fosamprenavir is a moderate CYP3A inhibitor. Foscarnet: (Major) Concomitant use of vardenafil and foscarnet increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Fostemsavir: (Moderate) Concomitant use of vardenafil and fostemsavir may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Granisetron: (Moderate) Concomitant use of vardenafil and granisetron may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Grapefruit juice: (Major) Grapefruit and grapefruit juice should be avoided during treatment with vardenafil orally disintegrating tablets 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; grapefruit juice is a moderate CYP3A4 inhibitor. Guaifenesin; levitra pastillas Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Halogenated Anesthetics: (Major) Concomitant use of vardenafil and halogenated anesthetics increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Haloperidol: (Moderate) Concomitant use of vardenafil and haloperidol may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. The intravenous route may carry a higher risk for haloperidol-induced QT/QTc prolongation than other routes of administration. Histrelin: (Moderate) Concomitant use of vardenafil and androgen deprivation therapy (i.e., histrelin) may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Consistent with their known effects on the nitric oxide/cGMP pathway, concomitant use of phosphodiesterase inhibitors and nitrates can cause severe hypotension, syncope, or myocardial infarction.
Dosing information
Emtricitabine; Rilpivirine; Tenofovir alafenamide: (Moderate) Concomitant use of vardenafil and rilpivirine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Emtricitabine; Rilpivirine; Tenofovir Disoproxil Fumarate: (Moderate) Concomitant use of vardenafil and rilpivirine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Entrectinib: (Major) Concomitant use of vardenafil and entrectinib increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Eribulin: (Major) Concomitant use of vardenafil and eribulin increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Erythromycin: (Major) Do not use vardenafil orally disintegrating tablets with erythromycin due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets.
What should I do if I miss a dose of vardenafil?
Vardenafil is primarily metabolized by CYP3A and erythromycin is a moderate CYP3A inhibitor. Coadministration with erythromycin increased the AUC of vardenafil by 4-fold. Escitalopram: (Moderate) Concomitant use of vardenafil and escitalopram may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Fedratinib: (Major) Do not use vardenafil orally disintegrating tablets with fedratinib 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; fedratinib is a moderate CYP3A4 inhibitor. Deaths have been reported in men who were using sildenafil while taking nitrate or nitrite therapy for angina. Hydroxychloroquine: (Major) Concomitant use of hydroxychloroquine and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP).
Tainted supplements
The safety and efficacy of combinations of tadalafil and other phosphodiesterase 5 (PDE5) inhibitors, such as vardenafil, has not been studied. Fingolimod: (Moderate) Concomitant use of vardenafil and fingolimod may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Flecainide: (Major) Concomitant use of flecainide and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Fluconazole: (Contraindicated) Avoid concomitant use of vardenafil and fluconazole due to an increased levitra canadian drugs risk for torsade de pointes (TdP) and QT/QTc prolongation. Concomitant use may also increase vardenafil exposure, further increasing the risk of adverse effects.
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If concomitant use of fluconazole and vardenafil oral tablets is required, the maximum single dose is 5 mg every 24 hours. Do not use vardenafil orally disintegrating tablets with fluconazole. Vardenafil is primarily metabolized by CYP3A and fluconazole is a moderate CYP3A inhibitor. Fluoxetine: (Moderate) Concomitant use of vardenafil and fluoxetine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Fluphenazine: (Minor) Use vardenafil with caution in combination with fluphenazine due to increased risk of QT prolongation. Hydroxyzine: (Moderate) Concomitant use of vardenafil and hydroxyzine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Ibutilide: (Major) Concomitant use of vardenafil and ibutilide increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Idelalisib: (Major) Do not use vardenafil orally disintegrating tablets with idelalisib 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; idelalisib is a strong CYP3A4 inhibitor. Iloperidone: (Major) Concomitant use of vardenafil and iloperidone increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Imatinib: (Major) Do not use vardenafil orally disintegrating tablets with imatinib 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; imatinib is a moderate CYP3A4 inhibitor.
| Region/Country | Approval Status | Prescription Required | OTC Availability |
|---|---|---|---|
| USA | Approved by FDA | Yes | No |
| European Union | Approved by EMA | Yes | No |
| Australia | Approved by TGA | Yes | No |
| Canada | Approved by Health Canada | Yes | No |
Indinavir: (Major) Do not use vardenafil orally disintegrating tablets with indinavir due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets.