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Vardenafil is primarily metabolized by CYP3A4/5; atazanavir is a strong CYP3A4 inhibitor.

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

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.

• 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.

(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.

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

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.

Results of the review

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.

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Arsenic Trioxide: (Major) Concomitant use of vardenafil and arsenic trioxide increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Artemether; Lumefantrine: (Major) Concomitant use of vardenafil and lumefantrine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). 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. 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. Discontinue bedaquiline if evidence of serious ventricular arrhythmia or if a QTcF interval greater than 500 ms occurs.

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Both therapeutic (10 mg) and supratherapeutic (80 mg) doses of vardenafil produce an increase in the QTc interval. Berotralstat: (Major) Do not use levitra cut price 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.

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Amoxicillin; Clarithromycin; Omeprazole: (Major) Do not use vardenafil orally disintegrating tablets with clarithromycin due to increased vardenafil exposure; do not exceed generic levitra pills canada a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets. Vardenafil is primarily metabolized by CYP3A4/5; clarithromycin is a strong CYP3A4 inhibitor. Use of vardenafil with other strong CYP3A4 inhibitors increased the AUC of vardenafil by 10 to16-fold. Use of these drugs together may increase the risk for QT prolongation or vardenafil-related side effects. Clarithromycin has an established risk of QT prolongation and torsade de pointes.

What is vardenafil (Levitra®)?

Vardenafil may produce an increase in QTc interval at both therapeutic and supratherapeutic doses. Anagrelide: (Major) Concomitant use of vardenafil and anagrelide increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Apomorphine: (Moderate) Concomitant use of vardenafil and apomorphine 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 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; berotralstat is a moderate CYP3A4 inhibitor. Bismuth Subcitrate Potassium; Metronidazole; Tetracycline: (Moderate) Concomitant use of metronidazole and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

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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. 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 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).

What are the most common side effects of vardenafil?

Vardenafil is primarily metabolized by CYP3A and amiodarone is a moderate CYP3A inhibitor. 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. Bismuth Subsalicylate; Metronidazole; Tetracycline: (Moderate) Concomitant use of metronidazole and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Brompheniramine; Dextromethorphan; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Brompheniramine; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Buprenorphine: (Major) Concomitant use of vardenafil and buprenorphine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Buprenorphine; Naloxone: (Major) Concomitant use of vardenafil and buprenorphine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Cabotegravir; Rilpivirine: (Moderate) Concomitant use of vardenafil and rilpivirine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. The degree of QT prolongation associated with rilpivirine is not clinically significant when administered within the recommended dosage range; QT prolongation has been described at 3 times the maximum recommended dose.

CRD summary

Acetaminophen; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. 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.

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Coadministration with other strong CYP3A inhibitors increased the AUC of vardenafil by 10- to 16-fold. 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. Ceritinib: (Major) Do not use vardenafil orally disintegrating tablets with ceritinib 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; ceritinib is a strong CYP3A inhibitor. Use of vardenafil with other strong CYP3A inhibitors increased the AUC of vardenafil by 10 to 16-fold. There may also be an increased potential for QT prolongation. Vardenafil can produce an increase in QTc interval at both therapeutic and supratherapeutic doses. Ceritinib has been reported to cause concentration-dependent QT prolongation. Periodically monitor ECGs and electrolytes during concurrent use of ceritinib and vardenafil oral tablets.

• 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.

Chloramphenicol: (Major) Do not use vardenafil orally disintegrating tablets with chloramphenicol due to increased vardenafil exposure; do not exceed a single dose of 2.5 mg per 24-hour period of vardenafil oral tablets.

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