Chiropraxis für Kleintiere Dr. med. vet. Iris Schwager

Safety Information

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Both therapeutic and supratherapeutic doses of vardenafil can produce an increase in the QTc interval.

Record Status

Dronedarone is associated with a dose-related increase in the QTc interval. Coadministration of other drugs that also prolong the QT interval may result in additive QT prolongation. Therapeutic and supratherapeutic doses of vardenafil can produce an increase in QTc interval. Dronedarone is a moderate inhibitor buy cheapest levitra of CYP3A4, the primary isoenzyme responsible for the metabolism of vardenafil. Droperidol: (Major) Concomitant use of vardenafil and droperidol increases the risk of QT/QTc prolongation and torsade de pointes (TdP).

Drug interactions

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.

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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. 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.

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Vardenafil is primarily metabolized by CYP3A; fosamprenavir is a moderate CYP3A inhibitor.

Overdose/Missed Dose

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. 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.

Results of the review

Dextromethorphan; Quinidine: (Major) Vardenafil should be avoided in patients taking Class IA antiarrhythmics (disopyramide, procainamide, and quinidine). Diltiazem: (Major) Do not use vardenafil orally disintegrating tablets with diltiazem due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets. Additive effects on blood pressure are also possible. Vardenafil is primarily metabolized by CYP3A and diltiazem is a moderate CYP3A inhibitor. Diphenhydramine; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors.

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Disopyramide: (Major) Vardenafil should be avoided in patients taking Class IA antiarrhythmics (disopyramide, procainamide, and quinidine). Dofetilide: (Major) Concomitant use of vardenafil and dofetilide increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Dolasetron: (Moderate) Concomitant use of vardenafil and dolasetron may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Dolutegravir; Rilpivirine: (Moderate) Concomitant use of vardenafil and rilpivirine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Donepezil: (Moderate) Concomitant use of vardenafil and donepezil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

What should I do if I accidentally take too much vardenafil?

Donepezil; Memantine: (Moderate) Concomitant use of vardenafil and donepezil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Doxazosin: (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. Dronedarone: (Contraindicated) Use of dronedarone with vardenafil is contraindicated due to an increased risk for QT prolongation and torsade de pointes. Increased vardenafil exposure may occur due to dronedarone inhibition of CYP3A4. An increase in vardenafil-related adverse effects, such as prolonged erection, hypotension, or QT prolongation, is possible. Gemifloxacin: (Moderate) Concomitant use of vardenafil and gemifloxacin may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

Study design

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 levitra order uk 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. 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.

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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: levitra 40 mg online (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.

Outcomes assessed in the review

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.

What is vardenafil used for?

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 risk for torsade de pointes (TdP) and QT/QTc prolongation. Concomitant use may also increase vardenafil exposure, further increasing the risk of adverse effects. Gilteritinib: (Moderate) Concomitant use of vardenafil and gilteritinib may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.

  • 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.

Glasdegib: (Major) Concomitant use of vardenafil and glasdegib increases the risk of QT/QTc prolongation and torsade de pointes (TdP). 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.

  • 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.

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

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

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.

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