| name | Vardenafil (Levitra) |
| classification | Phosphodiesterase 5 (PDE5) inhibitor |
| pharmacokinetics | Vardenafil is rapidly absorbed after oral administration, reaching peak plasma concentrations within 1-2 hours. The bioavailability is approximately 15%. The primary route of metabolism is via the cytochrome P450 3A4 enzyme system. Vardenafil is primarily eliminated in the feces. The half-life is approximately 5-6 hours. |
| suggested dosage | | male 25 70kg | The starting dose is typically 10 mg taken approximately 1 hour before sexual activity. The dose can be adjusted up to a maximum of 20 mg or down to 5 mg depending on individual response and tolerability. Consult a physician for specific dosage recommendations. Important to note that doses over 20mg are not routinely indicated and may not provide further benefit, but are sometimes prescribed in specialized cases and under direct medical supervision. Food intake may slightly delay absorption, but the effect is generally not clinically significant. |
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| indications | Erectile dysfunction (ED). |
| safety in pregnancy | Not indicated for use in pregnant women. Vardenafil, like other PDE5 inhibitors, has not been adequately studied in pregnant women. The potential for harm to the developing fetus is unknown. Avoid use during pregnancy. |
| safety in breastfeeding | It is unknown if vardenafil is excreted in human milk. Precaution is advised. Avoid use during breastfeeding. |
| side effects | | 1 | Headache | | 2 | Dyspepsia (indigestion) | | 3 | Nasal congestion | | 4 | Back pain | | 5 | Myalgia (muscle pain) | | 6 | Visual disturbances (e.g., blurred vision, blue-tinted vision) | | 7 | Flushing | | 8 | Dizziness | | 9 | Drowsiness | | 10 | Priapism (prolonged erection): although rare, it requires immediate medical attention. | | 11 | Hypotension (low blood pressure) |
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| alternatives | |
| contraindications | | 1 | Patients with known hypersensitivity to vardenafil or any of the inactive ingredients | | 2 | Patients with severe cardiovascular disease (e.g., unstable angina, recent myocardial infarction, or severe heart failure) | | 3 | Patients with retinitis pigmentosa | | 4 | Patients taking nitrates or nitric oxide donors (e.g., nitroglycerin). Combining vardenafil with nitrates can lead to a sudden and dangerous drop in blood pressure. | | 5 | Patients with a known visual defect or with a history of retinal disorders. |
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| interactions | | 1 | Significant interaction with nitrates (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate), causing potentially severe and dangerous drop in blood pressure. Avoid co-administration. | | 2 | Caution with CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, grapefruit juice): can increase vardenafil levels, potentially increasing side effects. | | 3 | Caution with CYP3A4 inducers (e.g., rifampin, St. John's wort): can decrease vardenafil levels, potentially reducing effectiveness. | | 4 | Caution with alpha-blockers: may increase the risk of low blood pressure. | | 5 | Interaction with certain medications for blood pressure control (be careful about combinations). |
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| warnings and precautions | | 1 | Patients with pre-existing cardiovascular conditions (e.g., hypertension, angina, heart failure): Use with extreme caution. Patients with low blood pressure should use with caution, monitoring for hypotensive effects. | | 2 | Patients with certain eye conditions: Use with caution and under direct medical supervision. Consult a physician for specific advice. | | 3 | Patients with a history of priapism: Avoid use. | | 4 | Avoid driving or operating machinery until the effects of the medication are known, as dizziness or lightheadedness may occur | | 5 | Do not use more than one dose per 24 hours. |
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| additional information | Consult a physician before starting any new medication, especially if you have pre-existing health conditions, or are taking other medications. Provide a complete medical history. Thorough monitoring and careful consideration of potential interactions and side effects is critical. |
