
Therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval.
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; 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). 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 levitra canadian drugs 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. The effect of vardenafil on the QT interval should be considered when prescribing the drug. Clofazimine: (Moderate) Concomitant use of clofazimine and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Clozapine: (Moderate) Concomitant use of vardenafil and clozapine may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients. Cobicistat: (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. Codeine; Phenylephrine; Promethazine: (Moderate) Concomitant use of promethazine and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
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(Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Codeine; Promethazine: (Moderate) Concomitant use of promethazine and vardenafil may increase the risk of QT/QTc prolongation and torsade de pointes (TdP) in some patients.
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. 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. 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.
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. 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. Conivaptan: (Major) Do not use vardenafil orally disintegrating tablets with conivaptan due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-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 CYP3A; conivaptan is a moderate CYP3A inhibitor.
Crizotinib: (Major) Do not use vardenafil orally disintegrating tablets with crizotinib due to increased vardenafil exposure; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets.
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. 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 levitra 10mg tablets 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. 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. Vardenafil is primarily metabolized by CYP3A4/5; chloramphenicol is a strong CYP3A4 inhibitor. Chloroquine: (Major) Concomitant use of vardenafil and chloroquine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Chlorpheniramine; Dextromethorphan; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Vardenafil is primarily metabolized by CYP3A4/5; crizotinib is a moderate CYP3A4 inhibitor. In addition, vardenafil is associated with QT prolongation.
Chlorpheniramine; Dihydrocodeine; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Chlorpheniramine; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. Chlorpromazine: (Major) Concomitant use of vardenafil and chlorpromazine increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Ciprofloxacin: (Major) Do not use vardenafil orally disintegrating tablets with ciprofloxacin 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 best price on levitra by CYP3A and ciprofloxacin is a moderate CYP3A inhibitor.
Cisapride: (Contraindicated) Avoid concomitant use of vardenafil and cisapride due to an increased risk for torsade de pointes (TdP) and QT/QTc prolongation. Citalopram: (Major) Concomitant use of citalopram and vardenafil increases the risk of QT/QTc prolongation and torsade de pointes (TdP). Clarithromycin: (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. Class IA Antiarrhythmics: (Major) Vardenafil should be avoided in patients taking Class IA antiarrhythmics (disopyramide, procainamide, and quinidine). Class IA antiarrhythmics are associated with QT prolongation and torsade de pointes (TdP). Both therapeutic and supratherapeutic doses of vardenafil may produce an increase in QTc interval. Crizotinib has also been associated with concentration-dependent QT prolongation.