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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.

Prescription Status: Rx-Only vs. OTC

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. 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.

Sustained efficacy and tolerability of vardenafil (Levitra®), a highly potent, selective phosphodiesterase-5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial

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). 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). 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).

Product	Dosage	Quantity + Bonus	Price
Levitra Generic	40mg	20 Pills	67.56€ 64.34€	Buy
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Levitra Generic	20mg	20 Pills	52.63€ 50.12€	Buy
Levitra Original	20mg	92 + 4 Pills	406.22€ 386.88€	Buy
Levitra Generic	60mg	90 + 6 Pills	291.82€ 277.92€	Buy
Levitra Generic	40mg	90 + 6 Pills	234.73€ 223.55€	Buy
Levitra Generic	10mg	270 + 10 Pills	338.09€ 321.99€	Buy
Levitra Original	20mg	48 + 4 Pills	235.14€ 223.94€	Buy
Levitra Soft Tabs	20mg	90 + 6 Pills	241.31€ 229.82€	Buy
Levitra Generic	10mg	120 + 10 Pills	178.59€ 170.09€	Buy
Levitra Generic	10mg	10 Pills	28.93€ 27.55€	Buy
Levitra Soft Tabs	20mg	120 + 8 Pills	288.52€ 274.78€	Buy
Levitra Generic	20mg	30 + 4 Pills	70.59€ 67.23€	Buy
Levitra Generic	40mg	180 + 10 Pills	405.06€ 385.77€	Buy

Coadministration with another moderate CYP3A4 inhibitor increased the AUC of vardenafil by 4-fold.

• 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.

Fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions.

CRD commentary

Vardenafil orally disintegrating tablets are not interchangeable with the film-coated tablets; vardenafil orally disintegrating tablets provide higher systemic exposure vs. vardenfil film-coated tablets. 10 mg PO as needed approximately 60 minutes before anticipated sexual activity. May decrease dose to 5 mg or increase dose to 20 mg PO as needed approximately 60 minutes before anticipated sexual activity. Coadministration of certain drugs may need to be avoided or vardenafil dosage adjustments may be necessary; review drug interactions.

Who should not take vardenafil?

5 mg PO as needed approximately 60 minutes before anticipated sexual activity. May increase dose up to 20 mg PO as needed approximately 60 minutes before anticipated sexual activity. Coadministration of certain drugs may need to be avoided or dosage adjustments may be necessary; review drug interactions. Patients with mild hepatic impairment (Child-Pugh class A): No dose adjustment is required. Patients with moderate hepatic impairment (Child-Pugh class B): Decrease starting dose to 5 mg/day PO using the regular tablets; the maximum dose should not exceed 10 mg/day PO. Monitor for an increase in vardenafil-related adverse effects for several days after administration of a multi-day aprepitant regimen.

• Levitra is available in 10 mg and 20 mg tablets.
• The medication is not an aphrodisiac; it enhances ability when sexually stimulated.
• Vardenafil is a PDE5 inhibitor class drug.
• It can be used by men with diabetes-related erectile issues.
• Levitra may cause dizziness; avoid driving after taking.
• The medication is approved by the FDA for ED treatment.
• Do not use if you have severe liver or kidney problems.
• Vardenafil should be stored at room temperature, away from moisture.
• It is not suitable for women or children.
• Consult your doctor for potential drug interactions.

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).

Brand Name	Active Ingredient	Medication Type	Typical Dosage	Available Forms
Levitra	Vardenafil	PDE5 Inhibitor	5 mg, 10 mg, 20 mg	Tablets
Staxyn	Vardenafil ODT	PDE5 Inhibitor	10 mg	Orally Disintegrating Tablets
Vidalista	Tadalafil (comparison)	PDE5 Inhibitor	2.5 mg, 5 mg, 10 mg	Tablets

Artemether; Lumefantrine: (Major) Concomitant use of vardenafil and lumefantrine increases the risk of QT/QTc prolongation and torsade de pointes (TdP).

References (13)

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. Amoxicillin; Clarithromycin; Omeprazole: (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. 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.

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

• 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.

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.

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Do not use vardenafil orally disintegrating tablets in patients with moderate hepatic impairment.Patients with severe hepatic impairment (Child-Pugh class C): Do not use. CrCl 30 mL/minute or more: No dosage adjustments are needed. HemodialysisDo not use vardenafil in patients requiring dialysis; vardenafil has not been studied in these patients. Abarelix: (Major) Avoid use of vardenafil in patients taking abarelix therapy. Abarelix has been associated with QT prolongation and torsade de pointes.

Contraindications for Levitra and Stendra?

Vardenafil is also associated with QT prolongation. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. A decreased pressor effect of phenylephrine might occur. Monitor for proper blood pressure when these drugs are used together. Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine: (Minor) The therapeutic effect of phenylephrine injection may be decreased in patients receiving phosphodiesterase inhibitors. 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.

Proper Use

Vardenafil is prescription-only (Rx) in nearly all countries. Medical screening is required because PDE5 inhibitors can interact with cardiovascular medications and may not be appropriate for everyone. Any seller offering OTC Levitra or “no-prescription vardenafil” is operating outside legal pharmaceutical channels. These products are frequently counterfeit or contaminated. Only through a licensed pharmacy, either in person or via a verified online or telehealth provider that requires a valid prescription.

RedBox Rx Reviews

Avoid unregulated websites and “miracle” supplements claiming ED effects, as many contain undeclared vardenafil. Vardenafil is administered orally approximately 1 hour before expected intercourse. May be administered with or without food. Orally disintegrating tablets: Place on tongue where tablet will disintegrate. Administer immediately upon removal from blister packaging. Atazanavir; Cobicistat: (Major) Do not use vardenafil orally disintegrating tablets with atazanavir due to increased vardenafil exposure.

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

(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.

Record Status

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

Insurance Information

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. 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 price levitra 10mg 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. 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.

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