Vardenafil

Indications

Vardenafil is used for: Erectile dysfunction

Adult Dose

Oral Erectile dysfunction Adult: Usual dose: 10 mg as needed; may adjust according to effectiveness and tolerance(range: 5-20 mg). Dose is taken 1hr before sexual intercourse. Max dosing frequency: 1 dose/day Hepatic impairment Child-Pugh class A: Dosage adjustment not necessary Child-Pugh class B: Film-coated tablet, 5 mg PO ~1 hour before sexual activity; not to exceed 10 mg once daily; ODT not recommended Child-Pugh class C: Not recommended

Child Dose

Renal Dose

Renal impairment Mild, moderate, severe impairment: Dosage adjustment not necessary Hemodialysis: Not recommended

Administration

May be taken with or without food.

Contra Indications

Known prolongation of QT interval (congenital or acquired); men for whom sexual intercourse is inadvisable due to CV risk factors; hypotension (systolic <90 mm Hg); hypertension (systolic >170 mm Hg or diastolic >110 mm Hg); recent stroke or MI (within last 6 mth); unstable angina; severe heart failure; end-stage renal disease requiring dialysis; severe hepatic impairment; known degenerative retinal disorders e.g. retinitis pigmentosa. Women, child.

Precautions

Anatomical deformation of the penis; predisposition to priapism e.g. sickle cell anaemia, multiple myeloma, or leukaemia; bleeding disorders or active peptic ulceration; left ventricular outflow obstruction; elderly (? 65 yr). Discontinue and seek medical advice if there is sudden vision loss or decreased vision in one or both eyes or tinnitus, dizziness or sudden loss or decrease in hearing, while taking vardenafil. May cause dizziness or abnormal vision so avoid driving or operating machinery until effects of vardenafil is known. Seek immediate medical advice if erection last > 4 hr.

Pregnancy-Lactation

Pregnancy category: B Lactation: Unknown whether drug is distributed into breast milk; indicated for males

Interactions

May enhance hypotensive effect of α-blockers. Increased serum concentration with guanylate cyclase stimulators (e.g. riociguat), potent CYP3A4 inhibitors (e.g. ketoconazole) and moderate CYP3A4 inhibitors (e.g. clarithromycin), HIV protease inhibitors (e.g. ritonavir). May prolong Qt interval with class IA (e.g. quinidine, procainamide) or class III (e.g. amiodarone, sotalol) antiarrhythmics. Potentially Fatal: Enhanced hypotensive effect with any form of organic nitrates/nitrites, guanylate cyclase stimulators (e.g. riociguat).

Side Effects

Side effects of Vardenafil : Dyspepsia, vomiting, headache, flushing, dizziness, visual disturbances, colour vision changes, raised intra-ocular pressure, nasal congestion, hypersensitivity reactions, nausea, photosensitivity reactions, hypotension, hypertension, priapism, palpitations, myalgia, increased creatinine kinase, sudden decrease or loss of hearing, tinnitus.

Mode of Action

Vardenafil is a phosphodiesterase type-5 inhibitor. It manages erectile dysfunction by increasing the amounts of cyclic guanosine monophosphate (cGMP).