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Vardenafil Disease Interactions

There are 10 disease interactions with vardenafil:

Major

Pde5 Inhibitors (Includes Vardenafil) ↔ Cardiovascular Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Hypotension, Cardiovascular Disease, Cerebral Vascular Disorder, History - Cerebrovascular Disease, History - Myocardial Infarction

The use of phosphodiesterase-5 (PDE5) inhibitors is not recommended in patients with preexisting cardiovascular disease for whom sexual activity is inadvisable due to the potential cardiac risk. Physicians should also consider the vasodilatory effect of these drugs and whether they may adversely affect patients with underlying cardio- and/or cerebrovascular conditions, in particular those who have suffered a myocardial infarction, stroke, or life-threatening arrhythmia within the last 6 months; those with resting hypotension (BP < 90/50) or hypertension (BP > 170/110); and those with unstable angina associated with cardiac failure or coronary artery disease. There are no controlled clinical data on the safety or efficacy in such patients. Other adverse cardiovascular effects reported include angina pectoris, myocardial infarction, AV block, ventricular arrhythmia, tachycardia, palpitation, hypotension, postural hypotension, syncope, cerebral thrombosis, cerebrovascular hemorrhage, transient ischemic attack, cardiac arrest, heart failure, and hypertension. Many of these events occurred in patients with cardiovascular risk factors and during or shortly after sexual activity.

References

  1. Kloner RA, Zusman RM "Cardiovascular effects of sildenafil citrate and recommendations for its use." Am J Cardiol 84 (1999): n11-7
  2. Conti CR, Pepine CJ, Sweeney M "Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease." Am J Cardiol 83 (1999): c29-34
  3. Malozowski S, Sahlroot JT "Hemodynamic effects of sildenafil." N Engl J Med 343 (2000): 967-8
  4. Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies." Urology 53 (1999): 1011-8
  5. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
  6. Dunn N "Cardiovascular events in users of sildenafil - Paper does not provide any reassurance." Br Med J 323 (2001): 50-1
  7. Awan GM, Calderon E, Dawood G, Alpert MA "Acute, symptomatic atrial fibrillation after sildenafil citrate therapy in a patient with hypertrophic obstructive cardiomyopathy." Am J Med Sci 320 (2000): 69-71
  8. Zusman RM "Cardiovascular data on sildenafil citrate - Introduction." Am J Cardiol 83 (1999): c1-2
  9. Zusman RM, Morales A, Glasser DB, Osterloh IH "Overall cardiovascular profile of sildenafil citrate." Am J Cardiol 83 (1999): c35-44
  10. Feenstra J, vanDriePierik RJHM, Lacle CF, Stricker BHC "Acute myocardial infarction associated with sildenafil." Lancet 352 (1998): 957-8
  11. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
  12. Kloner RA "Cardiovascular risk and sildenafil." Am J Cardiol 86 (2000): f57-61
  13. Moreira SG, Brannigan RE, Spitz A, Orejuela FJ, Lipshultz LI, Kim ED "Side-effect profile of sildenafil citrate (Viagra) in clinical practice." Urology 56 (2000): 474-6
  14. McMahon CG, Smali R, Johnson H "Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction." J Urol 164 (2000): 1192-6
View all 14 references
Major

Pde5 Inhibitors (Includes Vardenafil) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

The plasma clearance of phosphodiesterase-5 (PDE5) inhibitors may be decreased in patients with severe renal impairment, resulting in drug accumulation. Therapy with these agents should be avoided in patients with severe renal disease or on renal dialysis. Dose adjustments might be needed based on individual renal assessment and tolerability if used in these patients.

References

  1. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
Major

Vardenafil (Includes Vardenafil) ↔ Qt Prolongation

Severe Potential Hazard, High plausibility

Applies to: Long QT Syndrome

Vardenafil prolongs the QT interval. Patients taking Class 1A or Class III antiarrhythmic medications or those with congenital QT prolongation, should avoid using this agent. Caution should be exercised if used in patients with congenital QT syndrome, or using other QT prolonging drugs.

Moderate

Pde 5 Inhibitors (Includes Vardenafil) ↔ Priapism

Moderate Potential Hazard, Moderate plausibility

Applies to: Myeloproliferative Disorder, Sickle Cell Anemia, Peyronie's Disease, Cavernosal/Penile Tissue Abnormalities

Prolonged erection greater than 4 hours and priapism (painful erections greater than 6 hours) have been reported during treatment with phosphodiesterase-5 (PDE 5) inhibitors. Priapism may result in penile tissue damage and permanent loss of potency if not treated promptly. These agents should be used cautiously in patients with conditions that may predispose them to priapism such as sickle cell anemia, multiple myeloma, or leukemia, and those with anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie's disease). If an erection persists longer than 4 hours, the patient should seek immediate medical assistance.

References

  1. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
  2. Kassim AA, Fabry ME, Nagel RL "Acute priapism associated with the use of sildenafil in a patient with sickle cell trait." Blood 95 (2000): 1878-9
Moderate

Pde5 Inhibitors (Includes Vardenafil) ↔ Alcoholism

Moderate Potential Hazard, Moderate plausibility

Applies to: Alcoholism

Alcohol consumption may intensify the pressure-lowering effects of mild vasodilators, such as phosphodiesterase 5 (PDE5) inhibitors. Therefore, patients that consume alcohol should be warned to limit alcohol intake while receiving these agents.

Moderate

Pde5 Inhibitors (Includes Vardenafil) ↔ Hearing Loss

Moderate Potential Hazard, Moderate plausibility

Applies to: Hearing Loss, Tinnitus

Use of phosphodiesterase-5 (PDE5) inhibitors has been associated with sudden decrease or loss of hearing, which may be accompanied by tinnitus or dizziness. Patients with hearing problems should stop taking these agents and seek prompt medical care.

Moderate

Pde5 Inhibitors (Includes Vardenafil) ↔ Retinitis Pigmentosa

Moderate Potential Hazard, Moderate plausibility

Applies to: Retinitis Pigmentosa

Phosphodiesterase-5 (PDE5) inhibitors have been associated with transient impairment of color discrimination (blue/green) and blue- or color-tinged vision. These agents also inhibit phosphodiesterase-6 (PDE6), to a much lesser extent, which is involved in phototransduction in the retina. There are no controlled clinical data on the safety in patients with retinitis pigmentosa, a minority of whom may have genetic disorders of retinal phosphodiesterases. Therapy with these agents should be avoided in such patients.

References

  1. Montorsi F, McDermott TED, Morgan R, Olsson A, Schultz A, Kirkeby HJ, Osterloh IH "Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies." Urology 53 (1999): 1011-8
  2. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA "Oral sildenafil in the treatment of erectile dysfunction." N Engl J Med 338 (1998): 1397-404
  3. Goldenberg MM "Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction." Clin Ther 20 (1998): 1033-48
  4. Zrenner E "No cause for alarm over retinal side-effects of sildenafil." Lancet 353 (1999): 340-1
  5. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
  6. McMahon CG, Smali R, Johnson H "Efficacy, safety and patient acceptance of sildenafil citrate as treatment for erectile dysfunction." J Urol 164 (2000): 1192-6
  7. Vobig MA "Retinal side-effects of sildenafil." Lancet 353 (1999): 1442
  8. Vobig MA, Klotz T, Staak M, BartzSchmidt KU, Engelmann U, Walter P "Retinal side-effects of sildenafil." Lancet 353 (1999): 375
  9. Marmor MF "Sildenafil (Viagra) and ophthalmology." Arch Ophthalmol 117 (1999): 518-9
View all 9 references
Moderate

Pde5 Inhibitors (Includes Vardenafil) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

The use of phosphodiesterase 5 (PDE-5) inhibitors has been associated with seizures. Therapy with these agents should be administered cautiously in patients with preexisting seizure disorders.

References

  1. "Product Information. Viagra (sildenafil)." Pfizer US Pharmaceuticals, New York, NY.
Moderate

Vardenafil (Includes Vardenafil) ↔ Liver Disease

Moderate Potential Hazard, Moderate plausibility

Applies to: Liver Disease

Vardenafil is cleared predominantly by hepatic metabolism. The pharmacokinetic disposition of this agent has not been assessed in patients with severe hepatic impairment. No dosage modification is recommended for patients with mild hepatic impairment, however, therapy with this agent should not be administered to patients with moderate to severe hepatic impairment. In patients with mild hepatic impairment a lower dose of the oral tablet might be used as initial therapy and the maximum dose should not exceed 10 mg.

Moderate

Vardenafil (Includes Vardenafil) ↔ Pku

Moderate Potential Hazard, Moderate plausibility

Applies to: Phenylketonuria

Vardenafil oral disintegrating tablet contains 1.01 mg phenylalanine per tablet. The phenylalanine content should be considered when this product is used in patients who must restrict their intake of phenylalanine (i.e. phenylketonurics).

vardenafil drug Interactions

There are 560 drug interactions with vardenafil

vardenafil alcohol/food Interactions

There are 2 alcohol/food interactions with vardenafil

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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