Which drugs or supplements interact with vardenafil?

Vardenafil should be avoided in combination with ritonavir and indinavir. When combined with erythromycin, ketoconazole, and itraconazole, the maximum dose of this drug does not exceed 5mg, and the dose of ketoconazole and itraconazole must not exceed 200mg. 2. Patients taking nitrates or receiving nitric oxide donors should avoid using this drug. The mechanism of action is to further increase the concentration of cGMP, resulting in increased antihypertensive effect and increased heart rate. Used together with the alpha-blocker, it can enhance the antihypertensive effect and lead to hypotension, so it is forbidden to use this drug for those who are using alpha blockers.

Roxithromycin, Biaxin, Nizoral, Itraconazole, Crixivan, Norvir, Azavir (Reyataz) Grapefruit juice can inhibit the decomposition and elimination of vardenafil in the body. Therefore, these drugs increase the concentration of vardenafil in the blood and should not be used in combination with vardenafil.

Vardenafil reduces the concentration of ritonavir and indinavir and may reduce the effects of these drugs. Vardenafil increases heart rate and also exaggerates the hypotensive effect of nitrates such as nitroglycerin. For patients with chest pain (angina), especially those taking nitrate, vardenafil can cause chest pain by increasing heart rate and lowering blood pressure. Therefore, patients with angina should not use vardenafil.

Vardenafil also exaggerates the hypotensive effect of alpha-blockers (eg, Hytrin) and should not be used by individuals who also use alpha-blockers. Vardenafil also increases the blood pressure lowering effect of other drugs.

Like all PDE 5 inhibitors, vardenafil should not be used by people taking nitrates because using them in combination with vardenafil may cause life-threatening hypotension (hypotension).

It can be used together with CYP 3A4 inhibitors (such as ritonavir, indinavir, saquinavir, ketoconazole, itraconazole, erythromycin, etc.) to inhibit the metabolism of the drug in the liver. The blood concentration is increased, the half-life is prolonged, and the incidence of adverse reactions (such as hypotension, visual changes, headache, facial flushing, and abnormal penile erection) increases.

The medium fat diet (30% fat calorie) has no significant effect on the pharmacokinetics of a single oral dose of 20 mg. The high-fat diet (more than 55% fat) can prolong the peak time of the drug and reduce the blood concentration of the drug. The peak is about 18%.

In addition, vardenafil leads to an extension of the QT interval. Therefore, taking other drugs that affect the QT interval (such as amiodarone) should not be taken.

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