Vardenafil

Vardenafil is a phosphodiesterase type 5 (PDE5) inhibitor prescribed for the treatment of erectile dysfunction in adult men.

It is the active ingredient in Levitra and is also available as a generic medication.

Vardenafil enables men with erectile difficulties to achieve and maintain an erection sufficient for satisfactory sexual intercourse when sexually stimulated.

Vardenafil works by inhibiting PDE5, the enzyme responsible for the degradation of cyclic guanosine monophosphate (cGMP) in the corpus cavernosum.

During sexual arousal, nitric oxide is released locally, stimulating cGMP production, which relaxes smooth muscle and increases blood flow to the penis.

By preventing the breakdown of cGMP, vardenafil prolongs and enhances this vasodilatory process.

Vardenafil has a rapid onset of action, with some men responding within 15 to 25 minutes, and its effects typically last for four to five hours.

It is available as a standard film-coated tablet and as an orodispersible tablet that dissolves on the tongue, offering convenience for men who prefer not to swallow tablets or who wish to take the medication more discreetly.

Take one vardenafil tablet approximately 25 to 60 minutes before anticipated sexual activity.

The film-coated tablet should be swallowed whole with water and may be taken with or without food, although a heavy or high-fat meal may delay the onset of action.

The orodispersible tablet should be placed on the tongue and allowed to dissolve without water. Do not take more than one dose in any 24-hour period.

Sexual stimulation is required for vardenafil to work; it will not cause an erection without arousal.

The recommended starting dose is 10 mg, taken 25 to 60 minutes before sexual activity. Based on efficacy and tolerability, the dose may be increased to a maximum of 20 mg or decreased to 5 mg.

For the orodispersible tablet, the dose is 10 mg. Maximum one dose per day. In patients over 65 years, start with 5 mg. Patients taking moderate CYP3A4 inhibitors (e.g.

erythromycin) should not exceed 5 mg. In patients with moderate hepatic impairment, start with 5 mg and do not exceed 10 mg.

Common (1 in 10 to 1 in 100): headache, flushing, nasal congestion, dyspepsia, dizziness.

Uncommon (1 in 100 to 1 in 1,000): somnolence, paraesthesia, visual disturbances, photosensitivity, tinnitus, tachycardia, palpitations, nausea, gastro-oesophageal reflux, myalgia, elevated creatine phosphokinase, rash, back pain.

Rare (1 in 1,000 to 1 in 10,000): priapism, non-arteritic anterior ischaemic optic neuropathy (NAION), sudden sensorineural hearing loss, QT prolongation, seizures.

Seek urgent medical attention for any erection lasting more than four hours or sudden visual or hearing changes.

Vardenafil must not be combined with nitrates or nitric oxide donors in any form, as this can cause a dangerous drop in blood pressure.

Avoid co-administration with Class IA or Class III antiarrhythmic agents. Use with caution in patients with a history of QT prolongation or those taking medications known to prolong the QT interval.

Patients with significant cardiovascular disease should have a cardiac assessment before initiating PDE5 inhibitor therapy.

Discuss any anatomical penile deformity or conditions predisposing to priapism with your prescriber.

Vardenafil is contraindicated in patients taking nitrates or nitric oxide donors, those with severe hepatic impairment, end-stage renal disease requiring dialysis, recent stroke or myocardial infarction within the past six months, unstable angina, known hereditary retinal disorders, congenital QT prolongation, and hypersensitivity to vardenafil or any excipient.

The orodispersible formulation must not be used in patients taking potent or moderate CYP3A4 inhibitors if aged over 75 years.