Vardenafil

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 08, 2024

Warnings

Vardenafil (Levitra) Risks, Warnings, and Complications

Vardenafil can cause or worsen health problems in certain high-risk individuals. Talk to your doctor or pharmacist about other treatment options for erectile dysfunction if you are at an increased risk of complications from this medication.

Cardiovascular Effects: Treatment of erectile dysfunction with vardenafil is not recommended for men who are at cardiac risk with sexual activity. Using this medication is also not recommended for men with unstable angina, hypotension (low blood pressure), uncontrolled hypertension (high blood pressure), life-threatening arrhythmias, severe heart failure, recent stroke, or recent heart attack. Patients with conditions such as aortic stenosis are more sensitive to the action of PDE-5 inhibitors, which are vasodilators. Vardenafil can result in a transient decrease in supine blood pressure, even in healthy men. Your healthcare professional will carefully weigh the benefits vs risks of taking vardenafil before prescribing this medication to you for erectile dysfunction. Tell your doctor immediately or seek emergency medical help if you develop chest pain, difficulty breathing, dizziness, or fainting.
QT Prolongation: Studies have shown that taking vardenafil can lead to an increase in the QTc interval on electrocardiogram tracings. These ECG changes are more likely when you combine vardenafil with other drugs that also have effects on the QT interval. Tell your doctor if you have a history of congenital or acquired QT prolongation. Give your doctor a complete list of your medications before starting vardenafil therapy.
Interactions with Other Medications: Taking vardenafil with medications that are CYP3A4 inhibitors (for example, HIV medications such as ritonavir, indinavir, and cobicistat; antifungal agents such as ketoconazole; and antibiotics such as erythromycin) can lead to increased plasma concentrations of vardenafil. Your doctor will adjust the dose of vardenafil if you are taking certain medications.
Caution is also advised when taking PDE-5 inhibitors, including vardenafil, with a group of drugs called alpha-blockers, which are also vasodilators with blood-pressure-lowering effects. These medications are prescribed for high blood pressure and prostate problems. If you are taking an alpha blocker and vardenafil together, tell your doctor immediately if you develop symptomatic hypotension (low blood pressure) with lightheadedness or fainting.
Priapism: Rarely, taking PDE-5 inhibitors such as vardenafil to treat erectile dysfunction can lead to a prolonged, painful erection lasting more than 4 hours (this condition is called priapism). Seek immediate medical attention if this occurs. Without immediate treatment, priapism can lead to permanent damage to the penile tissue and loss of the ability to achieve erections. Before starting treatment, tell your health care professional if you have any structural defects of the penis, such as angulation, Peyronie’s disease, or cavernosal fibrosis. Also, tell your doctor if you have sickle cell anemia, leukemia, or multiple myeloma. These conditions can increase the risk of priapism.
Sudden Vision Loss: Rarely, taking phosphodiesterase type 5 inhibitors, including vardenafil, can lead to sudden loss of vision in one or both eyes. This may be a sign of a rare eye disorder called non-arteritic anterior ischemic optic neuropathy (NAION). Seek emergency medical attention if you develop any vision problems or loss of vision.
Sudden Hearing Loss: Rarely, PDE-5 inhibitors, including vardenafil, can cause serious problems such as a sudden decrease in hearing or hearing loss. This may be accompanied by dizziness and tinnitus (ringing in the ears). Seek prompt medical attention if this occurs.
Hepatic Impairment: The dose of vardenafil needs to be adjusted in people with moderate hepatic impairment (reduced liver function due to liver disease). Vardenafil is not prescribed to people with severe hepatic impairment.
Renal Impairment: Vardenafil is not for men who are on renal dialysis, as it has been studied for safety in such individuals.
Combined Treatment with Other ED Drugs: We do not know the safety and efficacy of taking vardenafil with other treatments for erectile dysfunction. The use of combination treatments is therefore not recommended.

Precautions Before Starting Vardenafil (Levitra)

Tell your doctor if you have ever had allergic reactions to vardenafil, any of the active compounds or inactive ingredients in vardenafil tablets, other PDE-5 inhibitors, or any other medicines. Your pharmacy can give you a list of ingredients.

Give your doctor a complete list of medications, including prescription drugs, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible interactions.

Vardenafil may not be safe for people with certain medical conditions. Tell your doctor if you currently have or have ever had a history of smoking; priapism (prolonged erection); conditions that affect the shape of your penis, such as Peyronie’s disease, cavernosal fibrosis, or angulation; high cholesterol; high blood pressure; low blood pressure; diabetes; heart disease; heart rhythm abnormalities; a personal or family history of long QT syndrome; angina (chest pain); heart attack; stroke; stomach ulcers; bleeding disorders; sickle cell anemia or other blood disorders; blood cancers such as leukemia or multiple myeloma; liver disease; kidney disease; seizures; hearing problems; severe vision loss or eye diseases such as retinitis pigmentosus.

Vardenafil tablets are only for men. Women should not take this medication. Call your doctor if a woman takes vardenafil, especially a woman who could be pregnant or is currently breastfeeding.

Precautions During Use of Vardenafil (Levitra)

Keep all your medical and laboratory appointments while taking vardenafil. Your health care professional may adjust your vardenafil dose based on your response and side effects.

Call your doctor immediately if you develop chest pain during sexual activity. Refrain from further sexual activity until your doctor clears you.

Tell all your healthcare providers you are on vardenafil, especially before any surgery or emergency treatment for heart problems.

Vardenafil (Levitra) Drug Interactions

Concomitant use of vardenafil with certain other drugs can affect how the medications work. Possible drug interactions between vardenafil and other medications can increase the risk of severe adverse effects. Your doctor may need to change the doses of your medications, switch you to alternative treatments, or monitor your carefully for side effects if there are potential interactions.

You should not take vardenafil if you are currently taking or have recently taken riociguat (Adempas) or a nitrate medicine such as nitroglycerin (Nitrostat, Nitro-Dur, Minitran, Nitromist, others), isosorbide mononitrate (Monoket), or isosorbide dinitrate (Dilatrate-SR, Isordil, in BiDil). These medicines come as tablets, sublingual tablets, patches, sprays, ointments, and pastes.

Also, you should not take street drugs containing nitrates such as amyl nitrate or butyl nitrate (commonly called poppers) while on vardenafil.

Vardenafil can also have interactions with the following medications:

Alpha blockers such as doxazosin (Cardura), alfuzosin (Uroxatral), tamsulosin (Flomax, in Jalyn), prazosin (Minipress), and terazosin
Antiarrhythmics such as amiodarone (Cordarone, Pacerone), procainamide, sotalol (Betapace, Sorine, Sotylize), quinidine, and disopyramide (Norpace)
Antifungal medications such as itraconazole (Onmel, Sporanox), fluconazole (Diflucan), and ketoconazole (Nizoral)
Antibiotics such as clarithromycin (Biaxin, in Prevpac), moxifloxacin (Avelox), and erythromycin (E-Mycin, E.E.S., Erythrocin)
Psychiatric medications such as haloperidol (Haldol) and thioridazine
HIV medications such as indinavir (Crixivan), ritonavir (Norvir, in Kaletra), atazanavir (Reyataz, in Evotaz), and saquinavir (Invirase)
Medications used to treat high blood pressure or irregular heartbeat
Calcium channel blockers such as verapamil (Covera, Calan, Verelan, others)
Other medications for erectile dysfunction
Opioid pain medications, including methadone (Dolophine, Methadose)
Medications prescribed for tics, such as pimozide (Orap)
Herbal products such as St. John's wort.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal remedies. Also, tell your health care professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medicines.

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