Vardenafil
Unchecked
PDE5 Inhibitor
Vardenafil
Levitra, Staxyn
Vardenafil is a PDE5 inhibitor very similar to Sildenafil in onset and duration, marketed mainly for erectile dysfunction. Same nitrate contraindication and alpha-blocker caution. Slightly different selectivity profile but in practice the three short-acting PDE5 inhibitors are nearly interchangeable; choice is often driven by patient preference and insurance.
Blood pressure; ECG (QT) in congenital long-QT.
Contraindicated with any nitrate. Avoid in congenital long-QT syndrome or with type-1A/type-3 antiarrhythmics.
Avanafil, Sildenafil, Tadalafil
Experience
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Effects
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Pharmacokinetics
Absorption
~15%; reduced by high-fat meals.Distribution
Plasma protein binding ~95%.Metabolism
Hepatic via CYP3A4 (primary).Elimination
Fecal as metabolites.Interactions
No interactions reported yet.
Monitoring
Patient counseling
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See also
References
Pharmacy
Starting dose
10 mg ~1 h before sexual activity
Preparations
2.5, 5, 10, 20 mg tabs (Levitra); 10 mg ODT (Staxyn)
US FDA Max
20 mg/d
Common uses
Classification(s)
Classes
PDE5 Inhibitor
Pharmacology
Routes
Oral
Onset
~30 min
Duration
4–5 h
Half-life
4–5 h
Bioavailability
~15% (extensive hepatic first-pass)
Pregnancy
Category B
Legal status
Rx-only in US
Purported mechanism
Selective inhibitor of PDE5. Slightly higher PDE5/PDE6 selectivity vs sildenafil (less visual side effect) but more PDE1 cross-activity (occasional QT effects at high doses).