Vardenafil is used to treat erectile dysfunction (ED).

Vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). Penile erection is a hemodynamic process initiated by relaxation of smooth muscle in the corpus cavernosum and its associated arterioles. During sexual stimulation, nitric oxide is released in the corpus cavernosum and activates guanylate cyclase, increasing the synthesis of cyclic guanosine monophosphate (cGMP) in smooth muscle cells. The increased cGMP causes smooth muscle relaxation, increasing blood flow into the penis and resulting in an erection. Inhibition of PDE5 enhances erectile function by increasing cGMP levels. Sexual stimulation is required for nitric oxide release; therefore, PDE5 inhibition has no effect in the absence of sexual stimulation.

The recommended starting dose: 10 mg once daily, taken orally approximately 60 minutes before sexual activity.
The dose may be increased to a maximum dose of 20 mg or decreased to 5 mg based on efficacy and side effects. The maximum recommended dosing frequency is once per day. Vardenafil can be taken with or without food.

Geriatrics: A starting dose of 5 mg should be considered in patients >65 years of age.

Renal impaired patients: In patients with renal impairment, no dose adjustment is required.

Hepatic impaired patients: In patients with moderate hepatic impairment, a starting dose of 5 mg is recommended and the maximum dose should not exceed 10 mg. Do not use in patients with severe hepatic impairment.

Vardenafil can potentiate the blood pressure–lowering effect of antihypertensive agents. In clinical studies, a single 20 mg dose of Vardenafil produced an average decrease in blood pressure of 7 mmHg systolic and 8 mmHg diastolic. Caution is required when used with other vasodilators, including alpha-blockers. Vardenafil does not enhance the hypotensive effect of alcohol. CYP3A4 inhibitors (such as ketoconazole, indinavir, ritonavir, and erythromycin) may reduce the clearance of Vardenafil from the body.

Vardenafil is contraindicated with nitrates (regular or intermittent use) and nitric oxide donors due to the risk of severe hypotension. It is also contraindicated in patients with hypersensitivity to Vardenafil or any of its components.

The most common side effects include headache, flushing, nasal congestion (stuffy or runny nose), dyspepsia, upset stomach, dizziness, and back pain.

Vardenafil is not indicated for use in women.

Physicians should assess cardiovascular status before prescribing, as sexual activity carries a degree of cardiac risk. Vardenafil should generally not be used in men for whom sexual activity is not recommended due to cardiovascular conditions.

The maximum reported human dose is a single 120 mg dose. Most cases reported blurred vision and back pain. Single doses up to 80 mg and repeated doses up to 40 mg daily for 4 weeks did not show serious adverse effects. In case of overdose, immediate medical attention is required.

Drugs for erectile dysfunction

Store at room temperature, protected from light and moisture. Keep out of the reach of children.