Levitra Plus (Vardenafil)
Class and Category of Drug
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Chemical class: Phosphodiesterase type 5 inhibitor
Therapeutic class: Anti-impotence agent
Pregnancy category: B
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Drug Indications and Dosages
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To treat erectile dysfunction
Tablets
Adults. 10 mg taken 1 hr before sexual activity; increased to 20 mg or decreased to 5 mg, as needed. Maximum: 20 mg and once-daily limit regardless of dosage.
Dosage Adjustment If patient takes ritonavir, vardenfil dosage shouldn't exceed 2.5 mg in 72 hr. If patient takes indinavir, saquinavir, atazanavir, clarithromycin, ketoconazole 400 mg daily, itraconazole 400 mg daily, or another potent CYP3A4 inhibitor, vardenafil dosage shouldn't exceed 2.5 mg in 24 hr. If patient takes ketoconazole 200 mg and itraconazole 200 mg daily, vardenafil dosage shouldn't exceed 5 mg in 24 hr.
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Contraindications of Drug
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Concurrent administration of alpha blockers, concurrent continuous or intermittent nitrate therapy, hypersensitivity to vardenafil or its components
Generic Drug Interactions
Drugs
alpha blockers, nitrates: Profound hypotension
atazanavir, clarithromycin, erythromycin, indinavir, itraconazole, ketoconazole, ritonavir, saquinavir: Increased vardenafil effects
class IA (procainamide, quinidine) and class III (amiodarone, sotalol) antiarrhythmics: Possibly increased QT-interval prolongation indinavir, ritonavir: Reduced blood levels of indinavir and ritonavir
Foods
grapefruit juice: Possibly increased vardenafil effect
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Drugs Adverse Reactions
Central Nervous System: Dizziness, headache, seizures, transient global amnesia
Cardiovascular: Hypotension
Eyes, Ears, Nose, And Throat: Decreased vision, hearing loss, nonarteritic anterior ischemic optic neuropathy, rhinitis, sinusitis, tinnitus
Gastrointestinal: Indigestion, nausea
Musculoskeletal: Back pain
Skin: Flushing
Other: Flulike symptoms, increased crea-tine kinase level
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Nursing Considerations for Generic Drugs
• Vardenafil shouldn't be used by men taking class IA (procainamide, quinidine) or class III (amiodarone, sotalol) antiarrhythmics or by men who have congenital prolonged QT interval. Drug may potentiate prolonged QT interval.
• Use vardenafil cautiously in men with renal or hepatic dysfunction, in elderly men, and in men with penile abnormalities that may predispose them to priapism.
• Also use cautiously in patients with left ventricular outflow obstruction, such as aortic stenosis, and those with severely impaired autonomic control of blood pressure. These conditions increase sensitivity to vasodilators, such as vardenafil.
• Monitor blood pressure and heart rate before and after giving drug, especially if patient takes an alpha blocker, because of increased risk of symptomatic hypotension.
• Monitor patient's vision, especially if he's over age 50; has diabetes, hypertension, coronary artery disease, or hyperlipidemia; or smokes, because vardenafil rarely leads to nonarteritic ischemic optic neuropathy and decreased vision, possibly permanent.
• Monitor patient's hearing. Sudden decrease or loss, possibly with tinnitus and dizziness, may occur with vardenafil use. Report such changes immediately, and expect drug to be discontinued.
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Vardenafil
Preparations
International Brand Drug Names
The information about drugs (tablets, pills, capsules, creams, solution, nasal spray, inhaler) around the world.
Proprietary Preparations
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