Levitra

Action

Selectively blocks PDE5, which neutralizes cyclic guanosine monophosphate, resulting in enhanced erectile function

Availability

Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg

Indications and dosages

➣ Erectile dysfunction

Adult males: 10 or 20 mg P.O. approximately 1 hour before anticipated sexual activity. Maximum dosing frequency is once daily.

Dosage adjustment

• Patients older than age 65

• Concurrent use of CYP450-3A4 inhibitors

• Concurrent HIV therapy (except highly active antiretroviral therapy)

Contraindications

• Hypersensitivity to drug

• Concurrent use of nitrates or nitrate patches to treat angina

• Concurrent use of alpha-adrenergic blockers

Precautions

Use cautiously in:

• cardiovascular disease, retinitis pigmentosa, hepatic or renal impairment, reduced hepatic blood flow

• patients at increased risk for priapism (as from sickle-cell disease, leukemia, multiple myeloma, polycythemia, or history of priapism).

Administration

• Advise patient not to take more than one tablet daily.

Adverse reactions

CNS: headache

CV: hypotension

EENT: blurred vision, altered color perception, light sensitivity, rhinitis

GI: dyspepsia

Skin: flushing

Other: flulike symptoms

Interactions

Drug-drug. Alpha-adrenergic blockers, nitrates: hypotension

Erythromycin, itraconazole, ketoconazole, protease inhibitors: increased vardenafil blood level

Drug-diagnostic tests. Creatine kinase: increased level

Patient monitoring

• Monitor blood pressure and heart rate, particularly if patient has cardiovascular disease.

Patient teaching

• Tell patient he may take with or without food.

• Instruct patient to take one tablet about 1 hour before anticipated sexual activity. Caution him not to take more than one tablet daily.

• Instruct patient to promptly contact prescriber if erection lasts more than 4 hours, because irreversible damage to penis may occur.

• Caution patient not to take nitrates. Tell him to inform prescriber of other drugs he's taking.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.