Vardenafil: Difference between revisions

{{Short description|Chemical compound}}

{{cs1 config|name-list-style=vanc}}

{{Use mdy dates|date=March 2024}}

| verifiedrevid = 458460083

| image = Vardenafil structure.svg

| width = 250

| tradename = Levitra, Staxyn, Vivanza

| pregnancy_AU = B3

| licence_EU = yes

| routes_of_administration = [[Oral administration|By mouth]]

| ATC_prefix = G04

| ATC_suffix = BE09

| ATC_supplemental =

| legal_US = Rx-only

| legal_US_comment = <ref name="Levitra FDA label">{{cite web | title=Levitra (vardenafil hydrochloride) tablets, for oral use Initial U.S. Approval: 2003 | website=DailyMed | url=https://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=595067 | access-date=April 3, 2023}}</ref>

| legal_status = Rx-only

| metabolism = [[Liver]] ([[CYP3A4]])

| excretion = [[Bile duct]]

| IUPHAR_ligand = 7320

| KEGG = D08668

| C=23 | H=32 | N=6 | O=4 | S=1

[[File:Sexual enhancer (phosphodiesterase-5 inhibitors) - Vardenafil - Aristo Pharma - Vardenaristo - 4 tablets Blister 20 mg - Image 002.jpg|thumb|Vardenafil 4 tablets Blister 20 mg]]

'''Vardenafil''', sold under the brand name '''Levitra''' among others, is a [[medication]] that is used for treating [[erectile dysfunction]].<ref name="Levitra FDA label" /><ref>{{cite web|url=https://deutschemedz.de/levitra/|title=Levitra (Vardenafil) is A Drug Used to Treat Erectile Problems in Men|access-date=May 12, 2010|publisher=Deutschemedz|language=de}}</ref> It is a [[PDE5 inhibitor]].<ref name="Levitra FDA label" /> It is taken [[by mouth]].<ref name="Levitra FDA label" />

==Medical use==

{{main|PDE5 inhibitor}}

Vardenafil's indications and contraindications are the same as with other PDE5 inhibitors; it is closely related in function to [[sildenafil]] citrate (Viagra) and [[tadalafil]] (Cialis). The difference between the vardenafil molecule and sildenafil citrate is a [[nitrogen]] atom's position and the change of sildenafil's [[piperazine]] ring [[methyl group]] to an [[ethyl group]]. Tadalafil is structurally different from both sildenafil and vardenafil. Vardenafil's relatively short effective time is comparable to but somewhat longer than sildenafil's. Vardenafil also does not have an effect on PDE6, which means that it does not have vision adverse effects.

Beyond its indications for erectile dysfunction, vardenafil may be effective in the treatment of [[premature ejaculation]], where it may significantly increase the time from penetration to ejaculation.<ref name="IJIR Premature Ejaculation">{{cite journal | vauthors = Aversa A, Pili M, Francomano D, Bruzziches R, Spera E, La Pera G, Spera G | title = Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation | journal = International Journal of Impotence Research | volume = 21 | issue = 4 | pages = 221–7 | date = July 2009 | pmid = 19474796 | doi = 10.1038/ijir.2009.21 | doi-access = | s2cid = 26078130 }}</ref>

==Adverse reactions==

The common, adverse drug reactions (side effects) are the same as with other PDE5 inhibitors. The frequent vardenafil-specific side-effect is [[nausea]]; the infrequent side effects are abdominal pain, back pain, [[photosensitivity]], abnormal vision, eye pain, facial [[edema]], [[hypotension]], palpitation, [[tachycardia]], [[arthralgia]], [[myalgia]], rash, itch, and [[priapism]].

One possibly serious, but rare, side effect with vardenafil is [[Myocardial infarction|heart attack]]. Also, in rare cases, vardenafil use may cause priapism, a very painful emergency condition that can cause impotence if left untreated.<ref name="MedScape PDE5">{{cite web|url=http://www.medscape.com/viewarticle/549253_6|title=Counseling Patients About Sexual Issues: Drug-Induced Priapism|first1=Glen L. |last1=Stimmel|first2=Mary A.|last2=Gutierrez|access-date=December 6, 2010|publisher=Medscape}}</ref>

In October 2007, the [[Food and Drug Administration (United States)|U.S. Food and Drug Administration]] (FDA) announced that a warning about possible deafness ([[Deafness|sudden hearing loss]]) would be added to the drug labels of vardenafil, and other PDE5 inhibitors.<ref name="FDA PDE5">{{cite web | url=https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm109012.htm| title= FDA Announces Revisions to Labels for Cialis, Levitra and Viagra| date= October 18, 2007| publisher= [[Food and Drug Administration (United States)|Food and Drug Administration]] | access-date=August 6, 2009 }}</ref>

== Interactions ==

Vardenafil should not be used by people taking [[nitrate]] medications, because combining them with vardenafil might provoke potentially life-threatening [[hypotension]] (low blood pressure).<ref>{{cite journal | vauthors = Kloner RA | title = Pharmacology and drug interaction effects of the phosphodiesterase 5 inhibitors: focus on alpha-blocker interactions | journal = The American Journal of Cardiology | volume = 96 | issue = 12B | pages = 42M–46M | date = December 2005 | pmid = 16387566 | doi = 10.1016/j.amjcard.2005.07.011 }}</ref><ref>{{cite journal | vauthors = Carson CC | title = PDE5 inhibitors: are there differences? | journal = The Canadian Journal of Urology | volume = 13 | pages = 34–9 | date = February 2006 | issue = Suppl 1 | pmid = 16526979 | author-link = Culley C. Carson III }}</ref>

Further, vardenafil causes lengthening of the [[QT interval]]. Therefore, it should not be taken by people taking other medications that affect the QT interval (such as [[amiodarone]]).<ref>{{cite journal | vauthors = Lepor H, Lepor NE, Hill LA, Trohman RG | title = The QT Interval and Selection of Alpha-Blockers for Benign Prostatic Hyperplasia | journal = Reviews in Urology | volume = 10 | issue = 2 | pages = 85–91 | date = 2008 | pmid = 18660858 | pmc = 2483321 }}</ref><ref>{{Cite book|url=https://books.google.com/books?id=PaiBU04wrrgC&q=vardenafil++QT+interval++amiodarone&pg=PA1079|title=2011 Nurse's Drug Handbook|last=Learning|first=Jones & Bartlett|date=June 29, 2010|publisher=Jones & Bartlett Publishers|isbn=978-1-4496-5372-9}}</ref>

==History==

Vardenafil was co-marketed by [[Bayer|Bayer Pharmaceuticals]], [[GlaxoSmithKline]], and [[Schering-Plough]] under the brand name Levitra. As of 2005, the co-promotion rights of GSK on Levitra have been returned to Bayer in many markets outside the US. In Italy, Bayer sells vardenafil as Levitra and GSK sells it as Vivanza. Thus, because of European Union trade rules, [[parallel import]]s might result in Vivanza sold next to Levitra in the EU.

An orally disintegrating form, marketed as Staxyn and Levitra Soft, has been gaining approvals in countries such as the United States<ref name="pharmpro.com 2012">{{cite web | title=New erectile dysfunction treatment Staxyn approved in the U.S. - Pharmaceutical Processing | website=pharmpro.com | date=June 21, 2010 | url=https://www.pharmpro.com/News/Feeds/2010/06/pharmaceutical-companies-bayer-new-erectile-dysfunction-treatment-staxyn-approve | archive-url=https://web.archive.org/web/20120406122727/https://www.pharmpro.com/News/Feeds/2010/06/pharmaceutical-companies-bayer-new-erectile-dysfunction-treatment-staxyn-approve | archive-date=April 6, 2012 | url-status=dead}}</ref> and Canada.<ref>{{cite web|url=http://www.newswire.ca/en/story/832217/staxyn-new-innovation-in-erectile-dysfunction-helps-younger-men-rise-to-the-occasion|title=Staxyn - New Innovation in Erectile Dysfunction Helps Younger Men Rise to the Occasion}}</ref>

==Tainted supplements==

The US [[Food and Drug Administration]] (FDA) has found vardenafil and other synthetic PDE5 inhibitors in numerous products marketed as "herbal" supplements or "all natural" products for male enhancement.<ref>{{cite web | url = https://www.accessdata.fda.gov/scripts/sda/sdNavigation.cfm?sd=tainted_supplements_cder&displayAll=false&page=1 | title = Tainted Products Marketed as Dietary Supplements | date = August 3, 2022 | publisher = U.S. [[Food and Drug Administration]] (FDA) }}</ref><ref>{{cite journal | vauthors = Tucker J, Fischer T, Upjohn L, Mazzera D, Kumar M | title = Unapproved Pharmaceutical Ingredients Included in Dietary Supplements Associated With US Food and Drug Administration Warnings | journal = JAMA Network Open | volume = 1 | issue = 6 | pages = e183337 | date = October 2018 | pmid = 30646238 | pmc = 6324457 | doi = 10.1001/jamanetworkopen.2018.3337 }}</ref>

==References==

{{Aphrodisiacs}}

{{Drugs for erectile dysfunction and PE}}

{{GlaxoSmithKline}}

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[[Category:Erectile dysfunction drugs]]

[[Category:HERG blocker]]

[[Category:Lactams]]

[[Category:Drugs developed by Schering-Plough]]

[[Category:Drugs developed by GSK plc]]

[[Category:Drugs developed by Merck & Co.]]

[[Category:Drugs developed by Bayer]]

[[Category:Phenol ethers]]

[[Category:Sulfonamides]]

[[Category:Ethoxy compounds]]