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QT prolongation and torsade de pointes have been reported in patients receiving clofazimine in combination with QT prolonging medications.

Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval.

Clozapine: (Moderate) Use vardenafil with caution in combination with clozapine due to increased risk of QT prolongation. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. Treatment with clozapine has sildenafil goodrx price also been associated with QT prolongation, torsade de pointes (TdP), cardiac arrest, and sudden death.

Cobicistat: (Major) When being administered with cobicistat, use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse reactions. Coadministration of vardenafil with cobicistat is expected to substantially increase the plasma concentrations of vardenafil and may result in increased associated adverse events including hypotension, syncope, visual changes, and prolonged erection.

Codeine; Phenylephrine; Promethazine: (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving phosphodiesterase inhibitors.

Monitor patients for decreased pressor effect if these agents are administered concomitantly. (Moderate) Use vardenafil with caution in combination with promethazine due to increased risk of QT prolongation.

Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval.

Promethazine, a phenothiazine, is associated with a possible risk for QT prolongation.

Codeine; Promethazine: (Moderate) Use vardenafil with caution in combination with promethazine due to increased risk of QT prolongation. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval.

Promethazine, a phenothiazine, is associated with a possible risk for QT prolongation. Conivaptan: (Major) According to the manufacturer, concomitant use of conivaptan, a strong CYP3A4 inhibitor, and CYP3A substrates, such as vardenafil, should be avoided. Coadministration of conivaptan with other CYP3A substrates has resulted in increased mean AUC values (2 to 3 times).

Theoretically, similar pharmacokinetic effects could be seen with vardenafil. Increased systemic exposure to vardenafil may result in an increase in vardenafil-induced adverse effects.

Treatment with vardenafil may be initiated no sooner than 1 week after completion of conivaptan therapy.

Crizotinib: (Major) Due to increased vardenafil exposure, avoid coadministration of vardenafil orally disintegrating tablets with crizotinib; do not exceed a single dose of 5 mg per 24-hour period of vardenafil oral tablets.

Additionally, monitor

ECGs

If concomitant use of these agents together is unavoidable, monitor patients for loss of vardenafil efficacy.

Dabrafenib is a moderate CYP3A4 inducer and vardenafil is a sensitive CYP3A4 substrate.

Concomitant use of dabrafenib with a single dose of another sensitive CYP3A4 substrate decreased the AUC value of the sensitive CYP3A4 substrate by 65%. Darunavir: (Major) Coadministration of darunavir with vardenafil is expected to substantially increase vardenafil plasma concentrations and may result in increased adverse events including hypotension, syncope, visual changes, and prolonged erection. Use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse reactions. Darunavir; Cobicistat: (Major) Coadministration of darunavir with vardenafil is expected to substantially increase vardenafil plasma concentrations and may result in increased adverse events including hypotension, syncope, visual changes, and prolonged erection.

Use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse reactions.

(Major) When being administered with cobicistat, use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse reactions.

Coadministration of vardenafil with cobicistat is expected to substantially increase the plasma concentrations of vardenafil and may result in increased associated adverse events including hypotension, syncope, visual changes, and prolonged erection. Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide: (Major) Coadministration of darunavir with vardenafil is expected to substantially increase vardenafil plasma concentrations and may result in increased adverse events including hypotension, syncope, visual changes, and prolonged erection. Use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse reactions. (Major) When being administered with cobicistat, use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with sildenafil goodrx price increased monitoring for

adverse

Coadministration of vardenafil with cobicistat is expected to substantially increase the plasma concentrations of vardenafil and may result in increased associated adverse events including hypotension, syncope, visual changes, and prolonged erection. Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: (Major) Coadministration of ritonavir with vardenafil results in a 20% decrease in ritonavir AUC and a 49-fold increase in vardenafil AUC. Substantially increased vardenafil plasma concentrations may result in increased associated adverse events including hypotension, syncope, visual changes, and prolonged erection.

If coadministered, use vardenafil at reduced doses of no more than 2.5 mg every 72 hours with increased monitoring for adverse reactions. Vardenafil orally disintegrating tablets provide increased exposure as compared to the regular tablets; therefore, use of the orally disintegrating tablets with ritonavir is not recommended. In addition, both ritonavir and vardenafil are associated with QT prolongation; concomitant use increases the risk of QT prolongation. Dasatinib: (Moderate) Monitor for evidence of QT prolongation during concurrent use of dasatinib and vardenafil.

In vitro studies have shown that dasatinib has the potential to prolong the QT interval.

Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. Degarelix: (Moderate) Consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients receiving vardenafil as concurrent use may increase the risk of QT prolongation. Androgen deprivation therapy (i.e., degarelix) may prolong the QT/QTc interval. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. Delavirdine: (Major) If used together, the vardenafil tablet dose should not exceed 2.5 mg in a 24-hour period; advise patients to promptly report adverse events such as dizziness, faintness on standing, or prolonged erection.

Vardenafil orally disintegrating tablets (ODT) provide increased exposure as compared to the regular tablets; therefore, use with potent CYP3A4 inhibitors such as delavirdine is not recommended. Delavirdine is expected to substantially increase vardenafil plasma concentrations and may result in vardenafil-related adverse events including hypotension, visual changes, and priapism. Deutetrabenazine: (Moderate) Use vardenafil with caution in combination with deutetrabenazine as concurrent use may increase the risk of QT prolongation.

For patients taking a deutetrabenazine dosage more than 24 mg/day with vardenafil, assess the QTc interval before and after increasing the dosage of either medication.

Clinically relevant QTc prolongation may occur with deutetrabenazine. Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. Dexamethasone: (Minor) Vardenafil is metabolized by cytochrome P450 3A4.

It can be expected that concomitant administration of CYP3A4 enzyme-inducers, such as dexamethasone, will decrease plasma levels of vardenafil.

Dextromethorphan; Diphenhydramine; Phenylephrine: (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving phosphodiesterase inhibitors.

Monitor patients for decreased pressor effect if these agents are administered concomitantly. Dextromethorphan; Guaifenesin; Phenylephrine: (Moderate) The therapeutic effect of phenylephrine may be decreased in patients receiving phosphodiesterase inhibitors. Monitor patients for decreased pressor effect if these agents are administered concomitantly. Dextromethorphan; Promethazine: (Moderate) Use vardenafil with caution in combination with promethazine due to increased risk of QT prolongation.

Both therapeutic and supratherapeutic doses of vardenafil produce an increase in QTc interval. Promethazine, a phenothiazine, is associated with a possible risk for QT prolongation. Dextromethorphan; Quinidine: (Major) The manufacturer recommends that vardenafil be avoided in patients taking Class IA antiarrhythmics (disopyramide, procainamide, and quinidine).

Class IA antiarrhythmics are associated with QT prolongation and torsades de pointes (TdP). Therapeutic (10 mg) and supratherapeutic (80 mg) doses of vardenafil produces an increase in QTc interval (e.g., 4 to 6 msec calculated by individual QT correction) The effect of vardenafil on the QT interval should be considered when prescribing the drug.