Vardenafil 20 Mg

What special precautions should I follow?
Vardenafil Oral jelly
Steps to Begin
What should I know about storage and disposal of this medication?
How to Order
In case of emergency/overdose

Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. tecovirimat will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What special precautions should I follow?

tetracyclinetetracycline will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Product	Dosage	Quantity + Bonus	Price
Kamagra Soft Tabs	100 mg	120 + 6 Pills	311.78€ 296.93€
Cialis Generic	40mg	180 + 10 Pills	277.29€ 264.09€
Apcalis SX Oral Jelly	20mg	30 + 5 Sachets	141.84€ 135.09€
Kamagra 100 mg	100 mg	20 Pills	86.09€ 81.99€
Levitra Generic	60mg	90 + 6 Pills	291.82€ 277.92€
Kamagra Gold	50 mg	360 + 6 Pills	713.95€ 679.95€
Cialis Professional	20mg	20 Pills	78.33€ 74.60€
Super Kamagra	160 mg	92 + 6 Pills	478.75€ 455.95€
Viagra Super Active	100mg	20 + 4 Pills	48.05€ 45.76€
Levitra Original	20mg	14 + 2 Pills	102.27€ 97.40€

Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors tetracycline will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Vardenafil Oral jelly

Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors tobramycin inhaledtobramycin inhaled and vardenafil both increase nephrotoxicity and/or ototoxicity. Avoid concurrent or sequential use to decrease risk for ototoxicity tobramycin inhaled and vardenafil both increase nephrotoxicity and/or ototoxicity.

Study	Percentage of Patients Reporting Improvement	Sample Size	Notes
Clinical Trial A	75%	150	Overall effectiveness high
Clinical Trial B	80%	200	Similar results across studies
Real-world data	70-85%	Varies	Effectiveness observed in practice

Avoid concurrent or sequential use to decrease risk for ototoxicity topiramatetopiramate will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Steps to Begin

Food and Diet:

topiramate will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

What should I know about storage and disposal of this medication?

Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. tecovirimat will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tetracyclinetetracycline will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors tetracycline will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors tobramycin inhaledtobramycin inhaled and vardenafil both increase nephrotoxicity and/or ototoxicity.

Does vardenafil interact with foods or drinks?

Avoid concurrent or sequential use to decrease risk for ototoxicity tobramycin inhaled and vardenafil both increase nephrotoxicity and/or ototoxicity. Avoid concurrent or sequential use to decrease risk for ototoxicity topiramatetopiramate will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. topiramate will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. valbenazinevalbenazine and vardenafil both increase QTc interval. valbenazine and vardenafil both increase QTc interval.

Long-term effects of combination treatment comprising low-intensity extracorporeal shockwave therapy and tadalafil for patients with erectile dysfunction: a retrospective study

verapamilverapamil will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil vigora spray dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors verapamil will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors Either increases effects of the other by QTc interval. voriconazolevoriconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors voriconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. valbenazinevalbenazine and vardenafil both increase QTc interval. valbenazine and vardenafil both increase QTc interval.

Vardenafil is contraindicated for women and children.
It can be used by men with diabetes-related erectile issues.
It's effective for men with prostate-related erectile problems.
Always measure dosage carefully to avoid adverse effects.
The medication is absorbed in the gastrointestinal tract.
Vardenafil does not protect against sexually transmitted infections.
Use caution if combining with other medications affecting circulation.
Some people may experience indigestion or stomach pain.
It is important to report any severe side effects immediately.
The drug's efficacy may be affected by certain medical conditions.
Always complete the full course prescribed by your doctor.

verapamilverapamil will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil vigora spray dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors verapamil will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors Either increases effects of the other by QTc interval. voriconazolevoriconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors voriconazole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors vorinostatvorinostat and vardenafil both increase QTc interval.

How to Order

cyclophosphamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. drospirenonedrospirenone will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. drospirenone will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. labetalolvardenafil increases effects of labetalol by pharmacodynamic synergism. vardenafil increases effects of labetalol by pharmacodynamic synergism.

Dosage Modifications

Possible additive vasorelaxation, leading to low blood pressure. Soluble guanylate cyclase (sGC) stimulators (eg, riociguat); concomitant use can cause hypotension Coadministration with nitrates (either regularly and/or intermittently) and nitric oxide donors Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitrates A suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined Use with caution in anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie’s disease), cardiovascular disease, left ventricular outflow obstruction, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors, patients who have conditions that may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia) There have been rare reports of prolonged erections >4 hr and priapism (painful erections greater than 6 hours in duration) for this class of compounds, including vardenafil; in the event that an erection persists >4 hours, the patient should seek immediate medical assistance; if priapism is not treated immediately, penile tissue damage and permanent loss of potency may result Physicians should consider the cardiovascular status of their patients; there is a degree of cardiac risk associated with sexual activity; treatment for erectile dysfunction, should not be used in men for whom sexual activity is not recommended because of their underlying cardiovascular status Patients with left ventricular outflow obstruction, (for example, aortic stenosis and idiopathic hypertrophic subaortic stenosis) can be sensitive to the action of vasodilators including PDE5 inhibitors Until further information available, use is not recommended in unstable angina; hypotension (resting systolic blood pressure of <90 mmHg); uncontrolled hypertension (>170/110 mmHg); recent history of stroke, life-threatening arrhythmia, or myocardial infarction (within last 6 months); severe cardiac failure Consider counseling patients about protective measures necessary to guard against sexually transmitted diseases, including Human Immunodeficiency Virus (HIV); drug offers no protection against sexually transmitted diseases Patients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using drug Safety and efficacy of drug used in combination with other treatments for erectile dysfunction not studied; use of such combinations not recommended Vision loss may occur rarely and may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION); patient should seek medical assistance for sudden loss in one or both eyes; patients who have already experienced NAION are at increased risk of recurrence; use is not recommended in patients with known degenerative retinal disorders May increase risk of rare sudden vision loss attributed to nonarteritic ischemic optic neuropathy; if vision problems arise, discontinue, and contact physician The drug has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of 7 mmHg systolic and 8 mmHg diastolic); while this normally would be expected to be of little consequence in most patients, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects Physicians should advise patients to stop taking all PDE5 inhibitors, and seek prompt medical attention in event of sudden decrease or loss of hearing; these events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to intake of PDE5 inhibitors, including vardenafil; it is not possible to determine whether these events are related directly to use of PDE5 inhibitors or to other factors CYP3A4 inhibitorsConcomitant administration with potent CYP3A4 inhibitors (eg, ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (eg, erythromycin) increases plasma concentrations of drug; dosage adjustment is necessary when drug is administered with certain CYP3A4 inhibitorsLong-term safety information is not available on concomitant administration of drug with HIV protease inhibitors Concomitant administration with potent CYP3A4 inhibitors (eg, ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (eg, erythromycin) increases plasma concentrations of drug; dosage adjustment is necessary when drug is administered with certain CYP3A4 inhibitors Long-term safety information is not available on concomitant administration of drug with HIV protease inhibitors Alpha blockersCaution advised when PDE5 inhibitors co-administered with alpha-blockers; PDE5 inhibitors, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects; when vasodilators are used in combination, an additive effect on blood pressure may be anticipated; in some patients, concomitant use of these two drug classes can lower blood pressure significantly leading to symptomatic hypotension (eg, fainting)Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor; patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitorsIn patients who are stable on alpha-blocker therapy, initiate PDE5 inhibitors at lowest recommended starting doseIn patients already taking optimized dose of PDE5 inhibitor, initiate alpha-blocker therapy at lowest dose; stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitorSafety of combined use of other PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs Caution advised when PDE5 inhibitors co-administered with alpha-blockers; PDE5 inhibitors, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects; when vasodilators are used in combination, an additive effect on blood pressure may be anticipated; in some patients, concomitant use of these two drug classes can lower blood pressure significantly leading to symptomatic hypotension (eg, fainting) Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor; patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors In patients who are stable on alpha-blocker therapy, initiate PDE5 inhibitors at lowest recommended starting dose In patients already taking optimized dose of PDE5 inhibitor, initiate alpha-blocker therapy at lowest dose; stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitor Safety of combined use of other PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs QT prolonging drugsAvoid coadministration with drugs that have a high risk for QT prolonationPatients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using drug Avoid coadministration with drugs that have a high risk for QT prolonation Patients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using drug Controlled studies in pregnant women show no evidence of fetal risk.

6.3 Storage and Handling

vorinostat and vardenafil both increase QTc interval. zafirlukastzafirlukast will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. zafirlukast will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamideacetazolamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Vardenafil enhances blood flow to the penis.
It is sold under brand names like Levitra and Staxyn.
The drug is generally well-tolerated when used correctly.
Common side effects include dizziness and nasal congestion.
It should be stored in a cool, dry place away from children.
Vardenafil is not an aphrodisiac; it requires sexual stimulation.
Excessive doses can increase cardiovascular risks.
It’s important to follow the doctor’s instructions for use.
Patients with heart conditions should consult a doctor before use.
Vardenafil may cause visual disturbances in some people.
Regular medical review is recommended during treatment.

anastrozoleanastrozole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Country	Legal Status	Purchase Regulations
United States	Prescription-only medication	Requires prescription from licensed physician
European Union	Prescription required	Available at licensed pharmacies
India	Over-the-counter in some regions	Varies by jurisdiction
Australia	Prescription-only medication	Prescription required

anastrozole will increase the tadalista super active 20 level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. azithromycinazithromycin increases toxicity of vardenafil by QTc interval. azithromycin increases toxicity of vardenafil by QTc interval. carvedilolvardenafil increases effects of carvedilol by pharmacodynamic synergism. vardenafil increases effects of carvedilol by pharmacodynamic synergism.

Condition	Recommendation	Notes
Concurrent nitrate therapy	Do not use	Risk of severe hypotension
Severe cardiac conditions	Consult healthcare provider	Use with caution
Liver impairment	Dose adjustment needed	Due to metabolism via liver
Allergic reaction to vardenafil	Discontinue use	Immediate medical attention

chloroquinechloroquine increases toxicity of vardenafil by QTc interval.

In case of emergency/overdose

Vardenafil dose may need to be reduced if coadministered with moderate or strong CYP3A4 inhibitors vorinostatvorinostat and vardenafil both increase QTc interval. vorinostat and vardenafil both increase QTc interval. zafirlukastzafirlukast will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. zafirlukast will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetazolamideacetazolamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Full Text Sources

acetazolamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. anastrozoleanastrozole will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. anastrozole will increase the tadalista super active 20 level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. azithromycinazithromycin increases toxicity of vardenafil by QTc interval. azithromycin increases toxicity of vardenafil by QTc interval.

Our Services

carvedilolvardenafil increases effects of carvedilol by pharmacodynamic synergism. vardenafil increases effects of carvedilol by pharmacodynamic synergism. chloroquinechloroquine increases toxicity of vardenafil by QTc interval. chloroquine increases toxicity of vardenafil by QTc interval. cyclophosphamidecyclophosphamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. chloroquine increases toxicity of vardenafil by QTc interval. cyclophosphamidecyclophosphamide will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Vardenafil is a medication used to treat erectile dysfunction.
It belongs to the class of PDE5 inhibitors.
Typical adult dosage ranges from 5 to 20 mg.
It is usually taken 30 to 60 minutes before activity.
The medication's effects can last up to 4-6 hours.
Vardenafil may cause side effects like headache or flushing.
Alcohol consumption can increase side effects risk.
It should not be used with nitrate drugs.
Vardenafil is available by prescription only.
It may interact with certain medications such as alpha-blockers.
Proper dosing depends on medical history and response.

Vardenafil dosage adjustments may be needed for older adults.
It may pose risks in men with low blood pressure.
Always adhere to the prescribed therapeutic regimen.
It is not recommended to exceed 20 mg per dose.
Vardenafil is not intended for use with other ED medications.
Precise timing of doses ensures efficacy and safety.
The drug may improve sexual confidence and satisfaction.
Side effects are usually temporary and dose-related.
Alcohol and high-fat foods can delay onset of action.
Avoid using Vardenafil if allergies to it are known.
Proper hydration can enhance its effectiveness.

labetalolvardenafil increases effects of labetalol by pharmacodynamic synergism. vardenafil increases effects of labetalol by pharmacodynamic synergism. Possible additive vasorelaxation, leading to low blood pressure. Soluble guanylate cyclase (sGC) stimulators (eg, riociguat); concomitant use can cause hypotension Coadministration with nitrates (either regularly and/or intermittently) and nitric oxide donors Consistent with the effects of PDE5 inhibition on the nitric oxide/cyclic guanosine monophosphate pathway, PDE5 inhibitors may potentiate the hypotensive effects of nitrates A suitable time interval following PDE5 dosing for the safe administration of nitrates or nitric oxide donors has not been determined Use with caution in anatomical deformation of the penis (such as angulation, cavernosal fibrosis, or Peyronie’s disease), cardiovascular disease, left ventricular outflow obstruction, bleeding disorders, active peptic ulcer disease, liver disease, renal impairment, multidrug antihypertensive regimens, retinitis pigmentosa, concomitant use of CYP3A4 inhibitors, patients who have conditions that may predispose them to priapism (such as sickle cell anemia, multiple myeloma, or leukemia) There have been rare reports of prolonged erections >4 hr and priapism (painful erections greater than 6 hours in duration) for this class of compounds, including vardenafil; in the event that an erection persists >4 hours, the patient should seek immediate medical assistance; if priapism is not treated immediately, penile tissue damage and permanent loss of potency may result Physicians should consider the cardiovascular status of their patients; there is a degree of cardiac risk associated with sexual activity; treatment for erectile dysfunction, should not be used in men for whom sexual activity is not recommended because of their underlying cardiovascular status Patients with left ventricular outflow obstruction, (for example, aortic stenosis and idiopathic hypertrophic subaortic stenosis) can be sensitive to the action of vasodilators including PDE5 inhibitors Until further information available, use is not recommended in unstable angina; hypotension (resting systolic blood pressure of <90 mmHg); uncontrolled hypertension (>170/110 mmHg); recent history of stroke, life-threatening arrhythmia, or myocardial infarction (within last 6 months); severe cardiac failure Consider counseling patients about protective measures necessary to guard against sexually transmitted diseases, including Human Immunodeficiency Virus (HIV); drug offers no protection against sexually transmitted diseases Patients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using drug Safety and efficacy of drug used in combination with other treatments for erectile dysfunction not studied; use of such combinations not recommended Vision loss may occur rarely and may be a sign of non-arteritic anterior ischemic optic neuropathy (NAION); patient should seek medical assistance for sudden loss in one or both eyes; patients who have already experienced NAION are at increased risk of recurrence; use is not recommended in patients with known degenerative retinal disorders May increase risk of rare sudden vision loss attributed to nonarteritic ischemic optic neuropathy; if vision problems arise, discontinue, and contact physician The drug has systemic vasodilatory properties that resulted in transient decreases in supine blood pressure in healthy volunteers (mean maximum decrease of 7 mmHg systolic and 8 mmHg diastolic); while this normally would be expected to be of little consequence in most patients, physicians should carefully consider whether their patients with underlying cardiovascular disease could be affected adversely by such vasodilatory effects Physicians should advise patients to stop taking all PDE5 inhibitors, and seek prompt medical attention in event of sudden decrease or loss of hearing; these events, which may be accompanied by tinnitus and dizziness, have been reported in temporal association to intake of PDE5 inhibitors, including vardenafil; it is not possible to determine whether these events are related directly to use of PDE5 inhibitors or to other factors CYP3A4 inhibitorsConcomitant administration with potent CYP3A4 inhibitors (eg, ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (eg, erythromycin) increases plasma concentrations of drug; dosage adjustment is necessary when drug is administered with certain CYP3A4 inhibitorsLong-term safety information is not available on concomitant administration of drug with HIV protease inhibitors Concomitant administration with potent CYP3A4 inhibitors (eg, ritonavir, indinavir, cobicistat, ketoconazole) or moderate CYP3A4 inhibitors (eg, erythromycin) increases plasma concentrations of drug; dosage adjustment is necessary when drug is administered with certain CYP3A4 inhibitors Long-term safety information is not available on concomitant administration of drug with HIV protease inhibitors Alpha blockersCaution advised when PDE5 inhibitors co-administered with alpha-blockers; PDE5 inhibitors, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects; when vasodilators are used in combination, an additive effect on blood pressure may be anticipated; in some patients, concomitant use of these two drug classes can lower blood pressure significantly leading to symptomatic hypotension (eg, fainting)Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor; patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitorsIn patients who are stable on alpha-blocker therapy, initiate PDE5 inhibitors at lowest recommended starting doseIn patients already taking optimized dose of PDE5 inhibitor, initiate alpha-blocker therapy at lowest dose; stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitorSafety of combined use of other PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs Caution advised when PDE5 inhibitors co-administered with alpha-blockers; PDE5 inhibitors, and alpha-adrenergic blocking agents are both vasodilators with blood-pressure lowering effects; when vasodilators are used in combination, an additive effect on blood pressure may be anticipated; in some patients, concomitant use of these two drug classes can lower blood pressure significantly leading to symptomatic hypotension (eg, fainting) Patients should be stable on alpha-blocker therapy prior to initiating a PDE5 inhibitor; patients who demonstrate hemodynamic instability on alpha-blocker therapy alone are at increased risk of symptomatic hypotension with concomitant use of PDE5 inhibitors In patients who are stable on alpha-blocker therapy, initiate PDE5 inhibitors at lowest recommended starting dose In patients already taking optimized dose of PDE5 inhibitor, initiate alpha-blocker therapy at lowest dose; stepwise increase in alpha-blocker dose may be associated with further lowering of blood pressure in patients taking a PDE5 inhibitor Safety of combined use of other PDE5 inhibitors and alpha-blockers may be affected by other variables, including intravascular volume depletion and other anti-hypertensive drugs QT prolonging drugsAvoid coadministration with drugs that have a high risk for QT prolonationPatients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using drug Avoid coadministration with drugs that have a high risk for QT prolonation Patients taking Class 1A (eg, quinidine, procainamide) or Class III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT prolongation, should avoid using drug Controlled studies in pregnant women show no evidence of fetal risk.