On-Demand Versus Daily Use of ardenafil 20 mg

Other > 20 mg vardenafil


solifenacinsolifenacin and vardenafil both increase QTc interval. solifenacin and vardenafil both increase QTc interval. sorafenibsorafenib and vardenafil both increase QTc interval. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. sunitinibsunitinib and vardenafil both increase QTc interval.

Vardenafil Generic Name & Formulations

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. 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.

Does Food Affect How ED Drugs Work?

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. 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) sunitinib and vardenafil both increase QTc interval.

Step Action Notes
Dose Administration Oral, with water Do not chew or crush
Timing before Activity 30-60 minutes before sexual activity Peak levels within this period
Food Intake Can be taken with or without food High-fat meals may delay absorption
Duration of Use As prescribed, typically occasional Avoid daily use unless instructed

suzetriginesuzetrigine decreases levels of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Property Description Value
Molecular Formula - C23H32N6O4
Molecular Weight - 488.54 g/mol
Solubility In water Slightly soluble
pKa - 4.8

Monitor patients for loss of therapeutic effect of sensitive CYP3A substrates with narrow therapeutic indexes when coadministered with suzetrigine. Consider modifying dose of sensitive substrate according to prescribing recommendations. suzetrigine decreases levels of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Concomitant use may increase the risk of QTc interval prolongation. If concomitant use is unavoidable, adjust the frequency of ECG and electrolyte monitoring. tecovirimattecovirimat will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered.

  • Effectiveness can vary based on individual physiology and ED severity.
  • Available in some markets as orally disintegrating tablets (ODT).
  • The 20 mg tablet is often scored, allowing for splitting if prescribed.
  • A patient assistance program may exist for the brand-name medication.
  • Regular follow-ups with a doctor are recommended to assess ongoing use.
  • It is one of several effective second-line oral treatments for ED.

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.

  • Combining vardenafil with other ED medications is not recommended.
  • Side effects like vision changes are rare but should be reported.
  • It may take several attempts to find the correct dose for optimal effect.
  • Regular monitoring is advised if using vardenafil frequently.

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.

  • 20 mg vardenafil can be part of a treatment plan for erectile health.
  • Always inform your doctor of all medications and supplements you take.
  • Using vardenafil does not protect against sexually transmitted infections.
  • Remember to seek medical advice if erectile issues persist despite medication.

valbenazinevalbenazine and vardenafil both vidalista 20mg uk increase QTc interval. valbenazine and vardenafil both increase QTc interval. verapamilverapamil will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Product Dosage Quantity + Bonus Price
Kamagra Effervescent Tablets100 mg14 Pills51.61€ 49.15€
Viagra Original100mg34 + 2 Pills163.67€ 155.88€
Levitra Generic10mg30 + 4 Pills62.39€ 59.42€
Priligy Generic Dapoxetine60mg60 + 8 Pills183.06€ 174.34€
Kamagra Polo100 mg32 Pills125.88€ 119.89€
Kamagra Gold50 mg20 Pills73.17€ 69.69€
Cialis Generic2.5mg20 Pills40.73€ 38.79€
Viagra Soft Tabs100mg120 + 8 Pills232.21€ 221.15€
Super Kamagra160 mg12 Pills101.10€ 96.29€
Levitra Professional20mg180 + 4 Pills502.31€ 478.39€

Vardenafil 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. vorinostat and vardenafil both increase QTc interval.

  • 20 mg vardenafil is effective in improving erectile function in most men.
  • Be aware of potential allergic reactions, such as rash or swelling.
  • The medication can interact with certain antibiotics and antifungals.
  • Regular check-ups are recommended during prolonged use of vardenafil.

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.

How Do Vardenafil and Viagra Compare?

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

Professional resources

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

How should I use vardenafil?

Concomitant use may increase the risk of QTc interval prolongation. If concomitant use is unavoidable, adjust the frequency of ECG and electrolyte monitoring. tecovirimattecovirimat will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. tecovirimat will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Viagra™ Efficacy

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. 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. 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.

What are the main differences between Levitra and Cialis?

topiramate will decrease the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. valbenazinevalbenazine and vardenafil both vidalista 20mg uk increase QTc interval. valbenazine and vardenafil both increase QTc interval. verapamilverapamil 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 verapamil will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

Pharmacotherapy for erectile dysfunction

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

Study design

solifenacinsolifenacin and vardenafil both increase QTc interval. solifenacin and vardenafil both increase QTc interval. sorafenibsorafenib and vardenafil both increase QTc interval. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. sunitinibsunitinib and vardenafil both increase QTc interval.

Safety and efficacy of vardenafil for the treatment of men with erectile dysfunction after radical retropubic prostatectomy

sunitinib and vardenafil both increase QTc interval. suzetriginesuzetrigine decreases levels of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor patients for loss of therapeutic effect of sensitive CYP3A substrates with narrow therapeutic indexes when coadministered with suzetrigine. Consider modifying dose of sensitive substrate according to prescribing recommendations. suzetrigine decreases levels 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. 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)