Vardenafil

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Systematic (IUPAC) name
4-[2-ethoxy-5-(4-ethylpiperazin-1-yl)sulfonyl-phenyl]-
9-methyl-7-propyl- 3,5,6,8-tetrazabicyclo[4.3.0]
nona-3,7,9-trien-2-one




Identifiers: CAS number 224785-90-4; ATC code G04BE09;
PubChem 110634; DrugBank APRD00699.
Chemical data: Formula C23H32N6O4S; Mol. mass 488.604 g/mol.
Pharmacokinetic data: Bioavailability 15%; Protein binding 95%;
Metabolism Hepatic (CYP3A4); Half life 4–5 hours; Excretion Biliary.
Therapeutic considerations: Pregnancy cat. B3 (Au), B (U.S.);
Legal status Prescription Only (S4)(AU) POM(UK) -only(US); Routes Oral.

Vardenafil (INN) is a PDE5 inhibitor used in the treatment of erectile dysfunction. It can assist men with this disorder in achieving and maintaining an erection during sexual activity. It is commonly marketed under the trade name Levitra (Bayer AG).

History: Vardenafil was co-marketed by Bayer Pharmaceuticals and GSK under the trade name Levitra. As of 2005, the co-promotion rights of GSK on Levitra have been "transferred back" to Bayer in many markets outside of the United States. In Italy, Bayer markets the product as Levitra and GSK markets the product as Vivanza. Due to European Union trade rules, parallel imports may result in the Vivanza branded packs being seen alongside Levitra packs in pharmacies in other EU member states.

Clinical use: Main article: PDE5 inhibitor.
Indications and contraindications are as for other PDE5 inhibitors. As a PDE5 inhibitor, vardenafil is closely related in both function and marketing to sildenafil and tadalafil. Structurally, the vardenafil molecule differs from sildenafil (Viagra) by only a methyl group and the position of one nitrogen atom in its structure. It has a relatively short effective time, comparable to sildenafil.

Adverse drug reactions: More common adverse drug reactions (ADRs) are as per other PDE5 inhibitors and are listed on that page.
Common vardenafil-specific ADRs include: nausea. Infrequent ADRs include: abdominal pain, back pain, photosensitivity, abnormal vision, eye pain, facial oedema, hypertension, palpitation, tachycardia, arthralgia, myalgia, rash, itch, priapism. (Rossi, 2004)
The use of products containing vardenafil has also been associated with serious side-effects which include serious cardiac events such as heart attacks. In rare cases, the use of vardenafil may result in penile tissue damage and permanent loss of potency. Health Canada (2006).

Drug interactions: Products containing vardenafil should not be used by individuals who are taking any nitrate medication because combining these products could result in the development of potentially life-threatening low blood pressure.

Dose forms: It is available in 2.5 mg, 5 mg, 10 mg, and 20 mg doses in round orange tablets. The normal starting dose is 10 mg (roughly equivalent to 50 mg of sildenafil). Vardenafil should be taken 25–60 minutes prior to sexual activity, with a maximum dose frequency of once per day. In some territories, such as the UK, only certain doses may be available, i.e. 5 mg, 10 mg, and 20 mg.