https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=7278
https://interactions.guidetherapeutiquevih.com/en/interaction-details?id=7278
No pharmaceutical opinion available for this interaction.
Lopinavir / ritonavir can inhibit the metabolism (CYP 3A4) and increase the plasma concentration of Vardenafil.
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Possible increase of adverse effects.
Use this combination with caution.
Use a single maximum dose of vardenafil of 2.5 mg every 72 hours according to the US product monograph.
Monitor closely for adverse effects.
The canadian monograph contraindicates this combination.
Sildenafil or tadalafil.
Vardenafil toxicity: hypotension, tachycardia, headache, dizziness, flushing, visual changes (difficulty distinguishing blue and green) and syncope.
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Studies confirming increased PDE-5 inhibitor concentrations with coadministration of PIs and pharmacokinetic enhancers have been well documented since these ED agents first became available for clinical use. At least two published case reports describe deaths associated with interactions involving PDE-5 inhibitors and a PI in combination with ritonavir. Such consequences make recommendations for PDE-5 inhibitor dose reduction and slow dose titration essential when these ED agents are co-prescribed with strong CYP 3A4 inhibitors such as PIs, ritonavir, or cobicistat.
Ref #3726 : In this cohort study of 235 men with erectile dysfunction receiving treatment with a PDE-5 inhibitor and antiretroviral therapy with potential for interactions. The majority of men receiving ART boosted with ritonavir or cobicistat demonstrated interactions.
Caution:
- Liver impairment (Child Pugh B) : increases AUC to 160% and
- kidney failure (Clcr < 30 ml/min) : increases AUC to 20-30% and
- age > 65 years old : increases 52% of AUC.
See ritonavir and vardenafil.