Ketoconazole (Systemic) and Levitra

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using vardenafil together with ketoconazole. Combining these medications may significantly increase the blood levels and effects of vardenafil. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Contact your doctor if your condition changes or you experience nausea, shortness of breath, dizziness, lightheadedness, fainting, visual disturbances, ringing in the ears, vision or hearing loss, chest pain or tightness, irregular heartbeat, and/or priapism (prolonged and painful erection unrelated to sexual activity), as these may be signs and symptoms of excessive vardenafil levels. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

ADJUST DOSE: Coadministration with the azole antifungal agents, ketoconazole and itraconazole, may significantly increase the plasma concentrations of vardenafil. The mechanism is azole inhibition of CYP450 3A4, the isoenzyme primarily responsible for the metabolic clearance of vardenafil. According to vardenafil labeling, coadministration of ketoconazole (200 mg once a day) and vardenafil (5 mg) in healthy volunteers resulted in a 4-fold increase in the peak plasma concentration (Cmax) and a 10-fold increase in the area under the concentration-time curve (AUC) of vardenafil. No data are available for itraconazole, although a similar interaction may be anticipated due to the potent inhibiting effect of itraconazole on CYP450 3A4.

MANAGEMENT: Patients treated with ketoconazole or itraconazole at a dosage of 200 mg/day should not receive more than a single 5 mg dose of vardenafil within a 24-hour period. Since higher dosages of the azole antifungal agents may result in higher increases in vardenafil plasma concentrations, a single 2.5 mg dose of vardenafil should not be exceeded within a 24-hour period when used in combination with ketoconazole or itraconazole 400 mg/day. Patients should be advised to promptly notify their physician if they experience pain or tightness in the chest or jaw, irregular heartbeat, nausea, shortness of breath, visual disturbances, syncope, or prolonged erection (greater than 4 hours).

Ketoconazole (Systemic)

Generic Name: ketoconazole

Brand name: Nizoral

Synonyms: Ketoconazole

What is Ketoconazole (Systemic)?

Levitra

Generic Name: vardenafil

Brand name: Levitra, Staxyn

Synonyms: n.a.

What is Levitra?