Levitra Treatment Plan

Be sure to take your time and read everything below. It is essential for you to understand the potential risks and benefits of treatment. Please do not hesitate to reach out to our medical support team if you have ANY questions.

Overview

Sleep

The value of sleep cannot be overstated. A lack of sleep can increase your risk for a cardiac event, slow your metabolism, weaken your immune system, and diminish cognitive abilities. It can also decrease your testosterone, which increases the likelihood of experiencing ED. Worse yet, a decrease in testosterone will most likely decrease your libido so your diminished sexual function may be less noticeable.

Stress

Unchecked stress can lead to high blood pressure, heart disease, obesity, and diabetes. Being in a high stress environment can affect the way your brain sends messages to your body, which can affect blood flow and your ability to achieve and maintain an erection.

There are many potential causes for stress induced ED (e.g., nervousness and anxiety, professional stress, loss of a loved one, changes in health, and financial burden).

It’s important for your overall (and sexual) health to manage your stress.


The importance of practicing safe sex with your partner

For many, starting an ED medication means increasing or returning to sexual activity. With that comes the positive aspects of sexual intimacy. However, it also comes with potentially uncomfortable conversations about sexually transmitted infections. Sharing your STI status is an important part of allowing your partner to make a truly informed decision about having sex.

If you have a sexually transmitted infection, you must inform any potential sexual partner. Moreover, this should be done before engaging in any activity that risks giving them an infection. It is also important to ask any prospective partner about their status. Lastly, while condoms are helpful in reducing the risk of pregnancy, transmitting, or acquiring an infection, they can never be 100% effective. That is why informed consent is such an important part of sharing sexual intimacy with honesty and clarity.


Why it’s important to keep all doctors in the loop

There are hundreds of medications that can interact with Sildenafil. Most are not severe but some can be life threatening, as with any nitrates, nitrites, or nitroglycerin. Even simple over the counter medications should be checked for interactions. Remember, something as safe as grapefruit can alter how your body handles sildenafil. All your providers should be kept informed of any medication that is added, dropped, or changed in your regimen.

The Physician Desk Reference (PDR) lists the medications that can interact with sildenafil, along with the contraindications to its use. The PDR is included because it is comprehensive and must be read in its entirety. Contraindications can be absolute, as with nitrates/nitrites, act as relative warnings about drug interactions, and inform patients and healthcare providers how certain conditions can affect the metabolism of sildenafil, either increasing or decreasing the amount in the blood. A few relevant sections are summarized below concerning contraindications and drug interactions, but it is not a complete overview. Please, read the entire package insert, as well.


Contraindications and precautions

GENERAL INFORMATION

It should not be used in anyone allergic to any of the components used to make Levitra tablets. Also, as discussed above, the use of multiple phosphodiesterase inhibitors at the same time, is not recommended. It has not been studied.

The use of Viagra is not recommended in patients with Pulmonary Veno-Occlusive Disease (PVOD).

Nitrate/Nitrite Therapy

ABSOLUTELY no one should take Levitra (Vardenafil) if they “are currently on nitrate/nitrite therapy.” (PDR) That includes even if the patient uses of nitrates/nitrite therapy intermittently. Also, no one who uses recreational nitrates/nitrites (poppers, etc.) should use Levitra.

Geriatric (The Elderly)

Lower starting doses for patients over 65 should be considered. The elderly may have some impairment of their kidney and liver function and this can result in higher levels of Levitra in the blood, which may lead to more side effects. Also, “patients who require lower doses of Levitra (vardenafil) should not take the orally disintegrating tablets.” (PDR) 

Hepatic (Liver) Disease, Renal (Kidney) Impairment, Renal Failure

Vardenafil tablets are not recommended in patients with severe liver or kidney impairment. Patients in renal failure or on dialysis also should not take Levitra. Patients with moderate liver impairment can use Levitra but at a lower starting dose. Patients with mild liver impairment or mild to moderate kidney impairment can use the same starting dose and do not require an adjustment to their initial dose. There are drugs that can affect how much Levitra is in the blood. Some lower the level; some will raise the level of Levitra and increase the risk of side effects. Dose adjustments must be made accordingly.
These are just a few examples:

Ritonavir: A single dose of 2.5 mg PO should not be exceeded in a 72-hour period.

Indinavir, Atazanavir, Saquinavir, Clarithromycin, Ketoconazole 400 mg daily, or Itraconazole 400 mg daily: Single dose of 2.5 mg not to be exceeded in a 24-hour period.

Erythromycin, Ketoconazole 200 mg daily, or Itraconazole 200 mg daily: A single dose of 5 mg PO should not be exceeded in a 24-hour period. If the patient is also taking an alpha-blocker, the initial dose should be 2.5 mg PO.

Alcoholism, Angina (Chest Pain), Aortic Stenosis, Cardiac Arrhythmias (Irregular Heartbeats), Cardiac Disease (Heart Disease), Coronary Artery Disease (Narrowing of the Heart Arteries), Diabetes, Females, Heart Failure, Hypertension (High Blood Pressure), Hypocalcemia (Low Calcium), Hypokalemia (Low Potassium), Hypomagnesemia (Low Magnesium), Hypotension (Low Blood Pressure), IHSS (Idiopathic Hypertrophic Subaortic Stenosis–a Heart Defect), Long QT Syndrome (An EKG Abnormality), Malnutrition, Myocardial Infarction (Heart Attack), QT Prolongation (An EKG abnormality), Stroke (like a heart attack but affecting the brain), Thyroid Disease

“There is a degree of cardiac risk associated with sexual activity; therefore, prescribers, should evaluate the cardiovascular status of their patients prior to initiating any treatment for erectile dysfunction.” [NOTE: This means that if you and your provider have a reason to believe after diagnosing erectile dysfunction that you are not healthy enough for sex, you shouldn’t use anything that will help you have sex until you are healthier. Your doctor counts on an honest answer about your health and your capacity to be sexually active. It may seem overly cautious but think about it; if you aren’t healthy enough for sex, shouldn’t you take care of your health before trying to regain your sex life? There have been more than 75 deaths due to cardiac events “reported in association with sildenafil use.” It may not seem like many deaths but you don’t want to be the person who bumps that number over 100.]

The PDR advises that “caution should be used if vardenafil is prescribed in the following groups: patients who have suffered a myocardial infarct, stroke, or life threatening arrhythmias in the last 6 months; patients with resting hypotension (BP<90/50) or resting hypertension (BP>170/100); patients with cardiac disease, heart failure, or coronary artery disease which causes unstable angina including those with left ventricular outflow obstruction.”

The PDR notes that the American College of Cardiology recommends that sildenafil be used in caution with patients (not on nitrates, of course) with active coronary ischemia, meaning they have blocked heart arteries that is compromising the function of their heart, such as would show by having symptoms like chest pain or by failing a stress test. They also advise caution in anyone with heart failure, low blood pressure or low blood volume, or in anyone with high blood pressure on a “complicated, multidrug, antihypertensive program.” 

Levitra (Vardenafil) can cause an abnormality seen on EKG called QT prolongation or long QT syndrome more pronounced. If that occurs, serious irregular heartbeats can follow. Therefore, when Levitra (Vardenafil) is prescribed, its potential effect on the QT interval should be considered. Almost every item listed in the heading above, along with medications and other conditions, can either cause QT prolongation, or increase the likelihood that it is present.  

Leukemia, Multiple Myeloma, Penile Structural Abnormality, Polycythemia, Priapism, Sickle Cell Disease
Priapism is an erection lasting more than 4 hours and it can occur with the use of Levitra (Vardenafil). Priapism can be painful but, with or without pain, an erection that lasts over 4 hours could result in damage to the tissues of the penis. People with the above conditions are at greater risk  of suffering from priapism with the use of Levitra (Vardenafil). The PDR states, “vardenafil and other agents for the treatment of erectile dysfunction, should be used with caution in patients with penile structural abnormality (such as angulation, cavernosal fibrosis, or Peyronie’s disease), or in patients who have conditions which may predispose them to priapism (such as sickle cell disease, leukemia, multiple myeloma, polycythemia, or history of priapism).”

Human Immunodeficiency Virus (HIV) Infection
The PDR states, “Patients should be reminded that Levitra, when used for erectile dysfunction, offers no protection against sexually transmitted disease.”

Coagulopathy (Bleeding Abnormalities), Peptic Ulcer Disease (Stomach Ulcer)
There is no safety information yet accumulated on how Levitra (Vardenafil) affects patients with bleeding disorders or active stomach ulcers so caution is recommended.

Gastroesophageal Reflux Disease (GERD–heartburn due to reflux of acid), Hiatal Hernia (part of stomach slips upward through the diaphragm)
Levitra (Vardenafil), like Sildenafil, decreases the pressure of the valve that stops acid from coming back up from the stomach and into the esophagus. It also inhibits the movement of the esophagus itself. It could make symptoms worse for people with GERD or a hiatal hernia so it is recommended that it be used with caution in these patients.

Non-arteritic Anterior Ischemic Optic Neuropathy (NAION), Retinitis Pigmentosa, Visual Disturbance
The PDR states, “Advise patients to stop use of all phosphodiesterase 5 (PDE5) inhibitors, including Levitra (Vardenafil), and seek medical attention for evaluation in the event of a sudden visual disturbance in 1 or both eyes. Postmarketing reports with PDE5 inhibitors have included cases of visual disturbances including retinal vein occlusion, visual field defects, reduced visual acuity, and loss of vision (temporary or permanent). Vision loss is attributed to a condition known as non-arteritic anterior ischemic optic neuropathy (NAION), where blood flow is blocked to the optic nerve; this can cause permanent loss of vision; discontinue vardenafil if there is visual loss in 1 or both eyes. It is never recommended for patients with known hereditary degenerative retinal disorders, including retinitis pigmentosa. It is recommended that Levitra (Vardenafil) only be used when the benefit outweighs the risk.

A Special Warning for Pilots and Air Traffic Controllers
Some people experience visual side effects when taking PDE5 inhibitors for erectile dysfunction. Due to the sensitive nature of their work, pilots and air traffic controllers should not take Viagra or sildenafil within 6 hours of aviation related duties. Cialis (tadalafil) is a much longer acting medication. Pilots and air traffic controllers should not take Cialis within 36 hours of aviation related duties. Daily Cialis use, at any dose, is not an option for men with these professions.

Hearing Impairment, Tinnitus
Patients should stop taking Levitra (Vardenafil) and go to the ER if they experience a sudden decrease or loss of hearing. Hearing loss, sometimes with tinnitus and dizziness, has happened around the time patients have taken PDE5 inhibitors, including Levitra (Vardenafil).
There are other situations that would give a healthcare provider pause. Some would be if you have lightheadedness, fainting spells, leg cramping when you walk, inability to climb stairs or walk a few blocks without getting short of breath, or if you have allergies to any of the other phosphodiesterases or their components. These, and any other symptoms, must be discussed.


Drug interactions from the PDR

The list below is long and not one drug on the list is meaningless. That is why we need to know every drug you take and every healthcare provider needs to know you take sildenafil.

Note: Some medications are not on the list but are included in the PDR, which is why it must be read as well. In addition, the list changes as medications may be added over time.

  • Abarelix (Viberzi) (Treats Irritable Bowel Syndrome that causes diarrhea) 
  • Alpha-blockers (e.g., Cardura, Coreg Flomax, Hytrin, Minipress, Oravase, Rapaflo, Regitine,Trandate) (Treats High Blood Pressure or Enlarged Prostate) 
  • Amiodarone (Cordarone, Pacerone) (Treats Irregular Heartbeats)
  • Amlodipine (Norvasc) (Treats High Blood Pressure)
  • Amyl Nitrite (Amyl nitrite Systemic, Poppers, Rush) (Recreational Drug)
  • Anagrelide (Agrylin) (Treats Patients with too many platelets–a type of blood cell)
  • Apomorphine (Apokyn) (Treats Parkinson’s Disease)
  • Aprepitant (Emend) (Treats Nausea)
  • Aripiprazole (Abilify, Abilify Discmelt) (Treats Mental Disorders)
  • Arsenic Trioxide (Trisenox) (Treats Leukemia)
  • Artemether; Lumefantrine (Coartem) (Treats Malaria) 
  • Asenapine (Saphris) (Treats Mental Disorders)
  • Atazanavir (Reyataz) (Treats HIV)
  • Atomoxetine (Strattera) (Treats ADHD Attention Deficit Hyperactivity Disorder)
  • Azithromycin (Zithromax, Zmax) (Antibiotic)
  • Bedaquiline (Sirturo) (Treats Tuberculosis)
  • Bepridil (Vascor) (Treats Chest Pain, High Blood Pressure)
  • Boceprevir (Pegasys, Pegintron) (Treats PAH and Hepatitis C)
  • Buprenorphine; Naloxone (
  • Butyl Nitrate (Poppers, Rush, Liquid Gold) (It is a recreational drug)
  • Ceritinib (Zykadia) (Cancer)
  • Chloroquine (Aralen Phosphate) (Treats Malaria)
  • Chlorpromazine (Thorazine) (Treats Mental Disorders)
  • Cimetidine (Tagamet) (Stomach Ulcers)
  • Ciprofloxacin (Proquin, Cipro) (Antibiotic)
  • Cisapride (Propulsid) (Treated Heartburn)
  • Citalopram (CeleXA) (Treats Depression)
  • Clarithromycin (Biaxin) (Antibiotic)
  • Class IA Antiarrhythmics (Disopyramide, Procainamide, and Quinidine) (Treats Irregular Heartbeats—If you are treated for Irregular Heartbeats check every single medicine you take with all your healthcare providers)
  • Clozapine (Clozaril, FazaClo, Versacloz) (Treats Mental Disorders)
  • Cobicistat (Stribild, Tybost) (Treats HIV)
  • Conivaptan (Vaprisol) (Treats Low Sodium in the blood)
  • Crizotinib (Xalkori) (Cancer)
  • Cyclobenzaprine (Amrix, Fexmid, Flexeril, FusePaq Tabradol) (Treats Muscle Spasm)
  • Darunavir (Prezista) (Treats HIV)
  • Dasabuvir (Viekira XR, Viekira Pak–contains Ritonavir*) (Treats Hepatitis C)
  • Dasatinib (Sprycel) (Treats Cancer–Leukemia)
  • Daunorubicin (Daunoxome) (Treats Cancer)
  • Degarelix (Treats Prostate Cancer)
  • Deutetrabenazine (Austedo) (Treats Neurological Diseases)
  • Delavirdine (Treats HIV)
  • Diltiazem (e.g., Cartia, Cardizem, Dilacor XR, Tiazac,) (Treats High Blood Pressure)
  • Disopyramide (Norpace, Norpace CR) (Treats Abnormal Heartbeats)
  • Dofetilide (Tikosyn) (Treats Abnormal Heartbeats)
  • Dolasetron (Anzemet) (Treats Nausea and Vomiting)
  • Donepezil (Aricept) (Treats Dementia and Memory Loss due to Alzheimer’s Disease)
  • Doxazosin (Cardura, Carduran) (Treats High Blood Pressure or Enlarged Prostate)
  • Doxorubicin (Adriamycin) (Treats Cancer)
  • Dronedarone (Multaq) (Irregular Heartbeats)
  • Droperidol (Inapsine) (Treats Nausea and Vomiting)
  • Efavirenz (Sustiva) (Treats HIV)
  • Eliglustat (Cerdelga) (Treats Gaucher’s Disease, a rare genetic disease)
  • Epirubicin (Ellence) (Treats Cancer)
  • Eribulin (Halaven) (Treats Cancer)
  • Erythromycin (Erythrocin, Ery-Tab, E-Mycin, Eryc) (Antibiotic)
  • Escitalopram (Lexapro) (Treat Mental Disorders) 
  • Ezogabine (Potiga) (Treats Seizures)
  • Fingolimod (Gilenya) (Treats Multiple Sclerosis MS)
  • Flecainide (Tambocor) (Treats Abnormal Heartbeats) 
  • Fluconazole (Diflucan) (Treats Fungal and Yeast Infections)
  • Fluoxetine (e.g., Prozac, Sarafem) (Treats Psychiatric disorders like depression) 
  • Fluphenazine (Prolixin, Permitil) (Treats Mental Disorders)
  • Fluvoxamine (Faverin, Fevarin, Floxyfral, Dumyrox, Luvox) (Treats OCD) 
  • Fosamprenavir (Lexiva) (Treats HIV)
  • Foscarnet (Foscavir) (Treats Viral Infections)
  • Gemifloxacin (Factive) (Antibiotic)
  • Goserelin (Zoladex) (Treats Cancer and Abnormal Growth of the Uterus Lining) 
  • Granisetron (Sancuso) ((Treats Nausea and Vomiting)
  • Grapefruit juice
  • Halofantrine (Halfan) (Treats Malaria)
  • Hologenated Anesthetics (Used to “put people under” before surgery)
  • Haloperidol (Haldol) (Treats Mental Conditions)
  • Hydroxychloroquine (Plaquenil) (Treats Malaria)
  • Hydroxyzine (Atarax, Vistaril) (Treats Anxiety) 
  • Ibutilide (Corvert) (Treats Abnormal Heartbeats)
  • Idarubicin (Idamycin PFS) (Treats Cancer)
  • Idelalisib (Zydelig) (Treats Cancer–Leukemia) 
  • Iloperidone (Fanapt, Fanapt Titration Pack) (Treats Mental Disorders)
  • Imatinib (Gleevec) (Treats Cancer–Leukemia) 
  • Indinavir (Crixivan) (Treats HIV)
  • Inotuzumab Ozogamicin (Besponsa) (Treats Cancer)
  • Isavuconazonium (Cresemba) (Treats Fungal Infections) 
  • Isoniazid, INH (Nydrazid) (Treats Tuberculosis TB)
  • Isosorbide Dinitrate or Monohydrate (Isordil Titradose, Dilatrate-SR, Imdur, Imdur ER, Ismo, Monoket, IsoDitrate) (Treats Heart Disease and Chest Pain)
  • Itraconazole (Sporanox, Onmel) (Treats Fungus and Yeast)
  • Ivacaftor (Kalydeco) (Treats Cystic Fibrosis)
  • Ketoconazole (Nizoral, Extina, Ketodan Kit, Kuric, Nizoral A-D, Xolegel) (Treats Fungal Infections)
  • Lapatinib (Tykerb) (Treats Breast Cancer) 
  • Lenvatinib (Lenvima) (Treats Cancer)
  • Leuprolide (Eligard, Lupron, Lupron depot, Viadur) (Hormone that treat cancer, etc.)
  • Levofloxacin (Levaquin) (Treats Infections)
  • Levomethadyl (Orlaam) (Narcotic used to treat Pain)
  • Lithium (Eskalith, Lithobid Eskalith-CR) (treats Mental Disorder)
  • Lomefloxacin (Maxaquin) (Treats Infections)
  • Long-Acting Beta Agonists (Too many names to list but they are used to treat asthma, slow heartbeats, heart failure, allergic reactions among other problems)
  • Loperamide (e.g., Imodium, Imogen, Diamode, Imotil) (Treats Diarrhea) 
  • Lopinavir; Ritonavir (Kaletra) (Contains Ritonavir and Treats HIV)
  • Lorcaserin (Belviq) (Weight Control) 
  • Maprotiline (ludiomil) (Treats Depression)
  • Mefloquine (Lariam) (Treats Malaria)
  • Mesoridazine (Serentil) (Treats Mental Conditions)
  • Methadone (Dolophine) (Treats Pain and Withdrawals)
  • Metronidazole (Flagyl, Flagyl ER) (Treats Fungal Infections)
  • Midostaurin (Rydapt) (Treats Cancer)
  • Mifepristone, RU-486 (Korlym, Mifeprex) (Treats Cushing’s Syndrome and Ends Pregnancy)
  • Mirtazapine (Ludiomil) (Treats Depression)
  • Mitotane (Lysodren) (Treats Cancer and Cushing’s Syndrome) 
  • Monoamine oxidase inhibitors (e.g., Azilect, Marplan, Nardil, Parnate) (Treats Depression)
  • Moxifloxacin (Avelox) (Treats Infections) 
  • Nefazodone (Serzone) (Treats Depression)
  • Nelfinavir (Viracept) (Treats HIV)
  • Nicardipine (Cardene, Cardene SR) (Chest Pain, High Blood Pressure)
  • Nifedipine (Procardia, Nifedical XL, Adalat, Procardia XL) (Heart Disease among others)
  • Nilotinib (Tasigna) (Treats Cancer–Leukemia)
  • Nitrates (Isordil Titradose, Dilatrate-SR, Imdur, Imdur ER, Ismo, Monoket, IsoDitrate) (Treats Heart Disease and Chest Pain)
  • Nitroglycerin (Nitro-bid, Nitrocot SA Capsule, Nitro-dur, Nitrostat, Nitrodisc, Nitrek transdermal, Minitran, Nitrol ointment, Transderm-Nitro, Nitro-Time, Nitrotab, NitroMist, Nitro-Par, Nitrolingual, Nitroquick, Transderm-Nitro, Nitrogard, Nitroglyn, Nitrong) (Treats Chest Pain and Heart Conditions) 
  • Nitroprusside (Nipride RTU, Nitropress) (Heart Failure and High Blood Pressure)
  • Ombitasvir; Paritaprevir; Ritonavir (Technivie, Viekira Pak) (Treat Hepatitis C)
  • Norfloxacin (Noroxin) (Treats Infections)
  • Octreotide (SandoSTATIN, SandoSTATIN LAR Depot) (Treats Diarrhea, Acromegaly)
  • Ofloxacin (Ocuflox) (Treats Infections)
  • Olanzapine (Zyprexa, Zyprexa, Zydis) (Treats Mental Conditions)
  • Ondansetron (Zofran) (Treats Nausea and Vomiting) 
  • Osimertinib (Tagrisso) (Treats Cancer)
  • Oxaliplatin (Eloxatin) (Treats Cancer)
  • Palbociclib (Ibrance) (Treats Cancer)
  • Paliperidone (Invega, Invega Sustenna) (Treats Mental Conditions)
  • Panobinostat (Farydak) (Treats Multiple Myeloma, a type of cancer)
  • Pasireotide (Signifor, Signifor LAR) (Treats Hormone Conditions)
  • Pazopanib (Votrient) (Treats Cancer)
  • Pentamidine (Nebupent) (Prevents AIDS related pneumonia)
  • Perphenazine (Duo-Vil 2-10, Duo-Vil 2-25, Etrafon) (Treats Mental Conditions)
  • Phenoxybenzamine (Dibenzyline) (Treat High Blood Pressure and Pheochromocytoma)
  • Phentolamine (Regitine, Oraverse) (Erectile Dysfunction, High Blood Pressure)
  • Phenylephrine (e.g.,Sudafed) (Decongestant)
  • Pimavanserin (Nulplazid) (Treats Mental Conditions like Hallucinations)
  • Pimozide (Orap) (Treats Neurological Conditions like Tourette’s Syndrome)
  • Posaconazole (Noxafil) (Treats Fungal Infections) 
  • Prazosin (e.g., Minipress, Vasoflex, Lentopres, Hypovase) (Treats High Blood Pressure, PTSD, and Anxiety)
  • Primaquine (Treats Malaria)
  • Procainamide (Pronestyl) (Treats Abnormal Heartbeats)
  • Prochlorperazine (Compazine, Compro, Procot) (Treats Nausea and Vomiting, hiccups)
  • Promethazine (Phenergan, Promacot) (Treats Allergies)
  • Propafenone (Rythmol, Rythmol SR) (Treats Abnormal Heartbeats)
  • Quetiapine (Seroquel, Seroquel SR) (Treats Mental Disorders)
  • Quinidine (Cardioquin, Quinaglute, Quinalan, Quinidex Extentabs) (Treats Abnormal Heartbeats)
  • Ranolazine (Ranexa) (Treats Chest Pain)
  • Regadenoson (Lexiscan) (Used for Cardiac Stress Testing)
  • Ribociclib (Kisqali) (Treats Cancer)
  • Rilpivirine 
  • Riociguat (Adempas) (Treats High Blood Pressure in the Arteries of the Lung)
  • Risperidone (Risperdal M-Tab, Risperdone M-Tab) (Treats Mental Disorders)
  • Ritonavir (Norvir) (Also found in Technivie and Viekira Pak) (Treats HIV and Hepatitis C)
  • Romidepsin (Istodax) (Treats Cancer)
  • Sapropterin (Kuvan) (Treats a disorder that causes amino acid buildup in the brain)
  • Saquinavir (Invirase, Fortovase) (Treats HIV)
  • Sertraline (Zoloft) (Treats Mental Conditions including depression)
  • Short-Acting Beta Agonist (Too many names to list but they are used to treat asthma, slow heartbeats, heart failure, allergic reactions among other problems)
  • Silodosin (Rapaflo) (Treats an Enlarged Prostate)
  • Solifenacin (Vesicare) (Treats an Overactive Bladder) 
  • Sorafenib (Nexavar) ((Treats Cancer)
  • Sotalol (Betapace, Betapace AF, Sorine, Sotylize) (Treats Abnormal Heartbeats)
  • Sparfloxacin (Zagam) (Treats Infections)
  • Sulfamethoxazole; Trimethoprim (Bactrim, Septra, Sulfatrim) (Treats Infections)
  • Sunitinib (Sutent) (Treats Cancer)
  • Tacrolimus (Prograft, Advagraf XL, Protopic, Hecoria) (Treats Organ Transplants)
  • Tadalafil (Cialis, Adcirca) (Treats Erectile Dysfunction, Enlarged Prostate, Pulmonary Hypertension–High Blood Pressure in the blood vessels of the lung
  • Tamoxifen (Nolvadex, Soltamox) (Treats Cancer)
  • Tamsulosin (Flomax) (Treats an Enlarged Prostate)
  • Telaprevir (Incivek, Incivo) (Treats Hepatitis C) 
  • Telavancin (Vibativ) (Treats Treats Infections)
  • Telithromycin (Ketek, Ketek Pak) (Antibiotic)
  • Telotristat Ethyl (Xermelo) (Treats diarrhea in cancer patients) 
  • Terazosin (Hytrin) (Treats High Blood Pressure) 
  • Tetrabenazine (Xenazine) (Treats Neurological Conditions)
  • Thiethylperazine (Torecan) (Treats Nausea and Vomiting)
  • Thioridazine (Mellaril, Mellaril-S) (Treats Mental Conditions like Schizophrenia)
  • Tipranavir (Aptivus) (Treats HIV)
  • Tizanidine (Zanaflex, Comfort Pac Tizanidine)
  • Tolterodine (Detrol) (Treats an Overactive Bladder)
  • Toremifene (Fareston) (Treats Cancer)
  • Trazodone (Desyrel, Oleptro)
  • Tricyclic Antidepressants (e.g. Elavil, Tofranil, Pamelor, Vivactil, Surmontil, Norpramin) (Treats Depression) 
  • Trifluoperazine (Stelazine) (Treats Mental Conditions like Schizophrenia or Anxiety)
  • Triptorelin (Trelstar) (Treats Cancer—blocks testosterone in men with prostate cancer)
  • Vandetanib (Caprelsa) (Treats Cancer)
  • Vemurafenib (Zelboraf) (Treats Cancer)
  • Venlafaxine (Effexor) (Treats Mental Disorders like Depression, Anxiety, and Panic disorder)
  • Verapamil (Calan, Isoptin) (Treats High Blood Pressure, Angina, Irregular Heart Beats) 
  • Vigabatrin (Sabril) (Treats Seizure Disorders) 
  • Voriconazole (Vfend) (Treats Fungal Infections) 
  • Vorinostat (Zolinza) (Treats Cancer)
  • Ziprasidone (Treats Mental Conditions like Schizophrenia or Bipolar Disorder)

Side effects

Again, to one degree or another, all the phosphodiesterase inhibitors have common or not unusual side effects They can cause headaches (10%-16%), nasal stuffiness (1%-10%), flushing (5%-12%), dizziness (~3%), and upset stomach (4%-12%). [Drugs 2005;65:1621-1650] Some can cause blue tinted vision as a side effect.The medicine prescribed is safe but some rare side effects can occur, as well. Please take a few minutes to familiarize yourself with the list of both common and rare side effects provided here.

Important: If any unusual side effect happens, contact us; however, if there is anything severe or emergent go immediately to an emergency room. Any new symptom is worth pursuing. Any severe symptom must be pursued as an emergency. Symptoms such as chest pain, shortness of breath, severe headache, fainting, visual changes, or anything out of the ordinary, even lightheadedness, warrant a visit to the ER. Contact us after it is addressed. Again, take the time to read the list of potential side effects. It doesn’t matter how rare a side effect is if you are experiencing it.