Alpha blockers Vardenafil

Flypersensitivity to any component of the tablet administration with nitrates (either regularly and/or intermittently) and nitric oxide donors because of the potentiation of hypotension (see Drug Interactions) coadministration with alpha-blockers (vardenafil only) coadministration with alpha-blockers other than 0.4 mg/day tamsulosin (tadalafil only). 

ALPHA-BLOCKERS PHOSPHODIESTERASE TYPE S INHIBITORS Risk of marked 1 BP Additive hypotensive effect Avoid co-administration. Avoid alpha-blockers for 4 hours after intake of sildenafil (6 hours after vardenafil)... 

The manufacturers of vardenafil have conducted several placebo-control-led, randomised, crossover studies, in patients with BPH and in healthy subjects taking alpha blockers, to assess the effects of concurrent vardena-fil on blood pressure. 

The manufacturer recommends that patients should be stable on their alpha blocker before using vardenafil, and that vardenafil should be initiated at a dose of 5 mg (or less in the presence of potent inhibitors of C YP3A4 such as the azoles , (p.l270) or the protease inhibitors , (p.l273)). The UK manufacturer also says that the doses should be separated if vardenafil is to be given with an alpha blocker (with the exception of tamsulosin, where they consider this precaution unnecessary). From the data above, 6 hours would seem adequate. When starting an alpha blocker in a patient taking vardenafil, the US manufacturer states that the alpha blocker should be started at the lowest dose. ... 

No clinically relevant interactions appear to occur between sildenafil, tadalafil or vardenafil and most antihypertensive drugs. The exceptions may be diltiazem and verapamil. The potentially serious interactions of sildenafil, tadalafil and vardenafil with the alpha blockers and nitrates are discussed elsewhere. See Phosphodiesterase type-5 inhibitors + Alpha blockers , p.l268 and Phosphodiesterase type-5 inhibitors -I- Nitrates , p.l272. 

Avoid using nitrate drugs and alpha-adrenergic blockers concurrently with vardenafil... 

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