Drug interactions
Atazanavir + Vardenafil
Severity: Major
Atazanavir and Vardenafil: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Atazanavir strongly inhibits CYP3A4 and markedly raises vardenafil exposure. This increases the risk of hypotension, syncope, visual disturbance, prolonged erection and QT effects.
What this interaction means in plain words
Atazanavir and Vardenafil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Vardenafil belongs to Genitourinary.
Why it happens
Inhibition of CYP3A4-mediated vardenafil metabolism by atazanavir.
What to do
Limit vardenafil to a very low dose with a long dosing interval as per labeling, and monitor blood pressure and symptoms. Consider an alternative agent if possible.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Vardenafil
- Amyl nitrite + Vardenafil Contraindicated
- Glyceryl trinitrate pr + Vardenafil Contraindicated
- Isosorbide dinitrate + Vardenafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Nicorandil + Vardenafil Contraindicated
- Nitroglycerin po + Vardenafil Contraindicated
Other interactions of Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Vardenafil?
MediHelp rates the interaction as major. Atazanavir and Vardenafil can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir strongly inhibits CYP3A4 and markedly raises vardenafil exposure. This increases the risk of hypotension, syncope, visual disturbance, prolonged erection and QT effects.
How serious is the interaction between Atazanavir and Vardenafil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Limit vardenafil to a very low dose with a long dosing interval as per labeling, and monitor blood pressure and symptoms. Consider an alternative agent if possible.
What other medicines interact with Vardenafil?
MediHelp also lists interactions of Vardenafil with, for example, Amyl nitrite, Glyceryl trinitrate pr, Isosorbide dinitrate. The full list is on the Vardenafil page.
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