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Pulse · ED note · 3 min read
Vardenafil 20 mg and QT interval monitoring
Medically reviewed by Dr. Mateo Ruiz, MD - Clinical pharmacology, Barcelona
Last reviewed
Updated
01Run the QT list before anyone prices 20 mg
Levitra's avoid list names Class IA and Class III antiarrhythmics and congenital QT prolongation. Twenty milligrams is the maximum labelled vardenafil dose, not a first click.
Splitting a 20 mg tablet does not create a safe micro-dose on amiodarone. Thorough QT work in healthy men showed small QTcF shifts. Additive effect appeared when another QT-active drug sat beside vardenafil.
Nitrates still forbid the class after you pass the arrhythmia screen.
02Onset after the list is clean
Median Tmax after 20 mg fasted sits near 60 minutes. High-fat meals cut Cmax. See the onset note. Do not test speed after mezze on a dirty QT list.
03Who sits on the avoid list
Quinidine, procainamide, amiodarone, sotalol, and congenital long QT. A $44.21 coupon on vardenafil 20 x 10 does not buy a pass.
If vardenafil is ruled out, the other two are still contraindicated with nitrates and still need a prescription.
Class IA and Class III antiarrhythmics: avoid
Congenital long QT: avoid
Nitrates / riociguat: still contraindicated
20 mg is the ceiling after a 10 mg start
04What a coupon cannot clear
It cannot clear amiodarone. It cannot clear congenital long QT. It cannot clear a nitrate spray in the travel kit.
Vardenafil prolongs QT at the 20 mg dose. This note is a list check, not an ECG manual. Chest pain is emergency care.
Ingrid B. Amiodarone. Can I split 20 mg?
Vault reply
No. Splitting a 20 mg tablet does not create a safe micro-dose on amiodarone. Cardiology review comes first. See vardenafil 20 mg.
Lars N. Congenital long QT. Any vardenafil strength?
Vault reply
Levitra's avoid list names congenital QT prolongation and Class IA / Class III antiarrhythmics. The coupon is irrelevant until that screen is clean.
Pia M. Sotalol last year, stopped. Still avoid?
Vault reply
Tell the prescriber the history. Do not self-clear a Class III drug because you 'finished the bottle'. This inbox will not clear it by email.
Omar J. Can I take tadalafil instead to dodge QT?
Vault reply
Tadalafil and sildenafil still need nitrate and interaction checks. They are not a silent workaround you pick at the counter because an insurer rejected vardenafil.
Cora L. Thorough QT study - how big were the shifts?
Vault reply
Thorough QT work in healthy men showed small QTcF shifts. Additive effect appeared when another QT-active drug sat beside vardenafil. That is why the list exists.
Nico A. 20 mg is this site's lock. Does that skip the 10 mg start?
Vault reply
No. 20 mg is the labelled maximum after a 10 mg start. Run the list, then the clock. The onset note is the stopwatch page.
Before you start, stop, or change any medicine, speak with your prescriber or pharmacist - they hold your chart, this vault card does not. Open the vault disclaimer.
