Date - 22 September 2004

Source- Drugs in Context 2004; 1B(9): Vardenafil - Erectile dysfunction p349

Author - Dr Scott Chambersor Bull

Vardenafil is a .second-generation. phosphodiesterase type-5 (PDE5) inhibitor indicated for the treatment of erectile dysfunction (ED) in the UK. It exhibits greater in vitro potency in terms of PDE5 inhibition than either sildenafil or tadalafil, and is also highly selective for this isoenzyme. Vardenafil is also associated with a more rapid onset of action than either sildenafil or the second-generation agent, tadalafil. Whether this pharmacological profile translates into greater clinical effectiveness in practice requires direct head-to-head clinical trials comparing vardenafil with the other PDE5 inhibitors, which have yet to report. However, in a number of randomised, placebo-controlled clinical trials, vardenafil has been shown to be a highly effective treatment for men with ED. Vardenafil has proven to be effective in both the shortand long-term treatment of men with ED of various aetiologies and of varying severity, and in difficult-to-treat patient populations including those with diabetes mellitus and those who have undergone nerve-sparing radical prostatectomy. Vardenafil also appears to offer an effective option for patients who have failed to respond to prior sildenafil therapy. In clinical trials, vardenafil is reportedly well tolerated, with an adverse event profile typical of the PDE5 inhibitors. The majority of treatment-emergent adverse events that are associated with vardenafil are mild in intensity and transient in nature, and are related to PDE5 inhibition in parts of the body other than penile tissue. The most common side-effects are cutaneous flushing, headache, rhinitis and dyspepsia, but these rarely warrant treatment discontinuation. Moreover, visual colour disturbances (a consequence of inhibition of PDE6) appear to occur rarely with vardenafil and with significantly less frequency than with sildenafil.

Keywords: Vardenafil, Erectile dysfunction