OBJECT DRUGS
Phosphodiesterase Inhibitors:
- Avanafil (Stendra)
- Sildenafil (Viagra, etc.)
- Tadalafil (Cialis, etc.)
- Vardenafil (Levitra, etc.)
PRECIPITANT DRUGS
Antidepressants:
- Fluvoxamine (Luvox, etc.)
- Nefazodone
Comment:
The phosphodiesterase inhibitors are metabolized by CYP3A4 and concurrent administration with CYP3A4 inhibitors could produce increased plasma concentrations. Increased side effects may occur during coadministered with CYP3A4 inhibitors.
Class 3: Assess Risk & Take Action if Necessary
- Consider Alternative: Sertraline (Zoloft), venlafaxine (Effexor), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro) are not known to inhibit CYP3A4. Fluoxetine (Prozac) appears to be a weak CYP3A4 inhibitor.
- Monitor: Monitor for phosphodiesterase inhibitor toxicity including visual disturbances, hypotension, and syncope. Reduced dose of the phosphodiesterase inhibitor may be required.