Apo-Vardenafil: Uses, Side Effects and Dosage

ABOUT THIS MEDICATION

What the medication is used for:

APO-VARDENAFIL is used in the treatment of erectile dysfunction. This is when a man cannot get or keep a hard, erect penis suitable for sexual activity.

What it does:

APO-VARDENAFIL belongs to a class of agents known as phosphodiesterase type 5 (PDE5) inhibitors. Following sexual stimulation, APO-VARDENAFIL works by helping the blood vessels in your penis relax, allowing blood to flow into your penis. This results in improved erectile function.

APO-VARDENAFIL will not increase your sex drive. APO-VARDENAFIL will only help you get an erection if you are sexually stimulated.

When it should not be used:

• If you are taking any medicines containing nitrates in

  any form. Similarly, nitrates must never be used by men who take APO-VARDENAFIL. Nitrates are found in many prescription medicines used to treat angina (chest pain due to heart disease) such as nitroglycerin, isosorbide mononitrate and isosorbide dinitrates. If you do not understand what nitrates are, or are unsure about whether a medication you are on is a "nitrate", ask your doctor or pharmacist.

• If you take APO-VARDENAFIL with nitrate-containing

  medicines or any other nitrates (eg, amyl nitrite "poppers"), your blood pressure could suddenly drop to a life-threatening level. You could get dizzy, faint, or even have a heart attack or stroke.

• If you are taking cobicistat, indinavir, ritonavir,

  saquinavir, atazanavir, ketoconazole, or itraconazole. Cobicistat, indinavir, ritonavir, saquinavir, and atazanavir are used to treat HIV infections.

  Ketoconazole and itraconazole are used against fungal infections.

  • If you have ever had an allergic reaction to any of the ingredients in APO-VARDENAFIL. (See What the medicinal ingredient is and What the nonmedicinal ingredients are)
  • If you have had an episode of vision loss in one or both eyes from a disease called non-arteritic anterior ischaemic optic neuropathy (NAION).
  • Do not take APO-VARDENAFIL with guanylate cyclase stimulators, such as riociguat.

What the medicinal ingredient is:

Vardenafil (as vardenafil hydrochloride)

What the nonmedicinal ingredients are:

The tablets contain the following non-medicinal ingredients: colloidal silicon dioxide, magnesium stearate, mannitol, polyethylene glycol, polyvinyl alcohol, talc, titanium dioxide, red ferric oxide, and yellow iron oxide.

What dosage forms it comes in:

APO-VARDENAFIL is available as orange coloured, round shaped, biconvex film-coated tablets, engraved with 'APO' on one side and 'V 5', 'V 10' or 'V 20' on other side. APO-VARDENAFIL is available in 3 dosage strengths: 5 mg, 10 mg, and 20 mg, containing 5 mg, 10 mg, or 20 mg of the active ingredient vardenafil.

WARNINGS AND PRECAUTIONS

BEFORE you use APO-VARDENAFIL talk to your doctor or pharmacist if you have or had any of the following conditions:

• Heart problems (irregular heartbeats, angina, chest pain, or had a previous heart attack). If you have heart problems, ask your doctor if your heart is healthy enough to handle the extra strain of having sex.
• Low blood pressure.
• Uncontrolled high blood pressure.
• Kidney dialysis.
• Severe liver problems.
• Blood problems, including sickle cell anemia or leukemia.
• Stomach ulcers or any type of bleeding problem.
• Deformation of the penis, Peyronie's disease or an erection that lasted more than 4 hours.
• If you are taking APO-VARDENAFIL and experience temporary or permanent loss or change in vision, stop taking APO-VARDENAFIL and call your doctor.
• Severe loss of vision, due to damage to the optic nerve from insufficient blood supply, a condition called Non-arteritic Anterior Ischemic Optic Neuropathy (NAION). If you are taking APO-VARDENAFIL and experience

temporary or permanent loss or change in vision, stop taking APO-VARDENAFIL and call your doctor.

• A rare, inherited eye disease called retinosa pigmentosa.

  APO-VARDENAFIL offers no protection against sexually transmitted diseases including Human Immunodeficiency Virus (HIV).

APO-VARDENAFIL is not recommended for patients less than 18 years old.

Sudden decrease or loss of hearing has been reported in a few postmarketing and clinical trial cases with the use of PDE5 inhibitors, including APO-VARDENAFIL. It has not been established whether these are related directly to the use of these medications or to other factors. If you experience these symptoms, stop taking APO-VARDENAFIL and call your doctor.

INTERACTIONS WITH THIS MEDICATION

Drugs that may interact with APO-VARDENAFIL include:

• nitrate-containing medicines or nitrates (eg, amyl nitrate

  “poppers”),

• cobicistat, indinavir, ritonavir, saquinavir, or atazanavir

  (used to treat HIV infections),

• ketoconazole, or itraconazole (used to treat fungal

  infections),

• erythromycin, clarithromycin, or gatifloxacin (used to

  treat infections),

• antiarrhythmic medications (for irregular heartbeat, eg,

  amiodarone, sotalol, quinidine, procainamide),

• alpha-blockers (used to treat prostate problems or high

  blood pressure).

• riociguat (medicine used to treat high blood pressure in

  the arteries carrying blood from the heart to the lungs). Taking this medicine with APO-VARDENAFIL could seriously affect your blood pressure (see “When it should not be used”).

APO_VARDENAFIL might increase the amount of some medicines in your blood (sensitive P-gp substrates). Dabigatran (used to prevent blood clots from forming) is an example of these medicines.

Do not consume grapefruit juice while taking APO-VARDENAFIL.

APO-VARDENAFIL should not be used together with other treatments of erectile dysfunction.

PROPER USE OF THIS MEDICATION

Usual dose:

• You must take this medicine exactly as prescribed by

  your doctor.

  • Take your APO-VARDENAFIL 25-60 minutes before sexual activity. However, sexual activity can be initiated as soon as 15 minutes and as long as 8-10 hours after taking APO-VARDENAFIL.
  • APO-VARDENAFIL will only help you get an erection if you are sexually stimulated.

  • APO-VARDENAFIL tablets should be swallowed whole with some water. It does not matter if you take APO-VARDENAFIL with or without food.

  • APO-VARDENAFIL is not affected by moderate amounts of alcohol (approximately 2 drinks of alcohol, wine, or beer in a 70 kg person). However, large amounts of alcohol can impair the ability to get an erection; therefore do not consume large amounts of alcohol prior to sexual activity.

  • You should not take more than one dose of APO-

    VARDENAFIL per day.

  • Never change the dose unless your doctor tells you to.
  • If you have to see a different doctor for any reason, be sure to inform him/her that you are taking APO-VARDENAFIL.

This medicine has been prescribed for you personally and you should not pass it on to others. It may harm them, even if their symptoms are the same as yours.

Overdose:

If you think you have taken too much APO-VARDENAFIL, contact your healthcare professional, hospital emergency department or regional poison control centre immediately, even if there are no symptoms.

SIDE EFFECTS AND WHAT TO DO ABOUT THEM

As with most drugs, APO-VARDENAFIL can cause some side-effects. These effects are usually mild to moderate in nature and do not last for a long time.

The most common side-effects are headache and flushing (a burning/warm sensation, usually in the face). Less commonly reported side-effects are indigestion, stuffy nose, sudden decrease or loss of hearing, and transient global amnesia (temporary memory loss). A small percentage of patients could experience abnormal vision (eg, decreased and blurred vision, increased perception to light, changes in blue/green colour discrimination) after taking APO-VARDENAFIL. If this happens to you, do not operate a motor vehicle or any heavy machinery until the adverse effects disappear. If you have any of these adverse effects and they are severe or do not disappear, talk to your doctor or pharmacist.

• If you have an erection which lasts longer than 4 hours, you should contact a doctor immediately. If this is not treated immediately, permanent penile tissue damage and erectile dysfunction may result.

• If you have a heart condition and you experience any

  symptoms of a heart attack upon starting sexual activity (such as chest pains, irregular heartbeat, or shortness of breath), you should stop this activity and consult a doctor.

• If an allergic reaction occurs after taking APO-

  VARDENAFIL, such as a rash, itching, swollen face, lips, throat, or shortness of breath, stop use and contact a doctor.

Sudden decrease or loss of vision has occurred rarely after the use of oral erectile dysfunction medications, including APO-VARDENAFIL. It has not been established whether the loss of vision is related directly to the use of PDE5 inhibitors or other factors. People who have previously experienced a type of vision loss called Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) may be at an increased risk of reoccurrence of NAION. If you experience reduction or loss of vision in one or both eyes, stop taking APO-VARDENAFIL and call your doctor.

This is not a complete list of side effects. For any unexpected effects while taking APO-VARDENAFIL, contact your doctor or pharmacist.

HOW TO STORE IT

APO-VARDENAFIL should be stored at room temperature 15°C to 30ºC. Do not freeze.

Keep out of the reach of children.

Reporting Side Effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

• Visiting the Web page on Adverse Reaction

  Reporting (https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/adverse-reaction-reporting.html) for information on how to report online, by mail or by fax; or

• Calling toll-free at 1-866-234-2345.

NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

MORE INFORMATION

If you want more information about APO-VARDENAFIL:

• Talk to your healthcare professional

• Find the full product monograph that is prepared for healthcare professionals and includes Consumer Information by visiting the Health Canada website (https://health-products.canada.ca/dpd-bdpp/index-eng.jsp). Find the Consumer Information on the manufacturer’s website

  (http://www.apotex.ca/products), or by calling 1-800-667-4708.

Date of Revision: August 06, 2020