Potential Side Effects of Vardenafil in PE Treatment

In vitro measurement of ejaculation latency time (ELT) and the effects of vardenafil on ELT on lifelong premature ejaculators: placebo-controlled, double-blind, cross-over laboratory setting.

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As the subject ingested the placebo or vardenafil, real-time penile tumescence and rigidity monitoring began. Audiovisual sexual stimulation (AVSS) was performed 45 min later. The patient began vibratory stimulation to the frenular area at 8th minute of AVSS till ejaculation. A button has been placed under the cover where the patient presses to operate the vibrator. ELT was calculated in seconds with a chronometer.

Fluoxetine (Prozac)

The test was repeated with second medication in 7–15 days. Among 40 patients, the results of 17 could be evaluated. When the patient took placebo and vardenafil, mean ELTs were 62.7 and 189.5 s, respectively. When compared with placebo, vardenafil improved ELT significantly (P = 0.04). After the beginning of AVSS, time to first recorded base or tip rigidities was shorter and time to last recorded tip or base rigidities following ejaculation was longer than placebo; however, these differences were not significant (P > 0.05 for each).

More Information

This laboratory design might be used to evaluate the effects of drugs on patients with ejaculation disorders. In this laboratory setting study, vardenafil exerted a threefold increase in ejaculation delay outside the vagina in patients with lifelong PE. Jannini EA, Lenzi A (2005) Ejaculatory disorders: epidemiology and current approaches to definition, classification and subtyping. Althof S, Rosen R, Symonds T, vardenafil oral Mundayat R, May K, Abraham L (2006) Development and validation of a new questionnaire to assess sexual satisfaction, control, and distress associated with premature ejaculation. McMahon CG, Althof SE, Waldinger MD, Porst H, Dean J, Sharlip ID, Adaikan PG, Becher E, Broderick GA, Buvat J, Dabees K, Giraldi A, Giuliano F, Hellstrom WJ, Incrocci L, Laan E, Meuleman E, Perelman MA, Rosen RC, Rowland DL, Segraves R (2008) An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. Health Care Professional-initiated education on U=U significantly improves patients' self-assessed sexual health, irrespective of gender. Further counseling, including mental health assessment and psychosexual therapy, remains the cornerstone of sexual dysfunction treatment for all genders.

Primarily oral PDE5 inhibitors (sildenafil, tadalafil, vardenafil)* On-demand use: administer at least 30 minutes before sexual activityContinuous use: Tadalafil 5 mg daily On-demand use: administer at least 30 minutes

• Vardenafil is a selective PDE5 inhibitor that can influence sexual performance.
• It may have off-label benefits for premature ejaculation.
• Use cautiously if you have cardiovascular issues.
• Some men combine Vardenafil with delay creams or behavioral therapy.
• Its onset of action is typically around 30-60 minutes.
• Some users find it helpful in reducing PE severity.
• The medication should be tested in a safe environment first.
• Do not exceed recommended dosage to avoid adverse effects.
• Effects last for several hours, providing flexibility.
• It is important to manage expectations realistically.
• Use only under medical supervision for off-label purposes.
• Store in a cool, dry place away from direct sunlight.

before sexual activity *Use lower doses with boosted PIs (PI/r or PI/c): sildenafil 25 mg every 48 hours; tadalafil 5 mg as an initial dose, maximum 10 mg every

Phosphodiesterase Type 5 Inhibitors

Sun XZ, Deng CH, Dai YP (2007) A clinical study of sertraline and vardenafil in the treatment of premature ejaculation complicated tadalista tablets by erectile dysfunction. Zhonghua Nan Ke Xue 13:610–612 Sun XZ, Deng CH, Dai YP (2007) A clinical study of sertraline and vardenafil in the treatment of premature ejaculation complicated by erectile dysfunction. Zhonghua Nan Ke Xue 13:610–612 Mathers MJ, Klotz T, Roth S, Lummen G, Sommer F (2009) Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study. Mathers MJ, Klotz T, Roth S, Lummen G, Sommer F (2009) Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study. Aversa A, Pili M, Francomano D, Bruzziches R, Spera E, La Pera G, Spera G (2009) Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation.

Efficacy in treatment of PE

Int J Impot Res 21:221–227 Aversa A, Pili M, Francomano D, Bruzziches R, Spera E, La Pera G, Spera G (2009) Effects of vardenafil administration on intravaginal ejaculatory latency time in men with lifelong premature ejaculation. Int J Impot Res 21:221–227 Waldinger MD, Hengeveld MW, Zwinderman AH (1994) Paroxetine treatment of premature ejaculation: a double-blind, randomized, placebo-controlled study. Waldinger MD, Hengeveld MW, Zwinderman AH (1994) Paroxetine treatment of premature ejaculation: a double-blind, randomized, placebo-controlled study. Waldinger MD (2007) Four measures of investigating ejaculatory performance. Burnett AL (2000) Lecture 2: nitric oxide synthase and heme oxygenase knockout mice-what have we learned?

How it Works

Int J Impot Res 12(Suppl 3):S42–S44 Burnett AL (2000) Lecture 2: nitric oxide synthase and heme oxygenase knockout mice-what have we learned? Int J Impot Res 12(Suppl 3):S42–S44 Burnett AL, Johns DG, Kriegsfeld LJ, Klein SL, Calvin DC, Demas GE, Schramm LP, Tonegawa S, Nelson RJ, Snyder SH, Poss KD (1998) Ejaculatory abnormalities in mice with targeted disruption of the gene for heme oxygenase-2. Burnett AL, Johns DG, Kriegsfeld LJ, Klein SL, Calvin DC, Demas GE, Schramm LP, Tonegawa S, Nelson RJ, Snyder SH, Poss KD (1998) Ejaculatory abnormalities in mice with targeted disruption of the gene for heme oxygenase-2. Truitt WA, Coolen LM (2002) Identification of a potential ejaculation generator in the spinal cord. Uckert S, Kuthe A, Jonas U, Stief CG (2001) Characterization and functional relevance of cyclic nucleotide phosphodiesterase isoenzymes of the 20 mg vardenafil human prostate. 72 hours; vardenafil 2.5 mg, maximum 2.5 mg every 72 hours Consider behavioral interventions and/or psychosexual counseling, SSRIs, tricyclic antidepressants, clomipramine, and topical anesthetics Use lower doses of clomipramine

• Vardenafil is primarily used for ED, but may impact ejaculation timing.
• Vardenafil can sometimes prolong the time before ejaculation.
• It works by increasing blood flow, possibly affecting ejaculatory control.
• Not approved specifically for premature ejaculation but used off-label.
• Combining Vardenafil with behavioral therapy may improve results.
• Possible side effects include headache, flushing, and nasal congestion.
• Using Vardenafil without medical guidance can be risky.
• It may interact with other medications, altering effectiveness or safety.
• Dose optimization is important to manage side effects and efficacy.
• Vardenafil requires careful timing relative to sexual activity.
• Not a cure for PE but can help some men delay ejaculation.
• Medical consultation is essential before using Vardenafil for PE.

and other tricyclics with boosted PIs; see Drug-drug interactions between antidepressants and ARVs Dapoxetine, a short-acting SSRI, is the only drug approved for on-demand treatment of premature ejaculation in Europe.

On call

Symonds T, Roblin D, Hart K, Althof S (2003) How does premature ejaculation impact a man s life? J Sex Marital Ther 29:361–370 Symonds T, Roblin D, Hart K, Althof S (2003) How does premature ejaculation impact a man s life? J Sex Marital Ther 19:276–288 Abdel-Hamid IA, El Naggar EA, El Gilany AH (2001) Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation. Int J Impot Res 13:41–45 Abdel-Hamid IA, El Naggar EA, El Gilany AH (2001) Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation. Int J Impot Res 13:41–45 Dinsmore WW, Wyllie MG (2009) PSD502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation: results of a phase III, multicentre, double-blind, placebo-controlled study.

What you can do in the meantime

Dinsmore WW, Wyllie MG (2009) PSD502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation: results of a phase III, multicentre, double-blind, placebo-controlled study. Perelman MA (2006) A new combination treatment for premature ejaculation: a sex therapist’s perspective. Waldinger MD, Schweitzer DH, Olivier B (2005) On-demand SSRI treatment of premature ejaculation: pharmacodynamic limitations for relevant ejaculation delay and consequent solutions. Yilmaz U, Tatlisen A, Turan H, Arman F, Ekmekcioglu O (1999) The effects of fluoxetine on several neurophysiological variables in patients with premature ejaculation. Beretta G, Chelo E, Fanciullacci F, Zanollo A (1986) Effect of an alpha-blocking agent (phenoxybenzamine) in the management of premature ejaculation.

Visual disturbances

Basar MM, Yilmaz E, Ferhat M, Basar H, Batislam E (2005) Terazosin in the treatment of premature ejaculation: a short-term follow-up. Balbay MD, Yildiz M, Salvarci A, Ozsan O, Ozbek E (1998) Treatment of premature ejaculation with sertralin. McMahon CG, Stuckey BG, Andersen M, Purvis K, Koppiker N, Haughie S, Boolell M (2005) Efficacy of sildenafil citrate (Viagra) in men with premature ejaculation. Atan A, Basar MM, Tuncel A, Ferhat M, Agras K, Tekdogan U (2006) Comparison of efficacy of sildenafil-only, sildenafil plus topical EMLA cream, and topical EMLA-cream-only in treatment of premature ejaculation. Salonia A, Maga T, Colombo R, Scattoni V, Briganti A, Cestari A, Guazzoni G, Rigatti P, Montorsi F (2002) A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation. Treatment must be maintained, as recurrence is highly likely upon discontinuation Discontinue or switch drugs contributing to delayed ejaculation (antidepressants, antipsychotics, diuretics, antiseizure medications) Treat comorbidities such as hypertension, pelvic nerve injury, or diabetic neuropathy PDE5 inhibitors (e.g., sildenafil —

see DDI); benefit in women is generally less than in men Lubricants and/or hormonal therapy (topical or systemic) if pain is related to vaginal dryness Analgesics for pain associated with menstrual symptoms Topical lidocaine, capsaicin, or vestibulectomy for irreversible pain conditions

What is Premature Ejaculation?

Orhan I, Onur R, Tasdemir C, Ayar A, Kadioglu A (2006) Sildenafil citrate inhibits agonist induced contractions in isolated rat seminal vesicles. Devan BD, Sierra-Mercado D Jr, Jimenez M, Bowker JL, Duffy KB, Spangler EL, Ingram DK (2004) Phosphodiesterase inhibition by sildenafil citrate attenuates the learning impairment induced by blockade of cholinergic muscarinic receptors in rats. Ekmekcioglu O, Inci M, Demirci D, Tatlisen A (2005) Effects of sildenafil citrate on ejaculation latency, detumescence time, and refractory period: placebo-controlled, double-blind, crossover laboratory setting study. Mondaini N, Ponchietti R, Muir GH, Montorsi F, Di Loro F, Lombardi G, Rizzo M (2003) Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time. Int J Impot Res 15:225–228 Mondaini N, Ponchietti R, Muir GH, Montorsi F, Di Loro F, Lombardi G, Rizzo M (2003) Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time.