Levitra and Grapefruit

Levitra (vardenafil) belongs to a group of medications called phosphodiesterase-5 (PDE5) inhibitors, others being sildenafil (Viagra) and tadalafil (Cialis). These medications are primarily used for treatment of erectile dysfunction (ED). They work by improving the blood flow to the penis which helps men achieve and sustain an erection.

Does Levitra Interact with Grapefruit?

Like other PDE5 inhibitors, Levitra should not be combined or used along with grapefruit, grapefruit juice or any grapefruit-containing products. Although the interaction between grapefruit and such medications are relatively minimal, health experts recommend avoiding grapefruit products altogether to avoid any adverse effects.

Aside from PDE5 inhibitors, grapefruit is also known to interact with a number of medications that include antihypertensive medications, antidepressants, cholesterol lowering medications, HIV drugs and many others. If you are taking any of these medications, your healthcare provider would definitely recommend avoiding the bitter, tangy and sweet taste of grapefruit juice to be safe.

Levitra is processed and broken down in the body by an enzyme called CYP3A5 which is produced in the intestine. This enzyme is responsible for the “first pass” metabolism of Levitra and other medications before it is absorbed into the bloodstream. Levitra is specifically formulated so that it can compensate with the different stages of metabolism. On the other hand, grapefruit and grapefruit juice contain certain substances that interfere with the action of CYP3A4 thereby reducing the metabolism of the drug. This causes increased Levitra serum levels. In addition, the medication may stay in the body much longer than expected. In rare cases, the delay in metabolism can lead to a drug overdose.

Possible Side Effects

Combining grapefruit and Levitra can potentially increase the pharmacologic effects of the medication, as well as its side effects. Concomitant use of grapefruit and Levitra increases the risk of side effects that include:

• Dizziness
• Drowsiness
• Flushing
• Headache
• Nausea

Consuming too much grapefruit while on Levitra can cause significant drop in blood pressure and can even be life-threatening. If not treated, this can lead to Levitra overdose and possible heart attack, stroke, and even brain damage.

Preventing Interactions

An 8 oz. of grapefruit juice can stay in the body for up to 24 to 72 hours. Therefore, even if you use Levitra only on an ‘as needed’ basis, you should avoid consuming grapefruit products because you do not know when you will need to take the medication. Likewise, if you have taken grapefruit, you should not use Levitra for at least 72 hours. Discuss with your healthcare provider alternative medications for erectile dysfunction.

If grapefruit is a regular part of your diet, you may try substituting it with other fruits that are similar to grapefruits but do not interact with Levitra. Some of the possible alternatives to grapefruits include:

• Limes
• Seville oranges
• Tangelos
• Lemons
• Oranges
• Other citrus fruits

These fruits are compatible with Levitra, as well as other erectile dysfunction medications. If you think you cannot do away with grapefruit, inform your healthcare provider for a possible change in medication.