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Etravirine: Decreased plasma sildenafil concentrations Delavirdine: Reduce initial sildenafil dose for treatment of ED to 25 mg and do not exceed a single mg dose every 48 hours; monitor for adverse effects 29 Etravirine: May administer concomitantly without dosage adjustment, but increase in sildenafil dosage may be needed based on clinical effect No increase in bleeding time reported 1 60 65 67 AUC and peak plasma concentrations of either drug not substantially altered Decreased plasma sildenafil concentrations; increased plasma bosentan concentrations Clinical importance symptoms pharmacokinetic interaction unclear Increased plasma sildenafil concentrations 1 67 Consider lower initial sildenafil dose 25 mg for treatment of ED No dosage adjustment necessary when used concomitantly with sildenafil for PAH AUC and peak plasma concentrations of sildenafil not substantially altered Pharmacokinetics of ethinyl estradiol and levonorgestrel not substantially Slight decrease in sildenafil exposure; not considered clinically important Current evidence does not preclude concomitant heparin 67 Possible sudden and marked BP reduction; potentially serious or even fatal 26 67 Possible beneficial augmented cardiovascular effects in PAH Concomitant use contraindicated 1 29 57 67 see Cautions, emotional health issues. Azithromycin: No pharmacokinetic interaction observed to date Erythromycin: Increased AUC of sildenafil 1 69 Azithromycin: No dosage adjustments necessary Erythromycin: Consider lower initial sildenafil dose 25 mg for treatment of ED; 1 no dosage adjustment necessary when used concomitantly with sildenafil for PAH Potentiation of vasodilatory effects e.

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The results are shown in Table 7. All adverse events potentially related to blood pressure effects were rated as mild or moderate.

In general, it is recommended that the dose selection for an elderly patient should be taken into consideration, reflecting the greater frequency of decreased hepatic, renal, or cardiac soft erection, and of soft erection disease or other drug therapy. Transient or permanent hearing loss has been reported in elderly patients receiving treatment with itraconazole.

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Manufacturer advises adjust cilostazol dose. Cimetidine is predicted to decrease the absorption of itraconazole.

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