Cannabidiol or CBD, a cannabinoid, may increase the risk of side effects from vardenafil (Levitra). Is this combination safe?
Vardenafil (Levitra) is used in the treatment of erectile dysfunction (ED) and pulmonary arterial hypertension (PAH).
Cannabidiol, a cannabinoid from the hemp plant, may slow the body’s ability to break down and eliminate vardenafil from the body.
While this could make the effects of the medication last longer, it can also increase the chances of side effects.
Yes. CBD may interact with vardenafil (Levitra).
There are two ways by which CBD can interact with vardenafil: The first is a slowed elimination (making vardenafil last longer), and the second is an increased effect (potentially leading to side effects).
The enzymes from the P450 family are responsible for drug metabolism in the body. When two drugs need the same enzymes to get metabolized, metabolic inhibition can occur. Hence, they end up competing against each other for the said enzymes. This action could result in a slow down in the metabolism of one or both drugs.
Vardenafil is metabolized by the enzyme CYP3A4, with some contributions from CYP3A5 and CYP2C isoforms.
CBD also gets metabolized by these same enzymes — thus competing for breakdown in the liver. Theoretically, this could lead to an increase in serum vardenafil levels if multiple doses are used back to back.
However, because of the sporadic nature of using vardenafil, this interaction isn’t considered high-risk. Drugs that are taken on a daily basis are most at risk for side effects as a result of metabolic competition.
An agonistic interaction occurs when two or more items exhibit the same effect on the body.
These substances might act on the same or different receptors, but they produce some effects in the same direction when consumed together.
The overlap of effects from CBD and vardenafil is minimal. However, both substances affect vasodilation (the ability of blood vessels to relax). If this effect is too strong, it could result in a condition called priapism, which is characterized by painful, long-lasting erections. This side effect is rare but requires immediate medical attention.
Vardenafil is sold under many different names. All share the same risk and potential interactions.
Other names for vardenafil include:
CBD and erectile dysfunction medications (PDE5 inhibitors) all share similar risks for interaction and side effects. The main concern with this class is an increased risk of side effects such as headaches, priapism, indigestion, or diarrhea.
Here’s a list of similar medications that share a similar level of risk when combined with CBD:
Vardenafil and CBD’s interaction is considered mild.
Always take caution when using these two drugs together. The most suitable way to prevent any interaction between these two medications is to consume one drug only when the course of the other drug has finished.
You should always talk with your medical practitioner if you wish to start using CBD while using vardenafil.
A low dosage of both the drugs may have fewer side effects. Adequate spacing or taking them on alternate days may prevent or lessen some side effects. However, if you encounter any unusual side effects, contact your medical practitioner immediately.
Related: What Are the Side Effects of CBD?
CBD is not considered a direct alternative to vardenafil.
CBD is undergoing studies to see its effectiveness in many conditions, including erectile dysfunction. However, the mechanisms of these two substances are entirely different.
The benefits of CBD for improving erections come from the anxiolytic action (alleviating performance anxiety as a cause for ED).
Vardenafil is very different — acting directly on the blood flow to the penis, facilitating erections mechanically. This means CBD is not a good alternative for vardenafil.
There are also some studies suggesting CBD may have a negative impact on erectile function. A study conducted on male mice showed that the chronic use of CBD caused impaired sexual behavior . The more CBD these mice were made to consume, the lower their sexual drive was. Another study showed that ED was twice as high in men who used cannabis regularly .
A study showed that CBD may be capable of reducing symptoms of ED and increasing libido by decreasing anxiety in the users .
Vardenafil is a phosphodiesterase type 5 (PDE5) inhibitor. Levitra is one of its brand names.
It’s used to treat erectile dysfunction (ED) and pulmonary arterial hypertension (PAH).
It is an FDA-approved drug. It is available as a prescription-only drug in most countries.
|Trade Names||Levitra, Vilitra, Levifil, Vardegra, Zhewitra, Valif, Auvitra, Penafil, Viprofil, Filitra, Staxyn, Vivanza|
|Classification||Phosphodiesterase 5 inhibitor|
|CYP Metabolism||CYP3A4, CYP3A5, and CYP2C|
|Interaction With CBD||Metabolic inhibitor, Agonistic|
|Risk of Interaction||Mild|
Vardenafil works by inhibiting the degradative action of the cGMP-specific phosphodiesterase type 5 (PDE5) on cyclic GMP found in the smooth muscle cells that border the blood vessels in different kinds of tissues. PDE5 is mainly found in corpora cavernosa, vascular smooth muscles, visceral smooth muscles, and platelets.
Vardenafil increases the blood flow to a flaccid penis, causing it to become erect.
Generally, in sexual intercourse, after an adequate amount of foreplay, there will be a release of nitric oxide (NO) from nerve terminals and endothelial cells. This action releases cyclic guanosine monophosphate (cGMP) too.
The cGMP’s release causes the muscles of corpora cavernosa in the penis to relax and the blood vessels to get dilated. It leads to a rapid entry of blood into those vessels, causing the penis to engorge, grow large, and get erect. The penis stays so until the end of the intercourse and until after ejaculation occurs.
The enzyme PDE5 prevents blood vessels in the penis from relaxing. It does this by causing the degradation of cGMP. In most ED patients, the blood vessels in the penis are also affected and lose their ability to relax properly or have some obstructions in them.
Vardenafil inhibits PDE5 and increases the level of cGMP in the corpus cavernosum. It also allows more blood to flow into the penis and causes the penis to get erect long enough to have sex.
However, vardenafil needs proper sexual stimulation to do its work. It has a half-life of 4 to 6 hours, which is slightly longer than sildenafil, another popular PDE5 inhibitor drug.
Apart from the presence of PDE5 in the corpus cavernosum of the penis, PDE5 is also present in the pulmonary vasculature. Hence, vardenafil can increase cGMP within pulmonary vascular smooth muscle cells and cause them to relax. In patients with pulmonary arterial hypertension, this can lead to vasodilation of the pulmonary vascular bed and systemic circulation. Vardenafil can also help to treat premature ejaculation by increasing the ejaculatory control in affected users.
This drug may show mild to dangerous interactions when combined with some medications. These include nitrates, antihypertensive medications, guanylate cyclase stimulators, antacids, grapefruit products, CYP3A4 inhibitors, and CYP3A4 inducers. Vardenafil should not be used with these medications.
It is not recommended for use in women and children. It does not cause dependence and addiction.
Vardenafil is not recommended for consumption alongside alcohol of any form. It must be avoided in users with severe heart disease, hypersensitivity to sildenafil, priapism, severe renal and liver disease, stomach ulcers, retinitis pigmentosa, and blood disorders.
CBD can slow down the metabolism of vardenafil in the body and make it more potent. It can also make them last longer, causing greater side effects. So the best way to take them is to finish one’s dosage before starting the other.
Do not take these medications of your own accord, and always talk to your physician before you begin.
If you need to take them together, it may be good to take only the minimum dosage of both medications. There must also be proper spacing in timing between them both.
If you encounter any unusual side effects, contact your physician at once. The research regarding CBD’s potentials as a medication for erectile dysfunction is still lacking.
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