Comparative Pharmacology
Head-to-head clinical analysis: REVATIO versus VARDENAFIL HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: REVATIO versus VARDENAFIL HYDROCHLORIDE.
REVATIO vs VARDENAFIL HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
REVATIO (sildenafil) is a phosphodiesterase type 5 (PDE5) inhibitor. By inhibiting PDE5, it increases cyclic guanosine monophosphate (cGMP) levels in pulmonary vascular smooth muscle, leading to vasodilation and reduced pulmonary vascular resistance.
Vardenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5). It enhances the effect of nitric oxide (NO) by inhibiting PDE5, which is responsible for degradation of cGMP in the corpus cavernosum. This results in increased cGMP levels, leading to smooth muscle relaxation and increased blood flow to the corpus cavernosum, thereby facilitating penile erection.
20 mg orally three times daily, administered 4-6 hours apart.
10 mg orally once daily as needed, approximately 60 minutes before sexual activity; maximum dose 20 mg; maximum frequency once daily.
None Documented
None Documented
Terminal elimination half-life ~4 hours (range 3-5 hours) in steady state; similar in pulmonary arterial hypertension patients.
Terminal elimination half-life is approximately 4-5 hours in healthy subjects. In elderly patients (≥65 years) or those with hepatic impairment (Child-Pugh A/B), half-life may be prolonged up to 6-8 hours.
Primarily hepatic metabolism (CYP3A4) to N-desmethyl sildenafil (active). Renal excretion accounts for ~80% as metabolites; ~13% fecal.
Primarily hepatic metabolism (CYP3A4, minor CYP2C9) followed by fecal excretion (approximately 91-95% of dose as metabolites) and renal excretion (approximately 2-6% as unchanged drug).
Category C
Category A/B
PDE5 Inhibitor
PDE5 Inhibitor