Severe Heart Disease
Patients with significant heart problems, including severe heart failure, unstable angina, or a recent history of heart attack or stroke (typically within the past 6 months), should avoid Zudena 100mg to prevent extra strain on the heart.
Uncontrolled High (Hypertension) or Low Blood Pressure (Hypotension)
Individuals with very high or uncontrolled low blood pressure should not take Zudena, as it may exacerbate blood pressure issues.
Arrhythmias (Irregular heartbeats)
Those with abnormal heart rhythms may be at a higher risk when taking PDE5 inhibitors.
Nitrate Use
Nitrate Medications
Patients taking nitrates (often prescribed for chest pain, angina, or heart disease) should not use Zudena. The combination can lead to a dangerous drop in blood pressure. Common nitrates include nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate.
Liver Disease
Severe liver impairment can affect how the body processes udenafil, potentially increasing side effects or toxicity.
Kidney Disease
In cases of severe renal impairment, your doctor may prescribe dose adjustments or avoid the medication altogether.
Inherited Eye Disorders
PDE5 inhibitors may exacerbate the conditions like retinitis pigmentosa, which affects the retina, leading to visual disturbances.
Non-arteritic Anterior Ischemic Optic Neuropathy (NAION)
This rare condition can lead to sudden vision loss and is a contraindication for udenafil use.
Bleeding Disorders
Blood Clotting Issues
Zudena 100mg may increase bleeding risk, so exercise caution in individuals with bleeding disorders such as hemophilia.
Peptic Ulcers
Stomach or Duodenal Ulcers
Zudena 100mg may increase the risk of bleeding in people with active peptic ulcers.
Deformities or Conditions of the Penis
Anatomical Deformities
Men with penile deformities, such as Peyronie’s disease) or conditions that predispose them to priapism (sickle cell anemia, leukemia, and multiple myeloma) should avoid udenafil because of the increased risk of prolonged erection.
Allergy to Udenafil
If there is a known allergy to udenafil or any inactive ingredients in Zudena, avoid it.
Drug Interactions and Contraindications
Nitrates (Absolute Contraindication)
Examples: Nitroglycerin, isosorbide mononitrate, isosorbide dinitrate.
Reason: The combination of udenafil with nitrates can lead to a severe drop in blood pressure, which can be life-threatening. Patients taking any form of nitrate for heart conditions or chest pain must avoid Zudena.
Alpha-Blockers
Examples: Doxazosin, tamsulosin, and prazosin.
Reason: Doctors often prescribe Alpha-blockers for high blood pressure or benign prostatic hyperplasia (BPH). Combining these with Zudena can lead to hypotension (a sudden drop in blood pressure), dizziness, or fainting.
Other PDE5 Inhibitors
Examples: Sildenafil, Tadalafil, Avanafil, and Vardenafil
Reason: Taking multiple PDE5 inhibitors can increase the risk of side effects and does not improve effectiveness.
CYP3A4 Inhibitors
Examples: Ketoconazole and Itraconazole (antifungals), ritonavir and saquinavir (HIV protease inhibitors), erythromycin and clarithromycin (antibiotics).
Reason: CYP3A4 inhibitors interfere with the metabolism of udenafil, leading to higher concentrations in the bloodstream and increasing the risk of side effects like headaches, dizziness, and prolonged erections (priapism). Your doctor may need dose adjustments or close monitoring.
CYP3A4 Inducers
Examples: Rifampin (antibiotic), carbamazepine, phenytoin (anticonvulsants), and St. John's Wort (herbal supplement)
Reason: CYP3A4 inducers can reduce the effectiveness of Zudena by increasing its breakdown, potentially making it less effective.
Blood Pressure Medications
Examples: Beta-blockers (metoprolol), ACE inhibitors (lisinopril), and calcium channel blockers (amlodipine)
Reason: Although not a strict contraindication, combining Zudena with blood pressure medications can lead to an additive effect, increasing the risk of hypotension. Doctors must monitor the patients for symptoms like dizziness or light-headedness.
Anticoagulants and Antiplatelet Drugs
Examples: Warfarin, heparin, aspirin, clopidogrel
Reason: Udenafil may increase bleeding risk, especially when combined with blood thinners. This combination requires caution and close medical supervision.
Alcohol
Interaction: While moderate alcohol intake may be acceptable, excessive alcohol can increase the risk of side effects, such as dizziness, low blood pressure, and impaired judgment. It may also reduce the effectiveness of udenafil in treating erectile dysfunction.
Grapefruit and Grapefruit Juice
Reason: Grapefruit products inhibit CYP3A4, increasing udenafil levels in the blood and potentially leading to side effects. Avoid grapefruit while using Zudena.
Recreational Drugs
Examples: Amyl nitrate or Poppers (used recreationally)
Reason: These substances, like nitrates, can cause a dangerous drop in blood pressure if used with udenafil. Avoid them altogether.