What Is Levitra (Vardenafil)?
Levitra is the brand name associated with vardenafil, a prescription medication belonging to the phosphodiesterase type 5 (PDE-5) inhibitor class.
Vardenafil is used to treat erectile dysfunction (ED)—difficulty getting or maintaining an erection sufficient for sexual activity. Current U.S. labeling for vardenafil tablets identifies the medication as a PDE-5 inhibitor indicated for erectile dysfunction.
Vardenafil works by increasing blood flow to the penis during sexual stimulation. It does not independently create sexual desire or cause an automatic erection.
ED is common, but persistent erectile difficulties can sometimes be associated with underlying cardiovascular, metabolic, neurological, hormonal, medication-related, or psychological factors. MedlinePlus notes that ED is not simply an inevitable consequence of aging and can sometimes signal other health problems.
Vardenafil is therefore more than a medication for sexual performance: persistent ED may warrant an assessment of overall health.
How Does Vardenafil Work?
Vardenafil inhibits an enzyme called phosphodiesterase type 5 (PDE-5).
During sexual stimulation, nerves in penile tissue release signals involving nitric oxide (NO). This increases production of cyclic guanosine monophosphate (cGMP).
cGMP helps relax smooth muscle in penile blood vessels, allowing increased blood flow into erectile tissue.
PDE-5 normally breaks down cGMP. Vardenafil inhibits PDE-5, allowing cGMP activity to persist longer.
The process can be summarized as:
Sexual stimulation → nitric oxide signaling → increased cGMP → smooth-muscle relaxation → increased penile blood flow → erection
This explains an important feature of vardenafil:
Sexual stimulation is still required.
Vardenafil does not directly increase libido or sexual desire. MedlinePlus specifically states that vardenafil does not increase sexual desire or cure erectile dysfunction.
What Is Levitra Used For?
Erectile Dysfunction
The primary U.S. therapeutic use of vardenafil is erectile dysfunction.
ED can involve difficulty:
- Getting an erection
- Maintaining an erection
- Maintaining sufficient firmness for sexual activity
The causes can be physical, psychological, medication-related, or a combination.
Potential contributing conditions include:
- Diabetes
- Cardiovascular disease
- High blood pressure
- Nerve disorders
- Hormonal abnormalities
- Certain medications
- Obesity
- Smoking
- Psychological or relationship factors
MedlinePlus notes that ED can sometimes indicate vascular disease or nerve damage associated with conditions such as diabetes.
Because of this, repeatedly treating ED without investigating persistent symptoms may overlook an underlying health issue.
Levitra Dosage and How Vardenafil Is Taken
Current U.S. vardenafil labeling states that tablets are generally taken as needed, with a recommended starting dose of 10 mg for most patients, up to once daily. Dose adjustments may be appropriate depending on effectiveness, tolerability, age, medical conditions, and interacting medicines.
Vardenafil is generally taken approximately 60 minutes before sexual activity. MedlinePlus states that it usually should not be taken more frequently than once every 24 hours.
Available tablet strengths in current U.S. labeling include:
- 2.5 mg
- 5 mg
- 10 mg
- 20 mg
The correct strength is individualized.
Do not increase the dose simply because the first dose does not produce the desired response.
A healthcare professional may need to assess the timing, underlying cause of ED, other medicines, cardiovascular status, and other factors.
How Quickly Does Vardenafil Work?
Vardenafil is usually taken about one hour before sexual activity. It does not need to be taken every day for typical as-needed ED treatment.
MedlinePlus notes that vardenafil may be taken with or without food.
The medication’s effect depends on sexual stimulation. Taking vardenafil without sexual arousal does not normally produce an erection.
Individual response can vary.
Common Levitra Side Effects
Vardenafil can cause side effects, although not everyone experiences them.
Common adverse effects include:
- Headache
- Flushing
- Nasal congestion
- Upset stomach
- Indigestion
- Heartburn
- Dizziness
- Nausea
- Back pain
- Flu-like symptoms
Current U.S. labeling identifies headache, flushing, nasal congestion, dyspepsia, sinusitis, flu syndrome, dizziness, nausea, and back pain among commonly reported adverse reactions.
These effects are generally related to the medication’s vascular and PDE-5 activity.
Persistent, severe, or unusual symptoms should be discussed with a healthcare professional.
Levitra and Nitrates: A Critical Safety Issue
One of the most important safety rules for vardenafil is:
Do not take vardenafil with nitrate medications.
Nitrates include medicines such as:
- Nitroglycerin
- Isosorbide mononitrate
- Isosorbide dinitrate
They may be prescribed to treat angina or certain cardiovascular conditions.
Vardenafil and nitrates both influence the nitric oxide/cGMP pathway and can lower blood pressure. Their combined effects can produce a dangerous drop in blood pressure. Current U.S. prescribing information identifies concomitant nitrate use as contraindicated.
The same concern applies to recreational nitrate products commonly called “poppers,” which can contain amyl or butyl nitrate. MedlinePlus specifically warns against combining these products with vardenafil.
Potential consequences of excessive blood-pressure lowering include:
- Severe dizziness
- Fainting
- Loss of consciousness
- Reduced blood flow to vital organs
- Cardiovascular complications
If you use nitroglycerin or another nitrate, tell your healthcare professional before taking any PDE-5 inhibitor.
Vardenafil and Riociguat
Vardenafil should also not be combined with riociguat, a guanylate cyclase stimulator.
Both drug classes can lower blood pressure, and the combination can produce excessive hypotension.
Current U.S. vardenafil labeling identifies concomitant use with guanylate cyclase stimulators such as riociguat as contraindicated.
This is a different interaction from the nitrate warning, but the underlying concern is similarly related to excessive blood-pressure reduction.
Vardenafil and Alpha-Blockers
Alpha-blockers are medicines that can be used for conditions such as:
- High blood pressure
- Benign prostatic hyperplasia (BPH)
Examples include certain medicines ending in “-osin,” such as tamsulosin or doxazosin.
Both alpha-blockers and PDE-5 inhibitors can lower blood pressure.
Consequently, combining them may cause:
- Dizziness
- Lightheadedness
- Fainting
- Low blood pressure
Current vardenafil labeling advises caution when PDE-5 inhibitors are administered with alpha-blockers and recommends consideration of timing and blood-pressure effects.
Patients should not independently change the timing or dose of either medication.
Vardenafil and Blood Pressure Medicines
Vardenafil can contribute to blood-pressure lowering.
Current U.S. labeling states that vardenafil can potentiate the hypotensive effects of alpha-blockers and antihypertensive medications.
This does not mean that everyone taking blood-pressure medication must avoid vardenafil.
Instead, the complete medication regimen and cardiovascular status should be assessed by a healthcare professional.
Particular caution may be necessary in people with:
- Very low blood pressure
- Multiple antihypertensive medicines
- Significant cardiovascular disease
- Recent cardiovascular events
- A history of fainting
Vardenafil and Alcohol
Alcohol can contribute to:
- Dizziness
- Low blood pressure
- Reduced coordination
- Impaired judgment
Heavy alcohol consumption can also make erectile function worse.
Patients taking vardenafil should discuss alcohol use with their healthcare professional, particularly if they have cardiovascular disease or use other medicines that lower blood pressure.
Vardenafil and Grapefruit
Grapefruit and grapefruit juice can affect the metabolism of some medications.
MedlinePlus advises patients taking vardenafil to discuss grapefruit consumption with their healthcare professional.
This is particularly relevant because altered drug metabolism can change the amount of vardenafil present in the body.
Can Vardenafil Be Taken With Viagra or Cialis?
Vardenafil should not be combined with other PDE-5 inhibitors unless specifically directed by a healthcare professional.
Other medicines in this class include:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Avanafil (Stendra)
Using multiple PDE-5 inhibitors can increase pharmacologic effects and potentially increase adverse effects such as low blood pressure, dizziness, and other reactions.
MedlinePlus specifically advises discussing all current medicines before taking vardenafil.
There is generally no medical reason to combine two PDE-5 inhibitors for routine ED treatment.
Levitra and Heart Health
Sexual activity itself increases cardiovascular workload.
Because vardenafil can affect blood pressure, a patient’s cardiovascular status is important when determining whether ED treatment is appropriate.
Current U.S. labeling advises consideration of cardiovascular status because sexual activity carries a degree of cardiac risk.
Medical assessment is particularly important for people with conditions such as:
- Recent heart attack
- Recent stroke
- Unstable angina
- Severe heart failure
- Significant arrhythmias
- Very low blood pressure
- Uncontrolled high blood pressure
ED itself can also provide an opportunity to identify previously unrecognized cardiovascular risk factors. MedlinePlus notes that ED can sometimes be associated with blood-vessel disease.
Vardenafil and Priapism
Priapism is an erection that lasts abnormally long and does not resolve normally.
An erection lasting more than four hours is a medical emergency.
If untreated, prolonged priapism can damage penile tissue and potentially result in permanent erectile dysfunction. MedlinePlus specifically instructs patients to seek immediate medical care for an erection lasting more than four hours.
Do not wait for the erection to disappear on its own.
Vardenafil and Vision Changes
Some people taking vardenafil can experience visual effects.
These may include:
- Blurred vision
- Changes in color perception
- Difficulty distinguishing certain colors
- Increased sensitivity to light
More serious visual events have also been reported with PDE-5 inhibitors.
MedlinePlus reports cases of sudden loss of some or all vision after vardenafil or similar medicines, including cases in which the loss was permanent. The causal relationship is not established for every report.
What should you do?
Sudden vision loss requires immediate medical evaluation.
MedlinePlus advises not taking additional vardenafil or similar PDE-5 inhibitors until the person has spoken with a healthcare professional.
Vardenafil and Hearing Changes
Sudden hearing changes have also been reported in people taking vardenafil and other PDE-5 inhibitors.
Potential symptoms include:
- Sudden hearing loss
- Reduced hearing
- Ringing in the ears
- Dizziness
MedlinePlus recommends immediate medical attention for sudden hearing loss and advises avoiding additional vardenafil or similar PDE-5 inhibitors until evaluated.
Does Levitra Increase Sexual Desire?
No.
Vardenafil does not directly increase libido.
It improves the physiological erectile response by supporting penile blood flow during sexual stimulation.
Someone experiencing low sexual desire without an erection problem may therefore need a different type of evaluation.
MedlinePlus specifically states that vardenafil does not increase sexual desire.
Does Levitra Cure Erectile Dysfunction?
No.
Vardenafil can help manage erectile dysfunction while it is active, but it does not necessarily eliminate the underlying cause.
ED can be associated with:
- Diabetes
- Cardiovascular disease
- Nerve disorders
- Hormonal conditions
- Medication effects
- Smoking
- Obesity
- Psychological factors
MedlinePlus emphasizes that ED can be associated with underlying health problems and should be discussed with a healthcare professional when persistent.
Treating contributing conditions may be an important part of managing ED.
Who Should Discuss Vardenafil With a Doctor Before Taking It?
Medical review is particularly important for people who:
- Take nitrates
- Use “poppers”
- Take riociguat
- Use alpha-blockers
- Take multiple blood-pressure medicines
- Have cardiovascular disease
- Have had a recent heart attack or stroke
- Have a history of prolonged erections
- Have liver disease
- Have kidney disease
- Have certain eye conditions
- Have experienced sudden hearing loss
- Take medications that may interact with vardenafil
MedlinePlus recommends telling a healthcare professional about cardiovascular disease, blood-pressure abnormalities, kidney or liver disease, previous prolonged erections, and other relevant conditions.
Vardenafil and Liver Problems
Vardenafil is metabolized primarily through the liver.
People with significant liver impairment can have increased exposure to the medication.
Current U.S. labeling recommends a lower starting dose for patients with moderate hepatic impairment and states that vardenafil should not be used in severe hepatic impairment (Child-Pugh C).
This is one reason why a standard dose should not automatically be assumed to be appropriate for everyone.
Vardenafil and Kidney Problems
Kidney function can also affect medication handling.
Current U.S. labeling states that vardenafil should not be used in patients receiving renal dialysis.
People with kidney disease should therefore discuss their kidney function and complete medication list with their healthcare professional before treatment.
Vardenafil in Older Adults
Age can affect the body’s handling of medicines.
Current U.S. labeling states that a 5 mg starting dose should be considered in patients aged 65 years and older because exposure to vardenafil can be higher in this population.
Older adults may also take several cardiovascular or prostate medications, increasing the importance of checking for interactions.
Age alone does not determine whether vardenafil is appropriate.
Vardenafil and Pregnancy
Vardenafil is approved for the treatment of erectile dysfunction in men and is not indicated for use in women.
It should not be used during pregnancy for ED.
The existence of other PDE-5 inhibitor research or products for different medical conditions should not be confused with the approved ED indication for vardenafil.
Vardenafil Does Not Prevent Pregnancy or STIs
Vardenafil is an ED medication.
It does not:
- Prevent pregnancy
- Prevent HIV
- Prevent sexually transmitted infections
- Act as contraception
- Replace condoms or other barrier methods
MedlinePlus explicitly states that vardenafil does not prevent pregnancy or transmission of sexually transmitted diseases such as HIV.
Vardenafil and Driving
Vardenafil can cause dizziness in some people.
Until a person knows how the medicine affects them, caution is appropriate with:
- Driving
- Operating machinery
- Working at heights
- Other activities requiring rapid reactions and coordination
Dizziness is among the recognized adverse effects of vardenafil.
What Happens in a Vardenafil Overdose?
Taking more vardenafil than prescribed can increase the risk and severity of adverse effects.
Potential problems can include:
- Severe headache
- Flushing
- Dizziness
- Low blood pressure
- Fainting
- Visual disturbances
- Prolonged erection
If a person becomes unconscious, experiences severe symptoms, or develops an erection lasting more than four hours, emergency medical care is required.
Do not take another PDE-5 inhibitor to try to counteract an unwanted effect.
Levitra vs. Viagra vs. Cialis
Levitra/vardenafil, Viagra/sildenafil, and Cialis/tadalafil all belong to the PDE-5 inhibitor class, but they are different medications.
| Feature | Levitra | Viagra | Cialis |
|---|---|---|---|
| Active ingredient | Vardenafil | Sildenafil | Tadalafil |
| Drug class | PDE-5 inhibitor | PDE-5 inhibitor | PDE-5 inhibitor |
| Primary ED use | Yes | Yes | Yes |
| Sexual stimulation required | Yes | Yes | Yes |
| Nitrates | Contraindicated | Contraindicated | Contraindicated |
| Typical use | As needed | As needed | As needed or daily, depending on indication |
| Other major U.S. indication | ED | Sildenafil has separate PAH products | ED and BPH for tadalafil products |
MedlinePlus identifies sildenafil, vardenafil, tadalafil, and avanafil as oral medicines used for ED and notes that they work when a person is sexually aroused.
These medicines should not be combined or switched without appropriate medical guidance.
Levitra vs. Generic Vardenafil
The active drug is vardenafil in both cases.
The important distinction is the brand/formulation and manufacturer.
Current FDA records show multiple approved generic vardenafil products in the United States, including film-coated tablets and orally disintegrating tablets.
The exact formulation matters because instructions, inactive ingredients, and available strengths can differ.
Patients should follow the labeling for the specific product they receive.
Frequently Asked Questions About Levitra
What is Levitra used for?
Levitra contains vardenafil, a PDE-5 inhibitor used to treat erectile dysfunction. Current U.S. labeling for vardenafil identifies ED as its indication.
Is Levitra the same as vardenafil?
Levitra is the brand name associated with vardenafil. Vardenafil is the active drug ingredient.
Is Levitra the same as Viagra?
No. Levitra contains vardenafil, while Viagra contains sildenafil. Both are PDE-5 inhibitors used for erectile dysfunction.
Does Levitra work without sexual stimulation?
No. Vardenafil helps increase penile blood flow during sexual stimulation. It does not independently cause an erection or increase sexual desire.
How long before sex should vardenafil be taken?
MedlinePlus states that vardenafil is usually taken about 60 minutes before sexual activity and generally should not be taken more than once every 24 hours.
Can Levitra be taken with nitroglycerin?
No. Vardenafil is contraindicated with nitrates such as nitroglycerin because the combination can cause a dangerous reduction in blood pressure.
Can Levitra be taken with Cialis or Viagra?
Vardenafil should not be combined with other PDE-5 inhibitors unless specifically directed by a healthcare professional.
Does Levitra increase testosterone?
No. Vardenafil is not testosterone replacement therapy and does not directly function by increasing testosterone.
Does Levitra increase sexual desire?
No. Vardenafil improves the physical erectile response during sexual stimulation but does not directly increase libido.
Can Levitra cause an erection that lasts too long?
Yes, although this is uncommon. An erection lasting more than four hours is an emergency and requires immediate medical treatment.
Can Levitra cause vision or hearing problems?
Rare serious vision and hearing events have been reported. Sudden vision loss or sudden hearing loss requires immediate medical evaluation.
Is Levitra still available in the United States?
The original Levitra brand and current generic vardenafil availability should be distinguished. FDA records show approved generic vardenafil products, while the FDA database also contains the historical Levitra NDA.
Key Takeaways
Levitra (vardenafil) is associated with the PDE-5 inhibitor class and is used to treat erectile dysfunction.
The most important facts are:
- Vardenafil is a PDE-5 inhibitor.
- It improves penile blood flow during sexual stimulation.
- It does not directly increase sexual desire.
- Current U.S. labeling recommends as-needed use, with 10 mg as the usual starting dose for most patients, up to once daily.
- Common side effects include headache, flushing, nasal congestion, indigestion, dizziness, nausea, and back pain.
- Nitrates such as nitroglycerin are contraindicated with vardenafil because of the risk of dangerous hypotension.
- Vardenafil is also contraindicated with riociguat and other guanylate cyclase stimulators.
- Alpha-blockers and other antihypertensive medicines can increase blood-pressure-lowering effects.
- Sudden vision or hearing loss requires prompt medical evaluation.
- An erection lasting more than four hours is a medical emergency.
- Persistent ED can sometimes indicate an underlying cardiovascular or metabolic condition.
- Current U.S. records show generic vardenafil products are available even though the branded Levitra product has a historical FDA record.
