What Is Vardenafil?
Vardenafil is a prescription medicine used to treat erectile dysfunction (ED) in adult men.
It belongs to a class of medicines called phosphodiesterase type 5 inhibitors, commonly known as PDE5 inhibitors.
Vardenafil is the active ingredient in the established branded ED medicine Levitra.
The European Medicines Agency confirms that Levitra is authorised for the treatment of erectile dysfunction in adult men and is available as:
- 5mg film-coated tablets;
- 10mg film-coated tablets;
- 20mg film-coated tablets; and
- 10mg orodispersible tablets.
Vardenafil only supports an erection when sexual stimulation is present.
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How Does Vardenafil Work?
During sexual stimulation, the body releases chemical signals that increase levels of cyclic guanosine monophosphate (cGMP) in the penis.
cGMP causes smooth muscle in the erectile tissue to relax, allowing more blood to flow into the penis.
An enzyme called PDE5 normally breaks down cGMP.
Vardenafil inhibits PDE5.
By slowing the breakdown of cGMP, vardenafil helps improve blood flow to erectile tissue during sexual stimulation and can make it easier to achieve and maintain an erection.
Vardenafil does not:
- automatically cause an erection;
- increase sexual desire;
- act as an aphrodisiac;
- directly increase testosterone; or
- work without sexual stimulation.
What Is Erectile Dysfunction?
Erectile dysfunction is difficulty getting or maintaining an erection firm enough for satisfactory sexual activity.
It can be occasional or persistent.
Possible contributing factors can include:
- cardiovascular disease;
- high blood pressure;
- diabetes;
- obesity;
- high cholesterol;
- smoking;
- excessive alcohol;
- certain prescription medicines;
- anxiety;
- stress;
- depression; and
- relationship or performance concerns.
Persistent ED can sometimes be associated with wider cardiovascular or metabolic health issues, so recurring symptoms should not always be treated purely as a sexual-performance concern.
Who May Be Suitable for Vardenafil?
Vardenafil is intended for adult men with erectile dysfunction.
Suitability depends on individual factors such as:
- cardiovascular health;
- current medicines;
- blood pressure;
- kidney function;
- liver function;
- eye conditions;
- previous ED treatment;
- age; and
- other medical history.
An appropriate consultation should be completed before treatment.
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How Do You Take Vardenafil?
The established European reference medicine Levitra has a usual recommended dose of:
10mg taken approximately 25–60 minutes before sexual activity.
Depending on effectiveness and tolerability, the film-coated tablet dose may be:
- reduced to 5mg; or
- increased to a maximum of 20mg.
The maximum recommended dosing frequency is generally once per day.
Always follow the dosage prescribed for you.
What Vardenafil Strength Should I Take?
The correct strength depends on treatment response and individual medical circumstances.
Vardenafil 5mg
The lower dose may be suitable for men who require a reduced dose because of:
- increased sensitivity to side effects;
- particular medicine interactions;
- some liver or kidney conditions; or
- other clinical considerations.
EMA guidance notes that a 5mg starting dose should be considered in mild to moderate liver impairment or severe kidney impairment.
Vardenafil 10mg
10mg is the usual recommended starting dose for many men.
Vardenafil 20mg
20mg is generally the maximum recommended dose and may be considered when 10mg is not sufficiently effective and the higher dose is medically appropriate.
Do not increase your own dose.
How Long Before Sex Should I Take Vardenafil?
Vardenafil is usually taken 25–60 minutes before sexual activity.
The exact onset can vary depending on:
- food;
- particularly high-fat meals;
- alcohol;
- individual metabolism;
- other medicines; and
- sexual stimulation.
Planning treatment in advance can improve reliability.
Does Food Affect Vardenafil?
Yes.
The EMA states that a high-fat meal can delay the onset of activity of vardenafil film-coated tablets.
This means the medicine may take longer to work after a particularly fatty meal.
A delayed response does not necessarily mean the medicine is ineffective.
Does Vardenafil Work Without Sexual Stimulation?
No.
Sexual stimulation is required for vardenafil to work.
The medicine supports the natural erectile-response pathway rather than producing an erection automatically.
How Effective Is Vardenafil?
Vardenafil has been studied extensively in men with erectile dysfunction.
EMA reports that Levitra tablets and orodispersible tablets were significantly more effective than placebo across the main clinical studies assessing the ability to achieve and maintain erections.
The clinical programme included men with different causes of erectile dysfunction, including:
- men with diabetes; and
- men who had undergone prostate surgery.
Individual response still varies.
What If Vardenafil Does Not Work?
A single unsuccessful attempt does not always mean treatment is ineffective.
Possible reasons include:
- insufficient sexual stimulation;
- incorrect timing;
- a heavy or high-fat meal;
- excessive alcohol;
- anxiety;
- an unsuitable dose;
- other medicines; or
- an underlying health condition.
Do not take extra tablets outside your prescribed dosing schedule.
If vardenafil repeatedly does not provide an adequate response, speak with an appropriate healthcare professional.
What Are the Common Side Effects of Vardenafil?
Like all medicines, vardenafil can cause side effects.
The EMA identifies headache as the most common Levitra side effect, occurring in more than 1 in 10 patients.
Other possible PDE5 inhibitor effects can include symptoms such as:
- flushing;
- nasal congestion;
- indigestion;
- dizziness; and
- other gastrointestinal or circulatory symptoms.
Always read the current patient leaflet supplied with your medicine for the complete list.
What Serious Side Effects Should I Know About?
Seek urgent medical help if you experience severe or concerning symptoms such as:
- chest pain;
- severe dizziness or fainting;
- sudden vision loss or significant visual change;
- a prolonged or painful erection;
- severe allergic symptoms; or
- another sudden serious reaction.
Do not rely on an online product page when urgent medical assessment may be required.
Can Vardenafil Be Taken With Nitrates?
No.
Vardenafil must not be taken with nitrate medicines commonly used for angina.
Combining PDE5 inhibitors with nitrates can cause a dangerous fall in blood pressure.
EMA also states that vardenafil must not be used with guanylate cyclase stimulators such as riociguat.
Always disclose every medicine you take during your consultation.
Who Should Not Take Vardenafil?
According to EMA information, vardenafil should not be used in several circumstances, including:
- allergy to vardenafil or another ingredient;
- use of nitrate medicines;
- use of applicable guanylate cyclase stimulators;
- severe heart disease where sexual activity is inadvisable;
- previous vision loss caused by NAION;
- severe liver disease;
- end-stage kidney disease requiring dialysis;
- significant low blood pressure;
- recent heart attack or stroke;
- unstable angina; or
- certain hereditary retinal disorders.
Additional restrictions and medicine interactions also apply.
Does Vardenafil Interact With Other Medicines?
Yes.
Important interactions can involve:
- nitrates;
- riociguat;
- certain antifungal medicines;
- some HIV medicines;
- some medicines that affect vardenafil metabolism; and
- other blood-pressure-lowering medicines.
EMA specifically notes restrictions involving ketoconazole and itraconazole in men over 75 and HIV protease inhibitors such as ritonavir or indinavir.
This is not a complete interaction list.
Always disclose all medicines and supplements.
Can I Drink Alcohol With Vardenafil?
Moderate alcohol does not necessarily prevent vardenafil from working.
However, excessive alcohol can:
- worsen erectile dysfunction;
- reduce sexual performance;
- increase dizziness; and
- contribute to blood-pressure changes.
Keeping alcohol moderate may improve both treatment reliability and sexual function.
Does Vardenafil Increase Sex Drive?
No.
Vardenafil treats the physical erectile response.
It does not directly increase libido or sexual desire.
If reduced sexual desire is the main issue, a broader assessment may be appropriate.
Does Vardenafil Increase Testosterone?
No.
Vardenafil is not a testosterone treatment.
It acts on the PDE5/cGMP pathway involved in erectile blood flow.
Vardenafil vs Levitra
Vardenafil is the active ingredient.
Levitra is the established branded medicine containing vardenafil.
Levitra
- Branded vardenafil
- EU-authorised reference medicine
- Available in 5mg, 10mg and 20mg film-coated tablets
- Also available as a 10mg orodispersible tablet
Generic Vardenafil
- Contains the same active ingredient
- May differ in manufacturer
- May differ in tablet appearance and inactive ingredients
- Often available at a different price
The active ingredient and basic mechanism are the same.
Vardenafil vs Viagra
Vardenafil and Viagra are both PDE5 inhibitors.
Vardenafil
Contains vardenafil.
The usual reference dose is 10mg taken 25–60 minutes before sexual activity.
Viagra
Contains sildenafil.
The usual recommended starting dose is 50mg taken approximately one hour before sexual activity.
They are not interchangeable dose-for-dose.
Vardenafil vs Cialis
Vardenafil and Cialis belong to the same broad medicine class but contain different active ingredients.
Vardenafil
Usually used as an on-demand ED treatment.
Cialis
Contains tadalafil, which has a longer duration of action and can also be prescribed in a lower-dose once-daily regimen.
Choice depends on individual preference, response and medical circumstances.
Vardenafil vs Spedra
Vardenafil contains vardenafil, while Spedra contains avanafil.
Both are PDE5 inhibitors but differ in:
- onset;
- duration;
- available strengths;
- interactions;
- tolerability; and
- individual response.
Vardenafil vs ED Pump Treatment
Some men may prefer or require a non-medicinal option.
A vacuum erection device such as the VaxAid Deluxe ED Pump Kit uses a mechanical approach rather than PDE5 inhibition.
This may be relevant for men who:
- cannot use PDE5 inhibitors;
- prefer a drug-free option;
- experience medication side effects; or
- need another treatment strategy.
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