Vardenafil

Key facts

• Vardenafil (the ingredient in Levitra and generics) is a PDE5 inhibitor. It relaxes blood vessels so more blood reaches the penis during arousal, and it only works with sexual stimulation.
• You take it 25 to 60 minutes before sex; the effect lasts around 4 to 5 hours. A heavy or fatty meal delays it.
• Never take vardenafil with nitrate heart medicines (glyceryl trinitrate, isosorbide) or the pulmonary-hypertension drug riociguat. Together they can drop your blood pressure to dangerous levels.
• Seek urgent care for an erection lasting more than 4 hours, or sudden loss of vision or hearing.

What vardenafil treats

Vardenafil treats erectile dysfunction, the inability to get or keep an erection firm enough for sex. It has no other approved medical use. It is not a treatment for angina, low sexual desire, or premature ejaculation.

How vardenafil works

An erection depends on a signal molecule called cyclic GMP relaxing the blood vessels in the penis so they fill with blood. An enzyme, PDE5, breaks that molecule down. Vardenafil blocks PDE5, so cyclic GMP lasts longer and the vessels stay relaxed once arousal begins. It does not trigger an erection on its own; sexual stimulation is still needed.

Before you take it

• Do not use vardenafil if you take any nitrate medicine or riociguat, or if a doctor has told you sex is too risky for your heart.
• Tell your prescriber about alpha-blockers, other blood-pressure medicines, recent heart attack or stroke, very low or uncontrolled high blood pressure, an irregular heart rhythm such as long QT, and severe liver or kidney disease. These may change your dose or rule the drug out.
• An erection lasting over 4 hours (priapism) can permanently damage the penis. Men with sickle cell disease, myeloma or leukaemia carry a higher risk.
• Buy only from a licensed pharmacy. Vardenafil is widely counterfeited, and fakes with wrong doses or contaminants are a documented cause of harm.

Side effects

Common effects fade as the dose wears off: headache, facial flushing, a blocked or runny nose, indigestion, and back or muscle ache.

Stop and seek urgent medical care for any of these:

• An erection lasting more than 4 hours.
• Sudden loss or dimming of vision in one or both eyes.
• Sudden hearing loss, sometimes with ringing or dizziness.
• Chest pain, a fast or irregular heartbeat, or fainting.

Safety essentials

• The nitrate rule is absolute: no vardenafil within 24 hours of any nitrate, and no nitrate given for chest pain while vardenafil is in your system. If you get chest pain during sex, tell emergency staff you have taken it.
• Tell your prescriber if you take medicines that affect heart rhythm, since vardenafil can add to QT-interval effects.
• Do not take more than one dose in 24 hours, and do not combine it with other erectile-dysfunction treatments.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.