How It Works
Vardenafil works by essentially running interference on phosphodiesterase type 5 (PDE5), an enzyme that can interfere with men achieving an erection.
When a man becomes sexually aroused, nerves in the penis release nitric oxide. This signals the body to increase levels of a chemical called cyclic guanosine monophosphate (cGMP), which relaxes the smooth muscle in the blood vessels of the penis. This relaxation allows more blood to flow in, causing the penis to become firm and erect.
The body also naturally produces PDE5, which breaks down cGMP. For many men with ED, either their PDE5 enzymes are working too hard or their cGMP count is low. By inhibiting PDE5, vardenafil allows smooth muscles in the penile blood cells to remain relaxed and helps increase blood flow to the penis.
| Quick Facts | |
|---|---|
| Common Brands | Levitra, Staxyn |
| Drug Class | Phosphodiesterase-5 (PDE5) Inhibitor |
| Generic Status | Generic version of Levitra |
| Availability | Prescription only |
Dosing
Unlike some other erectile dysfunction medications with suggested daily use, vardenafil may be taken “as needed” per the drug’s standard guidelines. Most providers recommend taking vardenafil a short time before expected sexual activity.
- Starting dose: Most men start vardenafil at a dose of 10 milligrams (mg).
- Adjusting dose: Doctors may adjust their patient’s dose based on factors like response and tolerability. The typical range for vardenafil is 5 to 20 mg.
- Special populations: Certain patients, such as men over the age of 65 and those with kidney or liver considerations, may be prescribed a starting dose lower than 5 mg to ensure their body safely processes the medication.
- Timing and frequency: Standard guidelines suggest taking vardenafil film-coated tablets about 60 minutes before any planned sexual activity. The oral dissolving tablets (ODTs) are also usually taken an hour before sex, though your doctor may also suggest taking the tablet sooner. It is not advised to take vardenafil more than once in a 24-hour period.
Note: Dosing information is educational only. Your prescribing physician will determine your specific dose based on your individual health needs. Always follow your healthcare provider’s instructions for exact dosing.
Uses
FDA-Approved Uses
Vardenafil is FDA-approved specifically to treat erectile dysfunction in adult men by improving the ability to maintain and achieve a penile erection sufficient for sexual intercourse. Older brand name versions of the drug have been discontinued, but the generic tablet and oral dissolving tablet (ODT) forms still hold FDA approval.
Off-Label Uses
You may see vardenafil prescribed for uses that are not “FDA-approved.” This is a very common and legal practice called “off-label” prescribing, where a doctor uses their clinical judgment to prescribe a drug for a different (but well-researched) purpose.
Common off-label uses for vardenafil currently found in clinical research and practice include:
- Raynaud’s syndrome: Vardenafil can be used off-label to improve circulation for people with Raynaud’s syndrome, a condition that constricts arteries that supply blood to the skin and causes patients to feel cold at their extremities.
- Pulmonary arterial hypertension (PAH): Although other PDE5 inhibitors are specifically FDA-approved to treat PAH, providers may choose vardenafil because it can relax blood vessels and lower blood pressure in the lungs.
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Side Effects
For most people who take vardenafil, side effects are mild to moderate and most will resolve as their body adapts to the new medication.
Common Side Effects
- Headache
- Flushing
- Nasal congestion
- Indigestion
- Dizziness
- Flu-like symptoms
Serious Side Effects
Serious side effects are rare, but it’s important to know what to look for if they do occur. Serious side effects of taking vardenafil can include:
- Priapism: Priapism refers to a painful erection or one that lasts longer than 4 hours. If untreated, it can cause permanent tissue damage. Immediate medical intervention is required.
- Vision loss: A rare condition called non-arteric anterior ischemic optic neuropathy (NAION) has been reported from some people who take vardenafil. NAOIN can cause sudden vision loss in one or both eyes.
- Hearing changes: A sudden decrease or loss of hearing in one or both ears, sometimes accompanied by tinnitus (ringing in ears), has been reported from some people who take vardenafil.
- Cardiovascular event: Vardenafil can prolong the QT interval, or measure of a heart rhythm, so the drug may cause chest pain, shortness of breath, irregular heartbeat, and other side effects for people with preexisting heart conditions.
- Severe allergic reaction: As with many different types of medication, vardenafil poses a risk of anaphylaxis for people who are allergic to one or more of its ingredients.
Call your doctor immediately if you experience any concerning or prolonged symptoms.
Pharmacist Tips
Plan Your Meals
Standard guidelines state vardenafil can be taken with or without food, but meals high in fat can delay the medication’s onset. Taking the tablet on an empty stomach or with a light meal is recommended for faster results.
Extra Steps for the ODT
If you take vardenafil in oral dissolving tablet form, it is recommended to set the tablet on your tongue, let it dissolve, and swallow without liquid. It is not advised to push the tablet through the foil when taking it, as this can affect the medication’s release.
Stimulation Needed
Vardenafil helps improve blood flow to achieve an erection, but the drug is not an aphrodisiac and some foreplay may also be needed to initiate sexual activity.
Ditch the Grapefruit
Grapefruit can elevate the levels of vardenafil in your body and increase the risk of side effects. Most doctors recommend avoiding grapefruit and grapefruit juice when taking vardenafil.
Practice Makes Perfect
For some people, the medication takes a few attempts to take full effect. If the drug does not work the first time you take it, your next attempt may be successful. You can also chat with your doctor about adjusting the dose.
Drug Interactions
The most significant interactions with vardenafil involve medications that affect blood pressure or are processed through liver enzymes. Known interactions with vardenafil include:
- Nitrates: Standard guidelines strictly prohibit taking vardenafil in combination with nitroglycerin, isosorbide dinitrate, amyl nitrate, and other nitrate medications. Taking these drugs together can cause a life-threatening drop in blood pressure.
- Alpha-blockers: Alpha-blockers used to treat prostate problems or hypertension can significantly lower blood pressure, so taking them with vardenafil can cause dizziness or fainting.
- CYP3A4 inhibitors: Ketoconazole, ritonavir, and other CYP3A4 inhibitors can increase the level of vardenafil in your body.
- Heart rhythm medications: Vardenafil is known to affect the QT interval, a measurement of heart rhythm. For this reason, doctors usually recommend that their patients avoid taking amiodarone, sotalol, and other heart rhythm medications.
- Alcohol: While there are no known major interactions between vardenafil and alcohol, drinking can lower blood pressure, reduce the drug’s effectiveness, and make it more difficult to achieve an erection.
Always give your doctor and pharmacist a complete list of all your medications, vitamins, and supplements to check for potential interactions.
FAQs
How long before sexual activity should I take vardenafil?
Standard guidelines recommend taking a vardenafil tablet or oral dissolving tablet (ODT) about an hour prior to sexual activity. Some men may notice results within 15 to 30 minutes, and the ODT form may act faster than the standard tablet, but one hour provides the most reliable window for peak effectiveness.
What is the difference between Levitra (tablet) and Staxyn (dissolvable tablet)?
Levitra is vardenafil in standard oral tablet form, while Staxyn is vardenafil in the form of an oral dissolving tablet (ODT). While both medications contain the same active ingredient, the ODT dissolves on the tongue and is absorbed differently into the body.
Why must I avoid taking nitrates (like nitroglycerin) while on vardenafil?
Vardenafil and nitrate medications both cause blood vessels to dilate, or widen. Taking these drugs together can cause blood pressure to plummet and reach dangerous, life-threatening levels.
How long does the effect of vardenafil last?
Vardenafil typically remains in the body for 5 to 7 hours, though some studies suggest the drug can assist with erections for up to 8 hours.
Can I drink alcohol while taking vardenafil?
Standard guidelines state moderate drinking shouldn’t cause adverse effects while taking vardenafil, but large amounts of alcohol consumption can lower blood pressure and make it harder to achieve an erection. Drinking also increases the risk of dizziness.
Does vardenafil affect my heart rhythm?
Vardenafil has been shown to cause small changes to the QT interval. These changes are not considered clinically significant for most men, but can be a more serious risk for people who experience “long QT syndrome” or take anti-arrhythmic medications.
Is vardenafil safe to take if I have high blood pressure?
Vardenafil is considered safe for most people with high blood pressure that is well-controlled with medication. Those with fluctuating or very high blood pressure should consult their physician before taking vardenafil, as the medication’s ability to lower blood pressure may pose a higher risk to these patients.
Can I take vardenafil every day?
Vardenafil is designed for “as needed” use, and it is never advised to take the drug more than once in a 24-hour period.
Does grapefruit juice interact with vardenafil?
Yes, grapefruit interacts with vardenafil by blocking the CYP3A4 enzyme that breaks down the drug. This can cause the drug to build up in your system, possibly to toxic levels, so doctors generally discourage consuming grapefruit or grapefruit juice while taking vardenafil.
Can I take vardenafil if I am already taking alpha-blockers for my prostate?
It is possible to take vardenafil if you are already taking alpha-blockers for your prostate, but it is advised to exercise caution and speak to your provider before doing so. Doctors usually suggest being on a stable dose of alpha-blocker before starting vardenafil at a lower dose, but their recommendations vary by patient.
Does vardenafil work if there is no sexual stimulation?
No, vardenafil does not work if there is no sexual stimulation. The medication assists with natural achievement of an erection, but requires physical or mental sexual arousal to work properly.
Is vardenafil safer for diabetics than other ED medications?
No ED medication is inherently “safer” for diabetic people. That said, some clinical trials show vardenafil is effective in diabetic populations.
Can women take vardenafil?
Vardenafil is only FDA-approved to treat erectile dysfunction in men, and there is insufficient clinical data to suggest the drug is safe or effective for women to use to treat sexual dysfunction.
Comparable Medications
Vardenafil, Sildenafil, or Tadalafil?
Vardenafil is a prescription-strength oral medication used to treat erectile dysfunction (ED). This is not the only ED medication on the market, and your doctor may suggest a vardenafil alternative based on your age and medical history. Two common alternatives to vardenafil are:
Sildenafil
From $24.99
Sold under the brand name Viagra, sildenafil – like vardenafil – typically assists with erections for 4 to 6 hours. However, vardenafil is a more potent drug and taken in smaller doses. Studies also suggest food does not affect vardenafil's absorption to the same extent as sildenafil's, but high-fat meals can delay the effects of both.
Tadalafil
From $29.99
Tadalafil, available under the brand name Cialis, has an active window of up to 36 hours. A lower-dose form of tadalafil has also been FDA-approved for daily use. Vardenafil's duration is shorter, typically lasting 4 to 6 hours, and is only FDA-approved for "as needed" use.
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Important: Information on this page is for educational purposes only. Prescribing decisions are made by independent, licensed providers. TelyRx operates technology-enabled pharmacies and a telehealth platform that connects patients with board-certified licensed providers. Prescriptions, when provider-approved and issued, are filled and shipped by TelyRx-affiliated pharmacies. We do not employ physicians or make prescribing decisions. Learn more about our editorial standards here.