Levitra (vardenafil): uses, side effects, interactions, and more

Erectile dysfunction affects millions of men each year. Fortunately, several effective treatment options exist, including Levitra or generic vardenafil. Read on to learn more about this drug, including its uses, side effects, and more. 

Levitra is a brand name form of vardenafil, a drug used to treat erectile dysfunction. Vardenafil is also marketed under the brand name Staxyn. 

Vardenafil is a PDE5 inhibitor, meaning it works by blocking an enzyme called phosphodiesterase-5 (PDE5). The PDE5 enzyme blocks erections by stopping a natural chemical called cGMP. This chemical is responsible for opening up blood vessels in the penis, increasing blood flow there, and making the penis harder. By inhibiting PDE5, Levitra allows cGMP to hang around longer to do its thing and make your erection last longer (Padda, 2021). 

In other words, Levitra helps with erectile dysfunction by helping blood vessels relax and increasing blood flow into the penis. 

But Levitra is not a magic pill—it cannot give you an erection if you aren’t aroused. You need arousal and sexual stimulation for it to work effectively.

Levitra is FDA-approved to treat erectile dysfunction (ED). 

ED is a common sexual dysfunction that can present in several ways: you may have trouble getting an erection, keeping an erection, or notice a lack of morning erections. And, its cause may be due to underlying medical conditions including (Sooriyamoorthy, 2021):

• Heart disease (atherosclerosis)

• High blood pressure (hypertension)

• Diabetes

• Mental health issues like anxiety and depression

Levitra is also sometimes used "off-label" to treat other medical conditions, including (UptoDate, n.d.):

• Reynaud's phenomenon, a medical condition where your blood vessels tighten (constrict), decreasing blood flow

• Pulmonary arterial hypertension, where the blood flow in your lungs is at a higher pressure than normal

Vardenafil hydrochloride or Levitra is available as an oral tablet in varying strengths: 2.5 mg, 5 mg, 10 mg, and 20 mg. Staxyn is vardenafil hydrochloride in a dissolving tablet form and comes in only 10 mg strength tablets.

For most people, the recommended starting dose of vardenafil is 10 mg. You should take it around 60 minutes before sexual activity. You can take Levitra with or without food, but it may work faster if you take it on an empty stomach. Research suggests that food, especially high-fat meals, may delay Levitra's effect (Zucchi, 2019).

The maximum daily dose for Levitra is 20 mg per day. 

Levitra can cause side effects, which may be more likely with higher doses. The most common side effects of vardenafil include (DailyMed, 2021):

• Headache

• Flushing

• Runny nose

• Heartburn (dyspepsia)

• Sinusitis

• Flu-like symptoms

• Nausea

• Dizziness/lightheadedness

• Back pain

Rarely, vardenafil can cause more serious side effects, including (DailyMed, 2021): 

• Priapism, a prolonged erection that requires emergency treatment

• Vision loss or color vision changes

• Loss of hearing or ringing in the ears (tinnitus)

• Drop in blood pressure (hypotension)

Seek medical attention immediately if you experience any of these concerning side effects. 

As with all medications, talk to your health care provider before starting vardenafil. Discuss your medical history and any over-the-counter supplements or prescription drugs you may be taking to avoid potential drug interactions. Certain medications, when taken with Levitra, increase the likelihood of adverse effects, including (DailyMed, 2021):

• Nitrates: Medications like nitroglycerin, used to treat chest pain (angina), and amyl nitrites, a popular club drug called "poppers," fall into the nitrate class. You should not take nitrates with Levitra, as together, they can cause a potentially fatal drop in blood pressure.

• Riociguat: A guanylate cyclase (GC) stimulator, riociguat (brand name Adempas), should not be taken with Levitra because both drugs lower your blood pressure, and the combination may cause levels to fall too low.

• CYP3A4 inhibitors: Certain medications may disrupt how your liver processes drugs by affecting the CYP3A4 enzyme system, changing the concentration, and increasing your risk of side effects. Examples of these include ketoconazole, ritonavir, indinavir, and erythromycin. Grapefruit juice may also act on this enzyme and affect vardenafil drug levels.

• Alpha-blockers: These drugs are used to help lower blood pressure and treat certain prostate conditions, like benign prostatic hyperplasia (BPH). Examples include doxazosin, terazosin, alfuzosin, and tamsulosin. Taking alpha-blockers with vardenafil may lead to a drop in blood pressure. 

This list does not include all potential drug interactions with Levitra. Seek medical advice from your pharmacist or healthcare professional if you have questions or concerns. 

You should not take Levitra if you're not healthy enough for sexual activity—your healthcare provider can help answer any questions about this.

Some people may want to avoid or use caution when taking vardenafil because of the increased risk of side effects, especially if they have any of the following (DailyMed, 2021):

• Low blood pressure (hypotension): Since Levitra can lower your blood pressure, you may be at higher risk of side effects.

• Heart problems: If you have heart problems, like a history of heart disease or heart failure, or a prolonged QT interval (a problem with your heart's electrical system), discuss with your healthcare professional whether you should use Levitra.

• Eye problems: People with a history of, or risk factors for, non-arteritic ischemic optic neuropathy (NAION) should check with their healthcare provider before using vardenafil. It may increase your risk of vision loss. Scientists are unsure of vardenafil's effects on people with hereditary eye problems, like retinitis pigmentosa, so talk to your provider.

Don't take Levitra if you have had an allergic reaction to vardenafil or any of the inactive ingredients in Levitra.

Levitra is not the only PDE5 inhibitor on the market. Other PDE5 inhibitors include sildenafil (brand name Viagra), tadalafil (brand name Cialis), and avanafil (brand name Stendra). And, to take it a step further, PDE5 inhibitors are not the only treatment options for ED. Talk to your healthcare provider about additional therapies available.

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Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

December 10, 2021

Written by

Chimene Richa, MD

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.