Levitra (Vardenafil) for ED: Uses, Dosage, Benefits
Updated: Sep 24
Written by Elizabeth Chernoby in TheSkyMeds Editorial Standards
Medically reviewed by Jonathan Reed, Medical Content Reviewer Mar 21 2026
Levitra is a brand name associated with vardenafil, a prescription phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction (ED). Levitra (vardenafil) for ED works by increasing blood flow to the penis during sexual stimulation, helping a man get and maintain an erection when the medicine is effective for him. It does not automatically cause an erection, increase sexual desire, cure the underlying cause of ED, or protect against sexually transmitted infections. For most patients, current U.S. prescribing information recommends a starting dose of 10 mg taken as needed about 60 minutes before sexual activity, with adjustment to 5 mg or 20 mg according to effectiveness and tolerability. Vardenafil must not be combined with nitrates or riociguat because blood pressure can fall dangerously. This guide explains its uses, timing, dosage, realistic benefits, common side effects, important interactions, and warning signs requiring medical care.
What Is Levitra (Vardenafil) Used For?
Vardenafil is approved for treating erectile dysfunction, meaning persistent difficulty getting or maintaining an erection sufficient for sexual activity. It belongs to the same broad PDE5-inhibitor drug class as sildenafil and tadalafil.
The medicine supports the physical erectile response rather than creating sexual desire. Sexual stimulation is still necessary for vardenafil to work.
The MedlinePlus vardenafil drug information explains that vardenafil increases penile blood flow during sexual stimulation but does not cure ED or increase sexual desire.
How does vardenafil help an erection?
Sexual stimulation triggers nitric oxide signaling in erectile tissue. This increases cyclic guanosine monophosphate, usually shortened to cGMP, which helps smooth muscle relax and allows more blood to enter the penis.
PDE5 normally breaks down cGMP. By inhibiting PDE5, vardenafil allows this erection-supporting signal to persist longer.
That mechanism explains an important practical point: taking vardenafil without sexual stimulation does not normally produce an erection on demand.
Vardenafil helps the body's normal erectile response work more effectively; it is not an aphrodisiac. If ED persists despite correctly used treatment, the answer is not automatically a higher dose—timing, stimulation, medication interactions, cardiovascular health, diabetes, psychological factors, and other causes may need review.
What Is the Usual Vardenafil Dosage for ED?
For most patients, the recommended starting dose of vardenafil tablets is 10 mg, taken as needed approximately 60 minutes before sexual activity. Depending on effectiveness and side effects, the dose can be reduced to 5 mg or increased to a maximum recommended dose of 20 mg.
The maximum recommended frequency is once per day. Vardenafil can be taken with or without food.
The current DailyMed vardenafil prescribing information provides the official U.S. dosing, contraindication, interaction, and safety information for prescription vardenafil tablets.
Situation | Current prescribing information |
Usual starting dose for most patients | 10 mg |
Usual timing | About 60 minutes before sexual activity |
Lower available dose | 5 mg; 2.5 mg products also exist |
Maximum recommended dose | 20 mg |
Maximum standard frequency | Once per day |
Sexual stimulation needed | Yes |
Can it be taken with food? | Yes |
Age 65 or older | A 5 mg starting dose should be considered |
Moderate liver impairment | 5 mg starting dose; maximum 10 mg |
Stable alpha-blocker treatment | 5 mg starting dose recommended |
Severe liver impairment | Do not use under current U.S. labeling |
Kidney dialysis | Do not use under current U.S. labeling |
These are prescribing-information ranges, not a recommendation for an individual reader to select or change a dose. Several medicines and health conditions can require substantially lower vardenafil exposure.
Is 20 mg of vardenafil stronger than 10 mg?
Twenty milligrams is a higher dose, but that does not make it the appropriate starting dose for everyone. Current prescribing information starts most patients at 10 mg and allows adjustment according to response and adverse effects.
Increasing the dose independently can also increase drug exposure and side effects. If 10 mg is ineffective, correct use and the reason for treatment failure should be reviewed before assuming that more medicine is required.
Why might someone need only 5 mg?
Lower dosing is used in several circumstances. Current U.S. labeling says a 5 mg starting dose should be considered from age 65 onward and recommends 5 mg for people with moderate hepatic impairment or those established on stable alpha-blocker treatment.
Strong or moderate CYP3A4 inhibitors can increase vardenafil concentrations considerably and may require even stricter dose limits. These interactions are one reason vardenafil dosing should be based on a complete medication list rather than age alone.
How Long Does Vardenafil Take to Work?
Vardenafil tablets are generally taken approximately 60 minutes before sexual activity. That does not mean every person will notice an effect at exactly the same minute.
Sexual stimulation is still required. Individual response can also be affected by health status, medications, alcohol, food, anxiety, and the underlying cause of ED.
Can you take Levitra with food?
Yes. Current prescribing information states that vardenafil tablets can be taken with or without food.
MedlinePlus similarly advises taking vardenafil as needed about 60 minutes before sexual activity, with or without food.
Can you take another tablet if it does not work?
Do not take additional doses within the same day simply because the expected response has not occurred. Current labeling sets the maximum recommended dosing frequency at once per day.
One unsuccessful attempt also does not necessarily establish treatment failure. Correct timing, adequate sexual stimulation, medication interactions, and the underlying cause of ED all influence response.
If vardenafil repeatedly fails despite correct use, medical reassessment is safer than independently exceeding the recommended dose.
What Are the Benefits of Vardenafil for Erectile Dysfunction?
The principal benefit is improved erectile function in men for whom a PDE5 inhibitor is appropriate. By strengthening the normal blood-flow response to sexual stimulation, vardenafil can make it easier to achieve and maintain an erection sufficient for sexual activity.
This is a treatment benefit, not a cure. When the medicine wears off, the underlying causes of ED remain.
Does vardenafil increase sex drive?
No. Vardenafil acts on the physical process involved in erections rather than directly increasing libido. MedlinePlus specifically notes that it does not increase sexual desire.
Low sexual desire and erectile dysfunction can occur together, but they are different problems. Persistent low libido can involve hormonal, psychological, relationship, medication, sleep, or medical factors that require a different evaluation.
Can vardenafil cure ED permanently?
No. Vardenafil treats erectile difficulties during its period of action but does not permanently correct the underlying cause.
ED can be associated with cardiovascular disease, diabetes, medication effects, neurological disease, hormonal problems, pelvic treatment or surgery, anxiety, depression, and relationship factors. A prescription can improve erections without resolving those underlying issues.
Does vardenafil improve fertility?
Vardenafil is not a fertility treatment. Improving erectile function may make intercourse possible when ED is interfering with sexual activity, but that is different from treating low sperm count, impaired sperm function, or other causes of infertility.
It also does not prevent pregnancy or sexually transmitted infections.
What Side Effects Can Levitra or Vardenafil Cause?
Common adverse effects include headache, flushing, nasal congestion, indigestion, dizziness, nausea, and related gastrointestinal or upper-respiratory symptoms.
These effects are often temporary, but persistent or troublesome symptoms should be discussed with the prescribing clinician.
Symptom or situation | General significance | What to do |
Headache | Common side effect | Discuss if severe or persistent |
Flushing | Common side effect | Usually temporary |
Stuffy/runny nose | Common side effect | Usually non-emergency |
Indigestion/heartburn | Common side effect | Discuss if persistent |
Dizziness | Can occur, including with blood-pressure effects | Sit or lie down; seek help if severe/fainting occurs |
Erection lasting over 4 hours | Priapism | Immediate medical care |
Sudden loss of vision | Rare serious event | Stop vardenafil and seek urgent medical attention |
Sudden hearing decrease/loss | Rare serious event | Stop vardenafil and seek urgent medical attention |
Chest pain during sexual activity | Potential cardiovascular emergency | Stop activity and seek urgent medical assessment |
Fainting or severe hypotension | Potential serious drug/cardiovascular effect | Urgent assessment |
The current label instructs patients to obtain immediate medical help for an erection lasting longer than four hours and to stop treatment and seek medical attention for sudden vision or hearing loss.
Which Medicines Should Not Be Combined With Vardenafil?
The most important contraindicated combination is vardenafil plus nitrates. Nitrates and PDE5 inhibitors both affect the nitric oxide–cGMP pathway, and combining them can produce a dangerous fall in blood pressure.
Nitroglycerin and isosorbide medicines used for angina are examples. Recreational nitrate products sometimes called “poppers” also need to be avoided.
Vardenafil is also contraindicated with guanylate cyclase stimulators such as riociguat because the combination can produce excessive blood-pressure reduction.
What about alpha-blockers and blood-pressure medicines?
Vardenafil and alpha-blockers both dilate blood vessels. Used together, they can sometimes lower blood pressure enough to cause symptoms such as dizziness or fainting.
Current labeling recommends a 5 mg vardenafil starting dose when the patient is stable on alpha-blocker therapy and says an interval between the medicines should be considered.
This does not mean every person taking a blood-pressure medicine is unable to use vardenafil. The medication combination and cardiovascular status need individual review.
Which other medicines can change vardenafil levels?
Vardenafil is affected by CYP3A4, an enzyme involved in drug metabolism. Strong or moderate CYP3A4 inhibitors can substantially increase exposure to vardenafil.
Current prescribing information includes specific dose restrictions with medicines such as ritonavir, cobicistat, ketoconazole, itraconazole, clarithromycin, erythromycin, indinavir, saquinavir, and atazanavir.
Do not try to calculate these adjustments independently. A pharmacist or prescriber should review the complete medication list.
Who Should Use Vardenafil With Extra Caution?
Cardiovascular status matters because sexual activity itself places additional demand on the heart and circulation. Current labeling states that vardenafil should not be used when sexual activity is medically inadvisable because of cardiovascular status.
The current vardenafil safety and contraindication information also highlights nitrate and riociguat use, alpha-blocker interactions, vision and hearing warnings, priapism, and a specific cardiac electrical-rhythm concern involving QT prolongation.
Why is QT prolongation important with vardenafil?
Vardenafil has a safety consideration that deserves particular attention in people with certain electrical heart-rhythm problems.
Current prescribing information says patients with congenital QT syndrome or those taking class IA or class III antiarrhythmic medicines should avoid vardenafil.
That warning makes a complete heart and medication history especially important before treatment.
What about liver or kidney disease?
Liver impairment can increase vardenafil exposure. Current U.S. labeling recommends starting at 5 mg in moderate hepatic impairment and limiting the maximum dose to 10 mg; it advises against use in severe hepatic impairment.
Current labeling also advises against vardenafil in patients receiving renal dialysis.
These recommendations are examples of why a standard ED dose should not simply be copied from another person's prescription.
When Should You Seek Medical Care?
An erection lasting longer than four hours requires immediate medical assistance. Prolonged erections can damage erectile tissue if treatment is delayed.
Stop vardenafil and seek urgent medical attention for sudden loss of vision in one or both eyes or a sudden decrease or loss of hearing. The causal relationship between PDE5 inhibitors and some reported sensory events is not always certain, but these symptoms still require prompt evaluation.
Chest pain, fainting, severe breathlessness, or marked dizziness during sexual activity also warrants urgent assessment. Tell emergency clinicians that vardenafil was taken and when it was used, particularly because nitrates are contraindicated with vardenafil.
Persistent ED itself deserves medical evaluation rather than indefinite self-treatment. Current prescribing information states that ED assessment should include evaluation for potential underlying causes and identification of appropriate treatment.
Conclusion
Levitra (vardenafil) for ED is a PDE5-inhibitor treatment that improves penile blood flow during sexual stimulation but does not increase libido or permanently cure erectile dysfunction. For most patients, current prescribing information starts vardenafil at 10 mg about 60 minutes before sexual activity, with adjustment between 5 and 20 mg according to response and tolerability; it should not be taken more than once daily.
Vardenafil must not be combined with nitrates or riociguat, and additional caution applies with alpha-blockers, interacting medicines, cardiovascular disease, liver impairment, and certain heart-rhythm conditions. Seek urgent care for prolonged erection, sudden vision or hearing loss, chest pain, or severe cardiovascular symptoms.
Frequently Asked Questions
1 . How long before sex should I take vardenafil?
Vardenafil tablets are generally taken approximately 60 minutes before sexual activity. Sexual stimulation is still necessary for the medicine to produce an erectile response. Current prescribing information allows it to be taken with or without food and limits standard dosing frequency to once daily.
2 . Is 10 mg or 20 mg of vardenafil better?
Neither dose is automatically “better.” Ten milligrams is the recommended starting dose for most patients, while 20 mg is the maximum recommended dose. The dose can be reduced to 5 mg or increased according to effectiveness, tolerability, health conditions, age, and interacting medicines.
3 . Does vardenafil make you sexually aroused?
No. Vardenafil improves the physical erectile response to sexual stimulation but does not increase sexual desire. Sexual stimulation is required for it to work. Persistent low libido therefore may need separate evaluation rather than simply increasing an ED medicine's dose.
4 . Can I take vardenafil every day?
Current prescribing information allows vardenafil as needed up to a maximum standard frequency of once per day. That does not mean daily use is appropriate for every person. Dose frequency can require modification with interacting medicines or particular medical conditions.
5 . Can I take vardenafil if I use blood-pressure medicine?
Sometimes, but the specific medicine matters. Vardenafil can add to the blood-pressure-lowering effects of antihypertensives and alpha-blockers, while nitrates are contraindicated completely. A clinician or pharmacist should review the medication list rather than assuming all blood-pressure treatments carry the same risk.
6 . What happens if vardenafil does not work?
Do not exceed the prescribed dose or take another tablet the same day. Correct timing, sexual stimulation, interactions, and the underlying cause of ED can affect response. Repeated treatment failure warrants medical reassessment rather than automatically increasing beyond the recommended maximum dose.
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