Levitra (Vardenafil)

What is Levitra?

Levitra (vardenafil) is a prescription-only oral medicine approved by the European Medicines Agency (EMA) for the treatment of erectile dysfunction (ED) in adult men. It belongs to the phosphodiesterase type 5 (PDE5) inhibitor class — the same family of medicines as sildenafil (Viagra) and tadalafil (Cialis) — but has a distinct molecular structure.

How does Levitra work?

Levitra inhibits phosphodiesterase type 5 (PDE5), an enzyme found primarily in penile smooth muscle tissue. This mechanism is shared with other PDE5 inhibitors.

During sexual stimulation, nitric oxide is released in the erectile tissue of the penis, stimulating the production of cGMP (cyclic guanosine monophosphate). cGMP causes smooth muscle relaxation in the penile blood vessels, increasing blood flow and producing an erection. PDE5 normally degrades cGMP; ED can have multiple causes. By inhibiting PDE5, vardenafil allows cGMP to accumulate, restoring the capacity for a normal erection in response to sexual stimulation.

Levitra does not produce an erection in the absence of sexual stimulation. Arousal is required for the medicine to be effective.

Molecular selectivity does not establish a lower clinical rate of visual adverse effects. Sudden visual changes require stopping Levitra and immediate medical advice.

Who is Levitra for?

Levitra is indicated for adult men with erectile dysfunction. It may be particularly considered for:

• Men for whom sildenafil (Viagra) has been insufficiently effective
• Men with ED secondary to diabetes mellitus (both type 1 and type 2), where clinical evidence supports vardenafil’s efficacy
• Men whose individual history and preferences favour vardenafil after medical assessment; food effects and molecular potency do not establish clinical superiority

Levitra is not appropriate for all men. Contraindications include:

• Concurrent use of nitrate medicines in any form
• Ritonavir or indinavir; oral ketoconazole or itraconazole in men over 75 years (this latter combination should also be avoided at other ages)
• Riociguat, hypotension, recent vascular events or other prohibitions listed below
• Severe hepatic impairment
• End-stage renal disease requiring dialysis
• Hereditary degenerative retinal disorders such as retinitis pigmentosa
• History of NAION (non-arteritic anterior ischaemic optic neuropathy)

Dosage

Levitra is taken orally, approximately 25 to 60 minutes before anticipated sexual activity. It is available in three strengths:

This table is for film-coated tablets, not the 10 mg orodispersible product, which is not bioequivalent and cannot be substituted directly. Age alone does not require dose reduction, but increasing to 20 mg needs caution in older men. Moderate hepatic impairment: maximum 10 mg. With erythromycin or clarithromycin: maximum 5 mg. Severe liver impairment and dialysis are contraindications.

The maximum recommended dose is 20 mg per 24-hour period. Levitra should not be taken more than once per day.

A high-fat meal may delay onset. Food effects do not establish superiority over another medicine.

Side effects

As with all medicines, Levitra may cause side effects.

Very common

• Headache

Common

• Dizziness, flushing, nasal congestion and indigestion

Uncommon

• Nausea, visual disturbances, back pain and muscle pain

Serious effects

• An erection lasting more than 4 hours requires emergency care regardless of stimulation.
• Sudden visual changes or hearing loss require stopping Levitra and immediate medical attention. NAION frequency is not known in the cited label.
• Severe hypotension, especially with nitrates, is dangerous; this combination is contraindicated.
• Avoid vardenafil with important QT risk factors such as congenital QT prolongation, hypokalaemia or class IA/III antiarrhythmics.

Consult the full product information.

Levitra vs alternatives

These four product rows represent three active molecules; generic and branded sildenafil are the same molecule. Authorisation does not establish stock. This table is provided for informational purposes only. Clinical suitability must be assessed by a qualified doctor.

Vardenafil and sildenafil have similar durations; molecular potency does not establish clinical superiority. Tadalafil has a longer window, a daily regimen and an indication for BPH, which vardenafil does not have.

Online assessment for Levitra (Vardenafil)

Levitra is a prescription-only medicine (POM) in all EU member states. A valid prescription from a licensed medical professional is required before it can be legally dispensed.

Prescrivia operates as a technology intermediary: we do not prescribe medicines, employ doctors, or sell medicines. Our platform connects patients with independent doctors who can conduct confidential online health assessments.

The process works as follows:

1. Complete a health assessment: Answer structured health questions covering your medical history, current medications, cardiovascular history, and relevant lifestyle factors.
2. Doctor review: An independent doctor reviews your assessment. If vardenafil is clinically appropriate, they may issue a prescription. If it is not appropriate, the doctor will explain why.
3. Prescription and fulfilment: If a prescription is issued, it is sent to a pharmacy partner, responsible for dispensing under applicable national rules; this article does not establish delivery or stock.

Important: Prescrivia does not guarantee that a prescription will be issued. All prescribing decisions are made independently by qualified medical professionals.

Important safety information

Do not use Levitra if you:

• Take nitrates/nitric oxide donors, riociguat, ritonavir or indinavir
• Are over 75 years and take oral ketoconazole or itraconazole
• Have severe liver impairment or end-stage renal disease requiring dialysis
• Have blood pressure below 90/50 mmHg, a heart attack or stroke within 6 months, unstable angina, or cardiac disease for which sex is inadvisable
• Have hereditary degenerative retinal disease or prior loss of vision due to NAION
• Are allergic to vardenafil or an excipient

Avoid these combinations: Oral ketoconazole/itraconazole also should be avoided at other ages. Avoid grapefruit. Avoid vardenafil with congenital QT prolongation, hypokalaemia or class IA/III antiarrhythmics such as quinidine, procainamide, amiodarone or sotalol. These warnings concern vardenafil and its combinations; do not stop another medicine yourself.

Other precautions: Discuss bleeding disorders, active peptic ulcer, sickle cell anaemia, myeloma, leukaemia, penile deformity and renal/hepatic impairment. With alpha-blockers, treatment must first be stable and vardenafil starts at 5 mg; timing differs by alpha-blocker. Do not combine ED treatments or Levitra formulations. Check effects on vision and balance before driving.

In Spain, distance sale of prescription medicines is prohibited under Article 3.5 of Royal Legislative Decree 1/2015. An online assessment does not remove this restriction. Dispensing and access depend on the exact product and applicable national rules.

Sources

Medical information on this page is based on the following sources:

• AEMPS: Levitra film-coated tablets, sections 4.1–4.8.
• AEMPS: Levitra 10 mg orodispersible tablets, section 4.2.

This editorial summary does not replace the full product information. It is provided for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for advice relevant to your individual health circumstances.