Vardenafil (generic Levitra®)

Vardenafil is a prescription tablet used to treat erectile dysfunction (ED) in adult men. It belongs to a class of medications called PDE5 inhibitors and works by increasing blood flow during sexual stimulation. Vardenafil is the active ingredient in the branded medication Levitra, and is available here as a clinically equivalent generic at a more affordable price.

Available in three strengths: 5mg, 10mg, and 20mg. The 10mg tablet is the standard recommended starting dose for most men. Vardenafil is taken 30 to 60 minutes before sexual activity and can remain effective for up to eight hours.

Vardenafil is a phosphodiesterase type 5 (PDE5) inhibitor. During sexual stimulation, the body releases nitric oxide in the penile tissue, which activates an enzyme that produces cyclic guanosine monophosphate (cGMP). cGMP causes the smooth muscle in the blood vessels of the penis to relax, allowing increased blood flow and the development of an erection. The enzyme PDE5 breaks down cGMP and reduces this effect. Vardenafil works by inhibiting PDE5, allowing cGMP to accumulate and sustain the relaxation of penile smooth muscle, which supports the ability to achieve and maintain an erection in response to sexual stimulation.

Vardenafil does not cause an erection independently. Sexual stimulation is still required for it to be effective. It works within 30 to 60 minutes of taking a tablet and its effects typically last for up to eight hours, which is somewhat longer than sildenafil (Viagra) and provides a useful window of time without requiring the rigidity of timing associated with shorter-acting PDE5 inhibitors.

Vardenafil is available in three strengths to allow your prescribing pharmacist to match the dose to your individual needs and response.

Vardenafil 5mg: The lowest available strength, typically used when a lower starting dose is clinically appropriate, such as in men who are older, have mild ED, or are taking medications that may interact at higher doses.

Vardenafil 10mg: The standard recommended starting dose for most adult men with ED. This is the most commonly prescribed strength and represents the dose used in the majority of clinical trials.

Vardenafil 20mg: The higher strength, used when the 10mg dose has not provided a sufficient clinical response and has been well tolerated. Should only be taken on the advice of your prescribing pharmacist.

Dose: Take one tablet as directed by your prescribing pharmacist, typically 30 to 60 minutes before anticipated sexual activity.

Frequency: Vardenafil should not be taken more than once in any 24-hour period.

Food: Vardenafil can be taken with or without food. A high-fat meal may delay the onset of action slightly, so taking it on an empty stomach or after a light meal is preferable if rapid onset is desired.

Alcohol: Avoid excessive alcohol consumption when taking vardenafil. Moderate alcohol is generally tolerated but heavy drinking can impair the ability to achieve an erection and increase the risk of side effects such as dizziness and low blood pressure.

Sexual stimulation: Vardenafil requires sexual stimulation to be effective. It does not produce an automatic erection.

Starting dose: Most men begin with the 10mg tablet. Your prescribing pharmacist may recommend starting on 5mg if you are over 65, have certain medical conditions, or are taking medications that affect how vardenafil is processed. Do not increase your dose without clinical guidance.

Common side effects of vardenafil include headache, facial flushing, nasal congestion or runny nose, indigestion, and dizziness. These are generally mild and temporary and are shared across all PDE5 inhibitors to varying degrees.

Less common side effects include visual disturbances, back pain, and muscle aches.

A rare but serious side effect is priapism, a prolonged erection lasting more than four hours that is not associated with sexual stimulation. This is a medical emergency requiring immediate attention as it can cause permanent damage if untreated. If this occurs, seek emergency medical care immediately.

Rare cases of sudden hearing loss or vision changes including loss of vision in one eye have been reported with PDE5 inhibitors. If you experience either of these, stop taking vardenafil and seek immediate medical attention.

If any side effect becomes severe or persistent, contact your prescribing pharmacist.

• Nitrates: Vardenafil must never be taken alongside nitrate medications, including glyceryl trinitrate (GTN spray or tablets), isosorbide mononitrate, or isosorbide dinitrate. The combination causes a dangerous and potentially fatal drop in blood pressure. This is an absolute contraindication.
• Alpha-blockers: Caution is required when taking vardenafil alongside alpha-blocker medications used for high blood pressure or prostate conditions, as the combination can also cause a significant drop in blood pressure. Inform your prescribing pharmacist if you take any alpha-blocker.
• Cardiovascular conditions: Vardenafil is not recommended for men with severe cardiovascular disease, unstable angina, recent heart attack or stroke (within the last six months), or uncontrolled high or low blood pressure. Sexual activity itself places demands on the cardiovascular system, and your prescribing pharmacist will assess your suitability during the consultation.
• Liver and kidney impairment: Dose adjustment may be necessary for men with moderate hepatic impairment or severe renal impairment. Vardenafil is not recommended in severe liver disease.
• QT prolongation: Vardenafil has been shown to prolong the QT interval in some individuals. It should not be used in men with congenital QT prolongation syndrome or those taking medications that also prolong QT.
• Age: Vardenafil is for adult men only. It is not suitable for use in women or children.
• Drug interactions: Always disclose all medications including prescription drugs, over-the-counter products, and supplements during your consultation. Vardenafil is metabolised by the CYP3A4 enzyme and certain medications including antifungals, HIV protease inhibitors, and some antibiotics can significantly increase vardenafil blood levels, requiring dose reduction or avoidance.
• Vision conditions: Men with a history of non-arteritic anterior ischaemic optic neuropathy (NAION) should use vardenafil with caution and should disclose this during consultation.

• What is vardenafil used for? Vardenafil is a prescription PDE5 inhibitor used to treat erectile dysfunction in adult men. It works by increasing blood flow during sexual stimulation and is available in 5mg, 10mg and 20mg strengths. It is the generic equivalent of the branded medication Levitra and contains the same active ingredient at the same concentration.
• What is the difference between vardenafil and Levitra? Vardenafil and Levitra contain the same active ingredient, vardenafil hydrochloride, at the same strengths and work in exactly the same way. Levitra is the original branded version. Generic vardenafil is the more affordable equivalent and is subject to the same regulatory standards. Both are equally effective.
• How quickly does vardenafil work? Vardenafil typically begins to work within 30 to 60 minutes of taking a tablet. Effects can last for up to eight hours, though this varies between individuals. Taking the tablet on an empty stomach or after a light meal may produce a faster onset compared to taking it after a heavy, high-fat meal.
• What dose of vardenafil should I take? The standard recommended starting dose for most adult men is 10mg. Your prescribing pharmacist may recommend starting on 5mg if clinically appropriate, or increasing to 20mg if the 10mg dose has been insufficient and well tolerated. Do not adjust your dose without guidance from your prescribing pharmacist.
• How often can I take vardenafil? Vardenafil should not be taken more than once in any 24-hour period.
• Can I take vardenafil with alcohol? Moderate alcohol consumption is generally tolerated, but excessive alcohol should be avoided as it can worsen erectile dysfunction and increase the risk of side effects such as dizziness and low blood pressure.
• Can I take vardenafil with other medications? Vardenafil must not be taken with nitrate medications as this combination can cause a dangerous drop in blood pressure. Caution is also required with alpha-blockers and certain other medications. Always disclose all current medications during your consultation.
• Is a prescription needed for vardenafil? Yes. Vardenafil is a prescription-only medication. At My London Pharmacy, you can obtain a prescription following a short online consultation reviewed by our UK-registered independent prescribing pharmacist. No GP appointment is required.
• How will my treatment be monitored? Your prescribing pharmacist will review your treatment at each renewal through a short follow-up questionnaire. This covers side effects, effectiveness, any new medical conditions, and any changes to your other medications. You are only charged when you actively confirm your next supply.
• Is vardenafil the same as Viagra or Cialis? Vardenafil, sildenafil (Viagra), and tadalafil (Cialis) are all PDE5 inhibitors that work by the same mechanism but are distinct molecules with different pharmacokinetic profiles. Vardenafil has a similar duration of action to sildenafil (around 8 hours) but may have a slightly faster onset in some men. Tadalafil has a significantly longer duration of up to 36 hours and is also available as a daily low-dose option. Your prescribing pharmacist can discuss which PDE5 inhibitor is most suitable for your circumstances.