What Is Vardenafil?

Uses and risks of Vardenafil, or Levitra

Vardenafil, also known by the brand name Levitra, is a prescription medication that treats male erectile dysfunction.

Erectile dysfunction is when a man is unable to get or sustain an erection. It usually happens because the arteries that carry the blood to the penis are too narrow.

Vardenafil increases blood flow to the penis.

Its action is similar to that of sildenafil, or Viagra, but Viagra lasts between 2 and 4 hours, while Levitra lasts 4 hours.

How does it work?

During a penile erection, the penis fills with blood.

The blood vessels that supply the penis with blood expand, or dilate, and the vessels that take blood away from the penis contract. The two large chambers in the penis, known as the corpus cavernosa, fill with blood.

As the blood accumulates in the penis, an erection results.

Vardenafil belongs to a class of drugs called phosphodiesterase type-5 (PDE5) inhibitors. A PDE5 inhibitor stops PDE5 from constricting the arteries.

By relaxing the arteries, vardenafil enhances blood flow when a man is sexually aroused.

The active ingredient works on the chain of reactions within the penis during arousal.

When a male is sexually aroused, nitric oxide is released into his penis, and this triggers a chain of reactions.

This causes an enzyme, guanylate cyclase, to produce cyclic guanosine monophosphate (cGMP).

cGMP regulates the contraction and dilation, or expansion, of blood vessels that carry blood to and from the penis. The chemical reaction causes the vessels that supply the penis to dilate, while those removing blood from the penis contract.

Phosphodiesterase-5 (PDE5), another enzyme breaks down or destroys cGMP.

When cGMP is destroyed, the blood vessels return to their normal size, effectively ending the erection. Vardenafil stops PDE5 from destroying cGMP. In this way, it allows cGMP to work for longer. As a result, it helps prolong an erection.

Dose and usage

Vardenafil is available in tablets of 2.5 milligrams (mg), 5 mg, 10 mg, and 20 mg. The first dose is normally 10 mg.

A 10-mg dose of vardenafil is approximately equivalent to 50 mg of sildenafil, or Viagra. This is because the chemical composition of vardenafil is different from that of sildenafil.

Vardenafil is taken 25 to 60 minutes before sex. The effect lasts for up to 5 hours. A maximum of one tablet can be used every 24 hours.

Orodispersible tablets must be left to dissolve on the tongue before swallowing. They should not be taken with any kind of drink.

The drug will not work unless the man is sexually aroused, so foreplay will normally be necessary.

Vardenafil can be taken with or without food, but drinking alcohol is not advised, as it reduces the chance of getting an erection. Alcohol can also increase the risk of adverse effects.

Cautions

As with all medications, adverse effects and interactions can occur when using vardenafil.

One in 10 men will experience headache.

Other common side effects include:

  • stuffy or runny nose
  • stomach upset
  • dizziness
  • flushing

In most cases, these disappear within a few hours.

Other potentially serious symptoms include:

  • ringing in the ears, or sudden hearing loss
  • irregular heartbeat
  • swelling in the ankles, hands, or feet
  • difficulty breathing
  • chest pain

The patient should stop using vardenafil if these occur.

Rarely, an allergic reaction may occur. This can lead to hives, difficulty breathing, and swelling of the face, tongue, and throat. It can lead to shock, and it can be fatal. If these symptoms appear, it should be treated as a medical emergency.

Priapism

Very rare side effects may include priapism, when an erection lasts longer than 4 hours. This can damage the penis. If an erection lasts too long, the individual should seek medical attention.

Visual disturbances

Visual disturbances can happen when blood pressure drops in the eye. The individual may see a blue tinge to objects, and they may have difficulty distinguishing between the colors green and blue.

Very rarely, there may be a sudden deterioration in vision in one or both eyes. This can indicate a heart condition, an existing eye problem, high cholesterol, diabetes, or hypertension.

If any sudden loss of vision occurs, the individual should stop taking the medication and seek medical help immediately.

Vision problems are most likely in patients with other conditions, such as heart or coronary artery disease, diabetes, and high cholesterol. Vision problems are more likely to happen if the person smokes, or if they are aged over 50 years.

Interactions

Using vardenafil with some other drugs can lead to serious adverse effects.

Possible reactions include:

  • a potentially dangerous drop in blood pressure, or hypotension
  • dizziness
  • fainting

There is also a risk of stroke and heart attack.

A man should not use vardenafil if he is taking nitrate drugs, such as riociguat (Adempas), or other nitrate drugs for chest pain or heart problems.

It should not be used with the recreational drugs, amyl nitrate and butyl nitrate, also known as poppers.

Other drugs that may interact include, but are not limited to:

  • antibiotic and antifungal medications
  • other medications for erectile dysfunction
  • drugs for prostate problems, blood pressure, or heart rhythm disorders
  • medications for HIV or AIDS

Grapefruit juice contains a chemical that makes adverse effects more likely, so it should not be consumed while using vardenafil.

Things to know

Patients should tell their doctor about all their medical conditions and any other medications or supplements they use before taking vardenafil.

This is especially important if they have:

  • a deformity in the shape of the penis, such as Peyronie’s disease
  • a heart condition, such as arrhythmia, heart failure, or angina
  • a family history of a rare heart condition known as long QT syndrome
  • hearing problems
  • hemophilia or some kind of bleeding problem
  • hypotension (low blood pressure) or hypertension (high blood pressure)
  • liver or kidney problems
  • multiple myeloma, leukemia, sickle cell anemia, or some other kind of blood cell problem
  • non-arteritic anterior ischemic optic neuropathy (NAION)
  • damage to the retina of the eye
  • stomach ulcers
  • retinitis pigmentosis, a rare genetic eye disease

They should also tell the doctor if they have ever experienced priapism, a seizure, or if they have recently had a stroke or a heart attack.

Levitra is available to purchase online, but users should consider the above points and check with their health provider first.

If any adverse effects occur, users are encouraged to report them to the FDA.

Levitra Effects

Uses

Vardenafil is used to treat male sexual function problems (impotence or erectile dysfunction-ED). In combination with sexual stimulation, vardenafil works by increasing blood flow to the penis to help a man get and keep an erection.

This drug does not protect against sexually transmitted diseases (such as HIV, hepatitis B, gonorrhea, syphilis). Practice “safe sex” such as using latex condoms. Consult your doctor or pharmacist for more details.

How to use Levitra

Read the Patient Information Leaflet provided by your pharmacist before you start taking vardenafil and each time you get a refill. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor, usually as needed. Take vardenafil, with or without food, about 1 hour before sexual activity. Do not take more than once daily. Doses should be taken at least 24 hours apart.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Avoid eating grapefruit or drinking grapefruit juice while using this medication unless your doctor or pharmacist says you may do so safely. Grapefruit can increase the chance of side effects with this medicine. Ask your doctor or pharmacist for more details.

Tell your doctor if your condition does not improve.

Side Effects Levitra

Headache, flushing, stuffy/runny nose, or dizziness may occur. Vision changes such as increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart may also occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Sexual activity may put extra strain on your heart, especially if you have heart problems. If you have heart problems and experience any of these serious side effects while having sex, stop and get medical help right away: severe dizziness, fainting, chest/jaw/left arm pain, nausea.

Rarely, sudden decreased vision, including permanent blindness, in one or both eyes (NAION) may occur. If this serious problem occurs, stop taking vardenafil and get medical help right away. You have a slightly greater chance of developing NAION if you have heart disease, diabetes, high cholesterol, certain other eye problems (“crowded disk”), high blood pressure, if you are over 50, or if you smoke.

Rarely, a sudden decrease or loss of hearing, sometimes with ringing in the ears and dizziness, may occur. Stop taking vardenafil and get medical help right away if these effects occur.

In the rare event you have a painful or prolonged erection lasting 4 or more hours, stop using this drug and get medical help right away, or permanent problems could occur.

Get medical help right away if you have any very serious side effects, including: fast/irregular heartbeat, seizures, temporary memory loss.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking vardenafil, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart problems (such as heart attack or life-threatening irregular heartbeat in the past 6 months, chest pain/angina, heart failure), stroke in the past 6 months, kidney disease (dialysis), liver disease, high or low blood pressure, a severe loss of body water (dehydration), penis conditions (such as angulation, fibrosis/scarring, Peyronie’s disease), history of painful/prolonged erection (priapism), conditions that may increase the risk of priapism (such as sickle cell anemia, leukemia, multiple myeloma), eye problems (such as retinitis pigmentosa, sudden decreased vision, NAION), bleeding disorders, active stomach ulcers.

Vardenafil may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using vardenafil, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using vardenafil safely.

This drug may make you dizzy or cause vision changes. Alcohol or marijuana can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above).

This medication is not usually used in women. Therefore, it is unlikely to be used during pregnancy or breast-feeding. Consult your doctor if you have any questions about this medication.