Levitra is a prescription medicinal product indicated for the treatment of erectile dysfunction in adult men. Erectile dysfunction is defined as the consistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. The active substance in Levitra is vardenafil, a selective inhibitor of phosphodiesterase type 5.
This document provides comprehensive, educational information intended to support safe and informed use of Levitra as of early 2026. It does not replace consultation with a licensed healthcare professional and should be read in conjunction with medical advice.
Therapeutic Indication
Levitra is indicated exclusively for men diagnosed with erectile dysfunction. The condition may result from vascular, neurological, hormonal, psychological, or mixed causes. Vardenafil improves erectile response regardless of the underlying etiology, provided sexual stimulation is present.
The medication does not cure erectile dysfunction and does not increase libido. Its therapeutic effect is limited to facilitating a physiological response to sexual arousal.
Pharmacological Properties
Vardenafil belongs to the class of phosphodiesterase type 5 inhibitors. These agents act by enhancing the natural erectile mechanism through selective inhibition of the PDE5 enzyme, which regulates blood flow in the corpus cavernosum.
During sexual stimulation, nitric oxide is released from nerve endings and endothelial cells in penile tissue. This stimulates the synthesis of cyclic guanosine monophosphate, which leads to smooth muscle relaxation and increased arterial blood flow. PDE5 degrades cyclic guanosine monophosphate, terminating the erectile response.
By inhibiting PDE5, vardenafil prolongs the activity of cyclic guanosine monophosphate, thereby supporting erection maintenance for a limited duration. Sexual stimulation remains necessary for the medication to exert its effect.
Pharmacokinetics
After oral administration, vardenafil is rapidly absorbed. Maximum plasma concentrations are generally achieved within 30 to 120 minutes. The presence of a high-fat meal may delay absorption and slow the onset of action.
Vardenafil is extensively metabolized in the liver, primarily via the CYP3A4 enzyme system, with minor contributions from CYP3A5 and CYP2C isoforms. The elimination half-life is approximately four to five hours in healthy adults.
Excretion occurs mainly as metabolites via feces and, to a lesser extent, urine.
Dosage and Method of Administration
The recommended starting dose for most adult men is Levitra 10 mg taken orally approximately 30 to 60 minutes before anticipated sexual activity. Dose adjustment should be based on individual efficacy and tolerability.
Levitra should be taken no more than once within a 24-hour period. Tablets are intended for oral use and should be swallowed whole with water. Crushing or splitting tablets is not recommended.
| Patient group | Recommended initial dose | Maximum dose |
|---|---|---|
| Adults under 65 years | 10 mg | 20 mg once daily |
| Adults 65 years and older | 5 mg | 20 mg once daily |
| Mild to moderate hepatic impairment | 5 mg | 10 mg once daily |
| Severe hepatic impairment | Use not recommended | Not applicable |
Timing and Food Interaction
Levitra may be taken with or without food. However, high-fat meals can delay the onset of action by reducing the rate of absorption. For faster onset, administration on an empty stomach or after a light meal is preferred.
Moderate alcohol consumption is unlikely to significantly affect the pharmacological action, but excessive intake may reduce erectile response and increase the risk of adverse reactions.
Duration of Effect
The therapeutic effect of Levitra typically lasts between four and six hours. The duration may vary depending on individual metabolic rate, age, comorbid conditions, and concomitant medication use.
Levitra does not cause a continuous erection and does not remain active beyond its pharmacological window.
Important Use Considerations
- Do not exceed the prescribed dose
- Do not combine with other erectile dysfunction treatments without medical approval
- Seek medical evaluation if erectile dysfunction persists despite treatment
Availability Information
Details on how to buy Levitra through licensed pharmacies are provided in our internal reference guide: Levitra prescription and access information.
Contraindications
Levitra must not be used in patients with known hypersensitivity to vardenafil or any of the excipients. The medication is contraindicated in men for whom sexual activity is inadvisable due to underlying cardiovascular conditions.
Concurrent use with nitrates or nitric oxide donors is strictly contraindicated, as this combination may result in a significant and potentially life-threatening decrease in blood pressure.
Drug Interactions
Vardenafil is metabolized primarily by the cytochrome P450 3A4 enzyme system. Medications that inhibit or induce this pathway may alter plasma concentrations and affect safety or efficacy.
| Interacting substance | Clinical relevance |
|---|---|
| Nitrates and nitric oxide donors | Severe hypotension risk, combination prohibited |
| Alpha-blockers | Risk of symptomatic hypotension, medical supervision required |
| Strong CYP3A4 inhibitors | Increased vardenafil exposure, dose adjustment necessary |
| Antihypertensive agents | Additive blood pressure lowering effect possible |
Patients should disclose all prescription medications, over-the-counter products, and supplements to their healthcare provider prior to initiating therapy.
Warnings and Precautions
Levitra should be used with caution in patients with anatomical deformation of the penis, conditions predisposing to priapism, or a history of prolonged erections. Any erection lasting longer than four hours requires immediate medical attention.
Sudden vision loss or hearing impairment has been reported rarely in association with PDE5 inhibitors. Patients experiencing such symptoms should discontinue use and seek urgent medical evaluation.
Use in Special Populations
Elderly patients may exhibit increased sensitivity to vardenafil due to reduced metabolic clearance. Initiation at the lowest effective dose is recommended in this population.
Patients with renal impairment generally do not require dose adjustment, although clinical monitoring is advised. In patients with hepatic impairment, particularly moderate to severe cases, reduced dosing or avoidance may be necessary.
Levitra is not indicated for use in women or individuals under 18 years of age.
Adverse Reactions
Adverse reactions associated with Levitra are typically dose-dependent and transient. Most reported events are mild to moderate in intensity and resolve without intervention.
- Headache and facial flushing
- Nasal congestion and sinus discomfort
- Dyspepsia and gastrointestinal discomfort
- Dizziness or lightheadedness
Serious adverse reactions are uncommon but may include priapism, cardiovascular events, or severe hypersensitivity reactions. Immediate discontinuation and medical evaluation are required if serious symptoms occur.
Overdose
In the event of overdose, supportive measures should be initiated as required. Dialysis is unlikely to accelerate clearance, as vardenafil is highly protein bound.
Patients experiencing severe adverse effects following overdose should seek emergency medical care.
Storage and Handling
Levitra should be stored at room temperature, protected from excessive moisture and heat. Tablets should be kept in their original packaging and out of reach of children.
Patient Guidance
Successful treatment of erectile dysfunction often requires both pharmacological therapy and management of contributing lifestyle factors. Patients are encouraged to address cardiovascular risk factors, maintain a healthy weight, and manage stress.
Regular follow-up with a healthcare provider is recommended to assess effectiveness, tolerability, and the continued appropriateness of therapy.
Summary
As of early 2026, Levitra remains a well-established and effective treatment option for erectile dysfunction when used according to prescribed guidelines. Proper patient selection, adherence to dosing recommendations, and awareness of contraindications are essential for safe and effective use.
Frequently Asked Questions
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Kari Quickenden, Pharm.D., RPh.