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Levitra (vardenafil hydrochloride) is an oral medication taken to treat erectile dysfunction (ED). It’s in the same class of drugs as other popular ED medications, including Viagra and Cialis.

But how does Levitra compare to other common ED treatments? Let’s get into how it’s used to treat ED, how it stacks up against other medications, and what side effects and precautions you should be aware of.

Levitra, like Viagra and Cialis, is what’s called a phosphodiesterase type 5 (PDE5) inhibitor.

These types of medications work by blocking your body’s production of an enzyme called PDE5 that’s part of the reason ED happens.

Here’s how Levitra is intended to help with ED:

  • Typically, an erection starts to happen (physically speaking) when nerves in your penis are stimulated by touch. Then nitric oxide is released, generating substances that help your smooth muscles begin to relax and allow blood to flow into the corpora cavernosa. This is the two shaft-like pieces of spongy cylindrical tissue that run along the top of your penis. This extra blood flow is ultimately what causes your penis to grow and harden.
  • With ED, your nerves don’t properly relay the signals between your penis and brain that allow nitric oxide to be released and your muscles to relax. As a result, blood can’t flow into your penis and give you an erection. This also happens because overactive PDE5 enzymes quickly break down the substances that nitric oxide releases to help you get an erection, making it difficult for the smooth muscles in your penis to relax.
  • Levitra blocks PDE5 from breaking down the substances produced by nitric oxide that allow the smooth muscles in your penis to relax. Blood can then flow more easily into the penis tissues and give you an erection.

There’s a lot of research about the effectiveness of PDE5 inhibitors in general as well as on Levitra.

A 2009 review of research on Levitra found that the medication is generally effective for helping people with ED quickly and reliably get erections when they’re sexually stimulated that lasted long enough for satisfying sex.

The review also noted that Levitra was especially helpful for people who had ED that resulted from:

  • diabetes
  • high blood pressure
  • dyslipidemia (high amount of fat in the bloodstream)
  • aging, one of the factors most correlated with ED

A 2018 study of 61 men with sleep apnea (another risk factor for ED) observed the effects of both Levitra and the use of a continuous positive airway pressure (CPAP) machine over a 12-week period.

The study suggests that the continuous use of a low dose of Levitra (about 10 mg) and a CPAP machine together can result in more consistent erections and sexual satisfaction.

Levitra is also known for its “fast-acting” effects. On average, people who use Levitra report that it starts working after less than an hour.

Most people also report that they can continue to have an erection for up to 5 hours after taking it. That’s because it stays in your bloodstream for about this long before it begins to leave your body through sweat and urine.

Levitra is similar to other PDE5 inhibitors like Viagra, Cialis, and Stendra, but it has different dosing schedule and duration.

Here’s a breakdown of how Levitra stacks up against these other common ED medications. Talk to your doctor if you’re not sure which one will work best for your overall health and lifestyle, especially when it comes to sex.

BrandViagraCialisLevitraStendra
Generic namesildenafiltadalafilvardenafil avanafil
Generic version?yesyesyesno
How it’s takenoral tabletoral tabletoral tabletoral tablet
Doses available25 mg, 50 mg, 100 mg2.5 mg, 5 mg, 10 mg, 20 mg5 mg, 10 mg, 20 mg50 mg, 100 mg, 200 mg
Usual dose you take50 mg10 mg (when used as needed); 2.5 mg (when used daily)10 mg; 5 mg (for men 65 years old and up)100 mg
When it’s taken for best resultsHalf an hour to 1 hour before sexHalf an hour before sex (as needed); or the same time daily1 hour before sex100/200 mg: 15 minutes before sex; 50 mg: 30 minutes before sex
How long it lasts4 hoursup to 2.5 daysUp to 5 hoursAbout 6 hours
How to store68°F–77°F (20°C–25°C)77°F (25°C)77°F (25°C)68°F–77°F (20°C–25°C)

Levitra can be taken as either a 5 mg or 10 mg oral tablet.

It’s best taken about an hour or so before sex so that it has time to metabolize for better results once you’re sexually stimulated.

You should only take Levitra once a day right before you plan to have sex. If you’d prefer to have sex more than once a day, ask your doctor about other ED medications that allow for a dosing schedule that will work better for you.

Here are some of the possible side effects of Levitra:

  • stuffy nose
  • headaches
  • dizziness
  • stomachache
  • gas and bloating
  • flushing and redness
  • pain in your lower back
  • confusion or disorientation

Priapism is a rare side effect that happens when you have a single erection that lasts 4 hours or more. This can be dangerous because blood can pool in the penis and lose oxygen, making your erection painful and damaging tissue.

Blurred vision or even losing your sight in one or both eyes is another rare reported side effect of Levitra and other common ED medications.

Call your doctor right away if you experience priapism or severe forms of any of the symptoms listed above. These can all be signs of a medical emergency.

Drug interactions

Levitra can also interact with certain medications and cause dangerous side effects. Some medications can’t be taken with PDE5 inhibitors at all, but others may be taken together with Levitra at lower doses.

Don’t take Levitra if you’re taking any of the following medications without first consulting with your doctor:

Some conditions or lifestyle choices may make it risky for you to use Levitra or other PDE5 inhibitors.

Children under 18 and pregnant people should never take Levitra for any reason. Anyone older than 65 may also need to ask their doctor about reducing the dosage of Levitra to lower their risk for side effects.

Some other risk factors for side effects from Levitra include:

  • drinking alcohol (increases chance of dizziness and passing out)
  • drinking grapefruit juice (can cause too much of the medication to pass into your bloodstream)

Don’t take Levitra without consulting with a doctor if you’ve been diagnosed with any of the following conditions, as the medication can have dangerous interactions with them:

  • high blood pressure
  • heart attack
  • stroke
  • reduction or loss of liver function
  • abnormal penis shape that results from conditions like Peyronie’s disease or cavernosal fibrosis
  • prostate conditions

Here are some of the pros and cons of using Levitra, as reported by users of the medications:

Pros

  • It works quickly after being taken.
  • It doesn’t need to be taken with food and may work better on an empty stomach.
  • It can replace higher doses of other PDE5 inhibitors like Viagra that may carry higher risk of side effects.
  • Many users report very hard erections that may happen multiple times in the course of the day.

Cons

  • Like many other PDE5 inhibitors, it can only be taken once a day.
  • It can have disruptive side effects, such as headaches or vision changes.
  • It may become less effective if you gain or lose significant amounts of weight.
  • The onset of erection may vary widely from 1 hour to as much as 3 hours.
  • The erections may not last long if you have other risk factors for ED, such as obesity and nutrient deficiencies.
  • Side effects like flushing, stuffy nose, and stomach pain are relatively common.
  • Taking it along with pain medications like Norco can reduce chances of maintaining an erection.
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Levitra doesn’t have to be your only treatment for ED. There are other diet and lifestyle changes you can make along with taking Levitra to help treat your ED symptoms, including:

  • reducing or stopping alcohol use
  • reducing or quitting smoking
  • keeping your weight at a healthy level
  • getting enough sleep every night (6 to 9 hours) at consistent times
  • exercising regularly for 15 to 20 minutes a day, especially aerobic exercises like running and swimming that help improve oxygen levels in your blood
  • trying pelvic floor exercises
  • using a penis pump

Like other PDE5 inhibitors, Levitra is often a relatively safe and effective way to treat ED along with dietary and lifestyle changes.

Just keep in mind that ED medication alone can’t always resolve ED symptoms. There are sometimes other, less obvious reasons for an inability to get or keep an erection that are out of your control.

Talk to your doctor or urologist to help uncover any underlying physical or psychological causes of ED that may be causing your symptoms. A combination of treatments may help you to have satisfying sex again.