Levitra (Vardenafil) 5 mg / 10 mg / 20 mg Tablets: Prescription PDE5 Inhibitor for Erectile Dysfunction — Onset 30–60 Minutes, Duration 4–5 Hours

Reviewed by the Lucas Clinic Medical Team | Updated May 2026

Levitra (vardenafil) is a selective phosphodiesterase type 5 (PDE5) inhibitor approved by the FDA in 2003 for the treatment of erectile dysfunction (ED) in adult males. It is the second member of the PDE5 inhibitor class after sildenafil (Viagra, approved 1998). Vardenafil shares the same fundamental mechanism of action as sildenafil — inhibition of PDE5, the enzyme that degrades cyclic GMP in corporal smooth muscle — but differs in its molecular structure, pharmacokinetic profile, and some tolerability characteristics. In clinical practice, Levitra is most commonly chosen when sildenafil response is partial, when tolerability of sildenafil side effects (particularly visual disturbances) is an issue, or as a patient-specific preference after trialling multiple agents.

Vardenafil is a prescription-only medicine in all markets where it is approved (FDA in US; MHRA/EMA in UK/EU). No OTC vardenafil product is authorised. An interesting variation is Staxyn (orally disintegrating tablet, 10 mg), which is dissolved on the tongue rather than swallowed — useful for patients who have difficulty swallowing tablets or who prefer discretion. Staxyn is not substitutable for Levitra tablet on a mg-per-mg basis as the ODT formulation has a different bioavailability profile (higher Cmax).

What Is Levitra (Vardenafil)?

Vardenafil is a piperazinyl sulfonamyl pyrimidinone derivative, structurally similar to sildenafil. It acts by competitively inhibiting PDE5 with approximately 10-fold higher potency for PDE5 compared to PDE6 (the retinal enzyme) — a slightly improved selectivity ratio versus sildenafil, which may account for the lower incidence of visual side effects (blue tinge, blur) seen with vardenafil. Like all PDE5 inhibitors, vardenafil does not produce an erection in the absence of sexual stimulation — it enhances the response to stimulation by prolonging cGMP-mediated vasodilation in corporal smooth muscle.

Vardenafil's Tmax is approximately 1 hour with an absolute bioavailability of approximately 15% (extensive first-pass hepatic metabolism). Half-life is approximately 4–5 hours, corresponding to a functional window of effect of approximately 4–5 hours. High-fat meals delay absorption and reduce Cmax — vardenafil should ideally be taken on an empty stomach or with a low-fat meal for fastest onset. Alcohol consumption does not dramatically alter vardenafil pharmacokinetics but increases the risk of orthostatic hypotension and impairs erectile function independently.

Prescription vs. Over-the-Counter Status

Levitra and generic vardenafil are prescription-only medicines in the US, UK, EU, and all other major markets. They are not available OTC. Prescriptions can be obtained from a GP, urologist, or registered online telehealth prescriber. The consultation must screen for nitrate use (absolute contraindication), alpha-blocker use (caution — requires dose adjustment), cardiovascular disease, and hypotension. A baseline blood pressure check is advisable. Vardenafil is not suitable for patients with congenital QTc prolongation, hereditary degenerative retinal disorders, or recent myocardial infarction/stroke.

Available Strengths and Forms

Levitra (vardenafil) is available as film-coated tablets in three strengths: 5 mg, 10 mg, and 20 mg. The recommended starting dose is 10 mg taken approximately 60 minutes before anticipated sexual activity. The dose may be titrated to 20 mg (maximum) or reduced to 5 mg depending on efficacy and tolerability. Staxyn (orally disintegrating 10 mg tablet) is an alternative formulation — place on the tongue and allow to dissolve, do not take with liquid. Because Staxyn ODT has higher Cmax, interchangeability with Levitra 10 mg tablets should not be assumed. Generic vardenafil is available from multiple manufacturers in 5/10/20 mg strengths. Patients using CYP3A4 inhibitors (ketoconazole, ritonavir, itraconazole, erythromycin, clarithromycin) may require dose reduction to 5 mg maximum (some inhibitors require a dose cap of 2.5 mg).

Price of Levitra (Vardenafil)

Branded Levitra is no longer widely available in some markets following patent expiry. Generic vardenafil has significantly lowered costs. In the US, brand Levitra is rarely stocked; generic vardenafil 10 mg or 20 mg is available for approximately $8–$25 per tablet at retail pharmacy, or substantially less via manufacturer discount programmes or mail-order pharmacy services. Telehealth ED platforms (Roman, Hims, Keeps, eDrugstore) sometimes offer sildenafil generics more cheaply. Patients can use GoodRx, NeedyMeds, and manufacturer patient assistance programmes to reduce out-of-pocket costs.

Frequently Asked Questions

How does Levitra compare to Viagra (sildenafil)?

Levitra and Viagra share the same mechanism of action (PDE5 inhibition) and similar efficacy across clinical trials — both achieve erections sufficient for intercourse in approximately 65–75% of men with ED in RCTs. Levitra may offer modestly better PDE5 selectivity over PDE6 (lower visual side effects) and less food interaction than sildenafil in some pharmacokinetic studies. Tadalafil (Cialis) differs more notably — 36-hour duration allows spontaneity that neither sildenafil nor vardenafil match. The choice between PDE5 inhibitors is largely guided by patient experience, tolerability, and the prescriber's clinical judgment after initial trials of the standard agent.

Can Levitra be taken with blood pressure medication?

Levitra can be taken with most antihypertensive medications with appropriate monitoring. The key exception is nitrates (GTN, isosorbide mononitrate/dinitrate, amyl nitrite/recreational "poppers") — combining PDE5 inhibitors with nitrates can cause severe life-threatening hypotension and is absolutely contraindicated. Alpha-blockers (tamsulosin, alfuzosin, doxazosin) require care — for most alpha-blockers other than tamsulosin, a lower starting dose of vardenafil (5 mg) is recommended and simultaneous administration should be avoided. For tamsulosin 0.4 mg, the interaction is less marked. ACE inhibitors, ARBs, beta-blockers, and calcium channel blockers are generally compatible with vardenafil with appropriate blood pressure monitoring.

Is vardenafil affected by food?

High-fat meals significantly delay and reduce vardenafil absorption — a high-fat meal can reduce Cmax by approximately 18–50% and delay Tmax by 1 hour. For fastest onset, vardenafil should be taken on an empty stomach or with a low-fat snack. This food interaction is more pronounced than with tadalafil (which is not meaningfully affected by food) and is similar to sildenafil's food effect. Alcohol should be consumed minimally or avoided, as it potentiates the vasodilatory hypotensive effect and independently impairs erectile function.

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