Vardenafil — evidence‑based review (general information, not medical advice)
Disclaimer: This article is for educational purposes only. It does not replace advice from a licensed healthcare professional. Always consult a clinician before starting or changing any medication.
Quick summary
- Vardenafil is a prescription medication used to treat erectile dysfunction (ED).
- It belongs to a drug class called phosphodiesterase‑5 (PDE‑5) inhibitors.
- Strong clinical evidence shows it can improve erectile function in many men when used appropriately.
- It works by improving blood flow during sexual stimulation; it does not increase desire.
- Like similar drugs, it can cause side effects and has important drug interactions.
What is known
What vardenafil is
Vardenafil is an oral medication approved in many countries for the treatment of erectile dysfunction.
It is commonly known by the brand name Levitra® and is chemically similar to sildenafil (Viagra®) and tadalafil (Cialis®).
How it works (mechanism of action)
Erections depend on increased blood flow to penile tissue. Vardenafil blocks the enzyme
phosphodiesterase‑5 (PDE‑5), which normally breaks down a signaling molecule (cGMP)
responsible for relaxing blood vessels.
By slowing this breakdown, vardenafil helps maintain blood vessel relaxation and blood flow
when sexual stimulation is present. It does not cause an erection on its own.
Effectiveness according to studies
Randomized controlled trials consistently show that vardenafil improves erectile function scores
compared with placebo in men with ED of various causes, including:
- Age‑related erectile dysfunction
- Diabetes‑associated ED
- ED after prostate surgery (with variable response)
Improvements are typically measured using validated questionnaires such as the
International Index of Erectile Function (IIEF).
Onset and duration
Clinical data suggest that vardenafil begins to work in many users within 30–60 minutes.
Its effects generally last several hours, shorter than tadalafil but comparable to sildenafil.
Common side effects
Side effects are usually mild to moderate and related to blood vessel dilation. Commonly reported effects include:
- Headache
- Flushing
- Nasal congestion
- Indigestion
- Dizziness
Serious risks and contraindications
Vardenafil should not be used together with nitrate medications (used for chest pain),
as this combination can cause a dangerous drop in blood pressure.
Caution is also advised in people with certain heart rhythm conditions, recent cardiovascular events,
or those taking medications that affect heart conduction.
What is unclear / where evidence is limited
-
Long‑term comparative superiority: Evidence does not clearly show that vardenafil is
consistently better than other PDE‑5 inhibitors; individual response varies. -
Effects in severe neurological ED: Data are limited for men with spinal cord injury
or advanced neurological disease. - Use in women: Vardenafil is not approved for women, and evidence for benefit is insufficient.
-
Daily low‑dose strategies: Unlike tadalafil, long‑term daily dosing of vardenafil
has not been well studied.
Overview of approaches
Erectile dysfunction is often multifactorial. Management typically involves addressing
underlying contributors as well as considering medication.
Lifestyle and health optimization
- Managing blood pressure, diabetes, and cholesterol
- Reducing smoking and excessive alcohol use
- Improving sleep and physical activity
Medication‑based approaches
Vardenafil is one of several PDE‑5 inhibitors. Others include sildenafil and tadalafil.
Choice often depends on side‑effect profile, timing preferences, and individual response.
Typical dosing ranges and administration instructions are described in official prescribing information,
such as the FDA‑approved vardenafil label. Any dosing decisions must be made
with a healthcare professional.
Non‑drug options
- Psychological or sex therapy when stress or anxiety is a major factor
- Vacuum erection devices
- Other medical or surgical options in refractory cases
| Statement | Confidence level | Why |
|---|---|---|
| Vardenafil improves erectile function in many men with ED | High | Supported by multiple randomized controlled trials and guidelines |
| It works only with sexual stimulation | High | Consistent pharmacological mechanism across PDE‑5 inhibitors |
| One PDE‑5 inhibitor is clearly superior to others | Low | Head‑to‑head trials show mixed results and individual variability |
| Long‑term daily use has proven additional benefits | Low | Limited long‑term studies specifically for vardenafil |
Practical recommendations
When to consider seeing a doctor
- Erectile difficulties persist for more than a few months
- ED appears suddenly or worsens quickly
- There are symptoms of heart disease, diabetes, or hormonal disorders
How to prepare for a consultation
- List all current medications and supplements
- Note cardiovascular history and prior reactions to ED medications
- Be open about lifestyle factors and mental health
General safety tips
- Use only prescription‑grade medication from legitimate sources
- Avoid combining with nitrates or recreational “poppers”
- Seek urgent care for chest pain, severe dizziness, or prolonged erections
For related background reading, see our overview on erectile dysfunction basics,
comparisons of PDE‑5 inhibitor options, and guidance on
talking to your doctor about sexual health.
Sources
- U.S. Food and Drug Administration (FDA). Vardenafil prescribing information.
- European Association of Urology (EAU). Guidelines on Sexual and Reproductive Health.
- American Urological Association (AUA). Erectile Dysfunction Clinical Guidelines.
- National Institutes of Health (NIH). MedlinePlus: Vardenafil.
