Vardenafil

Vardenafil is a prescription medicine that treats erectile dysfunction (ED) – sometimes called impotence. This is when a man cannot get, or keep, an erection that is hard enough for satisfactory sexual activity. Vardenafil belongs to a group of medicines called PDE5 inhibitors (the same family as sildenafil, tadalafil and avanafil). It works by relaxing and widening the blood vessels in your penis, allowing more blood to flow in when you become sexually aroused. A very important point: vardenafil only works if you are sexually stimulated. It is not an aphrodisiac – it does not increase your sex drive or produce an erection on its own. Vardenafil is available in the UK under several brand names, including Levitra, Vivanza and Staxyn. However, most doctors now prescribe it as generic vardenafil, which contains exactly the same active ingredient at a lower cost.

Your body has a natural chemical system that controls erections. When you are sexually aroused, your body releases a substance called nitric oxide, which starts a chain reaction. It produces a chemical called cGMP that widens the blood vessels in your penis, allowing blood to flow in and create an erection. At the same time, your body also produces an enzyme called PDE5, whose job is to “turn off” the erection once it is no longer needed by breaking down the cGMP. Vardenafil works by temporarily blocking that PDE5 enzyme. By preventing the breakdown of cGMP, the erection can last longer and stay firmer. Think of it as gently holding the door open a bit longer. The medicine does not create an erection out of nothing – it simply helps your natural system work better. This is why you still need to be sexually aroused for it to have any effect.

Vardenafil is intended to be taken “on demand” – meaning you take it only when you plan to have sex. It is not for continuous daily use. When to take it Take your tablet approximately 25 to 60 minutes before you plan to have sex. You can take it anywhere from 25 minutes up to 4 to 5 hours before sexual activity, and it can still be effective. How to take the tablet Swallow the tablet whole with a glass of water. You can take it with or without food. However, a heavy or fatty meal can delay the medicine from being absorbed, so it may take longer to work. To get the best effect, it is best to take it on an empty stomach or after a light meal. How often can you take it? You should take no more than one tablet in any 24‑hour period. Do not take two tablets close together – it will not make the medicine work better, but it will increase your risk of side effects. What if you want to take it regularly, not just “as needed”? Some men with very frequent ED (having sex several times a week) may be prescribed a 5 mg once‑daily dose. This provides a background level of treatment that allows them to be ready whenever the moment arises. If you take it this way, you need to continue for at least several weeks to properly assess whether it is working. Your doctor will advise you on the best schedule for your situation.

Vardenafil comes in three standard strengths: 5 mg, 10 mg and 20 mg. 5 mg – A lower dose, usually prescribed if you struggle with side effects from the 10 mg tablet, or for the once‑daily regimen. 10 mg – The standard starting dose for most men. This is what doctors usually recommend first because it works well for the majority of people while keeping side effects manageable. 20 mg – The maximum strength. It is used for men who have tried 10 mg and found that it does not work well enough, but who tolerate the medicine without troublesome side effects. Do not start with 20 mg unless a doctor or pharmacist has told you to. The maximum recommended dose is 20 mg. How do you know if your dose is right? If 10 mg works well for you – you get a firm erection with acceptable side effects – then stick with it. If 10 mg works but not quite well enough, your doctor may suggest increasing to 20 mg. If 10 mg gives you unpleasant side effects (such as bad headaches or flushing), your doctor may suggest reducing to 5 mg. If 10 mg does not work at all – you feel no effect even after several attempts – then vardenafil may not be the right medicine for you. Speak to your doctor. They may suggest a different ED treatment, such as tadalafil or sildenafil. Never change your dose on your own. Always speak to a doctor or pharmacist first.

Once you take vardenafil, it starts working within 25 to 60 minutes. The effect typically lasts for 4 to 5 hours, which gives you a good window of opportunity without being as long‑acting as tadalafil (which lasts up to 36 hours). What if you take it and it doesn’t work? There are several possible reasons: You were not sufficiently sexually aroused. Vardenafil is not an aphrodisiac. You still need to be turned on by touch, kissing, or other stimulation. You took it on a very full stomach. A heavy, fatty meal can delay absorption so much that the medicine does not reach a high enough level in your blood to work well. You have an underlying medical problem that vardenafil cannot overcome, such as very low testosterone levels, nerve damage from diabetes or surgery, or severe blood vessel disease. You are taking other medicines that interfere with vardenafil. Some medicines (such as certain antibiotics or antifungals) can reduce how well vardenafil works. If you have taken vardenafil exactly as directed on several occasions and you still cannot get or keep an erection firm enough for sex, you should speak to your doctor. There are other treatments available.

Most people tolerate vardenafil well, but side effects can occur. The good news is that they are usually mild and go away on their own. Common side effects – these affect more than 1 in 50 users (≥2%): Headache – this is the most common side effect. It is usually mild and can be treated with paracetamol or ibuprofen, but do not take nitrates for it. Flushing – redness and warmth of your face and neck. Nasal congestion – a stuffy or runny nose. Indigestion (dyspepsia) – you may feel a burning sensation in your upper stomach or behind your breastbone. Dizziness – a feeling of being lightheaded or unsteady. Nausea (feeling sick) . Back pain – this is less common than with tadalafil, but it can occur. Less common side effects (affect up to 1 in 100 users): Sinusitis (inflammation of your sinuses) Flu‑like symptoms Increased creatine kinase (an enzyme measured in blood tests; this is usually harmless) Serious side effects (rare but you need to know about them) : Priapism – a painful erection that will not go away. This is rare, but if you have an erection that lasts more than 4 hours, you must seek emergency medical attention immediately. If it is not treated, priapism can cause permanent damage to your penis and lead to long‑term erectile dysfunction. This is a medical emergency, not something to wait out. Sudden vision loss in one or both eyes – this can be a sign of a rare but serious condition. If you experience sudden loss of vision, stop taking vardenafil and seek medical help urgently. Visual disturbances, including vision loss (temporary or permanent), have been reported rarely. Sudden hearing loss – some people have reported a sudden decrease or loss of hearing, sometimes accompanied by ringing in the ears (tinnitus) or dizziness. If this happens, stop taking vardenafil and contact a doctor. Heart attack – very rare, but the risk may be increased in men with pre‑existing heart disease. If you develop chest pain during sex, stop sexual activity and seek medical attention. Severe allergic reaction – swelling of your face, lips, tongue or throat, or difficulty breathing. This is very rare, but if it happens, seek emergency medical help immediately. When to seek medical help: If you develop an erection that lasts more than 4 hours. If you lose your vision suddenly. If you develop chest pain, severe dizziness or nausea during sex. Stop sexual activity and seek medical attention immediately. If you develop sudden hearing loss or ringing in your ears.

There are several groups of people who must not take vardenafil. This is very important. Do NOT take vardenafil if: You take any medicine called a nitrate. Nitrates are prescribed for chest pain (angina). Common nitrate medicines include glyceryl trinitrate (GTN) , isosorbide mononitrate, isosorbide dinitrate, and nicorandil. Taking vardenafil with a nitrate can cause your blood pressure to drop suddenly and dangerously, leading to fainting, heart attack, or even death. You take “poppers” – amyl nitrite, often sold as a recreational drug, is also a nitrate. If you use poppers, you must not take vardenafil. The combination can be fatal. You have been advised by a doctor to avoid sexual activity because of a heart problem. If you have unstable angina, severe heart failure, or have had a heart attack or stroke within the last six months, you should not take vardenafil. You have low blood pressure (hypotension) or uncontrolled high blood pressure (hypertension) . You have a rare inherited condition that prolongs the QT interval (a measure of your heart’s electrical activity). Vardenafil can prolong the QT interval, which increases the risk of a serious heart rhythm disturbance called torsade de pointes. You are allergic to vardenafil or any of the other ingredients in the tablet. You do not have an erection problem. Vardenafil will not provide any benefit to a man with normal erectile function. You are a woman. Vardenafil is not indicated for use by women.

Yes, vardenafil can interact with several other medicines. Some interactions are dangerous, while others are manageable. Dangerous interactions (do not take vardenafil at all): Nitrates – as described above. This is absolute. Amyl nitrite (“poppers”) – also absolute. Interactions that need caution (tell your doctor before starting vardenafil): Alpha‑blockers – medicines such as doxazosin, tamsulosin (Flomax) , terazosin, alfuzosin, and silodosin. These are often prescribed for high blood pressure or for prostate problems (benign prostatic hyperplasia). Combining vardenafil with an alpha‑blocker can cause a drop in blood pressure that leads to dizziness or fainting. If you take an alpha‑blocker, vardenafil should only be started if you have been stabilised on your alpha‑blocker therapy. The starting dose should be 5 mg. Potent or moderate CYP3A4 inhibitors – medicines such as erythromycin, clarithromycin, itraconazole, ketoconazole, voriconazole, and HIV protease inhibitors (such as ritonavir). These can increase the level of vardenafil in your blood, leading to a greater risk of side effects. Your doctor will usually start you on a lower dose. Other PDE5 inhibitors – do not take vardenafil together with other ED medicines such as sildenafil (Viagra) or tadalafil (Cialis). Using more than one type at the same time will not improve the effect but will greatly increase the risk of side effects. What about anticoagulants (blood thinners)? There is no significant interaction between vardenafil and common blood thinners such as warfarin or apixaban. However, always tell your doctor about all medicines you are taking. What about alcohol? Drinking large amounts of alcohol can lower your blood pressure and make it harder to get an erection. It may also increase the risk of dizziness or lightheadedness when combined with vardenafil. Moderate drinking (one or two units) is generally fine.

You need to be careful. You should discuss vardenafil with your doctor or pharmacist if you have any of the following: Heart problems – such as a recent heart attack (within the last 90 days), unstable angina (chest pain that comes on unpredictably or at rest), severe heart failure, or an irregular heartbeat (arrhythmia). High blood pressure that is not well controlled or low blood pressure. A stroke or transient ischaemic attack (TIA) within the last 6 months. Liver problems (such as cirrhosis or hepatitis). You may need a lower dose. Severe kidney problems (including those on dialysis). You may need a lower dose. A physical deformity of the penis – such as Peyronie’s disease (where the penis is curved) or any other condition that could make erections painful. A blood disorder – such as sickle cell anaemia, multiple myeloma, or leukaemia. These conditions increase the risk of priapism. A rare eye disease called retinitis pigmentosa – which runs in families. A stomach ulcer – vardenafil can sometimes cause indigestion or aggravate an existing ulcer. A bleeding disorder – such as haemophilia. If you have any of these conditions, you may still be able to take vardenafil, but your doctor will need to start you on a lower dose (5 mg) and monitor you carefully.

There is no clear evidence that taking vardenafil reduces fertility in men. However, if you are trying to conceive with a partner, speak to your doctor before taking it.

In the UK, vardenafil is a prescription‑only medicine. You cannot buy it over the counter without a prescription. However, you can get a prescription for vardenafil through: Your NHS GP – but NHS prescriptions for erectile dysfunction are usually limited to men with specific medical conditions such as multiple sclerosis, Parkinson's disease, or a spinal cord injury. The regulations were originally introduced in 1998 and have not significantly changed since. A private prescription from a doctor or an online pharmacy – you will need to pay the full cost of the medicine. This is the most common route for most men. The 10 mg strength is also available to purchase over the counter (OTC) from a pharmacy following a consultation with the pharmacist in England and Scotland. You should never buy vardenafil from unregulated online sellers or from friends. Counterfeit ED medicines are common and can contain dangerous substances, including industrial dyes, floor wax, or even other drugs that could harm you. The MHRA has seized millions of illegal ED pills in recent years. Always buy from a registered pharmacy – either in person or from a legitimate online pharmacy that is registered with the General Pharmaceutical Council.

Store below 25°C (room temperature) in a dry place, away from direct sunlight and heat. Keep the blister pack or bottle in its outer carton to protect it from moisture. Keep the medicine out of the sight and reach of children. Do not use the tablets after the expiry date printed on the packaging. The active ingredient becomes less effective over time. If you have any leftover tablets, do not throw them away in household waste or pour them down the sink. Take them to your local pharmacy, where they will be disposed of safely.