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LEVITRA helps improve erectile function by increasing blood flow to the penis. LEVITRA has helped many men and it may help you, too.

LEVITRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. With a sudden drop in blood pressure, you could get dizzy, faint, or have a heart attack or stroke.

If, like millions of other men, you have noticed changes in your erections, you can do something about it. Talking to your doctor is the first step.

Why Choose LEVITRA

LEVITRA (vardenafil HCl) is an FDA -approved oral prescription medication for the treatment of erectile dysfunction (ED) in men. It belongs to a class of drugs called “PDE5 inhibitors.”

It works by increasing blood flow to the penis to help improve erectile function. The active ingredient in LEVITRA works specifically on the chain of events that occurs in the penis during arousal, when two large chambers in a man’s penis fill with blood.

Indication
LEVITRA is a prescription medicine used for the treatment of erectile dysfunction (ED) in men.

Important Safety Information

  • LEVITRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. With a sudden drop in blood pressure, you could get dizzy, faint, or have a heart attack or stroke.
  • Do not take LEVITRA if you:
    • Take any medications called “nitrates” (often used to control chest pain, also known as angina), or if you use recreational drugs called “poppers” like amyl nitrate and butyl nitrate. Nitrates may cause abnormally low blood pressure and LEVITRA may increase that risk
    • Take riociguat (Adempas ® ), a guanylate cyclase stimulator. a medicine that treats pulmonary arterial hypertension and chronic-thromboembolic pulmonary hypertension
    • Have been told by your healthcare provider not to have sexual activity because of health problems. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease
  • Tell all your healthcare providers that you take LEVITRA. If you need emergency medical care for a heart problem, it will be important for your healthcare provider to know when you last took LEVITRA.
  • LEVITRA does not protect a man or his partner from sexually transmitted diseases, including HIV.
  • Before taking LEVITRA, tell your doctor about all your medical problems, including if you:
    • have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack—ask your doctor if it is safe for you to have sexual activity
    • have low blood pressure or have high blood pressure that is not controlled
    • have pulmonary hypertension
    • have had a stroke
    • have had a seizure
    • or any family members have a rare heart condition known as prolongation of the QT interval (long QT syndrome)
    • have liver problems
    • have kidney problems and require dialysis
    • have retinitis pigmentosa, a rare genetic (runs in families) eye disease
    • have ever had severe vision loss, or if you have an eye condition called non-arteritic anterior ischemic optic neuropathy (NAION)
    • have stomach ulcers
    • have a bleeding problem
    • have a deformed penis shape or Peyronie’s disease
    • have had an erection that lasted more than 4 hours
    • have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
    • have hearing problems
  • Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. LEVITRA and other medicines may affect each other. Especially tell your doctor if you take any of the following:
    • Ritonavir (Norvir ® ) or indinavir sulfate (Crixivan ® ), saquinavir (Fortavase ® or Invirase ® ) or atazanavir (Reyataz ® ), or other HIV protease inhibitors
    • Ketoconazole or itraconazole (such as Nizoral ® or Sporanox ® )
    • Erythromycin or clarithromycin
  • Tell your doctor if you take alpha-blockers. These include Hytrin ® (terazosin HCl), Flomax ® (tamsulosin HCl), Cardura ® (doxazosin mesylate), Minipress ® (prazosin HCl), Uroxatral ® (alfuzosin HCl), or Rapaflo ® (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of PDE5 inhibitor drugs, including LEVITRA, with alpha-blockers can lower blood pressure significantly, leading to fainting.
    • Contact the prescribing physician if alpha-blockers or other drugs that lower blood pressure are prescribed by another healthcare provider
  • Tell your doctor if you take medicines that treat abnormal heartbeat. These include quinidine, procainamide, amiodarone, and sotalol. Patients taking these drugs should not use LEVITRA.
  • Do not use LEVITRA with other medicines or treatments for ED.
  • Take LEVITRA exactly as your doctor prescribes. LEVITRA comes in different doses (2.5 mg, 5 mg, 10 mg, and 20 mg). For most men, the recommended starting dose is 10 mg. Do not take more than one tablet of LEVITRA per day. Doses should be taken at least 24 hours apart. Some men can take only a low dose of LEVITRA because of medical conditions or medicines they take. Your doctor will prescribe the dose that is right for you.
    • If you are older than 65 or have liver problems, your doctor may start you on a lower dose of LEVITRA
    • If you have prostate problems or high blood pressure for which you take medicines called alpha-blockers, your doctor may start you on a lower dose of LEVITRA
    • If you are taking certain other medicines, your doctor may prescribe a lower starting dose and limit you to one dose of LEVITRA in a 72-hour (3-day) period.
  • The most common side effects with LEVITRA are headache, flushing, stuffy or runny nose, indigestion, upset stomach, dizziness, and back pain.
  • LEVITRA may uncommonly cause:
    • An erection that lasts more than 4 hours. Get medical help right away to avoid lasting damage to your penis
    • Color vision changes. such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green
  • In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including LEVITRA) reported a sudden decrease or loss of vision in one or both eyes or a sudden decrease or loss in hearing, sometimes with ringing in the ears and dizziness. It is not possible to determine whether these events are related directly to the PDE5 inhibitors, to other diseases or medications, to other factors, or to a combination of factors. If you experience sudden decrease or loss of vision or hearing, stop taking LEVITRA and contact a doctor right away.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please read the Patient Information and discuss it with your doctor.

The physician Prescribing Information is also available.

NOTE: All trademarks are the property of their respective owners.

Adobe is a registered trademark of Adobe Systems incorporated.

Compare Viagra, Levitra, Cialis

When a man can’t get an erection to have sex or can’t keep an erection long enough to finish having sex, it’s called erectile dysfunction. Erectile dysfunction is the preferred term rather than the more commonly used term of impotence. Sexual dysfunction is often associated with disorders such as diabetes, hypertension, coronary artery disease, neurologic disorders, and depression. In some patients, sexual dysfunction may be the presenting symptom of such disorders. Additionally, ED is often an adverse effect of many medications.

Although there are a number of options available for non-surgical treatment of sexual dysfunction, it is clear that oral therapy has revolutionized the treatment approach to men with erectile dysfunction.

The FDA approved Viagra in 1998, and it became the first oral therapy for erectile dysfunction on the market. Vardenafil hydrochloride (Levitra) was approved in September, 2003, and Tadalafil (Cialis) was approved in November, 2003. Viagra, Levitra and Cialis work in much the same way. These PDE-5 inhibitors share many similarities, but they have differences as well.

Although sildenafil citrate (Viagra), vardenafil HCl (Levitra) and tadalafil (Cialis) sometimes are called sexual enhancers, they do not directly cause an erection of the penis, but alter the body’s response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area.

PDE-5 inhibitors can be used to treat sexual dysfunction caused by high blood pressure, problems affecting nerve function, prostate surgery, side effects of medicines, emotional or psychological ED. Although they work in the similar way, they are not the same in all respects. Sildenafil and vardenafil have similar molecular structures, but tadalafil is structurally different.

  • The success rate of sildenafil amounts to an average of over 80%.
  • Several studies have shown a benefit of Viagra (sildenafil) for women with sexual arousal disorder, including an increased ability to lubricate, achieve orgasm, and experience sexual satisfaction.
  • Onset of action: 30-60 minutes.
  • Duration of action: up to 4 h.
  • Fatty food is known to delay the absorption of Viagra.
  • Contraindicated in persons taking organic nitrates; alpha-blockers (in the current labeling the interaction is considered a Precaution.)
  • Vision disturbances are more common after taking Viagra, than after other PDE-5 inhibitors. In July 2005, the FDA found that sildenafil could lead to vision impairment in rare cases and a number of studies have linked sildenafil use with nonarteritic anterior ischemic optic neuropathy.
  • The patent on Viagra expires in the early 2012.
  • Vardenafil is more potent and selective biochemically than other PDE-5 inhibitors.
  • Onset of action: 25 minutes (the quickest).
  • Duration of action is up to 5-6 hours, little longer than that reported for Viagra.
  • Not recommended in patients taking type 1A (such as quinidine, or procainamide) or type 3 antiarrhythmics (such as sotalol, or amiodarone).
  • The advantage that vardenafil has over sildenafil is that it does not alter color perception, a rare side effect which occurs with sildenafil (because vardenafil does not inhibit phosphodiesterase-6).
  • Vardenafil is contraindicated in patients taking organic nitrates, alpha-blockers (in the current labeling the interaction is considered a Precaution).
  • Fatty food delays the absorption of vardenafil. However, it is less sensitive than Viagra to food intake.
  • The patent on Levitra expires in 2018.
  • The most astounding feature of tadalafil is its length of action. It has long half life, which ensures 36-hour duration of effectiveness, allowing for more flexibility and spontaneity in sexual relations. This feature greatly distinguishes Cialis from its two predecessors Viagra and Levitra.
  • Onset of action: 16 to 30 minutes.
  • Tadalafil has the lowest prevalence of visual side effects. However, the myalgia seems to be more common with tadalafil, approaching 10%.
  • Tadalafil is contraindicated in patients taking organic nitrates, alpha-blockers.
  • Cialis is protected by a patent until 2016.

From a safety perspective, all three Viagra, Levitra and Cialis share similar drug interactions involving CY3A4 inhibitors and a contraindication in the use of nitrates. The side effects are similar for all three PDE-5 inhibitors and include headache, flushing, nasal congestion, and dyspepsia.

Which is better Viagra, Cialis or Levitra?

Cialis clearly works for 36 hours or more, making it an ideal choice for men who are very sexually active.

For men who develop angina and therefore might require an organic nitrate (such as nitroglycerine), the longer duration of action is a disadvantage. Also, some people are uncomfortable having the active ingredient in their system for an extended period of time.

Levitra works a little longer than Viagra, and gives a quite sufficient window of effectiveness for spontaneous sexual experience. Vardenafil is the most potent molecule of all PDE-5 inhibitors and works better in hard-to-treat cases of impotence [2].

Viagra clearly works for women with sexual arousal disorder [1].

Implicit advantage of Viagra: Many men have been ordering high-dose pills and splitting them, because Pfizer’s Viagra blue pills are pretty large (14mm) and easy to split.

Levitra, a small hard orange 8mm pill, is much more difficult to cut. Cialis 12mm pills are also inconvenient to split because of their asymmetrical almond shape.

Keep in mind that you don’t have to make a definitive choice and stay on one ED medication all the time. You can choose all three and alternate between them depending on your requirements. For example, Viagra or Levitra on weekdays and Cialis on weekend or holiday.

  • 1. Schoen C, Bachmann G. Sildenafil citrate for female sexual arousal disorder: a future possibility? Nat Rev Urol. 2009 Apr;6(4):216-22.
  • 2. Wang HY, Huang YF. Vardenafil for refractory erectile dysfunction: the latest advances. Zhonghua Nan Ke Xue. 2009 Nov;15(11):1035-8.

Last Updated: December 14, 2013

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