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Vardenafil, also known by the brand name Levitra, is a prescription medication that treats male erectile dysfunction.

Erectile dysfunction is when a man is unable to get or sustain an erection.

It usually happens because the arteries that carry the blood to the penis are too narrow.

Its action is similar to that of sildenafil, or Viagra, but Viagra lasts between 2 and 4 hours, while Levitra lasts 4 hours.

Share on Pinterest Vardenafil can help a man get and maintain an erection.

During a penile erection, the penis fills with blood. The blood vessels that supply the penis with blood expand, or dilate, and the vessels that take blood away from the penis contract.

The two large chambers in the penis, known as the corpus cavernosa, fill with blood. As the blood accumulates in the penis, an erection results. Vardenafil belongs to a class of drugs called phosphodiesterase type-5 (PDE5) inhibitors.

A PDE5 inhibitor stops PDE5 from constricting the arteries. By relaxing the arteries, vardenafil enhances blood flow when a man is sexually aroused.

The active ingredient works on the chain of reactions within the penis during arousal. When a male is sexually aroused, nitric oxide is released into his penis, and this triggers a chain of reactions. This causes an enzyme, guanylate cyclase, to produce cyclic guanosine monophosphate (cGMP). cGMP regulates the contraction and dilation, or expansion, of blood vessels that carry blood to and from the penis. The chemical reaction causes the vessels that supply the penis to dilate, while those removing blood from the penis contract. Phosphodiesterase-5 (PDE5), another enzyme breaks down or destroys cGMP. When cGMP is destroyed, the blood vessels return to their normal size, effectively ending the erection.

Visit Back2BU for the latest updates and information on BU's response to COVID-19. Students can find additional information in the Undergraduate Student Guide and Graduate & Professional Student Guide. Goals Center for Sexual Medicine Faculty and Staff Make an Appointment For Health Care Professionals Training Opportunities. The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction.

The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED. Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors.

Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction.

Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction.

Little attention has been paid to endocrine factors. Testosterone modulates desire, arousal and orgasmic function. Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra).

If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly.

The physician should also check the patient’s testosterone level.

One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra).

When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly.

Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression.

There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil (Viagra). Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil (Cialis), vardenafil (Levitra), yohimbine, phentolamine, trazodone, apomorphine and neutraceuticals.

PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people.

In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesn’t work. Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects. Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues.

Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects. Tadalafil is very specific for PDE5 and is also very specific for the enzyme PDE11.

Unfortunately, we don’t know much about PDE11, which is found in the heart, in the pituitary gland in the brain and in the testicles. Pharmacokinetics, half-life, is how long the medication stay s in the blood.

Sildenafil (Viagra) has a half-life of 4 hours and vardenafil (Levitra) has a half-life of 4-6 hours while tadalafil (Cialis) has a half-life of 17.5 hours.

This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known.

Tadalafil (Cialis) has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication. The drawback is if you need nitrates after using tadalafil (Cialis), this medication lasts a long time in your blood stream and may place you at a higher risk. Younger people might do well treated with tadalafil, (Cialis) while older people with other health issues might be better off using sildenafil (Viagra) or vardenafil (Levitra) but more data are needed.

The side effects of vardenafil (Levitra) are potentially less than sildenafil (Viagra), but more data are needed.

In a recent study on men with erectile dysfunction and diabetes, vardenafil (Levitra) improved their erectile dysfunction.

Tadalafil (Cialis) is as effective as sildenafil (Viagra), and vardenafil (Levitra) with similar side effects except for back pain that occurs occasionally with tadalafil, probably because of the long half-life.

Many people stop taking drugs because they are experiencing side effects, they no longer have a partner, or they are worried about safety.

Sexual activity is not a major contributor to the risk of a heart attack.

Sexual activity, with or without sildenafil (Viagra) increases the chance of an MI during sexual activity by only 0.1%. If pills fail, there are vacuum devices, Muse, injections, bypass surgery and implants. The patient making a presentation has had penile bypass surgery.

In addition he takes testosterone and sildenafil as needed.. This is a classic example of why people with ED need complete care: a psychological exam, history and physical exam, and diagnostic studies with long term follow-up care. Patients with ED should not just be prescribed sildenafil (Viagra) and then be lost to follow-up.

Tadalafil and vardenafil are phosphodiesterase-5 (PDE5) inhibitor used to treat impotence (the inability to attain or maintain a penile erection) Tadalafil is also used to treat symptoms of benign prostatic hyperplasia (BPH). Brand names for tadalafil include Adcirca and Cialis.

Brand names for vardenafil include Levitra and Staxyn ODT.

Side effects of tadalafil and vardenafil that are similar include facial flushing (reddening), headaches, stomach upset, diarrhea, flu-like symptoms, nausea, low blood pressure, blurred vision, changes in color vision, and abnormal ejaculation.

Side effects of vardenafil that are different from tadalafil include chest pain and priapism (painful erection lasting more than 6 hours). Tadalafil is a phosphodiesterase-5 (PDE5) inhibitor used to treat impotence (the inability to attain or maintain a penile erection) and benign prostatic hyperplasia (BPH). Other PDE5 inhibitors include sildenafil (Viagra) and vardenafil (Levitra). Sexual stimulation that leads to an erection causes the production and release of nitric oxide in the penis, which causes the enzyme guanylate cyclase to produce cyclic guanosine monophosphate (cGMP).

cGMP is responsible for increasing and decreasing the size of blood vessels carrying blood to and from the penis and causing an erection.

When phosphodiesterase-5 enzyme destroys cGMP, the blood vessels return to their normal size, blood leaves the penis, and the erection ends.

Tadalafil prevents PDE5 from destroying cGMP so cGMP stays around longer which leads to a more prolonged erection. It is unclear how tadalafil improves symptoms of BPH, but PDE5 is also present in the muscles of the bladder and the prostate, and it is believed that the relaxation of these muscles may make the passage of urine less difficult by reducing the pressure in the muscle surrounding the opening to the urethra that controls the flow of urine from the bladder.

Vardenafil is a phosphodiesterase-5 (PDE5) inhibitor used to treat impotence, the inability to attain or maintain a penile erection.

It has a mechanism of action that is similar to sildenafil (Viagra), and tadalafil (Cialis). Penile erection is caused by the engorgement of the penis with blood that occurs when the blood vessels delivering blood to the penis increase in size and blood vessels carrying blood away from the penis decrease in size.

Sexual stimulation that leads to the engorgement and erection causes the production and release of nitric oxide in the penis.

Nitric oxide then activates the enzyme guanylate cyclase to produce cyclic guanosine monophosphate (cGMP) that is primarily responsible for increasing and decreasing the size of the blood cialis coupon costco vessels carrying blood to and from the penis. Vardenafil prevents an enzyme called phosphodiesterase-5 (PDE-5) from destroying cGMP so that cGMP persists longer. The longer cGMP persists, the more prolonged the engorgement of the penis.

What are the side effects of tadalafil and vardenafil?

facial flushing (reddening), headaches, stomach upset, diarrhea, flu-like symptoms, and nausea. Tadalafil also may cause low blood pressure, blurred vision, changes in color vision, and abnormal ejaculation.

The most common side effects of vardenafil are facial flushing (reddening), headaches, stomach upset, diarrhea, flu like symptoms, and nausea. Vardenafil also may cause chest pain, low blood pressure, blurred vision and changes in color vision, abnormal ejaculation and priapism (painful erection lasting more than 6 hours).

Patients should seek immediate medical help if they experience an erection lasting more than 4 hours. Rare cases of sudden loss of hearing have been reported with phosphodiesterase inhibitors such as vardenafil, sometimes associated with ringing in the ears and dizziness. If changes in hearing occur, patients should discontinue their vardenafil and seek immediate medical attention.

For most individuals, the recommended starting dose of tadalafil is 10 mg per day taken before sexual activity (tadalafil for use as needed). Depending on the adequacy of the response or side effects, the dose may be increased to 20 mg or decreased to 5 mg a day.

Individuals who are taking medications that increase the blood levels of tadalafil should not exceed a total dose of 10 mg in 72 hours (See drug interactions).

For once daily use without regard to sexual activity the recommended dose is 2.5 to 5 mg daily.

Tadalafil should not be taken more than once daily. The recommended dose for BPH, or BPH and ED is 5 mg daily taken about the same time each day. Tadalafil may be taken with or without food since food does not affect its absorption from the intestine.

The dose of tadalafil may require adjustment for patients with reduced kidney or liver function. For most individuals, the recommended dose of vardenafil regular tablets is 10 mg per day taken 60 minutes before intercourse. If there is no response or side effects, the dose may be increased to 20 mg or, if there are side effects, it may be reduced to 5 mg.

Individuals 65 years of age or older should begin therapy with 5 mg.

Individuals who are taking medications that increase the blood levels of vardenafil should start treatment with 2.5 to 5 mg of vardenafil.

(See drug interactions.) Orally disintegrating tablets (ODT) are not interchangeable with regular vardenafil tablets because they are better absorbed and produce higher blood levels than regular tablets.

The recommended dosing when using ODT is one tablet 60 minutes before intercourse.

It should be placed on the tongue until it disintegrates and should not be swallowed with water.

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The breakdown and elimination of tadalafil from the body may be decreased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir).

Therefore, these drugs may increase the levels of tadalafil in the blood. If these drugs are being used at the same time as tadalafil, the dose of tadalafil should be reduced to 10 mg every 72 hours when used as needed or 2.5 mg when used daily in order to avoid side effects from high levels of tadalafil.

Rifampin, carbamazepine (Tegretol, Tegretol XR, Equerto, Carbatrol), phenytoin (Dilantin, Dilantin-125), and phenobarbital may decrease blood levels of tadalafil, possibly reducing the effect of tadalafil. Tadalafil exaggerates the increases in heart rate and lowering of blood pressure caused by nitrates, for example, nitroglycerin, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating heart pain (angina). In patients who take nitrates for angina, tadalafil could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure. Therefore, tadalafil should not be used with nitrates. Tadalafil also exaggerates the blood pressure lowering effects of some alpha-blocking drugs for example, terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate (BPH).