Levitra is an FDA-approved erectile dysfunction (ED) medication manufactured by Bayer.
The active ingredient (vardenafil) is also sold under the brand name Vivanza.
Levitra is very similar to Viagra and Cialis. All three drugs work by promoting blood flow to the penis to facilitate an erection.
Here, we’ll discuss everything you should know about Levitra before you use it.
We cover how it works, how much it costs, and where to buy it.
We even break down some of the most important research about the medication and offer tips on how to use the drug safely and when to avoid it altogether.
What is Levitra?
Levitra is the brand name for an erectile dysfunction medication called vardenafil. It’s used to increase hardness and correct impotence. Some studies have also shown Levitra can help with premature ejaculation.
The active ingredient — vardenafil — is used in a few other brand-name drugs, including Staxyn and Vivanza. The chemical structure is nearly identical to sildenafil — the active ingredient in Viagra.
In the early days of Levitra development, Bayer was granted a 20 year patent over the drug — preventing other manufacturers from making their own versions of the drug.
The patent protecting Bayer from competition has since expired. Today, you can find vardenafil medications in generic form from dozens of other manufacturers.
What’s the Dose of Levitra?
Levitra comes in three doses — 5 mg, 10 mg, and 20 mg.
Most doctors will start their patients on the standard 10 mg dose and wait to see how their patients respond before adjusting to the higher or lower dosage form.
Levitra should only be used once per day on an as-needed basis.
How Long Does it Take for Levitra to Start Working?
Levitra takes about 1 hour to start producing results and lasts anywhere from 4 to 6 hours.
This drug doesn’t induce erection on its own. You’ll still need to be aroused for the drug to work.
How Much Does Levitra Cost?
Levitra comes in packs of 10. The price can vary widely, but the average cost for a 20 mg tablet is around $454.54. This makes the cost per pill close to $45 USD. The price for the 5 mg and 10 mg pills are around the same amount.
Most health insurance plans will cover some or all of the cost of Levitra, and you can also find discounts on the medication at some online pharmacies.
Generic vardenafil is cheaper on average — costing around $17 per tablet when you buy them in packs of 30.
It pays to shop around for your Levitra because the cost of these little yellow tablets can vary substantially from one supplier to another.
The country you live in can also affect the cost of Levitra. The company prices the drug based on local competition, the average income of the area, and prevalence of erectile dysfunction.
The History of Levitra
Levitra was first developed by Bayer. In 2001, the company first announced it had a promising new candidate for treating erectile dysfunction. This development came over a decade after the first erectile dysfunction drug — Viagra — was first discovered, but only three years after it was released to the public.
Around the same time, Bayer filed for a patent on its new drug — which it called vardenafil. The company then joined forces with another pharmaceutical giant — GlaxoSmithKline (GSK), to market and distribute the new drug worldwide.
GSK was also involved in the early marketing efforts of Cialis but was eventually bought out by Eli Lilly for the full owner of the drug.
It took nearly two years after Bayer and GSK joined together before the drug was approved for sale in the European Union, Latin America, and the United States.
Just two years later, in 2005, Bayer severed it’s marketing cooperation with GSK and took full control over the drug.
For the next 13 years, Levitra was sold under the brand names Levitra (Bayer) and Vivanza (GSK) until the patents protecting the drug from the generic market expired.
Today, Levitra remains the most popular form of vardenafil, while Vivanza and generic versions made by independent manufacturers make up the rest of the market.
Who Should Take Levitra?
Levitra is indicated for one application only — erectile dysfunction. Off-label uses include treatment for premature ejaculation and athletic enhancement (neither are approved uses of the drug).
This medication is prescription-only — which means that to get ahold of Levitra yourself, you’ll need to visit a doctor for a written prescription.
Your doctor will weigh the benefits of the drug with your level of risk. They’ll assess your current medications to see if any potential drug interactions would exclude you from being able to safely use the drug.
In some cases, your doctor will need to change one or more of your current medications before using Levitra safely. If this is the case, you may need to change the medication first, wait a week or two, and then start using the Levitra once your doctor is sure the medication change hasn’t lead to other downstream health effects.
Levitra Safety & Side Effects
While Levitra is generally regarded as safe by the FDA and other regulatory agencies — it’s not without any side effects.
The side effects and safety considerations of Levitra are the same as any other PDE5 inhibitor medications — including Cialis, Vivanza, and Viagra. Therefore, if you experience side effects on any of these other medications, it’s unlikely Levitra will be any different.
This primary cause for concern with Levitra is its effects on blood pressure. The drug works by relaxing the arteries that supply blood to the penis. However, it can also affect other arteries as well. When the arteries relax, blood pressure drops.
If you already suffer from low blood pressure or use antihypertensive medications — blood pressure may fall too low. This results in dizzy episodes or fainting.
The second main concern of Levitra from a safety standpoint is hearing loss or eye damage. This is because PDE5 is abundant not only in the penis but also in the eyes and ears. People with underlying conditions affecting the eye and ears may be at a higher risk when using Levitra.
Side Effects of Levitra May Include:
- Priapism (<1% of users)
- Nausea (1.2% of users)
- Dizziness/Lightheadedness (1.6% of users)
- Headaches (10.4% of users)
- Nasal Congestion (4% of users)
- Flushing or Sweating (11.3% of users)
- Abdominal or Lower Back Pain (<1% of users)
- Edema/Swelling (<1% of users)
- Vision Disturbances (<1% of users)
- Hearing Loss (<1% of users)
- Skin Rash (<1% of users)
Drugs That May Interact with Levitra
Some medications don’t mix well with Levitra or other PDE5 inhibitors.
Here, we’ll cover some of the main negative drug interactions to be aware of before using Levitra:
1. Nitroglycerine & Other Nitrates
Nitroglycerine and nitrate medications are used to dilate the coronary arteries. They’re used to treat angina and coronary artery disease.
The coronary arteries feed blood to the heart. When these arteries become blocked, it can result in a heart attack.
Nitrate medications are exceptionally strong vasodilators. Combined with Levitra, it can cause a rapid drop in blood pressure — leading to side effects.
Anybody using nitrate medications will not be prescribed Levitra, Viagra, or Cialis.
2. CYP3A4 Inhibitors
Most drugs are eventually metabolized by the liver into smaller, water-soluble compounds, which can then get filtered out of the body by the kidneys.
The liver contains a series of enzymes known as the cytochrome 450 (CYP450) isoenzymes. These enzymes are responsible for metabolizing drugs, hormones, and metabolic byproducts produced by the body.
Each enzyme acts on a particular type of molecule. Some enzymes can pull apart nitrogen rings like caffeine — others are better at breaking apart sulfur-based molecules.
Every medication you take is metabolized by a specific CYP450 enzyme group. Levitra is broken down by the CYP3A4 enzymes.
If other medications that also require this enzyme class are used at the same time as Levitra, it can lead to a backup in the liver — making it much slower at metabolizing each medication.
Therefore, Levitra is not recommended for use with other known CYP3A4 medications, which include:
- HIV Protease inhibitors (indinavir, ritonavir, saquinavir, or atazanavir)
- Antifungals (ketoconazole, and itraconazole)
- Antibiotics (erythromycin)
Grapefruit is also a well-known CYP3A4 inhibitor to avoid while using Levitra or other PDE4 medications.
3. CYP3A4 Inducers
The same concept works in the other direction.
Some drugs have a stimulating effect on the CYP3A4 enzymes, which can make the liver break down and metabolize Levitra too quickly. This would make the effects of the drug much less potent, and can dramatically shorten the duration of effects.
Some CYP3A4 Inducers Include:
4. Anti-Hypertensive Medications
Hypertension means high blood pressure. There are many different forms of anti-hypertensive medicine, and not all have a negative interaction with Levitra.
The problem with blood pressure medications and Levitra is that both drugs have similar side effects. When taken together, these effects can become stronger — resulting in a sudden drop in blood pressure.
When blood pressure falls too low, the heart can’t pump enough oxygen-rich blood into the brain, making us feel dizzy or confused.
The most problematic antihypertensive drugs your doctor will need to review before prescribing Levitra include:
- Angiotensin-converting enzyme (ACE) inhibitors
- ACE II receptor blockers
- Calcium channel blockers
Who Should Avoid Using Levitra?
Some patients will be denied a prescription to Levitra based on their medication program or underlying health conditions:
- Patients using nitrate medications (including amyl nitrite “poppers” or nitroglycerine)
- Patients with a history of non-arteritic anterior ischaemic optic neuropathy (NAION) or a “crowded retina”
- Patients with vascular disorders of the ear and eardrum
- Patients with a history of allergy to vardenafil or related medications
- Patients taking HIV protease inhibitor medications
- Patients using the antifungals ketoconazole or itraconazole
How Does Levitra Work?
Levitra works similarly to Cialis and Viagra by blocking an enzyme called PDE5 (phosphodiesterase type 5).
Blocking this enzyme allows the blood vessels in the penis to relax — allowing blood to rush into erectile tissue called the corpora cavernosa. As blood pools in this region, an erection forms.
One of the most common causes of erectile dysfunction is a reduction in blood flow through the arteries supplying blood to the penis.
The signal of arousal is initiated in the brain, sent down the nerves to the penis, but the arteries cannot expand enough to cause an erection.
Problems with the arteries can be caused by heart disease, diabetes, high cholesterol, high blood pressure, or other underlying health conditions. It also occurs as a normal side effect of the aging process as testosterone levels naturally decline.
Dilating the arteries in the penis relies on the activity of a compound called cGMP. This compound causes the blood vessels to relax and widen to allow more blood to flow through. This chemical is then broken down by enzymes also present in the arteries.
The penis is especially high in the PDE5 enzyme, which targets cGMP. By blocking this enzyme with drugs like Levitra, cGMP levels rise, lowering the threshold for the chemical to relax the arteries.
Levitra does not increase sexual desire. An erection will only occur if the user is aroused.
Medical Research & Levitra
Both Bayer and GSK have invested a ton of capital into the research and development of vardenafil (Levitra and Vivanza).
To date, there have been nearly a dozen large-scale clinical trials on the drug. Some studies seek to explore the safety of the drug. Other studies investigate the effectiveness of the drug for premature ejaculation, erectile dysfunction, and several other applications.
Here are some of the highlights of this research:
Study #1: The Efficacy and Safety of Flexible-Dose Vardenafil (Levitra®) in a Broad Population of European Men
The goal of this study was to assess the impact of flexible dosing of vardenafil to see what impact it had on the effectiveness of the drug.
In this study, 323 men were randomly assigned either 10 mg vardenafil or a placebo (sugar pills). After four weeks, patients were given the option to switch to the 5 mg or 20 mg pill or remain on the 10 mg pill (both treatment and placebo group given this option). The study was then continued for another four weeks to measure any changes.
Throughout the study, 86% of men in the treatment group reported improvement in getting and maintaining an erection. Compare this to just 33% improvement in the placebo control group.
The study found that flexible dosing appeared to improve the effects of the drug. The largest improvement was noted in the group that increased the dose to 20 mg. Improvements were also reported in patients who reduced the dose to 5 mg.
Study #2: Vardenafil for Treatment of Men With Erectile Dysfunction: Efficacy and Safety in a Randomized, Double‐blind, Placebo‐controlled Trial
This study was one of several phase III clinical trials that lead to the approval of Levitra for use in Europe and the United States.
The aim of this study was to identify whether the active ingredient — vardenafil — was able to improve erection status in men.
The study was tightly controlled and rolled out over 54 health clinics in the United States and Canada.
Over 26 weeks, 805 men diagnosed with erectile dysfunction were given either a placebo (197 patients), 5 mg verdenafil (205 patients), 10 mg vardenafil (206 patients), or 20 mg vardenafil (197 patients).
Here’s the Study Results Breakdown:
|5 mg vardenafil
|10 mg vardenafil
|20 mg vardenafil
|Number of Patients Starting
|Dropouts Due to Side Effects
|Dropouts Due to Insufficient Results
|Other Dropouts(non-compliance, unknown, protocol violation)
|Total Number of Patients to Complete the Study
The study concluded by stating that 85% of men in the treatment groups had erectile function restored by the end of the 26-week trial.
89% of men with mild ED and 39% of men with severe ED had erectile function fully restored by the end of the study.
The study also found the 20 mg dose had the highest success rate, and all doses of the drug were well-tolerated, with only a few mild side-effects noted throughout the duration of the study.
The most common side effects reported were headache, rhinitis, cutaneous flushing, and dyspepsia.
This report summarizes the phase II and III clinical trials for vardenafil in the early 2000s.
The most notable was a phase III clinical trial conducted by Bayer. This study looked specifically at the impact of vardenafil on erectile dysfunction in diabetic men.
This 12-week, double-blind, placebo-controlled clinical trial involved 452 diabetic men experiencing erectile dysfunction.
Ths participants were randomly assigned into either a placebo-control group (143 patients), 10 mg vardenafil (152 patients), or 20 mg vardenafil (144 patients).
At the end of the trial, researchers found that 13% of men in the placebo group improved, while 57% and 72% improved in the 10 mg and 20 mg treatment groups, respectively.
Can Women Use Levitra?
Levitra is currently not approved for use in women — but this doesn’t mean women haven’t tried it.
There are reports of women using the medication to increase sexual satisfaction. It’s theorized that Levitra and other PDE5 inhibitors can increase blood flow to the corpora cavernosa in the clitoris through a similar response produced in males.
However, this effect has not been officially studied. Due to potential side-effects and the unknown impact on women’s health, Levitra is not recommended for use in women.
Levitra is just one of over a dozen erectile dysfunction medications available on the market. It’s most similar to Viagra (sildenafil) and Cialis (tadalafil).
- Sildenafil (Viagra)
- Vardenafil (Staxyn and Vivanza)
- Avanafil (Stendra)
- Mirodenafil (Mvix)
- Udenafil (Zydena)
Are There Any Natural Alternatives to Levitra?
Some herbs have similar effects to Levitra that either target PDE5, cGMP, or nitric oxide to improve erection — however, none of these compounds are going to be as potent as the pharmaceutical medications and may not be a reliable alternative for the drug.
- Horny Goat Weed (Epimedium spp.)
- Korean Red Ginseng (Panax ginseng)
- Tribulus (Tribulus terrestris)
Where to Buy Levitra in 2023
Levitra is only available by prescription. After visiting your doctor, you can go to any local pharmacy in person, or order some Levitra online at a digital pharmacy.
Most men prefer ordering their Levitra online because the price tends to be lower, and receiving the prescription is more discrete.
Expect to pay around $45 per tablet online, all the way up to $65 per tablet in-store. The price may be lower if you have health coverage or opt for generic forms of vardenafil instead.
Never order your vardenafil tablets from overseas companies. Not only could your order get intercepted at the border, you may also mistakenly order fake Levitra from unethical companies operating outside the US or EU.
References Cited in This Article
- Hatzichristou, D., Montorsi, F., Buvat, J., Laferriere, N., Bandel, T. J., Porst, H., & European Vardenafil Study Group. (2004). The efficacy and safety of flexible-dose vardenafil (Levitra®) in a broad population of European men. European urology, 45(5), 634-641.
- Hellstrom, W. J., Gittelman, M., Karlin, G., Segerson, T., Thibonnier, M., Taylor, T., & Padma‐nathan, H. A. R. I. N. (2002). Vardenafil for treatment of men with erectile dysfunction: Efficacy and safety in a randomized, double‐blind, placebo‐controlled trial. Journal of andrology, 23(6), 763-771.
- Pryor, J. (2002). Vardenafil: update on clinical experience. International journal of impotence research, 14(1), S65-S69.