Levitra (vardenafil) for erectile dysfunction — informational guide, not a substitute for medical advice

Levitra is a prescription medication containing vardenafil, a phosphodiesterase type 5 (PDE5) inhibitor used to treat erectile dysfunction (ED). While many online guides focus only on dosage and timing, this article approaches the topic differently — by audience segmentation. Different age groups and health profiles face distinct risks, benefits, and decision points.

This guide does not replace professional medical consultation. Always discuss treatment decisions with a licensed healthcare provider.

Who it is especially relevant for

Levitra may be especially relevant for:

• Men experiencing persistent difficulty achieving or maintaining an erection.
• Individuals with ED related to diabetes, hypertension, or metabolic syndrome.
• Patients who did not tolerate or respond well to other PDE5 inhibitors.
• Men seeking an on-demand treatment option rather than daily therapy.

It may not be suitable for people taking nitrates, certain antiarrhythmic medications, or those with unstable cardiovascular disease.

Sections by audience segment

Adults

Typical profile: Men aged 18–64 with psychogenic, vascular, or mixed erectile dysfunction.

Symptom features and risks:

• Performance anxiety combined with mild vascular impairment.
• ED associated with smoking, obesity, sedentary lifestyle.
• Occasional interaction with alcohol or recreational substances.

When to see a doctor:

• If ED persists for more than 3 months.
• If chest pain, shortness of breath, or fainting occurs during sexual activity.
• If experiencing prolonged erection (longer than 4 hours).

General safety measures:

• Avoid combining with nitrates or “poppers” (amyl nitrite).
• Limit alcohol intake to reduce dizziness or hypotension risk.
• Discuss cardiovascular fitness before initiating treatment.

Learn more about comprehensive erectile dysfunction evaluation and risk stratification.

Elderly

Typical profile: Men over 65, often with comorbid cardiovascular disease or polypharmacy.

Symptom features and risks:

• Higher likelihood of vascular-origin ED.
• Increased sensitivity to blood pressure changes.
• Greater risk of drug interactions (antihypertensives, alpha-blockers).

When to see a doctor:

• Before first use if history of heart attack, stroke, or arrhythmia.
• If experiencing sudden vision or hearing changes.
• If dizziness leads to falls.

General safety measures:

• Start at the lowest effective dose as recommended by a physician.
• Review complete medication list with a healthcare provider.
• Monitor blood pressure regularly.

For age-related considerations, review our section on sexual health in older adults.

Women (not indicated population)

Important note: Levitra is not approved for use in women. Research into PDE5 inhibitors for female sexual dysfunction is ongoing, but vardenafil is not indicated during pregnancy or breastfeeding.

Why this matters:

• No established safety profile in pregnancy.
• Unknown effects during lactation.
• No approved therapeutic indication for women.

If experiencing sexual dysfunction, consult a healthcare provider for appropriate evaluation rather than using medications off-label without supervision.

Children and adolescents (not indicated population)

Levitra is not approved for use in individuals under 18 years old.

Risks:

• Lack of safety and efficacy data in minors.
• Potential cardiovascular effects in developing systems.

Adolescents with sexual health concerns should be assessed for hormonal, psychological, or developmental factors by qualified professionals.

People with chronic conditions

This group requires the most careful assessment.

Common chronic conditions associated with ED:

• Diabetes mellitus
• Hypertension
• Coronary artery disease
• Chronic kidney disease
• Depression

Specific risks:

• Exaggerated hypotension when combined with nitrates.
• Altered drug metabolism in hepatic or renal impairment.
• Interaction with alpha-blockers used for benign prostatic hyperplasia.

When to seek medical supervision:

• If using antiarrhythmic drugs that affect QT interval.
• If ED developed suddenly (possible vascular event marker).
• If multiple cardiovascular risk factors are present.

General safety measures:

• Obtain cardiovascular clearance if moderate-to-high cardiac risk.
• Optimize control of underlying disease (e.g., HbA1c in diabetes).
• Use only pharmacy-dispensed medication to avoid counterfeit risks.

See also our guide on managing ED with chronic disease and medication safety.

Infographic: how Levitra works and what to monitor

Sexual stimulation 
      ↓
Nitric oxide release in penile tissue
      ↓
cGMP increase → smooth muscle relaxation
      ↓
Improved blood flow → erection
      ↓
Possible reactions:
  - Headache
  - Flushing
  - Nasal congestion
  - Dizziness
      ↓
Action:
  Mild → monitor
  Severe chest pain → emergency care
  Erection >4h → urgent medical help

Segment → specific risks → what to clarify with doctor

Segment	Specific risks	What to clarify with doctor
Adults	Alcohol interaction, undiagnosed heart disease	Cardiovascular fitness, appropriate starting dose
Elderly	Hypotension, polypharmacy, fall risk	Drug interactions, renal/hepatic function
Chronic conditions	Nitrate interaction, QT prolongation	Medication compatibility, cardiac risk level
Women	No approved indication	Alternative evidence-based therapies
Children	No safety data	Underlying developmental or hormonal causes

Mistakes and dangerous online advice

• Buying without prescription: Counterfeit PDE5 inhibitors are common and may contain incorrect dosages or contaminants.
• Doubling dose after one failed attempt: Response variability is normal; dose adjustments require medical guidance.
• Mixing with nitrates or recreational vasodilators: Can cause life-threatening hypotension.
• Ignoring cardiovascular symptoms: ED may be an early sign of systemic vascular disease.

For safe purchasing and storage guidance, visit our medication safety resource center.

Sources

• U.S. Food and Drug Administration (FDA). Levitra (vardenafil) prescribing information.
• European Medicines Agency (EMA). Vardenafil product information.
• American Urological Association (AUA). Guidelines on Erectile Dysfunction.
• Kloner RA et al. Cardiovascular safety of PDE5 inhibitors. Journal of the American College of Cardiology.
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Erectile Dysfunction overview.