Levitra (Vardenafil) Side Effects & Interactions

Vardenafil (generic for Levitra^®) improves erectile dysfunction (ED) by making it easier for blood to flow to the penis. It’s in the same class of drugs as Viagra^®, Cialis^®, and Stendra^®, and like these other medications for ED, vardenafil is safe and effective when taken as prescribed.

However, there are potential vardenafil side effects to consider, like headaches and nausea. While most adverse effects are mild, some may be more serious.

We’ll list the common and uncommon side effects of vardenafil and what you can do to deal with them and improve your experience while using this medication for ED.

Vardenafil is an erectile dysfunction medication. Like other ED meds, it’s a phosphodiesterase type 5 inhibitor, or PDE5 inhibitor. These drugs increase blood flow to erectile tissues in the penis, making it easier to get and keep an erection with sexual stimulation.

Vardenafil is the active ingredient in Levitra. It’s one of several medications for ED. Others include sildenafil (the active ingredient in Viagra), tadalafil (Cialis), and avanafil (Stendra).

Vardenafil is available as 2.5mg, 5mg, 10mg, or 20mg (milligrams) oral tablets. It’s also sold as disintegrating tablets under the brand name Staxyn^®.

Vardenafil pills are designed to be taken about an hour before sexual activity. You can take it with or without food, but it might work more quickly if you take it on an empty stomach.

The effects can last five to seven hours, making vardenafil a great choice for single-night use compared to longer-acting ED medications.

Our blog on Levitra versus Viagra compares vardenafil to another single-night-use ED medication.

Serious side effects from vardenafil and other ED medications are uncommon, only affecting a small percentage of men who use them. However, they can still happen, and some may require urgent medical attention when they occur. 

Let’s go over the more serious potential side effects and drug interactions of vardenafil, including those that call for medical help.

Priapism

Priapism is a painful, prolonged erection lasting four hours or longer. It happens when blood can’t flow out of the penis after an erection. When untreated, priapism can damage erectile tissues inside the penis.

There have been rare reports of priapism from all medications used to treat erectile dysfunction, including vardenafil.

Still, priapism is a serious medical issue. If you get an erection that lasts four or more hours after using vardenafil, seek medical assistance immediately.

Priapism can be treated successfully in a hospital, helping you avoid lasting damage to the erectile tissues of your penis.

Optic Nerve Damage

Vardenafil and other ED medications are linked to cases of optic nerve damage causing decreased vision.

Vision changes are a very uncommon side effect of PDE5 inhibitors. If you experience sudden vision loss in one or both eyes after using vardenafil, seek medical attention immediately.

Vision loss could be a sign of non-arteritic anterior ischemic optic neuropathy (NAION). That’s when optic nerve damage causes permanent vision loss in one or both eyes. Although research hasn’t established a direct link between PDE5 inhibitor use and damage to the optic nerve, some studies suggest an association.

If you have a history of vision issues or any underlying NAION risk factors, tell your healthcare provider before using medications to treat ED.

Hearing Issues

Vardenafil and other PDE5 inhibitors have been linked to hearing issues, including some cases of sudden hearing loss.

In a report from 2010, researchers discussed a patient who experienced a sudden loss of hearing after using vardenafil to treat erectile dysfunction.

This was only the second known case of hearing loss associated with vardenafil at the time the study came out — roughly seven years after the FDA (U.S. Food and Drug Administration) initially approved the medication.

This makes hearing loss one of the rarest potential side effects of vardenafil. 

If you experience hearing loss (with or without tinnitus and dizziness) after taking vardenafil, seek immediate medical treatment.

Vardenafil can cause several common side effects, most of which are mild and temporary:

• Headaches

• Flushing

• Nasal congestion

• Indigestion or heartburn

• Nausea

• Dizziness

• Reduced blood pressure

These side effects are similar to those of other ED medications. So switching to Viagra or Cialis may not be much better.

Most men who use brand-name or generic vardenafil don’t have significant issues. In clinical trials, only 3.4 percent of participants stopped taking the medication due to side effects (compared to 1.1 percent for a placebo).

Headaches

Headaches are by far the most common side effect of vardenafil and other oral medications used to treat ED. According to the FDA, around 15 percent of men who use vardenafil get one.

Headaches typically fade away on their own as the drug exits your system. Since the medication has a moderate half-life, it’s rare for this side effect to last more than five hours.

If you get severe headaches, it’s best to talk to your healthcare provider. They may suggest adjusting your dosage or using over-the-counter medication to reduce the severity of your headaches.

Our guide to dealing with headaches from ED medications has more tips.

Flushing

Flushing is the second-most common side effect of vardenafil. In clinical trials, 11 percent of men who used the medication experienced it, compared to just one percent of those who got a placebo.

Flushing may develop due to the medication’s effects on blood vessels. You might notice that your cheeks, nose, chin, and forehead take on an inflamed, red appearance.

Like other side effects, flushing typically improves over a few hours as the active ingredient exits your system.

Nasal Congestion

Irritation and inflammation inside the nostrils can also happen with vardenafil. Known medically as rhinitis, this side effect can result in a blocked airway or a runny nose.

In clinical trials with vardenafil, nine percent of men who used the medication to treat ED developed symptoms of rhinitis.

This side effect may be more common with vardenafil than other ED treatments. For example, only two to four percent of men prescribed Cialis in clinical trials reported nasal congestion.

About three percent of men who use vardenafil also report sinusitis, another form of nasal irritation and congestion. And general flu-like symptoms affect around three percent of users.

Like the other common side effects of vardenafil, nasal congestion usually fades gradually as the medication leaves your body.

Indigestion or Heartburn

Indigestion is a fairly common side effect reported by about four percent of men who use vardenafil.

You can usually treat indigestion (and resulting heartburn) from vardenafil and other oral ED drugs with over-the-counter medications and antacids.

If you have frequent or severe indigestion from vardenafil, talk to your healthcare provider for medical advice.

Nausea

Nausea is a common side effect of many medications — and it can happen with ED drugs like vardenafil. In clinical trials, two percent of men who used Levitra to treat erectile dysfunction developed nausea.

Like other vardenafil side effects, nausea is generally mild and temporary. If you feel nauseous after taking the medication, your healthcare provider may adjust your dosage, recommend taking your dose with a small amount of food, or suggest using anti-nausea medicine.

Alternatively, they may suggest switching to a different type of medication to treat erectile dysfunction.

Dizziness

A small percentage of men who use vardenafil experience some degree of dizziness after taking the medication.

In clinical trials, around two percent of men given a typical dose of Levitra noted that they felt dizzy while the medication was active.

Visual Disturbances

Several PDE5 inhibitor medications are linked to visual disturbances. These may include a noticeable color tinge to your eyesight, increased sensitivity to light, or blurred vision.

Though visual disturbances are more common with other ED medications than with vardenafil, a small percentage of users report ocular side effects.

In a small 2019 study, men who took a 40mg dose of vardenafil temporarily made more errors in a vision test (the Farnsworth–Munsell D100 color vision test) than those given a placebo. But 24 hours later, their vision was back to normal.

If you have noticeable or persistent visual disturbances while using vardenafil, contact your healthcare provider.

Reduced Blood Pressure

Since vardenafil dilates blood vessels throughout the body, it can cause a temporary decrease in blood pressure. This drop is usually mild and won’t negatively affect your health if you don’t already have cardiovascular issues.

If you have cardiovascular disease or currently take medication to treat high blood pressure (hypertension), using vardenafil could potentially lead to more serious health problems.

You should also discuss any history of ulcers, leukemia, sickle cell anemia, or bleeding disorders with a healthcare professional before taking this medication.

Vardenafil is a widely used medication most men can take without issues. However, like other prescription drugs, it can potentially interfere with other medications and substances.

Cardiovascular Medications

All PDE5 inhibitors, including vardenafil, shouldn’t be used with nitrites or other drugs prescribed to treat angina (chest pain) or heart failure. When combined with nitrates, vardenafil can cause a significant, sudden decrease in blood pressure that may be life-threatening.

Low blood pressure (hypotension) can lead to heart problems like irregular heartbeat, heart rhythm changes, dizziness, heart attack, and potentially death.

Nitrate medications include nitroglycerin, isosorbide dinitrate, and isosorbide mononitrate. Those used recreationally (called “poppers”) can also interact with the medication.

Vardenafil can also interact with alpha-blockers, a type of medication used to treat hypertension and benign prostatic hyperplasia (BPH). The same goes for male-enhancement supplements with phosphodiesterase (PDE) inhibitors in the ingredients.

Our guide to ED medication and heart disease has more info on treating ED when you have a cardiovascular medical condition.

Other Medications

Medications that inhibit the cytochrome P450 3A4 (CYP3A4) enzyme may increase vardenafil’s effects in the body.

These include antifungal, antibiotic, and antiviral medications, such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, atazanavir, and clarithromycin. In some cases, your healthcare provider will tell you to adjust your vardenafil dosage to use it safely with these medications.

Let your healthcare provider know if you use any of these medications before taking vardenafil.

Although most men can use Levitra and generic vardenafil safely, it’s important to talk with your healthcare provider about potential risks before you get started.

There are also several steps to take on your own to ensure vardenafil is safe and effective:

• Talk to your healthcare provider about heart conditions. If you have a condition affecting your heart or recently had a stroke or heart attack, inform your healthcare provider.

• Inform your healthcare provider about other conditions. Tell your provider about any current medical conditions like Peyronie’s disease, painful erections, or a history of allergic reactions to other ED medications.

• Consider other treatment options for ED. When erectile dysfunction is psychological, options like therapy and lifestyle changes help you to stay hard without medication.

• Understand how to use vardenafil effectively. Vardenafil should be taken about 60 minutes before sex, with or without food. Make sure you’re familiar with how to use vardenafil before taking it.

• Look into other ED medications. Other medications for ED, such as Viagra (sildenafil), Cialis  (tadalafil), and Stendra (avanafil), offer similar effects to vardenafil. Depending on your needs, you may get better results from one of these medications.

• Don’t consume grapefruit. Grapefruit juice can impact how vardenafil is metabolized in the body, leading to higher blood levels of the drug and more side effects.

Overall, vardenafil offers similar effects to other ED medications, as well as a similar range of side effects.

Here’s what to keep in mind about vardenafil side effects:

• Vardenafil should be used as prescribed. When used as prescribed, vardenafil is a safe and effective medication for treating ED that rarely causes more than minor side effects, such as nausea, headache, flushing, and nasal congestion.

• Vardenafil may cause serious side effects. In rare cases, vardenafil can cause priapism, vision loss, or hearing loss.

• Vardenafil may cause drug interactions. Vardenafil can cause dangerous side effects if combined with certain cardiovascular medications. Always tell your medical provider about your current medications.

We offer several ED medications online, following a virtual consultation with a healthcare provider. Get a recommendation today to see if you’re a good candidate.

You can also learn more about what to expect from erectile dysfunction medication in our full guide.