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Levitra (Vardenafil) Side Effects & Interactions

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Our Editorial Team

Published 07/01/2019

Updated 04/01/2024

Levitra, which contains the active ingredient vardenafil, is a PDE5 inhibitor that works by making it easier for blood to flow to your penis. It belongs to the same class of medications as drugs like Viagra®, Cialis® and Stendra®, and like each of those other medications for ED, Levitra is safe and effective when taken as prescribed.

However, Levitra can potentially cause some side effects like headaches, and while most of these side effects are mild, some may be more serious.

Want to know what to watch out for, which drug interactions to avoid, and how to to reduce your side effect risk? We’re here to help.

Below, we’ve listed the common and uncommon side effects of Levitra, as well as what you can do to deal with these side effects and improve your experience while using Levitra to treat ED.

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Levitra is a medication for the treatment of erectile dysfunction — a PDE5 inhibitor, which works by increasing blood flow to the erectile tissues of your penis, making it easier to get and keep an erection during sexual stimulation.

Vardenafil, the active ingredient in Levitra, is one of several medications used to treat ED. Other medications used to treat ED include sildenafil (the active ingredient in Viagra), tadalafil (Cialis) and avanafil (Stendra).

Levitra is available as 2.5mg, 5mg, 10mg or 20mg oral tablets, designed for use approximately one hour before sexual activity. Vardenafil is also sold as a generic medicine and in dissolvable tablet form under the brand name Staxyn® and vardenafil chewable form from Hims.

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

For a comparison between Levitra and another single-night-use ED medication, you can read our blog on Levitra vs. Viagra.

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

Below, we’ve listed potential side effects and drug interactions of Levitra that are more serious, including some that can require medical care.

Priapism

Priapism is a type of painful, prolonged erection that lasts for four hours or longer. It develops when blood is unable to flow out of the penis after an erection and when untreated, can cause damage to the erectile tissues inside the penis.

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

Although priapism sounds alarming, it’s highly uncommon.

Priapism is a serious medical issue, meaning that if you get an erection that lasts for four hours or longer after using Levitra, you should seek medical assistance immediately.

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

Damage to the Optic Nerve

Levitra, as well as other ED medications such as Viagra and Cialis, are linked to cases of optic neuropathy, or optic nerve damage.

This is a very uncommon side effect of PDE5 inhibitors. Although research has not established a direct link between PDE5 inhibitor use and damage to the optic nerve, some studies suggest that there may be a temporal association between the use of ED drugs and decreased vision.

If you experience any loss of vision after using Levitra, excluding the transient color vision issue listed below, you should seek medical attention immediately.

This could potentially be a sign of non-arteritic anterior ischemic optic neuropathy (NAION) -- a condition in which damage to the optic nerve causes permanent vision loss, to some degree, in either one or both eyes.

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

Hearing Issues

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

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

It’s worth noting that this was, to the researchers’ knowledge, only the second case of hearing loss associated with vardenafil to occur by 2010 (approximately seven years after Levitra was initially approved by the FDA).

This makes hearing loss one of the rarest potential side effects of Levitra. This rare side effect has also occurred with Viagra and Cialis, although only a tiny number of users are affected.

According to the FDA, cases of hearing loss, potentially accompanied by tinnitus and dizziness, have a “temporal association to the intake of PDE5 inhibitors.”

If you experience any loss of hearing in either or both ears after taking Levitra, you should seek immediate medical treatment.

Levitra can cause several common side effects, most of which are mild and temporary. These side effects are similar to those of other ED medications, meaning you may develop the same issues from medications such as Viagra and Cialis.

Most men who use Levitra do so without significant issues. In clinical trials, only 3.4 percent of the men who took part stopped taking Levitra due to side effects (compared to 1.1 percent for a placebo).

Headaches

Headaches are by far the most common side effect of Levitra. In fact, headaches are the most common side effect of most oral medications used to treat ED.

According to data from the FDA, approximately 15 percent of men who use Levitra experience some form of headache.

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

If you get severe headaches from Levitra, 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 also lists several techniques you can use to treat headaches from Levitra.

Flushing

Flushing is the second-most common side effect of Levitra. In trials of Levitra, 11 percent of men who used the medication developed flushing as a side effect, compared to just 1 percent of men who used a non-therapeutic placebo.

Like headaches, flushing is a common side effect of all oral ED medications. This means that if you experience flushing after taking Levitra, it’s possible you might experience the same side effect even if you switch to Viagra or Cialis.

Flushing may develop as a result of the effects of Levitra on your blood vessels. After you use Levitra, you might notice that your cheeks, nose, chin and forehead begin to take on a flushed, red appearance.

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

Nasal Congestion

Rhinitis, or irritation and inflammation of the mucous membrane inside your nostrils, is another common side effect of Levitra.

This side effect can result in symptoms such as a blocked nose or a runny nose.

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

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

Sinusitis, another form of nasal irritation and congestion, is also reported by about three percent of men who use Levitra. Flu-like symptoms, which may involve nasal congestion in addition to other side effects such as headache, affect approximately three percent of Levitra users.

Like the other common side effects of Levitra, nasal congestion usually fades away gradually as Levitra exits your body.

Indigestion/Heartburn

Dyspepsia, or indigestion, is a common side effect of oral ED medications that’s reported by around four percent of men who use Levitra.

Levitra may cause indigestion due to its effects on the lower esophageal sphincter - the bundle of muscles at the low end of your esophagus that typically restricts the flow of stomach contents and acid into your esophagus.

It’s usually possible to treat indigestion from Levitra and other oral ED drugs using over-the-counter medications and antacids.

If you have frequent or severe indigestion from Levitra, you can talk to your healthcare provider about your options. They may recommend adjusting your dosage or making changes to the way you use your medication.

Nausea

Nausea is a common side effect of lots of medications, including ED drugs such as Levitra. In fact, a small percentage of people who use all oral ED medications report developing nausea while the medication is active.

According to data from clinical trials, approximately two percent of men who use Levitra to treat erectile dysfunction develop nausea.

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

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

Dizziness

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

In trials of Levitra, around 2 percent of men given a typical dose of Levitra noted that they felt dizzy while the medication was active.

Like nausea and other side effects of ED medication, dizziness may improve by adjusting your Levitra dosage or making other changes to the way you use your medication. Make sure to talk to your healthcare provider if you frequently feel dizzy after using Levitra.

Visual Disturbance

Several PDE5 inhibitor medications for erectile dysfunction, including Levitra, Cialis and Viagra, are linked to visual disturbances. These may include a noticeable color tinge to your eyesight, increased sensitivity to light and blurred vision.

Although visual disturbances are more common with other ED medications than with Levitra, a small percentage of Levitra uses report ocular side effects.

The most common visual side effect of Levitra is a mild change in color perception after taking the medication.

In a 2019 study, researchers found that men who took a 40mg dose of vardenafil temporarily made more errors in a vision test (the Farnsworth–Munsell D100 color vision test) than men who were given a non-therapeutic placebo.

Like other side effects of ED medications, vision-related issues with Levitra are generally short term in nature. In the study above, after 24 hours, the two groups didn’t display any differences in color vision.

As with other adverse effects, if you start to develop noticeable or persistent visual disturbances while using Levitra, you should contact your healthcare provider.

Reduced Blood Pressure

Because Levitra dilates blood vessels throughout your body, it can cause a temporary decrease in your blood pressure levels. This drop in blood pressure is usually mild and doesn’t negatively affect your health if you have an otherwise normal cardiovascular system.

In research, a typical dose of Levitra produces a maximum drop of 7 mmHg in systolic blood pressure and 8 mmHg in diastolic blood pressure.

While this decrease in blood pressure isn’t an issue in healthy men, if you have a cardiovascular health issue, or if you currently take medication to treat high blood pressure, using Levitra could potentially lead to more serious health problems.

You should also discuss with healthcare professionals any history of ulcers, blood diseases like leukemia or sickle cell anemia or bleeding disorders before taking this medication.

We’ve discussed these problems below, with information on specific blood pressure medications that should not be used with Levitra or other ED medications.

Choose your chew

Levitra is a widely used medication that can be taken by most men without issues. However, like other prescription drugs, it can potentially interfere with other medications and substances.

Cardiovascular Medications

All PDE5 inhibitors, including Levitra, should not be used with nitrites or nitrates prescribed to treat angina and/or heart failure. When used with nitrates, Levitra can cause a significant, sudden decrease in blood pressure that may be life-threatening. Low blood pressure can lead to heart problems like irregular heartbeat, dizziness and potentially death.

Nitrate medications that have the potential to interact with Levitra and other medications for ED include nitroglycerin, isosorbide dinitrate and isosorbide mononitrate. Nitrites (including the nitrites used in recreational “poppers”) can also interact with Levitra.

Levitra can also interact with alpha-blockers, a type of medication used to treat hypertension (high blood pressure) and symptoms of benign prostatic hyperplasia (BPH). The same goes for male enhancement products and supplements with phosphodiesterase inhibitor medications in the ingredients.

If you have any heart condition or take any medication to treat hypertension, chest pain or other cardiovascular conditions, it’s important to inform your healthcare provider and discuss how you can stay safe before considering Levitra or any other type of ED medication.

Our guide to ED medication and heart disease provides more information on your options if you have ED and a cardiovascular medical condition.

Other Medications

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

These medications include antifungal, antibiotic and antiviral medications such as ketoconazole, itraconazole, ritonavir, indinavir, saquinavir, atazanavir, and clarithromycin. In some cases, you may need to adjust your dosage of Levitra to use it safely with these medications.

Make sure to inform your healthcare provider if you use any of these medications before taking Levitra.

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 that you can use Levitra safely and effectively:

  • Talk to your healthcare provider about heart conditions. If you have a condition that affects your heart health or function, such as angina, low or high blood pressure, a heart rate that’s overly slow or fast, or heart failure, inform your healthcare provider. It’s also important to talk to your healthcare provider if you’ve recently suffered a stroke or heart attack.

  • Inform your healthcare provider about other conditions. Other medical issues, such as issues that prevent you from digesting or metabolizing medication correctly, may also affect your ability to use Levitra or similar ED medication. This also includes Peyronie’s disease or painful erection, and any history of allergic reaction to other ED medications.

  • Consider other treatment options for ED. When erectile dysfunction is psychological, options such as therapy or making certain changes to your habits may help you to stay hard without medication.

  • Understand how to use Levitra effectively. Levitra should be taken approximately 60 minutes before sex, either with or without food. Make sure that you’re familiar with how to use Levitra before taking it prior to sex.

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

  • Don’t consume grapefruit. Grapefruit juice can also impact how Levitra is metabolized in the body.

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

Used as prescribed, Levitra is a safe and effective medication for treating ED that rarely causes anything more than minor side effects.

We offer several ED medications online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.

You can also learn more about using Levitra and similar medications to treat ED in our full guide to what to expect from erectile dysfunction medication.

13 Sources

  1. Definition & Facts for Erectile Dysfunction. (2017, July). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts
  2. LEVITRA (vardenafil hydrochloride) tablets, for oral use. (2014, April). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021400s017lbl.pdf
  3. STAXYN (vardenafil hydrochloride) orally disintegrating tablets. (2010, June). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/200179lbl.pdf
  4. Porst, H. (2006, November). Extended duration of efficacy of vardenafil when taken 8 hours before intercourse: a randomized, double-blind, placebo-controlled study. European Urology. 50 (5), 1086-94, discussion 1094-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16820261/
  5. Dhaliwal, A. & Gupta, M. (2021, June 25). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/
  6. Beard, S. (2014, March). Rhinitis. Primary Care. 41 (1), 33–46. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7119310/
  7. CIALIS (tadalafil) tablets, for oral use. (2011, October). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf
  8. Lee, T.H., et al. (2012, October). Examination of the Effects of Vardenafil on Esophageal Function Using Multichannel Intraluminal Impedance and Manometry. Journal of Neurogastroenterology and Motility. 18 (4), 399–405. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479253/
  9. VIAGRA® (sildenafil citrate) tablets, for oral use. (2014, March). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf
  10. Roessler, G., Vobig, M. & Walter, P. & Mazinani, B.A. (2019). Ocular side effects of Levitra® (vardenafil) – results of a double-blind crossover study in healthy male subjects. Drug Design, Development and Therapy. 13, 37–43. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6305137/
  11. Siilberman, M., Stormont, G. & Hu, E.W. (2021, June 16). Priapism. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459178/
  12. Mapes, D. (2008, September 11). Too much of a good thing: The 4-hour erection. Retrieved from https://www.nbcnews.com/healthmain/too-much-good-thing-4-hour-erection-1C9926694
  13. Snodgrass, A.J., et al. (2010, January). Sudden sensorineural hearing loss associated with vardenafil. Pharmacotherapy. 30 (1), 112. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20030481/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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