How can you reduce Levitra's side effects? Mostly through the dose and what you take with it. The label's levers are a lower dose (5 mg instead of 10 or 20 mg), no grapefruit, going easy on alcohol, telling your doctor about medicines that raise vardenafil levels, and never more than one tablet a day. Of erectile dysfunction medicines in general, healthdirect says: "Usually, these side effects are mild and temporary" (healthdirect — ED medicines). The Levitra brand is not on the Australian Register of Therapeutic Goods; vardenafil, the medicine in it, is, as generic 5, 10 and 20 mg tablets (ARTG search), on prescription. Label facts below: the European Levitra product information.
What are the side effects of Levitra?
Headache, in more than 1 man in 10; most side effects are "mild or moderate" (EMA — Levitra product information):
| How often | Side effects |
|---|---|
| Very common (more than 1 in 10) | Headache |
| Common (up to 1 in 10) | Dizziness, flushing, a blocked or runny nose, indigestion |
| Uncommon (up to 1 in 100) | Among others: sleepiness, effects on vision, a fast or pounding heartbeat, acid reflux, nausea, back or muscle pain, prolonged erections |
| Rare (up to 1 in 1,000) | Among others: fainting, chest pain, high or low blood pressure, painful erections |
Source: EMA — Levitra product information, package leaflet section 4.
Does a lower dose of vardenafil cause fewer side effects?
That is the label's lever. The usual starting dose is 10 mg, and "Based on efficacy and tolerability the dose may be increased to 20 mg or decreased to 5 mg" (EMA — Levitra). At 20 mg, men aged 65 or over reported headache (16.2% against 11.8%) and dizziness (3.7% against 0.7%) more often than younger men, and "Tolerability of the maximum dose of 20 mg may be lower in elderly patients". The leaflet's advice: "Tell your doctor if you think Levitra is too strong or too weak." Your doctor "can adjust the dose if necessary" (healthdirect — ED medicines). More is not better: men who take too much "may experience more side effects or may get severe back pain" (EMA — Levitra).
Does food make a difference to vardenafil?
A heavy meal slows it down; the label does not offer food as a way to avoid side effects. "You can take Levitra with or without food but preferably not after a heavy or high-fat meal as this may delay the effect" (EMA — Levitra). After a meal that was 57% fat, it peaked about an hour later; a 30% fat meal changed nothing. Indigestion is one of its common side effects: can ED medicines cause heartburn and indigestion?
Should you avoid grapefruit and alcohol with vardenafil?
Avoid grapefruit; go easy on alcohol. Grapefruit or grapefruit juice "is expected to increase the plasma concentrations of vardenafil. The combination should be avoided", and the leaflet says plainly: "Don't drink grapefruit juice when you use Levitra" (EMA — Levitra). Alcohol is different: taken together, vardenafil "did not potentiate the effects of alcohol on blood pressure and heart rate", but "Alcoholic drink can make erection difficulties worse" (EMA — Levitra). For sildenafil: does grapefruit juice affect Viagra? and can you drink alcohol with Viagra?
Which medicines make Levitra's side effects more likely?
Those that raise vardenafil levels or lower blood pressure. Never nitrates, "medicines for angina", or amyl nitrite: together they "could seriously affect your blood pressure". Ritonavir and indinavir (HIV) are ruled out, ketoconazole and itraconazole (antifungals) avoided; with erythromycin or clarithromycin the dose "should not exceed 5 mg"; with alpha-blockers, for blood pressure or the prostate, vardenafil starts at 5 mg (EMA — Levitra). Tell your doctor about every medicine you take (healthdirect — ED medicines), and never add a second ED medicine: can you take Viagra and Levitra together?
What helps with headache, flushing or a blocked nose?
Time, usually, or a lower dose if they persist. Each has its own page: how to ease headaches, how to reduce flushing, and how to clear a blocked or runny nose (nasal congestion). For dizziness: "If you feel dizzy, or if your vision is affected after taking Levitra don't drive or operate any tools or machines" (EMA — Levitra).
Which side effects need help straight away?
Sudden changes in sight or hearing, chest pain, a serious skin reaction, or an erection that will not go down. For sudden loss of vision, "Stop taking Levitra and contact your doctor immediately"; likewise for a serious rash with blisters or peeling (EMA — Levitra). healthdirect lists priapism, "a painful erection that won't go down even after sex", and sudden hearing loss among the more severe side effects (healthdirect — ED medicines). For chest pain that goes on for more than a few minutes, or other signs of a heart attack, call triple zero (000) (healthdirect — Indigestion). More on vision: can Cialis and other ED drugs cause vision problems or blindness?
The short answer
Ask your doctor about a lower dose, skip grapefruit, keep alcohol light, take one tablet a day at most, and make sure the prescriber knows every other medicine you take. Most side effects are mild and pass; sudden vision or hearing loss, chest pain or a lasting erection need help straight away. Every side effect of ED medicines is in our guide to side effects of ED medicines.
