Selective phosphodiesterase-5 (PDE-5) inhibitor
ATC code: G04BE09 (Vardenafil)
A selective PDE-5 inhibitor that degrades cGMP in penile cavernous body smooth muscle. Compared with sildenafil, 9-fold more selective for PDE-5 and less for retinal PDE-6 (fewer visual side effects). Half-life 4–5 hours. CYP3A4-metabolized.
First line
First-line for erectile dysfunction per EAU 2024 and AUA 2018 alongside other PDE-5 inhibitors (sildenafil, tadalafil, avanafil). Taken 25–60 minutes before intercourse at 10–20 mg. In diabetes or post-prostatectomy, efficacy is lower (40–50% vs 70% in healthy patients). Do not combine with nitrates.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Vardenafil is a phosphodiesterase-5 (PDE5) inhibitor. It is prescribed for erectile dysfunction (AEMPS Ficha Técnica). In sports circles, vardenafil is promoted to improve blood flow and physical endurance in healthy athletes. Clinical studies in healthy athletes are insufficient. The drug has specific risks: headache, facial flushing, nasal congestion, dyspepsia, QT prolongation, visual disturbances, and is dangerous combined with nitrates. If vardenafil is used for training, consider seeking a second opinion.
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Not used in women (male indication).
Not used in women.
Vardenafil is evaluated for the following indications with varying evidence strength: Erectile dysfunction (evidence tier A), Athletic endurance (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Vardenafil (≥ 1 in 100): Headache, Facial flushing, Nasal congestion, Dyspepsia, Dizziness. See the Safety section for uncommon and serious reactions.
FDA category B. Not used in women (male indication).
Not used in women.
Vardenafil is contraindicated in: Vardenafil hypersensitivity; Concomitant organic nitrates in any form; Concomitant riociguat; Severe heart failure, unstable angina; Stroke or MI in last 6 months. Full list in the Safety section.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.