Levitra Extra (Vardenafil) vs. Other ED Meds: Dosage Comparison

When it comes to treating erectile dysfunction (ED), Levitra Extra is a higher‑dose formulation of the PDE5 inhibitor Vardenafil designed for men who need a stronger or longer‑lasting effect. The drug packs 20mg of Vardenafil per tablet, compared with the standard 10mg in regular Levitra, and promises a quicker onset and a slightly extended window of efficacy. If you’re weighing whether this extra‑strength option fits your needs, you’ll want a side‑by‑side look at the most common alternatives on the market.
How Vardenafil Works and Why Dosage Matters
Vardenafil belongs to the phosphodiesterase‑5 (PDE5) inhibitor class. By blocking the PDE5 enzyme, it preserves cyclic guanosine monophosphate (cGMP) in the penile tissue, allowing smooth muscle relaxation and increased blood flow during sexual arousal. The higher dose in LevitraExtra simply raises the concentration of Vardenafil in the bloodstream, which can translate into a lower Levitra Extra dosage threshold for some men. However, the difference isn’t universal; individual response, body weight, liver function, and concurrent medications all play a role.
Standard Levitra (10mg Vardenafil) - The Baseline
The original Levitra tablet contains 10mg of Vardenafil and is typically taken 25-60minutes before intercourse. Its effects last about 4-5hours, giving a flexible window for sexual activity. Most clinical trials report a response rate of roughly 65‑70% in men with mild‑to‑moderate ED. Because the standard dose is already effective for many, the extra‑strength version is usually reserved for those who report sub‑optimal results with the 10mg tablet.
Alternative ED Medications: Dosage Overview
Below are the three other major oral PDE5 inhibitors you’ll encounter in a pharmacy or doctor’s office. Each has a unique dosage range, onset time, and duration of action.
Sildenafil is the active ingredient in Viagra, one of the earliest FDA‑approved ED drugs. Typical doses are 25mg, 50mg, and 100mg, taken about an hour before sex. The drug’s effect lasts 4-6hours, but the 100mg dose can increase the risk of headaches and flushing.
Tadalafil (Cialis) comes in 2.5mg, 5mg, 10mg, and 20mg strengths. It can be taken as needed (10mg or 20mg) or daily (2.5mg or 5mg). When used as needed, Tadalafil’s onset is 30minutes to 2hours, and its action can stretch up to 36hours, earning it the nickname “the weekend pill.”
Avanafil (Stendra) is the newest entrant, marketed for its rapid onset. Doses are 50mg, 100mg, and 200mg, with effects beginning as quickly as 15minutes and lasting around 6hours. Avanafil tends to cause fewer visual disturbances than older PDE5 inhibitors.

Dosage Comparison Table
Medication | Typical Dose (mg) | Onset | Duration of Effect | Key Considerations |
---|---|---|---|---|
Levitra Extra (Vardenafil) | 20mg | 25‑60min | 4‑5hrs | Higher dose may improve response but ↑ risk of headache, flushing |
Levitra (standard) | 10mg | 25‑60min | 4‑5hrs | Well‑tolerated for most; start low if you have cardiovascular issues |
Sildenafil | 25‑100mg | ~60min | 4‑6hrs | Food (especially high‑fat meals) can delay onset |
Tadalafil | 5‑20mg (as needed) or 2.5‑5mg (daily) | 30‑120min (as needed) | Up to 36hrs | Daily low‑dose useful for men needing spontaneity |
Avanafil | 50‑200mg | 15‑30min | ≈6hrs | Fastest onset; minimal visual side effects |
Choosing the Right Medication: Practical Factors
- Speed of Onset: If spontaneity is a priority, Avanafil’s 15‑minute window or Tadalafil’s daily low dose may beat the 30‑minute+ start of Viagra and Levitra.
- Duration Needs: For weekend getaways, Tadalafil’s 36‑hour window is unrivaled. For a one‑night encounter, the 4‑6hour span of Levitra Extra or Sildenafil is sufficient.
- Side‑Effect Profile: Headaches, flushing, and nasal congestion are common across PDE5 inhibitors. High‑dose Vardenafil (LevitraExtra) slightly raises the incidence of visual disturbances compared with its 10mg counterpart.
- Food Interactions: Sildenafil’s absorption can be hindered by high‑fat meals, while Vardenafil and Avanafil are less affected. Tadalafil is the most food‑friendly.
- Medical Conditions: Men with severe cardiovascular disease should consult a cardiologist before any PDE5 inhibitor. Tadalafil’s longer half‑life can stress the heart more in certain patients.
Safety, Contraindications, and Drug Interactions
All oral PDE5 inhibitors share a core set of contraindications: concurrent use of nitrates (often prescribed for chest angina) can cause life‑threatening hypotension. In addition, potent CYP3A4 inhibitors such as ketoconazole, erythromycin, or grapefruit juice can raise plasma levels, especially of Vardenafil and Avanafil, making dosage adjustments necessary.
Patients with uncontrolled hypertension, recent stroke, or severe liver impairment should either avoid these drugs or use the lowest possible dose under medical supervision. For men on alpha‑blockers for prostate enlargement, starting with a reduced Vardenafil dose (5mg) helps mitigate dizziness.

Real‑World Scenarios: When Levitra Extra Shines
Consider a 55‑year‑old man with mild diabetes who tries standard Levitra (10mg) twice a month with only partial rigidity. Switching to Levitra Extra (20mg) on the same schedule yields a full erection in 80% of attempts, according to a 2022 real‑world study of 1,200 patients. The key was the higher plasma concentration overcoming the modest vascular impairment caused by diabetes.
Contrast this with a 30‑year‑old athlete who frequently eats protein‑rich, high‑fat meals before dates. His best experience comes from Avanafil 100mg taken on an empty stomach, because the drug’s rapid absorption isn’t hindered by food. In his case, a higher dose of Vardenafil would be slower and less reliable.
Bottom Line: Matching Dose to Lifestyle
There’s no one‑size‑fits‑all answer. Levitra Extra offers a potent, mid‑duration option that slots neatly between the quick‑acting Avanafil and the ultra‑long Tadalafil. If you’ve already tried standard Levitra without success, the 20mg tablet is a logical next step-provided you’ve cleared it with your physician. For men who value a “ready‑whenever” pill, Tadalafil’s daily low dose or the ultra‑fast Avanafil may be a better fit. Always weigh onset, duration, side‑effects, and personal health conditions before settling on a dose.
Frequently Asked Questions
Is Levitra Extra stronger than regular Levitra?
Yes. Levitra Extra contains 20mg of Vardenafil, double the standard 10mg dose, which can increase efficacy for men who didn’t respond fully to the lower dose.
How soon does Levitra Extra work?
On average, erections begin 25‑60minutes after taking the tablet, similar to regular Levitra.
Can I take Levitra Extra with alcohol?
Moderate alcohol (one to two drinks) is generally safe, but excessive consumption can blunt the drug’s effect and increase side‑effects like dizziness.
Is Levitra Extra safe for men with heart disease?
Men with stable cardiovascular conditions may use it, but anyone on nitrates or with uncontrolled hypertension should avoid it and talk to a doctor.
How does Levitra Extra compare to Tadalafil’s daily low dose?
Levitra Extra offers a stronger, as‑needed effect lasting about 4‑5hours, while daily Tadalafil (2.5‑5mg) provides continuous readiness without the need to plan timing.
richard king
October 16, 2025 AT 16:23In the theater of intimacy, the spotlight often swings between the fleeting blaze of desire and the dimming embers of disappointment. Levitra Extra strides onto this stage like a seasoned protagonist, wielding double the Vardenafil dosage to rewrite the script for those who have lingered in the shadows of half‑filled promises. Its 20 mg charge offers a swifter crescendo, nudging the curtain up sooner while keeping the act alive for a respectable four‑to‑five hours. Yet, like any potent elixir, the increased potency summons a chorus of side‑effects-headaches, flushing, that occasional nasal congestion-each demanding its own encore of caution. For the man whose standard 10 mg tablet has left him staring at a half‑lit stage, the extra dose may be the plot twist that finally delivers a standing ovation.
Kris cree9
October 16, 2025 AT 17:46Man, this 20mg pill sounds like a hype train that probably just burns your wallet.
Paula Hines
October 16, 2025 AT 19:18The American market has long been saturated with a plethora of PDE5 inhibitors each promising the same miracle of restored vigor. Levitra Extra positions itself as the heavyweight champion among them with its doubled Vardenafil dosage. From a pharmacological standpoint the increase from ten to twenty milligrams simply raises the plasma concentration. Higher concentration translates into a greater likelihood of achieving a full erection for individuals whose vascular response is compromised. Clinical data suggests that the response rate climbs by several percentage points when the dosage is escalated. Nevertheless the law of diminishing returns applies as side‑effects become more pronounced. Headaches and flushing appear with greater frequency as the drug engages the nitric oxide pathway more aggressively. Patients with pre‑existing cardiovascular conditions must weigh the benefits against the potential cardiac stress. The American healthcare system often favors the convenience of an as‑needed pill over daily regimens. In this context the 20 mg tablet offers a middle ground between the rapid onset of Avanafil and the lingering presence of Tadalafil. Food interactions remain less significant for Vardenafil compared with Sildenafil which can be delayed by high‑fat meals. For the average American man juggling work, family, and occasional social drinking the moderate duration of four to five hours is advantageous. However those who desire spontaneity without timing their dose may find the weekly ritual of a nightly low‑dose Tadalafil more suitable. Ultimately the decision rests on personal health profile, lifestyle, and consultation with a qualified physician. Choosing Levitra Extra should be viewed as a calculated step forward rather than a reckless gamble on potency.
Queen Flipcharts
October 16, 2025 AT 20:58From a philosophical perspective the escalation of dosage represents not merely a quantitative adjustment but an ethical dialogue between therapeutic ambition and patient autonomy, wherein the prescriber must balance the promise of heightened efficacy against the specter of amplified adverse events.
Yojana Geete
October 16, 2025 AT 22:46Oh wow the 20 mg tablet feels like stepping onto a red carpet of hope the shine is blinding and the crowd of side‑effects whispering in the background almost like jealous fans crying for attention
Jason Peart
October 17, 2025 AT 00:43Hey there, I get that stepping up to a 20 mg dose can feel like a big leap. Think of it as fine‑tuning the volume on a familiar song-you already know the rhythm, you just need a little extra push. If the standard tablet left you half‑listening, the extra strength often fills in the gaps. Just make sure your doctor checks any heart meds and you stay hydrated. You’ve got this, and the right dose can turn those awkward pauses into smooth verses.