5-20 mg compared without a shop ranking
Levitra never won the 2026 headline the way Cialis and Viagra did. That is a search fact, not an efficacy fact. The film tablets are 2.5, 5, 10, and 20 mg. Recommended start is 10 mg as needed, about 60 minutes before sexual activity, then 5 mg or 20 mg on effect and tolerability. Maximum frequency is once per day.
Xalira locks 5-20 mg because that is the compare a 2026 'best generic vardenafil' title should have printed. Two-point-five milligrams is a CYP-cut tablet, not a first Helsinki rung. Twenty milligrams is a ceiling. Five milligrams is where age 65 and moderate hepatic impairment begin.
Healthline-style lists sometimes give Levitra a 'fewest side effects' ribbon. This desk will not reprint that ribbon. Headache, flushing, rhinitis, and dyspepsia are still the common list. The line that actually separates this INN is the QT study the other two specimens do not carry at the same length.
Fast peak, 15% bioavailability, fat still matters
Absolute bioavailability is only about 15%. Fasted Tmax after 20 mg is usually 30 minutes to 2 hours, median 60 minutes. That median is why 'fast Levitra' titles are half true. Some men notice an effect earlier. The peak the label will stand behind is still about an hour.
Two food-effect studies showed high-fat meals cut Cmax by 18-50%. That is a wider, messier cut than sildenafil's tidy 29%, and it is not tadalafil's 'without regard to food'. A 2026 onset compare that ignores dinner will over-praise this tablet and then blame the INN.
Volume of distribution is about 208 L. Protein binding is about 95% for parent and M1. Clearance is about 56 L/h. Terminal half-life of vardenafil and M1 is about 4-5 hours. Feces carry about 91-95% of the oral dose as metabolites; urine only 2-6%. Short clock, thin bioavailability, fat-sensitive peak.
| Absorption | Bioavailability about 15%. Fasted Tmax 0.5-2 h (median 60 min). High-fat meal: Cmax -18% to -50%. |
|---|---|
| Distribution | Vss about 208 L; ~95% protein-bound (parent and M1). |
| Metabolism | Hepatic, CYP3A4 (and CYP2C9 contribution in the ritonavir story); active metabolite M1. |
| Excretion | Clearance about 56 L/h; t½ about 4-5 hours; feces 91-95%, urine 2-6%. |
Staxyn 10 mg ODT is not a film-tablet swap
Staxyn is a 10 mg orodispersible vardenafil tablet. It is not interchangeable milligram-for-milligram with Levitra film. A 2026 compare that treats every 'vardenafil 10' as the same swallow is sloppy. This specimen is the film ladder, 5-20 mg.
Treadmill studies at 10 mg (n=41) and 20 mg (n=39) in men with stable exercise-induced angina, not within six months of MI or revascularization, found no change in total exercise time versus placebo (433 vs 426 seconds at 10 mg; 414 vs 411 at 20 mg). Time to angina and time to 1 mm ST depression were similar to placebo. That is a selected, labelled reassurance. It does not open nitrates.
The onset sample is the place for the stopwatch argument. Keep Staxyn out of that stopwatch unless the written product is Staxyn.
Formulation dates this specimen refuses to collapse
FDA approves Levitra (vardenafil) film tablets, including 5, 10, and 20 mg.
Staxyn 10 mg ODT arrives as a separate vardenafil formulation.
US generic vardenafil film becomes the cheap-compare object 2026 titles still use.
Age 65 and Child-Pugh B start at five
Elderly men 65 and older showed 34% higher Cmax and 52% higher AUC than men 18-45. The label says a lower 5 mg start should be considered. That is the Helsinki floor for this specimen's SERP lock, not a 2.5 mg first pull.
Child-Pugh A after 10 mg: Cmax +22%, AUC +17%. Child-Pugh B: Cmax +130%, AUC +160%. Start 5 mg in moderate hepatic impairment and do not exceed 10 mg. Child-Pugh C was not studied; this desk does not invent a rung. Severe hepatic disease keeps vardenafil off the casual 2026 list.
Alpha-blockers: start at the lowest recommended vardenafil dose once the alpha-blocker is stable. Nitrates remain contraindicated, same class rule as the other two specimens. The difference is not the nitrate ban. The difference is the QT line plus these start-at-five cuts.
| Who | Labelled start on film tablets | Ceiling in that lane |
|---|---|---|
| Most adults | 10 mg about 60 minutes before | 20 mg once daily |
| Age ≥65 | Consider 5 mg | Usual 20 mg cap still needs a chart |
| Child-Pugh B | 5 mg | 10 mg maximum |
| Child-Pugh C | Not evaluated | Do not invent a dose |
Ordinary reactions versus the QT headline
Headache, flushing, rhinitis, and dyspepsia are the reactions 2026 lists forget when they hand Levitra a mildness ribbon. They are still the common list. Priapism past four hours is the same four-hour clock as the other two INNs. Sudden vision or hearing loss is the same stop. NAION talk is class-wide, not a vardenafil exclusive scare.
Alpha-blockers: start vardenafil at the lowest recommended dose once the alpha-blocker is stable. Standing hypotension is the watch. This is not the QT avoid. A man on tamsulosin and amiodarone has two different reasons to pause, and only the second closes the INN outright.
Other antihypertensives can add to the vasodilator load. The treadmill studies at 10 and 20 mg in selected men with stable exertional angina found no change in total exercise time versus placebo. That is a narrow, labelled reassurance for a group that was not within six months of MI or revascularization and was not on chronic oral nitrates. It is not a green light for chest-pain plans.
Staxyn 10 mg ODT remains a different formulation. Food numbers and Tmax on this specimen are film numbers. A 2026 onset title that dissolves a film tablet in water to 'make it Staxyn' is not an assay. Ask the window which NDC they priced.
Export vardenafil names do not invent a new QT rule. If the blister says 20 mg vardenafil, the 59-man study and the Class IA/III avoid still apply. A cheaper strip is not a quieter ECG.
Common reactions still need a sentence that is not a ribbon. Flushing and rhinitis show up often enough that a 2026 'fewest side effects' line is doing marketing work. Priapism past four hours is a four-hour clock. Sudden vision or hearing loss is a stop. Those lines match the other two INNs. The QT avoid is what does not.
North American SEP3 of 51%, 64%, and 65% on 5, 10, and 20 mg versus 32% placebo is why this INN belongs on a 2026 compare at all. Diabetes SEP3 of 49% and 54% versus 23%, and post-prostatectomy SEP3 of 37% and 34% versus 10%, are why a title that quotes only 65% is selling the easy trial. Quote the population you have. Then keep the QT list attached.
Bioavailability of 15% is the quiet number behind the loud CYP folds. A tablet that is mostly first-pass will jump hard when ritonavir shuts the gate. That is why 2.5 mg every 72 hours exists. It is also why a 'fast, light dose' story that ignores protease inhibitors is unfinished. Fast is a median. Light is a cut. They are not the same sentence. Jonas will stamp both. He will not stamp a trophy for either.
QT screen that Cialis and Viagra pages skip
A single-dose, double-blind, placebo- and moxifloxacin-controlled crossover in 59 healthy men aged 45-60 measured QT at one hour, near peak. Ten milligrams and 80 mg vardenafil (four times the highest recommended dose) produced QTc increases in the same conversation as moxifloxacin 400 mg. The 80 mg arm was chosen because it covers concentrations seen when 5 mg vardenafil meets ritonavir 600 mg twice daily.
A later 44-volunteer study found 10 mg Levitra placebo-subtracted QTcF about 5 msec (90% CI 2-8). Gatifloxacin 400 mg was about 4 msec. Together they were additive at about 9 msec (90% CI 6-11). The clinical meaning of those millisecond shifts is unknown. The prescribing decision is not: men with congenital long QT, or on quinidine, procainamide, amiodarone, or sotalol, should avoid vardenafil.
That is why a 2026 Levitra compare that never mentions an ECG history is unfinished. The QT log keeps the 59-man table and the gatifloxacin add-on on one page. This specimen only needs the rule: if the chart already has a Class IA or Class III drug, pick a different INN.
North American trial numbers, not a league table
Four major fixed-dose trials enrolled 2431 men aged 20-83 (mean 57). Doses were 5, 10, and 20 mg. Two trials in a general ED population, one in diabetes, one after prostatectomy. Primary endpoints at 3 months: EF domain, SEP2, SEP3.
North American general-ED trial, 762 men. EF domain at 3 months: 18, 21, and 21 on 5, 10, and 20 mg versus 15 on placebo. SEP2 (penetration): 65%, 75%, 80% versus 52% placebo. SEP3 (intercourse): 51%, 64%, 65% versus 32% placebo. The European trial (803 men) confirmed the pattern. Gains held at 6 months in the North American study.
Diabetes trial: SEP2 61% and 64% on 10 and 20 mg versus 36% placebo; SEP3 49% and 54% versus 23%. Post-prostatectomy: SEP2 47% and 48% versus 22%; SEP3 37% and 34% versus 10%. Those are real, labelled drops from the general-ED numbers. They are not a reason to call vardenafil weak. They are a reason not to promise a 2026 'best' rate copied from the general trial.
Sourced US board for the 5 mg thirty-count
The cash band reprints GoodRx for generic vardenafil 5 mg x 30, the floor this site locked. Twenty-milligram ten-count is named as the ceiling board, not invented as a second dollar. Xalira does not dispense. Ask the window to price the written film strength.
Generic vardenafil 5 mg x 30, GoodRx Levitra tablet table.
Generic vardenafil 5 mg, thirty tablets, the Xalira Levitra floor lock, August 2026. GoodRx lists 5 mg x 30 at $1,093.22 average retail and $125.33 with a coupon. Twenty-milligram ten-count is the ceiling board on the same table. Xalira does not dispense.
Why this specimen stays on the QT log
If the 2026 title was 'Levitra 5-20 mg compared', the honest answer is a 10 mg start for most men, a 5 mg start when age or Child-Pugh B says so, a fat-meal caveat, and a QT screen the other two oral PDE5 drugs do not force at this length. Twenty milligrams is a ceiling. Two-point-five is a CYP-cut.
Jonas Berg, Mannerheimintie 18. [email protected]. The rack sheet is where this INN sits next to tadalafil and sildenafil without a trophy.