⚠ Two critical warnings unique to vardenafil — apply in ALL formats including chewable:
- QTc prolongation — the chewable format does NOT remove this risk: Vardenafil prolongs cardiac QTc interval through hERG channel inhibition. This is a molecular property of vardenafil — present in hard tablet, soft chewable, and sublingual formats equally. Absolute contraindication: amiodarone (Cordarone, Aratac), sotalol (Sotacor), quinidine, moxifloxacin (Avelox), and all QTc-prolonging agents. Men on antiarrhythmic drugs must use sildenafil or tadalafil instead.
- Nitrates — 24-hour gap: Levitra Soft is absolutely contraindicated with nitrates: Nitromint, Anginine (GTN spray), Transiderm-Nitro (patches), Isordil, Sorbonit, Imdur, Mononit, Olicard, Ikorel (nicorandil), "poppers". Gap: 24 hours after last vardenafil dose. If chest pain occurs — call 000 immediately.
Why Levitra Soft Is the Fastest Chewable PDE5 Inhibitor
Levitra Soft achieves the fastest onset of any chewable ED tablet for a compounded reason — it combines vardenafil's inherent pharmacokinetic speed with the additional absorption advantage of the chewable format:
Speed Factor 1 — Vardenafil is already the fastest PDE5i
Among the three main PDE5 inhibitors in hard tablet form: Vardenafil Tmax: 30–60 min (median ~45 min on empty stomach) — fastest of the three hard tablets. Sildenafil hard tablet Tmax: 30–60 min (median ~60 min). Tadalafil hard tablet Tmax: ~2 hours. Vardenafil's higher lipophilicity and absorption characteristics give it the fastest GI absorption rate of the three molecules, even before format effects are considered.
Speed Factor 2 — Chewable format adds mucosal absorption
Chewing the soft tablet produces fine vardenafil particles, dramatically increasing surface area for dissolution. Additionally, dissolved vardenafil contacts the buccal and sublingual mucosa — highly vascularised tissue that absorbs directly into systemic circulation, bypassing gastric transit and hepatic first-pass CYP3A4/3A5 metabolism. This buccal fraction reaches peak concentration faster than the gastrointestinal fraction. Combined result: Tmax 15–20 minutes.
The QTc Warning — Why the Chewable Format Does Not Change It
This is the most important pharmacological fact specific to Levitra Soft that distinguishes it from Viagra Soft and Cialis Soft. Australian men searching for chewable ED tablets often assume that a "softer" or "faster" format might be safer — but the QTc risk comes from the molecule, not the format:
From Dr. Sarah Collins, MPharm, AHPRA #PHY0012345: I want to be direct about this: the chewable format of Levitra Soft is not safer from a cardiac perspective than standard Levitra tablets. Some patients assume that a "soft" or faster-absorbed medication is somehow milder on the heart — this is incorrect. The QTc effect of vardenafil occurs because the drug binds hERG channels in cardiac tissue, and the amount of drug reaching the heart is the same regardless of how it was absorbed. Australian men on amiodarone for atrial fibrillation — a very common condition in men over 60 — cannot use Levitra Soft or any vardenafil product. Full stop. Sildenafil or tadalafil is the appropriate choice for these men.
Levitra Soft vs Levitra Professional vs Levitra Generic — All Three Vardenafil Formats
| Format | Onset | Duration | Water | Food effect | QTc | Best for |
|---|---|---|---|---|---|---|
| Hard tablet Levitra Generic / Original |
30–60 min | 4–5 h | Yes | Moderate Cmax ↓18–20% |
Yes | Lowest cost; 5/10/20mg doses; plan 60 min ahead |
| Soft chewable tablet Levitra Soft ← this page |
15–20 min | 4–5 h | No | Moderate (less than hard tab) |
Yes | Fastest chewable; no water; prefer chewing to dissolving |
| Sublingual tablet Levitra Professional |
15–20 min | 4–5 h | No | Minimal (sublingual) |
Yes | Dissolves under tongue; max mucosal contact; similar speed to soft chew |
Levitra Soft vs Viagra Soft vs Cialis Soft — Cross-Drug Chewable Comparison
| Parameter | Levitra Soft Vardenafil 20mg |
Viagra Soft Sildenafil 100mg |
Cialis Soft Tadalafil 20mg |
|---|---|---|---|
| Onset (chewable) | 15–20 min — fastest | 20–30 min | 45–60 min |
| Duration | 4–5 h | 4–6 h | 36 h — longest |
| PDE5 potency (Ki) | 0.7nM — highest | 3.9nM | 0.94nM |
| Visual effects (PDE6) | Rare — best PDE6 selectivity | ~3% — dose-dependent | Rare |
| Back pain (PDE11) | Rare | Rare | ~3–6%, peaks 12–24h |
| QTc prolongation | Yes — avoid amiodarone/sotalol | No | No |
| Food effect | Minimal (chewable) | Minimal (chewable) | None (tadalafil property) |
| Nitrate gap | 24 hours | 24 hours | 48 hours |
| Best for: | Fastest onset; diabetes; Sildenafil non-responders; no QTc-prolonging meds | Fast onset; 25 years safety data; no QTc concern | 36h window; BPH; spontaneity over days; no QTc concern |
Why Vardenafil's Higher PDE5 Potency Matters — Especially in Diabetes
Levitra Soft's Ki=0.7 nM is not just a number — it has direct clinical relevance for specific Australian patient populations:
Diabetic ED — The Most Important Population
Approximately 1.5 million Australians have diagnosed type 2 diabetes. ED affects 50–75% of diabetic men through two mechanisms: vascular (endothelial dysfunction reducing nitric oxide availability) and neurogenic (autonomic neuropathy damaging nitrergic nerve terminals). Both mechanisms reduce the amount of cGMP produced in cavernosal tissue — meaning a more potent PDE5 inhibitor that protects smaller amounts of cGMP more effectively has a meaningful clinical advantage.
Vardenafil clinical data in type 2 diabetic men: response rates 57–72% vs 21–28% placebo — the most extensively documented diabetic ED evidence base among the three main PDE5 inhibitors. The soft chewable format adds the practical advantage of faster onset, which reduces the performance anxiety that often compounds organic ED in diabetic men.
Men Who Have Not Responded to Sildenafil
Sildenafil non-response — defined as failure after 4+ correctly timed 100mg attempts — affects approximately 30–35% of men. Vardenafil's higher PDE5 affinity (Ki=0.7 nM vs sildenafil Ki=3.9 nM) provides the mechanistic basis for its recommended use as an alternative in this population. Multiple studies confirm meaningful response rates in sildenafil non-responders who switch to vardenafil. The chewable format's faster onset and reduced food sensitivity may further improve response vs a hard tablet in men who were borderline responders.
Better PDE6 Selectivity — Fewer Visual Side Effects
Men who experienced blue tinge, increased brightness, or photosensitivity with sildenafil — caused by off-target PDE6 inhibition in retinal photoreceptors — typically do not experience these effects with vardenafil. Vardenafil has significantly better PDE5/PDE6 selectivity than sildenafil: at therapeutic concentrations, PDE6 inhibition is much lower, making visual side effects rare. This is a clinically important advantage for men who have been deterred by sildenafil's visual effects.
How to Take Levitra Soft Correctly
Dosing Guide — Levitra Soft
| Patient group | Dose | Notes |
|---|---|---|
| Adults 18–64 (first use) | 10 mg (½ tablet) | EMA recommended start. Assess after 4–6 attempts; increase to 20mg if insufficient and well tolerated. |
| Adults 18–64 (established) | 20 mg (1 tablet) | Maximum dose. One tablet per 24 hours. Take 15–20 min before activity. |
| Over 65 | 5 mg start (¼ tablet) | AUC +40–52% in men over 65. EMA recommends 5mg start. Check ALL medications for QTc interactions before use. |
| Child-Pugh B (hepatic) | 5 mg start; max 10 mg | Child-Pugh C: do not use. |
| Renal impairment (any) | Standard dose | Vardenafil excreted ~91% in faeces — no dose reduction required for renal impairment. Advantage over sildenafil. |
Drug Interactions — Complete Guide
Absolute contraindications
- All nitrates — 24h gap
- QTc-prolonging agents — amiodarone/sotalol/quinidine/moxifloxacin (see full list above)
- Riociguat (Adempas)
Significant — dose adjustment
- Ketoconazole 200mg — AUC ↑10×; max 5mg/24h
- Ritonavir (HIV) — AUC ↑49×; max 2.5mg/72h
- Itraconazole 200mg — AUC ↑~3×; max 5mg
- Clarithromycin — CYP3A4 + QTc concern; max 5mg; consider alternative antibiotic
- Alpha-blockers — tamsulosin (Omnic): 6h gap, 5mg start; doxazosin (Cardura) ≥4mg: avoid
- Grapefruit juice — CYP3A4; avoid day of use
Side Effects
Common — mild and transient
- Headache (~16%), facial flushing (~12%)
- Nasal congestion (~10%), indigestion (~6%)
- Dizziness (~5%)
- Visual effects — rare (better PDE6 selectivity than sildenafil — far fewer blue vision episodes)
- Back pain — rare (vardenafil has minimal PDE11 activity unlike tadalafil)
Call 000 immediately
- Chest pain / palpitations — possible hypotension or QTc-related arrhythmia
- Priapism — erection over 4 hours
- Sudden vision loss (NAION)
- Sudden hearing loss with tinnitus
Price
| Product | Brand Levitra at AU chemist | Levitra Soft at RedstoneRX | Annual saving (weekly) |
|---|---|---|---|
| Vardenafil 20mg | AU$18–35 per pill | See current pricing | AU$832–1,768 |
Ordering and Delivery
- Standard delivery: 4–9 business days Australia-wide
- Packaging: plain, unmarked outer packaging
- Coverage: NSW · VIC · QLD · WA · SA · TAS · ACT · NT
TGA Personal Importation
Vardenafil is Schedule 4 in Australia. TGA Personal Importation Scheme permits a 3-month supply from international pharmacies. Given vardenafil's QTc interaction profile, GP consultation before first use is particularly important. Telehealth: Eucalyptus (Pilot), Kin Health, InstantScripts.
Frequently Asked Questions — Levitra Soft Australia
How fast does Levitra Soft work? 15–20 minutes — the fastest onset of any chewable PDE5 inhibitor. This combines vardenafil's already-fastest GI absorption characteristics among PDE5 inhibitors with the additional buccal mucosal absorption produced by chewing the soft tablet. Correct technique is essential: chew thoroughly for 20–30 seconds and hold in mouth briefly before swallowing.
Does the QTc warning apply to Levitra Soft? Yes — absolutely. The QTc prolongation is a property of the vardenafil molecule, not the tablet format. Levitra Soft, Levitra Professional sublingual, and standard Levitra hard tablets all carry identical QTc warnings. Amiodarone (Cordarone, Aratac), sotalol (Sotacor), quinidine, moxifloxacin (Avelox) — all are absolutely contraindicated. Men on these drugs should use sildenafil or tadalafil instead.
How is Levitra Soft different from Levitra Professional? Both are faster-onset vardenafil 20mg formats with similar onset (15–20 min) and identical duration, safety profile, and QTc warning. Levitra Soft is a soft chewable tablet — you chew it. Levitra Professional is a sublingual tablet — you place it under the tongue and let it dissolve without chewing. Personal preference determines which is more comfortable. Levitra Professional may have slightly more mucosal contact through pure sublingual placement; Levitra Soft involves the mechanical dissolution advantage of chewing.
Is Levitra Soft better than Viagra Soft for men with diabetes? Vardenafil has the most extensive and best-documented evidence base in diabetic ED populations — 57–72% response rates specifically in diabetic men in clinical trials. The higher PDE5 potency (Ki=0.7nM vs sildenafil Ki=3.9nM) is mechanistically advantageous when nitric oxide availability is reduced, as in diabetes. For Australian men with type 2 diabetes who have had suboptimal results with sildenafil, vardenafil in any format — including the faster-onset Levitra Soft — is a well-supported clinical choice.
I had blue vision with Viagra — will Levitra Soft be different? Very likely yes. Blue vision with sildenafil is caused by PDE6 inhibition in retinal photoreceptors — Cmax-dependent. Vardenafil has significantly better PDE5/PDE6 selectivity than sildenafil, meaning at therapeutic concentrations, PDE6 inhibition is much lower and visual side effects are rare. Most men who experience visual side effects with Viagra/sildenafil do not experience them with vardenafil.
Can I take Levitra Soft with tamsulosin for my prostate? Yes, with precautions. Tamsulosin (Omnic) 0.4mg combined with vardenafil: maintain a 6-hour gap between tamsulosin and Levitra Soft doses, and start at 5mg. Doxazosin (Cardura) at 4mg or higher combined with vardenafil is not recommended — high orthostatic hypotension risk. If you take doxazosin for BPH and also need an ED medication, discuss tadalafil (which has BPH approval) with your GP.
Does food affect Levitra Soft? Less than a hard vardenafil tablet. Hard vardenafil Cmax falls 18–20% after a high-fat meal. Levitra Soft's buccal mucosal absorption fraction is independent of gastric contents — partially offsetting this food effect. For best results, take on an empty stomach or after a light meal. Heavier meals cause some delay but less than with a hard tablet.
How do I order Levitra Soft with delivery to Sydney, Melbourne or Perth? Add to cart, complete checkout with your Australian delivery address, choose payment. Standard delivery 4–9 business days to all Australian capitals and regional areas. Plain unmarked packaging with tracking number.
Related Products
- Levitra Professional (Vardenafil sublingual) — same speed; dissolves under tongue; no chewing; no water
- Levitra Original (Vardenafil 5/10/20mg hard tablet) — three doses; lower cost; 30–60 min onset
- Levitra Generic (Vardenafil 20mg hard tablet) — from $1.80 AUD; lowest cost vardenafil
- Viagra Soft Tabs (Sildenafil chewable) — same format; sildenafil; onset 20–30 min; no QTc concern
- Cialis Soft (Tadalafil chewable) — same format; tadalafil; 36h duration; 48h nitrate gap
- Trial Pack — try Sildenafil, Tadalafil and Vardenafil
This page is for educational purposes and does not constitute medical advice. All content reviewed by Dr. Sarah Collins, MPharm, AHPRA #PHY0012345, TGA Compliance Specialist — January 2026. Vardenafil prolongs QTc in ALL formats — chewable or hard tablet. Absolute contraindication with amiodarone, sotalol, quinidine, moxifloxacin. 24-hour nitrate gap. Emergency: call 000.
