Levitra Super Force (Vardenafil/Dapoxetine): Comprehensive Patient Guide for Australia
Basic Product Information
| International Nonproprietary Name (INN) | Vardenafil / Dapoxetine |
| Australia Brand Names | Levitra Super Force (Note: Combination preparations may not be TGA-registered; consult your pharmacist or doctor for alternatives.) |
| ATC Code | G04BE09 (Vardenafil), N06AX11 (Dapoxetine) |
| Available Forms & Strengths | Oral tablet, Vardenafil 20 mg/Dapoxetine 60 mg |
| Manufacturers | Various generic manufacturers, not officially registered with the TGA; available via select pharmacies importing from accredited suppliers |
| Prescription Status | Prescription Only (Schedule 4 medicine in Australia) |
Mechanism of Action
- Simple Explanation: Levitra Super Force combines vardenafil, which helps achieve an erection by increasing blood flow to the penis, with dapoxetine, which delays ejaculation by acting on the brain’s serotonin system.
- Specialist Explanation: Vardenafil is a selective phosphodiesterase type 5 inhibitor (PDE5i), enhancing nitric oxide-mediated vasodilation in corpus cavernosum during sexual stimulation. Dapoxetine, a short-acting selective serotonin reuptake inhibitor (SSRI), increases synaptic serotonin, delaying the ejaculatory reflex by modulating central nervous system pathways.
Pharmacokinetics
- Absorption: Both agents are rapidly absorbed orally; vardenafil reaches peak concentrations in roughly 30–60 minutes, dapoxetine in around 1–2 hours.
- Metabolism: Metabolised primarily in the liver via CYP3A4 (vardenafil) and CYP2D6/CYP3A4 (dapoxetine).
- Elimination: Main route is hepatic and renal, with excretion mostly via urine (vardenafil) and faeces (dapoxetine); terminal half-lives are 4–5 hours (vardenafil) and 1.5 hours (dapoxetine).
- Duration of Action: Erectile support typically lasts 4–5 hours, delay in ejaculation for up to 2–4 hours after dosing.
Use in Everyday Life and Best Practices in Australia
- Typical Adult Dose: 1 tablet (20 mg vardenafil/60 mg dapoxetine) approximately 30–60 minutes before anticipated sexual activity.
- How to Take: Swallow whole with water. Do not take more than one tablet in 24 hours.
- Australian Context: Should be used under the guidance of an Australian GP or urologist, particularly as off-label combinations may not be available in all community settings.
- Best Practices:
- Regular consultations for men’s health are recommended.
- Consider sexual health clinics for confidential, specialist advice.
- Do not combine with other erectile dysfunction or antidepressant medicines without seeking medical advice.
Dosing in the Morning vs Evening
- Evening Use: Most effective if taken 30–60 minutes before planned sexual activity, commonly in the evening.
- Morning Use: May be inconvenient due to variable sexual timing and possible increased risk of side effects (such as headache or dyspepsia) while at work or driving.
- Consistency: For best results, aim for regular timing, but tailor to individual lifestyle and sexual routines.
Taking With Food or on an Empty Stomach
- With Food: A light meal will generally not affect absorption significantly; however, high-fat meals can delay uptake and reduce intensity of action.
- Empty Stomach: Optimal absorption and fastest onset achieved when taken on an empty stomach.
- Australian Dietary Habits: Try to avoid large, greasy dinners immediately before use; typical Australian meals (grilled meats, salads, moderate carbohydrates) are generally suitable.
Interaction Warnings
| Interactions to Consider |
| Alcohol | Increases risk of side effects (e.g., dizziness, fainting, impaired judgment) |
| Grapefruit Juice | Can increase blood levels of vardenafil and dapoxetine, leading to toxicity |
| Nitrates (e.g., GTN spray, heart medicines) | Contraindicated—can cause severe, dangerous drops in blood pressure |
| Other PDE5 Inhibitors (e.g., Viagra, Cialis) | Not to be used together; increased risk of severe side effects |
| SSRIs, SNRIs, Tricyclics, MAOIs | May potentiate serotonergic side effects (risk of serotonin syndrome with dapoxetine) |
| Macrolide antibiotics (e.g., erythromycin) | Can increase vardenafil/dapoxetine toxicity |
| Antifungal agents (e.g., ketoconazole) | Interact with hepatic metabolism, increasing blood levels |
| Antiepileptics, Rifampicin | May reduce effectiveness by inducing liver enzymes |
Indications
| Indication | Status in Australia | Notes |
| Erectile Dysfunction (ED) | Primary/Official (for vardenafil) | Consult TGA guidelines for monotherapy |
| Premature Ejaculation (PE) | Primary/Official (for dapoxetine) | Not all brands/formulations available on PBS |
| Simultaneous management of ED & PE | Off-label (combination preparations) | Requires specialist prescription; off-label use must be justified |
| Other sexual dysfunctions | Off-label | Consider alternative or adjunctive therapies |
Dosing According to Clinical Indications
| Population | Recommended Dose | Comments |
| Adults (18-64 years) | 1 tablet (20/60 mg) as needed
Max: 1 per 24 hours | Take before anticipated sexual activity |
| Younger adults (18-21 years) | Off-label, not recommended without specialist consultation | Use only if clearly indicated |
| Elderly (65+ years) | Lower starting dose advised or monitor closely (often half dose) | Greater risk of adverse effects, interactions |
| Paediatric (under 18 years) | Contraindicated | Not for use in children or adolescents |
Safety Profile and Side Effects
| Side Effect | Frequency | Notes / Warnings |
| Headache | Common (5-10%) | Mild–moderate, usually self-limiting |
| Dizziness | Common | Exacerbated by alcohol, dehydration |
| Flushing | Common | May feel warm or red in face/neck |
| Indigestion (dyspepsia) | Occasional | Take with water, light meal |
| Nausea and stomach upset | Possible | More likely with dapoxetine; take on a full stomach |
| Insomnia, nervousness | Less common | Dapoxetine can cause stimulation |
| Palpitations, rapid heart rate | Rare | Stop use and seek urgent care if severe |
| Prolonged or painful erection (priapism) | Very rare (<0.1%) | Seek medical attention if erection lasts >4 hours |
| Vision changes | Very rare | Stop medicine, report to doctor |
| Allergic reactions | Very rare | Swelling, rash, breathing issues: call 000—emergency |
- Warnings: Caution in people with cardiovascular disease, severe liver/kidney impairment, or who are taking interacting medications. Do not combine with recreational drugs (e.g., "poppers").
- Women, children, and adolescents must not use this medicine.
Guidelines for Proper Use (Australian Pharmacist Advice)
- Always obtain from a reputable, TGA-approved pharmacy.
- Do not exceed recommended dose or frequency.
- Alcohol increases risk of side effects; limit to 1–2 standard drinks if unavoidable.
- Interactions: Inform your GP or community pharmacist about all medicines and supplements.
- Do not drive or operate heavy machinery until you know how the medicine affects you.
- Store at room temperature, out of reach of children. Do not use expired medicine.
- Report any unusual symptoms promptly to your healthcare provider or the Adverse Medicine Events Line (1300 134 237).
Alternative Treatment Options
- PDE5 Inhibitors: Sildenafil (Viagra), Tadalafil (Cialis), Avanafil (not always PBS-reimbursed)
- For Premature Ejaculation: Paroxetine, Sertraline (SSRIs used off-label), topical lignocaine spray, behavioural techniques
- Combined ED/PE management: No PBS-listed combination products; use separate prescription of single agents under clinical supervision
- Comparative Overview:
- Vardenafil: Fast onset, fewer side effects than sildenafil, suitable for diabetics
- Sildenafil: Most evidence, wider availability, cost-effective
- Tadalafil: Longer duration, good for spontaneous intercourse
- Dapoxetine: Only SSRI licensed for PE, rapid onset/offset
Legal, Registration, and Reimbursement Status in Australia
- Legal Status: Prescription required (Schedule 4); possession or supply without prescription is illegal.
- TGA Registration: Only individual ingredients (vardenafil, dapoxetine) currently listed; combination therapies may not be registered. Verify with your pharmacist.
- Reimbursement: Neither vardenafil nor dapoxetine currently has PBS subsidy for erectile or ejaculatory disorders (as of 2024).
- Prescriber Guidance: GPs or urologists may provide off-label prescriptions; documentation required for custom compounding or importation.
Latest Research and Clinical Guidance (2022–2025)
- Combination therapies for sexual dysfunction commonly recommended in European and international (ISSWSH, EAU) guidelines; latest Australian consensus advocates careful selection and individualised risk assessment (Chung et al., Aust Fam Physician, 2022).
- Dapoxetine affirmed in the International Society for Sexual Medicine guidelines as preferred first-line agent for PE (McMahon et al., J Sex Med, 2023).
- Specialist review recommended for persistent or multidrug-resistant sexual dysfunction (Anderson & Lin, Australian Prescriber, 2024).
- Beware of internet-supplied “combination” products; use only with proven quality and on advice from a registered health professional.
Availability and Delivery
- Available in: 4-, 8-, 12-, 24-tablet blister packs (from select Australian online or compounding pharmacies)
- Price guide (2024): 4-tablet pack approx. $45–65 AUD; larger packs may offer savings per dose
| City | Delivery Time* |
| Sydney | 2–3 business days |
| Melbourne | 2–3 business days |
| Brisbane | 3–5 business days |
| Perth | 5–7 business days |
| Adelaide | 3–5 business days |
| Regional Australia | Up to 7 business days |
*Indicative delivery times for in-stock items from AU-based mail-order or online pharmacies. Confirm timelines and costs at checkout. FAQ: Common Patient Questions
- 1. Can I use Levitra Super Force if I have a heart condition?
No. If you have known significant cardiovascular disease, a history of heart attack, stroke, or taking any nitrates, you must not use this medicine. Always consult your GP or cardiologist first. - 2. Will Levitra Super Force cure my sexual dysfunction permanently?
No. It provides temporary symptom relief but does not cure underlying causes. Regular review with your doctor will help determine the need for continued treatment or alternatives. - 3. Is it safe to buy Levitra Super Force online?
Only use pharmacies licensed by the Australian Health Practitioner Regulation Agency (AHPRA) and avoid overseas or unverified sites. Counterfeit or substandard products are a known risk. - 4. Can I take this medication if I am already using an antidepressant?
Not without medical advice. Combining SSRIs (including dapoxetine) risks serotonin syndrome and other interactions. Inform your doctor and discuss safer alternatives. - 5. What should I do if I experience severe side effects?
Stop taking the medicine immediately and contact your GP, local pharmacist, or, for emergencies (chest pain, breathing difficulty, severe allergic reaction), call 000 for ambulance.
Always consult a registered healthcare professional for individual medical guidance.
