If Vilitra 20 mg contains vardenafil 20 mg, it can improve ***** performance mainly by helping you get and maintain a firm erection when you are *****ly aroused. It does not directly increase ***** desire. What you may notice Easier erections: improves blood flow to the ***** during ***** stimulation. Better erection firmness: can make it easier to achieve *****. Better maintenance: may help you stay hard long enough for *****. Clinical studies found significant improvements in both achieving and maintaining erections with vardenafil. It doesn't automatically cause an erection: ***** stimulation is required. It doesn't necessarily make you last longer before *****. Vardenafil is primarily an ED medicine, not a treatment specifically for premature *****. About the 20 mg dose 20 mg is the maximum recommended dose of vardenafil, and the usual starting dose is 10 mg. It should generally be taken about 60 minutes before ***** activity and no more than once in 24 hours. Higher doses can also increase side effects such as headache, flushing, nasal congestion, indigestion and dizziness. Important: Never combine vardenafil with nitrate medicines (such as nitroglycerin) or riociguat because blood pressure can drop dangerously. An erection lasting more than 4 hours needs immediate medical attention.