If Vilitra (vardenafil) sometimes doesn't work, that doesn't necessarily mean the medicine is ineffective. Several factors can reduce or delay its effect: Timing: It generally needs around 30–60 minutes to take effect. Taking it immediately before sex may not give it enough time. Sexual stimulation: Vardenafil doesn't automatically produce an erection. You need sexual arousal for the medication to enhance the erectile response. Heavy/fatty meal: A very high-fat meal can delay absorption and make the onset less predictable. Alcohol: A lot of  Vilitra can interfere with erections and may also increase dizziness or low blood pressure. Stress or anxiety: Performance anxiety, fatigue, relationship issues, or lack of sleep can overpower the medication's benefits. Dose: The appropriate dose varies. More isn't necessarily better, and you shouldn't increase the dose beyond what is prescribed. Underlying conditions: Diabetes, high blood pressure, cardiovascular disease, low testosterone, and some medications can contribute to ED. If it repeatedly doesn't work despite taking it correctly, it's worth discussing with a doctor rather than simply increasing the dose. They can check whether another treatment or a different ED medicine would be more appropriate. If you tell me your Vilitra strength, when you take it, whether you take it with food, and roughly how long you wait before sex, I can help identify the most likely reason.