Vilitra 60 is marketed as containing vardenafil 60 mg, a PDE-5 inhibitor used for erectile dysfunction (ED). However, 60 mg is above the commonly studied and approved vardenafil dose range for ED in many guidelines (often up to 20 mg). A doctor may review the situation, but a healthcare professional would usually be cautious about recommending such a high dose because: Higher doses may increase the risk of side effects such as headache, flushing, dizziness, low blood pressure, vision changes, and fainting. There is limited clinical evidence that increasing vardenafil beyond standard doses provides better results. Poor response to lower doses may be due to factors such as incorrect timing, alcohol use, stress, medication interactions, diabetes, blood pressure problems, or other causes of ED. Before using any high-dose ED medicine, a doctor may check: Heart health and blood pressure Other medicines being taken Kidney and liver function (when relevant) The underlying cause of ED Do not take Vilitra 60 with nitrate medicines (such as nitroglycerin for chest pain) or combine it with other ED medicines (such as sildenafil or tadalafil) unless specifically directed by a doctor. If you are asking because Vilitra 20 mg is not working, I can explain what doctors usually check before changing treatment.