Vilitra 20 mg should not be taken twice daily. Vilitra contains vardenafil, a medicine for erectile dysfunction, and the maximum recommended dosing frequency is once in 24 hours. The usual maximum recommended dose is 20 mg per dose. 9841 +1 Taking it twice daily can increase the risk of headache, flushing, dizziness, low blood pressure and other adverse effects. If 20 mg does not work well, do not take another tablet the same day; discuss the problem with your doctor. Do not combine it with sildenafil, tadalafil (Vidalista), nitrate medicines or riociguat. Seek emergency care for chest pain, sudden vision or hearing changes, or an erection lasting more than four hours. Have you already taken Vilitra 20 mg today, or are you planning to take it twice daily?