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Vilitra 40 mg enhances the natural erectile response. During sexual arousal, nitric oxide is released in the penile tissues, which increases cyclic guanosine monophosphate (cGMP). cGMP relaxes smooth muscles and dilates blood vessels, allowing more blood to fill the penis. Vardenafil inhibits PDE5, the enzyme that breaks down cGMP, helping sustain a strong erection. Sexual stimulation is required for the medication to be effective.