Cialis vs. Viagra: Which One Is Best for You in 2023?
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Erectile dysfunction medications, including Viagra and Cialis, help the muscles in the penis relax so you can get and maintain an erection. But these drugs differ by side effects, dosage schedule, and other factors. Read on to see how they stack up.
Viagra, Cialis, Levitra, and Stendra are oral medications used to treat erectile dysfunction (ED). You may also know them by their generic names:
About 30 million men in the United States occasionally have a problem with getting or keeping an erection, according to the Urology Care Foundation. When ED becomes a problem, many turn to these oral ED medications to help address the issue.
The medications work in similar ways. However, they also have some key differences, such as when you take them, how long they work, and what their side effects are.
Viagra, Cialis, Levitra, and Stendra are all in a class of medications called phosphodiesterase type 5 (PDE5) inhibitors. These drugs work by blocking the PDE5 enzyme.
They also boost a chemical in your body called nitric oxide. This action encourages the muscles in your penis to relax. Relaxed muscles allow blood to flow freely, so you can get an erection when you’re aroused. It also helps you maintain the erection long enough to have sex.
Unlike Viagra and the other PDE5 inhibitors, Cialis is also approved to treat enlarged prostate.
Both Viagra and Cialis can be taken 30 minutes before sexual activity. However, Cialis lasts much longer and is noteworthy for the amount of time it remains in your body. You may feel the effects of the drug up to 36 hours after you take it.
The fact that it comes in a low dose of 2.5 milligrams (mg) also means that you can take Cialis every day. A daily dose will ensure that the drug’s always in your system.
If you take Cialis, there’s a chance of limb pain. This side effect is not associated with any other oral ED drugs.
| Similarities | Differences |
|---|---|
| They’re both PDE5 inhibitors. | Cialis lasts up to 36 hours in the body, while Viagra lasts 4–6 hours in the body. |
| Both are taken 30 minutes before sex. | Cialis can cause limb pain, while Viagra can cause vision change, rash, and dizziness. |
| Side effects include flushing, back pain, headaches, muscle pain, and upset stomach. |
Pros of Cialis
Cons of Cialis
Pros of Viagra
Cons of Viagra
Viagra can take 30 to 60 minutes to work in the body, while Levitra takes 60 minutes. The effects of both drugs last for about 4 hours.
Levitra does have fewer common side effects than Viagra, and it’s not associated with rash or muscle aches. Vision color changes are considered side effects of both Viagra and Levitra.
| Similarities | Differences |
|---|---|
| They’re both PDE5 inhibitors. | Viagra can be taken 30 minutes before sex, while Levitra should be taken 1 hour before. |
| Side effects include stuffy or runny nose, headaches, vision changes, dizziness, flushing, and back pain. | Levitra may increase creatine kinase levels, a sign of possible muscle injury, but is not associated with rash or muscle aches that may occur with Viagra. |
Pros of Levitra
Cons of Levitra
Pros of Viagra
Cons of Viagra
Stendra is the newest drug on the market. No generic version is available for sale yet.
A hallmark of Stendra is its fast-acting nature. You can take the 100-mg and 200-mg doses as shortly as 15 minutes before sexual activity.
As a second-generation medication, Stendra also seems to have milder side effects than Viagra and the other PDE5 inhibitors that came before it. Side effects commonly caused by Viagra — but not Stendra — include vision changes, nausea, and muscle aches.
The only common side effect caused by Stendra — but not Viagra — is a sore throat.
| Similarities | Differences |
|---|---|
| They’re both PDE5 inhibitors. | Stendra can be taken 15 minutes before sex, while Viagra should be taken at least 30 minutes beforehand. |
| Side effects include stuffy or runny nose, headaches, flushing, and back pain. | Viagra can cause side effects including nausea, muscle aches, vision changes, and rashes. |
Pros of Stendra
Cons of Stendra
Pros of Viagra
Cons of Viagra
As mentioned earlier, Cialis can be used as a daily medication to treat enlarged prostate, unlike Levitra, which is strictly used as a treatment for erectile dysfunction.
Cialis is also faster acting than Levitra. You can take it 30 minutes before sexual activity, while you should take Levitra at least 1 hour in advance.
Cialis and Levitra both have similar side effects, but some side effects unique to Cialis include muscle aches and pain in the limbs.
| Similarities | Differences |
|---|---|
| They’re both PDE5 inhibitors. | Cialis can be taken 30 minutes before sex, while Levitra should be taken at least 60 minutes beforehand. |
| Side effects include stuffy or runny nose, headaches, flushing, upset stomach, indigestion, and back pain. | Cialis can cause muscle aches and pain in the limbs, while Levitra does not. |
Pros of Levitra
Cons of Levitra
Pros of Cialis
Cons of Cialis
Here are the basic features of each of these drugs:
| Viagra | Cialis | Levitra | Stendra | |
|---|---|---|---|---|
| What’s the generic name? | sildenafil | tadalafil | vardenafil | avanafil |
| Is a generic version available? | yes | yes | yes | no |
| What form does it come in? | oral tablet | oral tablet | oral tablet | oral tablet |
| What strengths does it come in? | 25 mg, 50 mg, 100 mg | 2.5 mg, 5 mg, 10 mg, 20 mg | 5 mg, 10 mg, 20 mg | 50 mg, 100 mg, 200 mg |
| What’s the typical dosage? | 50 mg | 10 mg as needed or 2.5 mg daily | 10 mg (5 mg if you’re 65 years or older) | 100 mg |
| When do I take it? | 30–60 minutes before sex | 30 minutes before sex | 60 minutes before sex | 15 minutes before sex for 100 mg and 200 mg, 30 minutes before sex for 50 mg |
| How long does it work? | 4 hours | up to 36 hours | 4–5 hours | 6 hours |
| How do I store it? | around room temperature, between 68–77°F (20–25°C) | at 77°F (25°C) | at 77°F (25°C) | around room temperature, between 68–77°F (20–25°C) |
These medications are available in a variety of doses, ranging from 2.5 mg to 200 mg. You can take all of them with or without food. However, taking Viagra, Levitra, or Stendra after eating a high fat meal does slow the rate of absorption.
Most of them stay in your bloodstream for about 4 to 5 hours. Cialis is the exception, as it remains in your bloodstream for up to 36 hours. The length of time a drug stays in your system may be important if you’re taking other medications.
Do not take any of these medications more than once in a 24-hour period.
The side effects of these medications are mostly similar, and they’re usually mild. Tell your doctor if you have any side effects that linger and do not go away on their own.
Below are the most common side effects, according to their manufacturers:
| Side effect | Viagra | Cialis | Levitra | Stendra |
|---|---|---|---|---|
| stuffy or runny nose | x | x | x | x |
| headache | x | x | x | x |
| dizziness | x | x | ||
| upset stomach | x | x | x | |
| nausea | x | |||
| indigestion | x | x | x | |
| vision changes | x | x | ||
| rash | x | |||
| flushing | x | x | x | x |
| back pain | x | x | x | x |
| pain in the limbs | x | |||
| muscle aches | x | x | ||
| sore throat | x |
Priapism warning
If you have an erection that lasts longer than 4 hours, contact your doctor right away. This condition, known as priapism, is a risk associated with all of these ED drugs.
To get any ED medication, you’ll need a prescription. You can get a prescription through your primary care doctor or online through telehealth companies.
Unless prescribed by a doctor, online ED medications are not FDA-approved. They may contain ineffective or harmful ingredients.
Usually, you’ll go to the pharmacy to pick up your Viagra, Cialis, Levitra, or Stendra prescription. If you have health insurance, keep in mind that most insurance companies will not cover the cost of your prescription. But if you have certain medical conditions, your insurance plan may pay for the drug with prior authorization.
The exact price you pay for any drug will depend on your insurance plan, if you have one, and your pharmacy.
If you’re on a tighter budget, it’s also worth considering generic versions of ED medications like Viagra, Cialis, and Levitra. They can be just as effective at treating ED and are available at a fraction of the cost.
If your insurance company covers brand-name ED medications, they’re very likely to cover generics, too, which will bring down the price even further.
If your insurance plan doesn’t cover ED medication or you don’t have insurance, you can still get FDA-approved medication through a reputable source — but the price will be higher.
Online ED treatment companies, like Roman, Hims, RexMD, and Lemonaid, all offer ED medication (brand name and generic) even without insurance.
Because these medications require a doctor’s prescription, you’ll need to meet with a doctor first. Most of these online providers allow you to meet with a licensed doctor in your state virtually.
These prices can vary based on your state, subscription package discounts, and whether you have the prescription mailed to you or filled through a pharmacy.
Here’s a quick look at what you can generally expect to pay, as of August 2023, through these services:
| Viagra | Generic Viagra (sildenafil) | Cialis | Daily Generic Cialis (tadalafil) | Generic Cialis (tadalafil) | |
|---|---|---|---|---|---|
| Roman | $90 per dose | $4-$10 per dose | $20-$80 per dose | $8 per dose | $11-$44 per dose |
| Hims | $139 per dose | $4 per dose | $958 per month | $40 per month | $40 per month |
| RexMD | $90 per dose | $10 per dose | $29 per dose | $3 per dose | $10 per dose |
| Lemonaid | — | $2 per dose | — | $220 per month | $8 per dose |
Each drug comes with the risk of drug interactions. Since PDE5 inhibitors work on the body in similar ways, Viagra, Cialis, Levitra, and Stendra lead to similar interactions.
- nitrates, such as isosorbide mononitrate (Monoket) and nitroglycerin (Nitrostat)
- certain blood pressure drugs, such as calcium channel blockers
- alpha-blockers, which can treat high blood pressure or an enlarged prostate
- certain pulmonary hypertension drugs, such as riociguat (Adempas)
- protease inhibitors, a class of HIV medications
- antifungal drugs, such as ketoconazole and itraconazole (Onmel, Sporanox)
- antibacterial drugs, such as clarithromycin (Biaxin)
Avoid drinking alcohol excessively while on any PDE5 inhibitor. Do not combine them with different ED drugs.
Cialis may also be less effective if used alongside antiseizure medications such as carbamazepine (Tegretol) and phenobarbital.
For specifics on which medications are safe for you to use, it’s best to consult your doctor or pharmacist.
In some cases, using these medications may mean you need to completely avoid PDE5 inhibitors. In other cases, your doctor or a healthcare professional may adjust your medication dosage, which can help lower the possibility of drug interactions while using PDE5 inhibitors.
It’s normal to lose your erection sometimes. Several factors can cause short-term erection issues, from anxiety and stress to just simply not being aroused or interested in a sexual encounter.
But if you’re having difficulties becoming erect or maintaining an erection throughout sex several times a week for longer than 4 weeks, it may be worth talking with a doctor to see whether you may be experiencing ED.
While ED can be more common as someone ages, it can affect males at almost any age. Talk with your doctor about what you have been experiencing. Ask them about what treatments they recommend.
Sometimes, just making lifestyle changes, like to your nutrition, work routine, or home life, can improve ED symptoms.
If your doctor believes you could benefit from ED medication, they can discuss your treatment options and prescribe the best ED medication for you.
Additionally, your doctor can check in with you if you start to experience any side effects from using Viagra or a similar ED medication.
Are Cialis and Viagra the same?
No. Although Cialis and Viagra are both PDE5 inhibitors that boost nitric oxide in your body to help with ED, they’re different medications.
Cialis comes in a lower dose than Viagra and can be taken daily. Also, the effects of Cialis last longer than the effects of Viagra.
How long does it take for Cialis to peak?
It depends on the individual and the level of arousal. It’s recommended that you take Cialis 30 minutes before engaging in sexual activity, but it may take as long as 2 hours to take effect. Cialis also requires sexual stimulation in order to work, so arousal also factors into this equation.
Do ED medications make you last longer?
These medications are meant to help you have an erection long enough to have sex. However, medications like Viagra aren’t approved to treat premature ejaculation.
Can Viagra and Cialis be taken together?
It’s unnecessary to take Viagra and Cialis together. They’re both PDE5 inhibitors that help achieve the same goal. Your doctor can help you decide which would be best for you, but there’s no need to take both.
Is there a generic of Stendra?
No, there is currently no generic of Stendra available in the United States.
Which ED medication is best?
It depends on the individual. While all ED medications help achieve the same goal, they differ in dosage, length of effects, and potential side effects. Consider all of these factors when determining which ED medication might work best for you.
Which ED medication causes the fewest side effects?
Stendra has the fewest side effects. Viagra, although the most well-known, has the most side effects.
If you have ED, consider talking with your doctor about Viagra, Cialis, Levitra, and Stendra. Tell your doctor if you take other over-the-counter or prescription drugs or supplements. Be sure to mention all other health conditions you have.
When used correctly, each of these drugs has been shown to help people with ED. Take them exactly as your doctor prescribes, and be sure to let them know if you have questions or concerns.
All of these medications have been shown to lead to good results, but it may take a little time and patience to find the right one for your needs. If one drug does not work or produces unpleasant side effects, you can try another one.
It may also take some trial and error to find the dosage that works best for you. If you’re not sure that using ED medication is right for you, you can also give natural ED treatments a try.
If you’re considering natural ED treatments, talk with your doctor or a healthcare professional first to learn more about risks, benefits, and potential drug interactions.
Last medically reviewed on May 26, 2023
