Levitra vs. Cialis: Differences, similarities, and which is better for you
Levitra vs. Viagra: Which ED Medication is Better?
Levitra® (which contains the active ingredient vardenafil) and Viagra® (sildenafil) are two of the most popular medications for the treatment of erectile dysfunction (ED) on the market, used by millions of men in the US and tens of millions worldwide.
Both drugs are designed to help treat erectile dysfunction by improving blood flow to the erectile tissue of the penis. While the effects of Levitra and Viagra are very similar, there are also a few key differences between the two medications that are worth knowing about.
Below, we’ve listed the main differences between Levitra and Viagra, from the best time to take each medication before sex to the different amounts of time that Levitra and Viagra will improve your sexual performance and provide relief from erectile dysfunction.
TL;DR: The Main Differences Between Levitra and Viagra
Levitra and Viagra are very similar medications, but there are a few major differences between them that could make one a better choice for you than the other:
Levitra and Viagra are both oral medications that can be taken as needed before sexual activity. They’re both good choices for most men with ED, with studies showing a similar average level of effectiveness.
Both Levitra and Viagra are prescription medications, meaning you’ll need to talk to your healthcare provider before you can purchase and use either one.
Levitra and Viagra both work for a similar amount of time. Levitra typically provides relief from ED for four to six hours per dose, whereas Viagra provides relief from ED for about four hours.
Levitra is only slightly affected by food, meaning you can take it with a meal without any significant loss of effectiveness. In contrast, Viagra might take longer to work if it’s taken with a large, high-fat meal.
Overall, there’s no “best” erectile dysfunction medication for everyone. You’ll usually get the best results by working with your healthcare provider to choose the medication that’s best suited to your needs and preferences.
How Levitra and Viagra Work
Before we go into more detail about the key differences between Levitra and Viagra, let’s briefly go over how both of these medications work.
Levitra, which contains vardenafil, and Viagra, which contains sildenafil, both belong to a class of medications referred to as PDE5 inhibitors.
As their name suggests, PDE5 inhibitors work by inhibiting the effects of the PDE5 enzyme, or phosphodiesterase-5. This enzyme is found in the smooth muscle cells of your blood vessels, where it’s involved in regulating blood flow.
Healthy erections are all about steady, consistent blood flow. When you feel sexually aroused, your nervous system causes the muscles in your penis to relax, increasing the flow of blood to the corpora cavernosa — a pair of sponge-like chambers of tissue inside your penis.
This process usually begins in response to sexual stimulation, such as being touched by your partner or seeing sexual imagery.
As more blood flows to the corpora cavernosa, your penis becomes larger and firmer, creating an erection. A fibrous membrane called the tunica albuginea wraps around this tissue, helping you to maintain your erection during sexual intercourse.
After you reach orgasm and ejaculate, blood flows out from this tissue and your penis starts to become flaccid once again.
A range of issues can cause erectile dysfunction, but many cases of ED are caused by health issues that affect blood flow to your penis.
As PDE5 inhibitors, Levitra and Viagra increase the diameter of the blood vessels that supply your penis and improve blood flow, making it easier for you to get a penile erection.
The active ingredient in Levitra is called vardenafil. Under the brand name Levitra, vardenafil was approved by the FDA in 2003 as an erectile dysfunction medication. This makes Levitra the newer of the two drugs.
The active ingredient in Viagra is called sildenafil. As Viagra, sildenafil received approval from the FDA in 1998, making it the oldest oral medication that’s currently available to treat erectile dysfunction.
Because of its effects on arterial blood flow, sildenafil is also used as a treatment for pulmonary hypertension, a form of high blood pressure that affects the lungs.
Vardenafil, on the other hand, is used exclusively to treat ED and is not marketed or used as a treatment for any form of hypertension.
Does Levitra or Viagra Last Longer?
Levitra and Viagra both last for a similar amount of time inside the body. Body medications are intended to provide short-term relief from erectile dysfunction, usually for a few hours of sexual activity.
Levitra, as well as generic vardenafil, has a half-life of four to five hours. This means it usually takes four to five hours for your body to metabolize and remove half of the active ingredient in the medication.
On average, vardenafil works for around four to six hours after you take it. However, the drug’s effects usually start to fade after about four hours.
Viagra, as well as generic sildenafil, has a half-life of three to five hours. It provides relief from erectile dysfunction for approximately four hours when taken at a normal dose.
In general, Levitra and Viagra both last for a similar amount of time. Neither drug is particularly long-lasting, meaning that if you take them after dinner, the effects will usually end right before you go to sleep for the night.
Cialis® (tadalafil), on the other hand, is designed to provide relief from erectile dysfunction for up to 36 hours per dose, making it the best option if you need a “weekend” ED drug that offers longer-lasting results or a regular-use medication that can be taken as a daily dose.
Overall, Levitra and Viagra both last for a similar amount of time, although Levitra has a slightly longer duration of action. Both medications are a good option if you want to enjoy relief from ED and improve your sexual performance for one night.
Levitra vs. Viagra: Which Medication is More Effective?
Levitra and Viagra are both very effective at treating erectile dysfunction. In clinical trials, around 80 percent of men affected by ED reported being able to get and maintain satisfactory erections after taking Levitra or Viagra.
In a clinical trial of Levitra published by the FDA, 80 percent of men with erectile dysfunction reported improvements in their ability to develop an erection sufficient for penetrative sex after taking 20mg of Levitra (the highest recommended dose), compared to 52 percent who used a placebo.
Trials of Levitra also demonstrated that 65 percent of men treated using a 20mg dose were able to maintain their erection throughout sexual activity.
Clinical trials of Viagra produced similar results. In a randomized, double-blind trial on men with erectile dysfunction, 82 percent reported improvements in their erections after using Viagra at a dose of 100mg (the highest recommended dose).
In comparison, only 24 percent of men with erectile dysfunction who were treated with a placebo showed improvements.
When it comes to treating erectile dysfunction, Levitra and Viagra are both equally effective. If you’re prone to ED, both medications should provide relief from ED and an improvement in your sexual performance, provided you take the correct dose for you.
Verdict: There is no statistically significant difference in effectiveness between Levitra and Viagra.
Levitra vs. Viagra: Which Drug Works Faster?
Levitra and Viagra are both fast-acting medications, meaning you usually won’t need to wait for long after taking either drug to have sex.
Taken at a standard dose, Levitra starts working after around 30 minutes. You’ll typically get the best results by taking your prescribed dosage of Levitra or generic vardenafil approximately one hour before you plan to have sex.
Viagra can be taken as needed 30 minutes before sex. However, like with Levitra, it’s generally recommended to take your prescribed dosage of Viagra approximately one hour before you plan to engage in sexual activity for optimal results.
Overall, both medications take around the same time to start working and provide the best results after approximately one hour.
Are Levitra and Viagra Affected by Food?
Levitra usually isn’t affected by food, meaning you can take it with or shortly after a meal without affecting the amount of time required for the medication to start working. It’s best to avoid highly fatty meals when using Levitra, as these may slow down absorption of the medication.
Viagra is affected by food and is designed to be taken on an empty stomach. If you take Viagra after eating, it might take longer than one hour for the medication to begin working, especially if you eat a large meal with a high fat content.
Overall, if you need an ED medication you can take at dinner without having to worry too much about effectiveness, Levitra is a better choice than Viagra. However, with both drugs, it’s best to avoid large, high-fat meals.
Levitra vs. Viagra: Which Drug Has Fewer Side Effects?
Because Levitra and Viagra are both PDE5 inhibitors that work in the same way to reduce the severity of erectile dysfunction, their adverse effects are almost identical.
Levitra vs. Cialis: Differences, similarities, and which is better for you
For many men, erectile dysfunction (ED) can be a temporary or long-term problem. In fact, approximately 52% of men between the ages of 40 and 70 years old experience ED at some point. Due to the stigma surrounding this common sexual disorder, the percentage of men with ED may actually be underreported. In today’s world, ED treatment is more accessible with several options available.
The most commonly prescribed ED medications belong to a class of drugs called phosphodiesterase (PDE-5) inhibitors. Levitra (vardenafil) and Cialis (tadalafil) are two PDE-5 inhibitors that primarily work by increasing blood flow to get and maintain an erection.
Although these drugs work in similar ways, they do have some differences to be aware of when choosing the best treatment option. Your doctor may recommend lifestyle changes as well as a medication like Levitra or Cialis to help improve your sex life.
What are the main differences between Levitra and Cialis?
The main difference between Levitra and Cialis is in their active ingredients. Levitra contains vardenafil and Cialis contains tadalafil.
Although both drugs can be used as needed before sexual activity, Cialis can be used for other purposes. For those who have benign prostatic hyperplasia (BPH) and/or erectile dysfunction, Cialis can be used as a daily medication. In this way, Cialis can treat more than one condition at a time.
Levitra can take up to 1 hour to start working with effects that last for about 4 to 6 hours. While the drug label for Cialis says it can be taken 30 minutes before sexual activity, it can often take 2 or 3 hours for Cialis to start working. However, Cialis lasts longer than Levitra with effects that can last for up to 36 hours.
Levitra and Cialis can be taken with or without food, according to their drug labels, but studies suggest otherwise. The absorption of Levitra may be affected by high-fat food intake whereas the absorption of Cialis is not affected as much by food.
| Main differences between Levitra and Cialis | ||
|---|---|---|
| Levitra | Cialis | |
| Drug class | Phosphodiesterase-5 (PDE5) inhibitor | Phosphodiesterase-5 (PDE5) inhibitor |
| Brand/generic status | Brand and generic available | Brand and generic available |
| What is the generic name? | Vardenafil | Tadalafil |
| What form(s) does the drug come in? | Oral tablet | Oral tablet |
| What is the standard dosage? | 5 to 20 mg as needed before sexual activity up to once daily as directed by a doctor | 5 to 20 mg as needed before sexual activity or 2.5 to 5 mg once daily as directed by a doctor |
| How long is the typical treatment? | This medication is taken as needed. Long-term daily use is not recommended. | This medication is taken as needed. Daily use may be appropriate for some people. |
| Who typically uses the medication? | Adults 18 years of age and older | Adults 18 years of age and older |
Conditions treated by Levitra and Cialis
Levitra and Cialis are both FDA-approved to treat erectile dysfunction (ED). This sexual disorder is diagnosed after a medical evaluation from a doctor. ED can be caused by both psychological and/or physical problems that result in a persistent inability to get or keep an erection.
While PDE5 inhibitors have been studied to improve benign prostatic hyperplasia (BPH), Cialis is the only one that is FDA-approved to treat it. BPH is a medical condition characterized by an enlarged prostate. It can cause symptoms like an increased need to urinate, difficulty urinating, and an inability to fully empty the bladder.
Off-label uses of Levitra and Cialis include the treatment of Raynaud’s phenomenon and pulmonary arterial hypertension (PAH). Raynaud’s phenomenon is a rare condition where the fingers or toes can become discolored or numb due to cold temperature changes. PAH is another rare disorder that is caused by high blood pressure in the lungs and can lead to shortness of breath and chest pain.
The active ingredients of Levitra and Cialis have also been shown to prevent and improve altitude sickness. These drugs may be useful for climbers who are at risk of experiencing high-altitude pulmonary edema (HAPE), a condition caused by fluid leakage in the lungs. This condition can be fatal if it’s not treated in a timely manner.
| Condition | Levitra | Cialis |
| Erectile dysfunction (ED) | Yes | Yes |
| Benign prostatic hyperplasia (BPH) | Off-label | Yes |
| Raynaud’s phenomenon | Off-label | Off-label |
| Pulmonary arterial hypertension (PAH) | Off-label | Off-label |
| Altitude sickness | Off-label | Off-label |
Is Levitra or Cialis more effective?
When taken correctly, Levitra and Cialis can be effective ED treatments. However, Cialis may be preferred for its once-daily treatment option, longer duration of action, and broader range of use.
According to a meta-analysis, tadalafil, the active ingredient of Cialis, was found to be the most effective agent for ED. This meta-analysis included 118 different trials and compared Cialis (tadalafil), Levitra (vardenafil), and Stendra (avanafil). All PDE5 inhibitors in the studies were found to have similar safety profiles.
In an observational study that compared Cialis (tadalafil), Levitra (vardenafil), and Viagra (sildenafil), users reported higher effectiveness and satisfaction with Cialis. Levitra and Viagra were shown to have similar effectiveness. One advantage that Levitra has over Viagra is that it is less likely to cause a rare, visual side effect of altered color perception.
Levitra or Cialis may be more effective depending on the symptoms you experience and other health conditions you may have. Your healthcare provider will be able to help you decide which ED medication is best for you.
Coverage and cost comparison of Levitra vs. Cialis
Cost can be a huge limitation when deciding on an ED pill. Levitra is not usually covered by Medicare and insurance plans. Instead, it may be considered one of the more expensive ED medications. For two 20 mg Levitra tablets, the average retail price is around $120. Fortunately, generic Levitra is available as a cheaper alternative. With a SingleCare coupon card, you can lower the cost to $81.
Most Medicare and insurance plans do not cover brand-name Cialis. However, some plans may cover it if you are using it to treat another condition, like BPH, on top of ED. Cialis is available in a generic form, which can reduce the cost. The average retail price of Cialis can be around $500 for thirty 5 mg tablets. A SingleCare savings card for tadalafil can bring this cost down close to $20 at participating pharmacies.
| Levitra | Cialis | |
| Typically covered by insurance? | No | No |
| Typically covered by Medicare? | No | No |
| Standard dosage | 10 mg | 10 mg |
| Typical Medicare copay | $314, varies depending on the plan | $7–$37, varies depending on the plan |
| SingleCare cost | $81 | $90 |
Common side effects of Levitra vs. Cialis
Levitra and Cialis share similar side effects that are often associated with most PDE5 inhibitors. Their most common side effects are headache, nasal congestion or stuffy nose, indigestion, and back pain. Both medications can also cause facial flushing, or redness and warmth of the face.
Other common side effects of Levitra are dizziness, flu symptoms, and inflamed sinuses (sinusitis). Other common side effects of Cialis include muscle pain and pain in the arms or legs.
Most side effects with these medications are mild and go away on their own. If you experience serious side effects, such as visual problems or sudden hearing loss, seek medical attention immediately.
| Levitra | Cialis | |||
| Side Effect | Applicable? | Frequency | Applicable? | Frequency |
| Headache | Yes | 15% | Yes | 11% |
| Flushing | Yes | 11% | Yes | 3% |
| Nasal congestion | Yes | 9% | Yes | 3% |
| Indigestion | Yes | 4% | Yes | 8% |
| Dizziness | Yes | 2% | No | – |
| Nausea | Yes | 2% | Yes | *not reported |
| Back pain | Yes | 2% | Yes | 5% |
| Pain in the arms or legs | No | – | Yes | 3% |
| Sinusitis | Yes | 3% | No | – |
| Flu syndrome | Yes | 3% | No | – |
| Muscle pain | No | – | Yes | 4% |
This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.
Source: DailyMed (Levitra), DailyMed (Cialis)
Drug interactions of Levitra vs. Cialis
PDE5 inhibitors like Levitra and Cialis help relax and dilate blood vessels. While this effect can help produce the therapeutic benefits of these drugs, it can also cause adverse effects.
Combining Levitra or Cialis with nitrates, alpha-blockers, or blood pressure medications (antihypertensives) can lead to a dangerous drop in blood pressure. This drop inhttps://www.singlecare.com/conditions/blood-pressure-treatment-and-medications blood pressure can be fatal in severe cases. Levitra and Cialis should not be used with guanylate cyclase (GC) stimulators like riociguat for this same reason.
Levitra and Cialis are both metabolized or processed in the liver. The doses of these drugs may need to be adjusted when taking other drugs that alter certain liver enzymes, such as the CYP3A4 enzyme. Grapefruit juice can also block this enzyme and increase drug levels in the body, which may lead to adverse effects.
| Drug | Drug Class | Levitra | Cialis |
| Nitroglycerin Isosorbide mononitrate Isosorbide dinitrate Nitroprusside Amyl nitrite or Amyl nitrate |
Nitrates | Yes | Yes |
| Prazosin Terazosin Doxazosin |
Alpha-blockers | Yes | Yes |
| Lisinopril Losartan Amlodipine Verapamil Carvedilol |
Antihypertensives | Yes | Yes |
| Riociguat | Guanylate cyclase (GC) stimulators | Yes | Yes |
| Ritonavir Indinavir Ketoconazole Erythromycin |
CYP3A4 inhibitors | Yes | Yes |
| Rifampin Carbamazepine Phenytoin |
CYP3A4 inducers | Yes | Yes |
This is not a complete list of drug interactions. Please consult your doctor before taking these medications.
Warnings of Levitra and Cialis
Taking a drug like Levitra or Cialis may increase the risk of heart attack, stroke, or other heart problems in certain people. The use of Levitra and Cialis should be avoided in people with a history of unstable angina (chest pain), uncontrolled high blood pressure, stroke, heart attack, arrhythmia, and/or severe heart disease.
PDE5 inhibitors can increase the risk of dangerously low blood pressure, especially if they’re taken with other blood pressure medications. Blood pressure should be regularly monitored if you are prescribed a drug like Levitra or Cialis.
If you experience priapism, or a painful erection that lasts longer than 4 hours, seek emergency medical attention. Priapism can cause damage to the penile tissue if it’s not treated promptly.
Visual problems, such as a sudden loss of vision, are a rare adverse effect with Levitra and Cialis. Using these medications can also increase the risk of a sudden decrease or loss of hearing. Seek prompt medical attention if you experience these effects.
Frequently asked questions about Levitra vs. Cialis
What is Levitra?
Levitra is a brand-name ED medication that can help increase blood flow for an erection. It is a PDE5 inhibitor that can be taken as needed before sexual activity. Levitra tablets come in strengths of 5 mg, 10 mg, and 20 mg. Levitra is also available as a generic drug.
What is Cialis?
Cialis, also known by its generic name tadalafil, is a prescription ED medication. With sexual stimulation, Cialis can improve blood flow to get or keep an erection for sexual activity. Cialis is also approved by the FDA to treat benign prostatic hyperplasia (BPH). Cialis can be taken as needed or once daily for ED.
Are Levitra and Cialis the same?
Levitra and Cialis belong to the same class of drugs called PDE5 inhibitors but they are not the same drug. These drugs contain different active ingredients and can be used in different ways. Cialis is available as a once-daily pill while Levitra is only taken as needed.
Is Levitra or Cialis better?
Levitra and Cialis are both effective for treating ED. According to studies, Cialis has been shown to have better effectiveness and produce more satisfaction compared to Levitra. Because Cialis comes in a daily pill that can also treat BPH, it is often a preferred option.
Can I use Levitra or Cialis while pregnant?
Levitra and Cialis are not used to treat women. Although no studies have been done in women, it is not recommended to take Levitra or Cialis while pregnant.
Can I use Levitra or Cialis with alcohol?
Taking Levitra or Cialis with alcohol may increase the incidence of adverse side effects. Because alcohol has similar effects on blood vessels, side effects like flushing may be more pronounced while taking a PDE5 inhibitor at the same time.
Does Cialis make you last longer?
There is not enough evidence to show that Cialis can make you last longer. While Cialis may help improve premature ejaculation, most evidence is anecdotal. Premature ejaculation and sexual stamina is often associated with psychological factors rather than physical ones.
Which erectile dysfunction drug is best?
There is no single ED drug that is considered the best. ED treatment is highly individualized and, thus, the best drug is the one that helps you the most. Price and potential side effects should also be considered when picking the right ED drug.
What are the dangers of taking Cialis?
Cialis is not recommended to be taken with nitrates, alpha-blockers, and blood pressure medications, which can increase the risk of hypotension, or dangerously low blood pressure. Cialis has the potential to cause cardiovascular events like heart attack and stroke, especially in those with a history of heart problems
Erectile Dysfunction: Medicines to Treat ED
Some men with erectile dysfunction, or ED, find they can return to an active sex life by treating an underlying condition, such as high blood pressure or diabetes, or with counseling and lifestyle changes. But others find they may need medication to get and keep an erection.
The FDA has approved several prescription drugs you take orally to treat ED.
What Medications Are Available?
All of these work by relaxing your muscles and boosting blood flow to your penis, making erections easier to get and maintain. They are:
Caution: Do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain. The combination can cause dangerously low blood pressure.
Are There Differences in Them?
These medications all work similarly to each other. However, there are subtle differences in how long they stay effective and how quickly they begin to work.
Levitra takes about 30 minutes to start working and the effects last a little longer than Viagra, about 5 hours.
Staxyn dissolves in your mouth. It contains the same active ingredient as Levitra and can begin working in about 15 minutes.
Viagra takes around 30 minutes to become effective and lasts about 4 hours.
Cialis lasts much longer — up to 36 hours in some cases.
Stendra can start doing its thing in as little as 15 minutes, and its effects last up to 6 hours.
Can I Make a Switch?
Yes. You may find that one works better for your schedule or that there are differences in the side effects for you. But these medications work the same basic way, so you’re likely to have similar results.
What Precautions Should I Take?
Again, do not use these ED medications if you take nitrates, such as nitroglycerin or a similar medicine, for chest pain. But there are other situations that may make these medications unsafe as well. Before you take Viagra or one of the others, tell your doctor:
- If you are allergic to any medications, including other ED medications
- About any prescription or nonprescription medications you take, as well as any herbal and dietary supplements
- If you are scheduled for surgery, even dental surgery
- If you take alpha-blockers for blood pressure or prostate problems. These can lower your blood pressure when taken with ED pills.
Always follow the directions on your prescription label carefully. Also, make sure to ask your doctor or pharmacist to explain anything you don’t understand. Take these drugs exactly as directed.
Who Should Not Take These?
If you’ve had a heart attack, stroke, or life-threatening irregular heart rate within the past 6 months, you should discuss other options with your doctor.
You should also avoid these medications if you have uncontrolled high or low blood pressure or if you get chest pain while having sex.
Any Side Effects?
Side effects are not common, but they can happen. You may get:
• A headache
• Upset stomach or heartburn
• Feeling of warmth
• Nasal congestion
• Changes in vision (lights tinged with color, glare)
Warnings
You may need emergency treatment if you get an erection that lasts for more than 4 hours and happens without any sexual excitement. You may hear a doctor call it a “priapism.” Blood becomes trapped in the penis and can’t flow back out. It can lead to scarring and permanent ED if not treated.
Also get emergency treatment with any of the following:
If you’re having chest pain and have taken Viagra in the past 24 hours or Cialis in the past 48 hours, don’t take nitroglycerin. Call for an EMS and make sure you or someone with you tells them which ED medicine you took.
Vision Problems
You should also stop these medications and call your doctor right away if you have vision loss.
A rare vision problem called NAION — short for “nonarteritic anterior ischemic optic neuropathy” — has been reported by a few men using these drugs.
The condition causes a sudden loss of eyesight because blood flow is blocked to the optic nerve. People who have a higher chance for NAION include those who:
How Should I Store Them?
Keep them in their original container and out of reach of children. Store them away from heat and moisture (not in the bathroom). When they expire or you don’t need them anymore, get rid of them.
Show Sources
National Health Services. UK. “Erectile dysfunction (impotence) – Treatment.”
NIH. National Institute of Diabetes and Digestive and Kidney Diseases, “What causes erectile dysfunction?” “Prescribing Erectile Dysfunction Medications.”
U.S. National Library of Medicine. NIH. “Treatment of Nonarteritic Anterior Ischemic Optic Neuropathy.”
Viagra Vs Cialis Vs Levitra
Viagra, Cialis, and Levitra are all branded medications used to help you get and keep an erection. They all have different active ingredients and have different advantages and disadvantages, so choosing between them can be tricky.
Below are some comparisons between these treatments and a guide to help you choose the right pill.
Contents
Viagra vs Cialis vs Levitra
Viagra |
Cialis |
Levitra |
|
| How effective are they? | 74% | 60-70% | 58-74% |
| Our patients rating | 4.6 out of 5 | 4.6 out of 5 | 4.4 out of 5 |
| Drugs.com rating (out of 10) | 8.5 out of 10 | 8.7 out of 10 | 8.0 out of 10 |
| Generic available? | Sildenafil | Tadalafil | Vardenafil |
| Over the counter version? | Viagra Connect | No | No |
| Available in a daily dosage? | No | Cialis Daily | No |
| Available Dosages | 25mg, 50mg, 100mg | 2.5mg, 5mg, 10mg, 20mg | 5mg, 10mg, 20mg |
| How fast do they work? | Up to an hour | 30 minutes | Up to an hour |
| How long do they last? | 4 to 6 hours | Up to 36 hours | 4 to 6 hours |
| Chance of side effects | Less than 2% | Less than 2% | Less than 2% |
Which pill is the most effective?
All of these medications are about as effective as each other.
Even though some of the dosages for certain treatments appear higher than other treatments, that does not mean that some treatments are stronger than the others.
For each of these medications, the chance of it working is slightly higher as the dosage goes up, but so is the risk of side effects. We recommend starting on the standard dose and only changing to a higher one if the standard dose didn’t work and you didn’t get any serious side effects. You should only change doses with the help of a doctor.
You may need to try more than one tablet to find one that works for you. Never take more than one erectile dysfunction tablet of any kind within 24 hours. Also, don’t switch medications or change the dose of your treatment without the help of a doctor.
Which pill is the most cost effective?
| Viagra | Cialis | Levitra | |
| Effective for. | £19.99 | £39.99 | £43.00 |
| Our Trustpilot rating | £3.21 | £9.68* | £7.32 |
*this price is for on-demand Cialis, and doesn’t include daily doses
Out of Viagra, Cialis, and Levitra, Viagra works out the cheapest, if you order from us.
Other erectile dysfunction medications may be cheaper:
- If you have sex on up to 3 different days a week, then the most cost effective treatment for you could be Sildenafil. We offer Sildenafil from just £15.00 for 4x 50mg tablets, or £2.79 per pill if you buy 28x 25mg or 50mg tablets.
- If you have sex on more than 3 different days a week, then the most cost effective treatment might be Cialis Daily. At £75.00 for 28 pills it works out as £2.68 per pill, but you have to take one every day, so they might not last you as long if you’re not having sex that often.
Which tablet has the least side effects?
Less than 2% of men who use Viagra, Cialis, or Levitra will get side effects. The dose of the medication you’re taking will also affect how likely you are to get side effects.
Lower dosages of medications are less likely to give you side effects. We normally recommend you try standard doses first to see if you get any side effects before thinking about switching to lower dosages. Never change dosages without the help of a doctor.
Which tablet works the fastest?
Cialis works the fastest out of Viagra, Cialis, and Levitra. Cialis starts working in just 30 minutes, while Viagra and Levitra can take up to an hour to start working after you take it.
If you don’t want to take a pill every time you want to have sex, you can try Cialis Daily. Cialis Daily is a pill that you take every day, and helps you get an erection whenever you want to have sex.
Which tablet lasts the longest?
Cialis is the longest lasting tablet out of Viagra, Cialis, and Levitra. Cialis can last up to 36 hours, which is why it’s sometimes known as the ‘weekend’ pill. Viagra and Levitra can last up to 6 hours.
Cialis Daily is always in effect. As long as you keep taking your daily tablet, Cialis Daily will keep working.
Just because the effect of these pills can last for hours does not mean that you will have an erection for that long. These medications can help you get and keep an erection when you are aroused, but they will not give you an erection for the full time that they are effective
Boston University Medical Campus
Sexual Medicine
The most common sexual dysfunctions in men include lack of interest, premature ejaculation and erectile dysfunction. The latter affects 52% of men between the ages of 40 and 70, including mild, moderate and complete forms of ED.
Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors. Concerning vascular causes, the risk factors for atherosclerosis (including smoking, high blood pressure, diabetes (diabetics do not respond well to pills like sildenafil (Viagra)) and high cholesterol are ALSO risk factors for erectile dysfunction. Since a straddle injury or use of a narrow saddle can obstruct and impair arteries to the penis, bicycle riding is also considered a risk factor for erectile dysfunction.
Little attention has been paid to endocrine factors. Testosterone modulates desire, arousal and orgasmic function. Concerning the orgasmic response, testosterone modulates the integrity of genital sensory receptors. Concerning the arousal response, decreased testosterone blood levels can influence the efficacy of sildenafil (Viagra). If the sildenafil response is not reliably improving erection, the physician should first check if the patient is taking the pill correctly. The physician should also check the patient’s testosterone level. One investigator in Italy gave testosterone to patients with low testosterone who did not respond to sildenafil (Viagra). When daily testosterone was given, subsequent sildenafil (Viagra) use resulted in IIEF (the International Index of Erectile Function questionnaire used to determine erectile function) scores improving significantly.
Other risk factors for erectile dysfunction include neurologic problems (multiple sclerosis, stroke), depression and medications for treating diabetes, hypertension, heart disease and depression.
There are many oral therapies for erectile dysfunction, but the only approved medication in the US is the PDE 5 enzyme inhibitor sildenafil (Viagra). Unapproved therapies, some of which are available in the US and some elsewhere, some of which have data to prove efficacy and some not, include tadalafil (Cialis), vardenafil (Levitra), yohimbine, phentolamine, trazodone, apomorphine and neutraceuticals. PDE5 inhibitors act to relax penile erectile tissues with sexual stimulation thus enhancing your ability to get an erection. Sildenafil (Viagra) is effective for all sorts of erectile dysfunction in 69% of people. Why is there a need for another pill? In some cases the erection is not hard enough, sometimes sildenafil (Viagra) just doesn’t work.
Structurally vardenafil (Levitra) is similar to sildenafil, while tadalafil (Cialis) is very different. Vardenafil (Levitra) is almost 10 times more biochemically potent than sildenafil, therefore a lower dose is needed to facilitate the penile erection, potentially resulting in less side effects. Selectivity is the ability of the drug to attach to the specific enzyme PDE 5 found in penile tissues. Vardenafil (Levitra) is more selective than sildenafil and tadalafil (Cialis) to PDE5, which again means a lower dose is needed with potentially less side effects. Tadalafil is very specific for PDE5 and is also very specific for the enzyme PDE11. Unfortunately, we don’t know much about PDE11, which is found in the heart, in the pituitary gland in the brain and in the testicles. Pharmacokinetics, half-life, is how long the medication stay s in the blood. Sildenafil (Viagra) has a half-life of 4 hours and vardenafil (Levitra) has a half-life of 4-6 hours while tadalafil (Cialis) has a half-life of 17.5 hours. This means that vardenafil (Levitra) should act longer than sildenafil (Viagra) but the clinical significance is not known. Tadalafil (Cialis) has the longest half-life and allows you to take the medication and not relate the sexual activity to the immediate use of the medication. The drawback is if you need nitrates after using tadalafil (Cialis), this medication lasts a long time in your blood stream and may place you at a higher risk. Younger people might do well treated with tadalafil, (Cialis) while older people with other health issues might be better off using sildenafil (Viagra) or vardenafil (Levitra) but more data are needed. The side effects of vardenafil (Levitra) are potentially less than sildenafil (Viagra), but more data are needed. In a recent study on men with erectile dysfunction and diabetes, vardenafil (Levitra) improved their erectile dysfunction. Tadalafil (Cialis) is as effective as sildenafil (Viagra), and vardenafil (Levitra) with similar side effects except for back pain that occurs occasionally with tadalafil, probably because of the long half-life.
Many people stop taking drugs because they are experiencing side effects, they no longer have a partner, or they are worried about safety. Sexual activity is not a major contributor to the risk of a heart attack. Sexual activity, with or without sildenafil (Viagra) increases the chance of an MI during sexual activity by only 0.1%. If pills fail, there are vacuum devices, Muse, injections, bypass surgery and implants.
The patient making a presentation has had penile bypass surgery. In addition he takes testosterone and sildenafil as needed.. This is a classic example of why people with ED need complete care: a psychological exam, history and physical exam, and diagnostic studies with long term follow-up care. Patients with ED should not just be prescribed sildenafil (Viagra) and then be lost to follow-up.
