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
