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Cialis vs. Levitra vs. Viagra: How Each Stacks Up

Three of a kind?

Cialis, Levitra, and Viagra are oral medications used to treat erectile dysfunction (ED). You may also know them by their generic names, tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra).

About 30 million men occasionally have a problem with getting or keeping an erection, according to the Urology Care Foundation. When ED becomes a problem, many men turn to oral ED medications. These drugs often help. Cialis, Levitra, and Viagra each work in similar ways. But there are also some differences, such as when you take them, how long they work, and what their side effects are.

Drug features

Cialis, Levitra, and Viagra are all in a class of drugs called PDE-5 inhibitors. These drugs work by blocking an enzyme called phosphodiesterase type 5. 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 that when you’re aroused, you can get an erection. It also helps you maintain the erection long enough to have sex.

Levitra and Viagra stay in your bloodstream for about four to six hours. Cialis remains in your bloodstream for 17 to 18 hours or longer. The length of time a drug stays in your system may be important if you’re taking other medications.

Here are more basics on each of these drugs:

Brand nameCialisLevitraViagra
What is the generic drug?tadalafilvardenafil sildenafil
Is a generic version available?nonono
What does it treat?erectile dysfunctionerectile dysfunctionerectile dysfunction
What form does it come in?oral tabletoral tabletoral tablet
What strengths does it come in?2.5 mg, 5 mg, 10 mg, 20 mg2.5 mg, 5 mg, 10 mg, 20 mg25 mg, 50 mg, 100 mg
When do I take it?30-60 mins before sex or once daily30-60 mins before sex30-60 mins before sex
How long does it work?up to 8 hoursup to 8 hours4-5 hours
Should I take it with food?take it with or without foodtake it on an empty stomachtake it with or without food
How do I store it?store at room temperature close to 77°F (25°C)store at room temperature close to 77°F (25°C)store at room temperature close to 77°F (25°C)
Does this drug have potential for misuse?yes*yes*yes*
 
* This drug is commonly misused without a prescription.

Be sure to take this drug exactly as your doctor tells you to. If you have questions or concerns, talk with your doctor.

Cost, availability, and insurance

Cialis, Levitra, and Viagra are usually stocked at most pharmacies. All three of these drugs cost about the same amount. In general, most health insurance companies won’t cover their costs. But if you have certain medical conditions, your health plan may pay for the drug with prior authorization.

Side effects

The side effects of these medications are similar. Most men have only mild side effects.

The chart below compares the side effects of these drugs.

Side effectCialisLevitraViagra
stuffy or runny nosexxx
headachexxx
upset stomachxxx
changes in vision xx
flushing xx
back painx  
muscle achesx  
priapism (an erection that won’t go away)xxx
sudden cardiac arrest and deathxxx
 

Tell your doctor if you have any side effects that linger and don’t go away on their own. If you have an erection that lasts longer than four hours, call your doctor right away.

Keep reading: More info on the 7 common side effects of ED drugs »

Drug interactions

Each drug comes with the chance of drug interactions. Since PDE-5 inhibitors work on the body in similar ways, Cialis, Levitra, and Viagra come with similar interactions.

If you have an erection that lasts longer than four hours, call your doctor right away.

All three of these drugs interact with nitrates. They also all interact with blood pressure drugs such as alpha-blockers. For Cialis, these also include the drugs bendrofluazine, enalapril, and metoprolol. For Viagra, these also include the blood pressure drug amlodipine.

Viagra also interacts with the drug ritonavir.

Cialis can also interact with alcohol. Drinking alcohol with Cialis can cause low blood pressure when you stand up from a sitting or lying position. This may result in dizziness or a headache. To learn more, read more about the effects of mixing Cialis and alcohol.

Levitra and Viagra do not seem to cause low blood pressure when taken with alcohol. However, alcohol may interfere with your ability to get an erection, even while you’re taking any of these drugs.

Outlook

If you have ED, talk to your doctor about Cialis, Levitra, and Viagra. 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.

Each of these three popular drugs has been shown to help men with ED when they’re used correctly. All three drugs have good results, but it may take a little time and patience to get it right. If one drug doesn’t work or produces unpleasant side effects, you can try another drug. It may also take some trial and error to find the dosage that works best for you. And if you’re not sure that drug treatment is right for you, you can give these natural treatments for erectile dysfunction a try.

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