Which Is Best: Viagra vs Cialis vs Levitra?

Viagra, Cialis and Levitra are three of the best-known medicines for erectile dysfunction. Which one is best? There is no universal answer. They all belong to the same family of medicines, but they differ in how quickly they work, how long they last, how food affects them and how individual men respond.

One treatment may work particularly well for one person and disappoint another. Understanding the practical differences can help you have a more useful conversation with a doctor or pharmacist.

What is Viagra?

Sildenafil citrate was developed by the US pharmaceutical company Pfizer. It was initially investigated as a treatment for chest pain, but researchers noticed its effect on erections. In 1998 sildenafil was approved for erectile dysfunction under the brand name Viagra.

Sildenafil is also used in different doses and products to treat pulmonary arterial hypertension.

What is Cialis?

Cialis is the original brand of tadalafil developed by Eli Lilly. Tadalafil belongs to the same PDE5 inhibitor family as sildenafil.

Its defining feature is duration. Tadalafil may remain effective for up to 36 hours, which is why Cialis is sometimes called the “weekend pill”. It is also available in low daily doses for selected men.

What is Levitra?

After sildenafil became successful, other manufacturers developed additional PDE5 inhibitors. Bayer, GlaxoSmithKline and Schering were involved in the development of vardenafil, marketed under the brand name Levitra.

Vardenafil was authorised in the early 2000s as another oral treatment for erectile dysfunction. Generic versions are now available in some markets.

How quickly do they work?

The infographic below compares their typical onset.

Viagra and Levitra usually begin working within 30–60 minutes. The response may be slower after a heavy meal.

Cialis can also begin working within about 30 minutes, although some men find that the strongest effect develops later. It does not normally need to be taken two full hours before sex.

How long do the effects last?

The next infographic compares duration.

Viagra usually remains useful for around four to six hours. Levitra has a similar window, often around four to five hours. Cialis is much longer acting and may support erections during sexual stimulation for up to 36 hours.

This does not mean that any of the medicines cause a continuous erection. They simply make it easier to respond to sexual arousal during their active window.

The difference is partly explained by half-life—the time the body takes to reduce the amount of medicine in circulation by half. Tadalafil has a half-life of roughly 17.5 hours, considerably longer than sildenafil or vardenafil.

Which is most effective?

A treatment is considered effective when it helps produce an erection firm enough for satisfactory sexual activity. All three medicines work well for many men, and published response rates vary according to dose, health condition and study design.

There is no clear winner for every patient. Individual response is often more important than small average differences between the medicines.

Food can influence the onset of Viagra and Levitra, particularly a heavy, high-fat meal. Tadalafil is generally less affected by food. Excessive alcohol can undermine erections and increase dizziness or low blood pressure with any PDE5 inhibitor, even if one product appears less sensitive than another.

How do prices compare?

Price depends on whether you choose an original branded product or a generic medicine. Branded Viagra, Cialis and Levitra are usually more expensive than generic sildenafil, tadalafil or vardenafil.

The image below shows an older price comparison for four-tablet packs.

Prices and product availability change over time, so the graphic should be treated as a general illustration rather than a current price list. Compare the cost per tablet at an equivalent strength and include consultation and delivery fees.

Milligram amounts cannot be compared directly across different active ingredients. Ten milligrams of tadalafil or vardenafil is not “weaker” than 50mg of sildenafil; each medicine has its own dosing range.

Would you like to compare Viagra, Cialis and Levitra? View our collection here.