Viagra, Cialis, and Levitra are all prescription medications used for the same thing — erectile dysfunction.
While all three medications have the same application, there are some distinct differences to be aware of before deciding which one is best for you.
The cheapest option is Viagra, but Cialis has the longest duration of effects.
Levitra is very expensive and doesn’t offer any practical advantages over the other two medications.
In this article, we’ll explore each medication in more detail and compare and contrast all the differences between them.
We’ve broken this down into four main sections:
- How it Works
- Onset and Duration of Effects
- Side Effects & Safety Concerns
- Cost for Brand Name & Generic Versions
By the end of this article, you will have a good understanding of what makes Viagra, Cialis, and Levitra different, what makes them the same, and which one you should be using.
Summary: The Differences Between Viagra, Cialis, & Levitra
Overall, all three medications will do the same thing. They all work through the same mechanism with a few subtle differences.
Cialis is the longest-lasting ED medication (~36 hours), while Viagra is the shortest (~3 hours).
All three have the same general side-effects. Roughly 1 in 10 users of each medication report either headache, indigestion, or both. Viagra and Levitra are the most likely to have side effects related to vision.
Viagra is the cheapest option for both the brand name forms, and generic versions, but has the shortest duration.
| Medication | Viagra (sildenafil) | Cialis (tadalafil) | Levitra (vardenafil) |
| Image | |||
| Dosage Forms | 25, 50, 100 mg Tablets | 2.5, 5, 10, 20 mg Tablets | 5, 10, 20 mg Tablets |
| Mechanism of Action | PDE5 Inhibitor | PDE5 Inhibitor | PDE5 Inhibitor |
| Duration of Effects | Onset: 30 – 60 minDuration: 3 hours | Onset: 30 – 60 minDuration: | Onset: Duration: 4 – 6 hours |
| Most Common Side-Effects | HeadacheFlushingIndigestion | HeadacheIndigestionBack Pain | HeadacheFlushingNasal Congestion |
| Cost | Cheap | Cheap to Moderately Priced | Expensive |
1. How it Works: Viagra, Cialis, & Levitra
All three of these medications work through the same basic principle — they block PDE5.
In order to discuss exactly how this works, we have to cover how an erection works.
In order to get an erection, tiny blood vessels in the penis need to dilate (widen) to allow more blood to flow through to the corpora cavernosa (erectile tissue). As blood flows into the penis, it becomes rigid.
The initial stimulation to widen these vessels and produce erection starts in the brain. As the signal heads down to the penis, it triggers a chemical reaction. Chemicals like cGMP are released into the area to force the blood vessels to widen.
cGMP is quickly broken down by PDE5 (phosphodiesterase type 5) — one of 11 related enzymes that work to reverse blood vessel dilation in different parts of the body. PDE5 if the form most abundant in the penis.
Men with erectile dysfunction may have too much PDE5 or lack enough cGMP to maintain or achieve an erection.
Viagra, Cialis, and Levitra all work by blocking the PDE5 enzyme. This slows the rate of breakdown for cGMP, which leads to a fuller, long-lasting erection.
2. How Long Will It Last?
All three medications take roughly the same time to start taking effect (30 to 60 minutes). This is the amount of time needed for the drugs to pass through the stomach and into the small intestines where they can be absorbed.
But the similarities end here.
All three drugs have a different duration of effect.
A) How Long Does Viagra Last?
It takes anywhere from 30 minutes to an hour before you’ll start to feel the effects of Viagra. These effects last an average of 3 hours, but some people report improvements lasting up to 24 hours after taking the medication.
Viagra is the shortest-lasting out of the three medications.
B) How Long Does Cialis Last?
Cialis is, by far, the longest-lasting ED medication on this list. It’s common for the effects of the drug to remain for up to 36 hours — leading to it being referred to as “the weekend pill.”
This medication is the best option if you want the longest-lasting effects possible.
The half-life of Cialis is around 17.5 hours — which means exactly 50% of the drug should be gone from the body in 17.5 hours, 75% by 35 hours.
Usually, by 35 hours, the amount of Cialis that remains is too small to have an effect. Cialis will remain detectable in trace amounts up to 72 hours after taking the drug.
C) How Long Does Levitra Last?
Levitra is longer-lasting than Viagra, but not by much.
By the sixth hour after taking the drug, most of the effects will have worn off. The average duration of effects for Levitra is about 5 hours, but some people have reported effects lasting just over 24 hours.
3. What Are the Side Effects?
The side effects of Viagra, Cialis, and Levitra are all very similar because they all work through the same mechanism (PDE5 inhibition).
The most common side effects of all three medications are headache, flushing, and indigestion.
With that said, each medication has a higher prevalence of certain side effects compared to others.
For example, Cialis has less of an effect on the related enzymes, PDE1 and PDE6, so it’s less common for this medication to cause side effects related to vision (where PDE1 and PDE6 are prevalent). However, the longer half-life of this drug can lead to other side effects — such as increased urination, low blood pressure, dizziness, or fatigue.
Here, we compare the most common side effects of each medication, along with the prevalence of side-effects noted in the phase III clinical trials conducted for each drug.
Comparing the Side-Effects of Viagra, Cialis, & Levitra (Prevalence of Side-Effect During Phase III Clinical Trials):
| Side Effect | Viagra | Cialis | Levitra |
| Headache | 21% | 6% | 10.4% |
| Flushing | 19% | 3% | 11.3% |
| Indigestion | 9% | 5% | Not Listed |
| Vision Disturbances | 2% | <1% | <1% |
| Nasal Congestion | 4% | 2% | 4% |
| Back Pain | 4% | 3% | <1% |
| Dizziness | 4% | Not Listed | 1.6% |
| Nausea | 3% | Not Listed | 1.2% |
| Rash | 2% | Not Listed | <1% |
| Muscle Pain | 2% | 2% | Not Listed |
| Cough | Not Listed | 3% | Not Listed |
| Diarrhea | Not Listed | 2% | Not Listed |
| Heartburn (GERD) | Not Listed | 1% | Not Listed |
| Priapism (Painful Erection) | <1% | <1% | <1% |
| Edema or Swelling | <1% | <1% | <1% |
| Hearing Loss | Not Listed | Not Listed | <1% |
4. How Much Does Viagra, Cialis, & Levitra Cost?
The cost of these ED medications can vary substantially. Pharmacies will update the price of these medications based on supply and demand. There are also a lot of rebate programs, insurance plan coverage, and coupons that complicate the prices of these medications.
Overall, Viagra is the cheapest of the ED medications, with Cialis at a close second. Levitra is the most expensive, by far.
All three of these drugs are available in both brand name versions (made by the original manufacturer), and generic forms (made by a third-party company).
Generic versions of these drugs are always cheaper than the brand name versions. When the patents protecting the original creator of the drug from competition wears off, any company can start making the medication (with proper approval from regulators, that is). These companies can justify charging a much lower price because they don’t need to recoup any research and development costs for the drug.
Generic drugs are also cheaper because the manufacturer doesn’t have the brand name’s velocity behind them to help sell the medication. Instead, generic manufacturers try to earn customers by offering lower prices.
The cheapest generic drugs are generic Viagra (sildenafil), then Cialis (tadalafil), and Levitra (vardenafil).
Approximate Costs for Viagra, Cialis, Levitra, and Generic Equivalents (2020 Prices)
| Viagra | Cialis | Levitra | |
| Brand Name | $70 | $70 | $245 |
| Generic Versions | $6 | $11 | $120 |
Viagra, Cialis, or Levitra: Which One Should I Choose?
Viagra, Cialis, and Levitra are all well-established ED medications with proven efficacy. All three have the same effect, but the cost, duration of effects, and side effects of each are slightly different.
Viagra is the cheapest option and the most commonly prescribed by doctors — but it also has the shortest duration of effects. If you just need a little bit of a boost every once in a while, Viagra is the way to go.
Cialis is more expensive than Viagra but lasts longer. This pill is better for people who want long-lasting effects for a weekend away.
Levitra works, but the high cost and short duration (in between Viagra and Cialis) make it hard to justify as a better choice than the other two. People who use Levitra usually turn to this option only if Viagra or Cialis didn’t produce the results they were looking for.
Cialis is unique because it’s also used for benign prostatic hyperplasia (BPH) at a reduced daily dose (2.5 mg instead of 5, 10, or 20 mg).
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