Viagra and Levitra: What's The Difference?

October 14, 2020

4 mins

With so many options among erectile dysfunction medicines these days – and easier ordering capabilities through telehealth providers like Rex MD – choosing the best med for yourself *ain't easy.*

Viagra? Cialis? What about Levitra for ED? 

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Levitra For Erectile Dysfunction

Levitra (vardenafil), Viagra (sildenafil) and Cialis (tadalafil) all work the same way. They're PDE5 inhibitors (phosphodiesterase type 5), though they differ in small ways due to their molecular structures. 

This is quite common in the pharmaceutical industry: when one company finds a drug that works, other companies rush to find similar molecules that work the same way. It's how they can launch similar drugs under different brands, and the PDE5 inhibitors are a good example of this. 

Sildenafil was the first to be approved for ED by the United States FDA in 1998, as Viagra. It was incredibly popular and quickly became part of American vernacular: Vitamin V and the little blue pill. Vardenafil (Levitra) came along next in mid-2003, and tadalafil (Viagra) later that year.

While Cialis and Viagra are often the first ED meds that come to mind for people, Levitra is still remarkably popular. 

How Levitra Compares

Levitra (vardenafil) is often the forgotten middle child of the big ED meds, but not for any fault of its own. Levitra works just like its counterparts – it's an on-demand tablet that's taken just prior to sexual intimacy; it's available as a generic, like sildenafil and tadalafil; and the potential side effects are largely the same. 

Let's take a look at how Levitra is different from Viagra and Cialis. 

Levitra Doses

Levitra comes in doses of 5 mg, 10 mg, and 20 mg. Most men begin taking Levitra at 10 mg, though older men maybe advised by their doctor to begin treatment at 5 mg. If it's effective at that dose, no changes are necessary, but some men may find that they need to move up to the highest dose, at 20 mg. 

Timing With Levitra

Like Viagra and Cialis, Levitra is also taken in the hours before sexual intimacy, though the prescribing instructions differ slightly and the time in which Levitra can maintain its effects are a little different.

Viagra (silednafil) is to be taken in the 30-60 minutes prior to sex, and its effects should last for about 4 hours. 

Cialis (tadalafil) is to be taken 60 minutes before sex, and its effects can last for up to 36 hours (a compelling feature for many men). 

Levitra (vardenafil) is to be taken 60 minutes before sex, and its effects can last up to 5 hours. 

Cialis gets preference from many men because it's the only PDE5 inhibitor also available as a once-daily medication. This low-dose version, at 2.5 and 5 mg, can be taken every day in order to keep men primed for sex whenever. Not having to hassle with a pill in the hour before intimacy is a big deal for a lot of guys. 

Levitra Side Effects

Potential side effects of vardenafil are similar to the other PDE5 inhibitors. They include headache, facial flushing, an upset stomach or nausea, dizziness, and sometimes back pain.

It's also important never to take these medications with nitrates, blood pressure medications like calcium channel blockers, alpha blockers, and more. A full list can be found in vardenafil's FDA-approved label. A doctor can help navigate this process for guys who may have other health issues, which may involve avoiding PDE5 inhibitors altogether or adjusting dosage as necessary. 

What Do Guys Prefer?

Multiple studies that have compared men's preferences between sildenafil, tadalafil, and vardenafil have all suggested that tadalafil is a favorite, primarily because of Cialis' long-lasting effects. 

But other have suggested that men's preferences are inconclusive. For instance, one research program concluded that

[Patients who had never been treated before for ED] preferred a short-acting drug while previously treated patients preferred a long-acting drug. Patients with mild ED tended to prefer a long-acting drug, but there was no difference in preference related to age or cause of ED.

Guys who have never tried an ED medication tend to go with a popular on-demand med first, like Viagra, because it's what they're used to seeing advertised. But men with more experience with these medications often switch to try long-acting tadalafil instead, most likely because they know the drugs work and they now want more control over their sex life. 

Ultimately, much of this comes down to personal preference, and some men will find that while one medication does little for them, another works really well. The researchers above suggest allowing a patient to try all three (under medical supervision, of course) to choose which best suits him and his partner.

Our experience at Rex MD is that men who are price-sensitive and have some experience with their own ED over the years opt for low-dose tadalafil (Cialis Daily) because they like that it helps them get things moving at any time and without much planning. Tadalafil has been shown to improve psychosocial and psychological factors, and men AND their partners generally prefer it.

Read more about why Cialis is the most preferred offering. Then, try Rex MD's virtual visit process. If approved, your medication could be on your doorstep within a week.