Cialis vs Levitra: Which is Best?

Written by
The Manual Team
Medically approved by
Dr Earim Chaudry
Last updated
19th August 2021

In 30 seconds

Cialis or Levitra? Both are branded medications for the treatment of erectile dysfunction. Known medically as Tadalafil and Vardenafil, they work in very similar ways too, as they are both a type of drug known as PDE5 inhibitors.

These drugs target the enzyme, phosphodiesterase-5 (PDE5), which is responsible for smooth muscle contraction in the penis. By inhibiting its activity, both Cialis and Levitra enable more blood to flow to the soft tissue in the penis, thereby increasing your ability to achieve and sustain an erection.

Despite their similarities, though, there are differences between Levitra and Cialis. Whilst Levitra can last up to 4 hours, the effects of Cialis endure for up to 36 hours. That’s why they call it the ‘weekend pill’.

Tadalafil tends to emerge as slightly more effective in scientific studies. Meanwhile, Levitra is marginally more likely to give users the common side effects of PDE5 inhibitors too – including dizziness and nausea.

Cialis or Levitra?

These days, the market for erectile dysfunction (ED) medications is pretty competitive, with a number of different branded and unbranded options available. You’ll probably have heard of Viagra, the famed ‘Vitamin V’, and its active agent Sildenafil. Yet, it’s worth knowing some of the others too – as different drugs can suit different people slightly better.

Besides Viagra, it is Cialis and Levitra that are most well-known. These drugs – known alternatively by their medical names, Tadalafil and Vardenafil – are similar, and they work in a similar way to Viagra.

All three are PDE5 inhibitors, which work to ease erectile dysfunction by targeting an enzyme – phosphodiesterase-5 – responsible for smooth muscle contraction in the penis. By inhibiting this enzyme, the drugs allow more blood to flow to the penis, increasing the chance that you’ll get and keep an erection.

Obviously, though, they wouldn’t be different drugs if they didn’t have their differences – and their respective advantages and disadvantages. So, let’s take a look at which one’s right for you. In this article, we’re staging the debate: Levitra vs Cialis – which one is best?

Levitra vs. Cialis: What’s the Difference?

Whilst Cialis and Levitra work by targeting the same mechanism, they differ in important ways. The most significant of these are the length of time that the respective drugs last and when you need to take them before you hope to see their effects.

Levitra needs to be taken about an hour before sexual activity to maximise its effectiveness. As such, a bit of planning is inevitable, as you’ll want to know when you are intending to feel its benefits. After that, the effects of the Vardenafil will be felt for four to six hours.

Cialis, on the other hand, gives you a little more freedom. You can take it half an hour before you hope to see its effects, and you will retain its power for as long as 36 hours. It’s this that gives Tadalafil the nickname, ‘the weekend pill’ – because having taken the pill, you are ready to go all weekend.

Is Cialis or Levitra More Effective?

When it comes to their ability to tackle erectile dysfunction, Cialis and Levitra largely emerge as similar in their effectiveness. Whilst the length of time for which they are effective differ, they should both be successful in their treatment of ED.

However, if one of the drugs has the edge, it would be Tadalafil. According to a meta-analysis of 118 different trials – involving over 30,000 patients – Tadalafil was found to be the most effective PDE5 inhibitor overall. In a slightly smaller study, which tracked users of Tadalafil, Vardenafil, and Sildenafil over six months, Tadalafil again emerged as the drug with the “higher levels of therapeutic effectiveness and satisfaction.”

In a number of further studies comparing Sildenafil, Tadalafil, and Vardenafil, patients generally demonstrated a preference for Tadalafil overall. However, different drugs have different levels of efficacy for different people. In this respect, even though Vardenafil appears to be slightly less effective, it may well work for you.

Tadalafil vs Vardenafil: The Side Effects

The side effects of Vardenafil and Tadalafil are those commonly seen in other PDE5 inhibitors. Generally, PDE5 inhibitors lower your blood pressure – and, in the majority of cases, the side effects are the result of precisely this. These can include headaches, flushing, congestion, and muscle pain – but it’s rare.

However, there is also the chance of the notorious condition known as priapism, a prolonged and painful erection that will not subside. This is incredibly rare – and whilst the first known case of priapism from Tadalafil caused a stir, the side effect is probably equally uncommon with Levitra, too.

Despite this, studies have suggested that Vardenafil is the PDE5 inhibitor with the highest rate of side effects, with at least one side effect occurring in 25% of cases. Similarly, according to official US medical advice, Levitra can cause dizziness, nausea, and flu-like symptoms, side effects that are not seen with Tadalafil.

Tadalafil, however, has demonstrated slightly higher chances of experiencing back and muscle pain as side effects. This is believed to be the result of the longer time it takes for the drug to be broken down. Vardenafil also is much less likely to cause changes to the colour of your vision, a side effect more commonly associated with Sildenafil.

Whilst it is not hugely comfortable to dwell on the side effects of drugs, it is important to know what to expect. Meanwhile, it is worth repeating: yes, both drugs are safe – and they have been licensed for medical use precisely because of this.

How to Choose between Vardenafil and Tadalafil?

Both Cialis and Levitra are safe, effective, and licensed for the treatment of erectile dysfunction. As a result, the treatment that you pick is ultimately down to you.

In the end, it might be merely a question of practicalities. Would you prefer a longer-lasting effect, so that you are ready whenever you need it? Or would taking the pill just when it’s required be more convenient?

Only you can make the decision. But remember, you are not obliged to stick to one option for life. If one drug doesn’t work for you, there is no problem in trying the alternative. Every man’s body is different – and the drugs will inevitably work a little differently from person to person.

Cialis (Tadalafil)

The weekend pill

Known as the “weekend pill” because it is effective for up to 36 hours, Tadalafil is the generic, unbranded version of Cialis. Clinically proven to help you get an erection when you need it.


Best for
Weekend use
Effective in
Effective in 8 out of 10 men
Dosage
2.5mg, 10mg, 20mg

Key Takeaways

Cialis vs Levitra, then – which is it to be? Whilst Tadalafil might have the edge in terms of effectiveness and the frequency of side effects, you may not want the drug in your system for 36 hours. Alternatively, this might be exactly what is attractive about this option. The choice is yours!

References

  1. JinQiu Yuan, RenJie Zhang, ZuYao Yang, Jack Lee, YaLi Liu, JinHui Tian, XiWen Qin, ZhengJia Ren, Hong Ding, Qing Chen, Chen Mao, JinLing Tang (2013). Comparative effectiveness and safety of oral phosphodiesterase type 5 inhibitors for erectile dysfunction: a systematic review and network meta-analysis: https://pubmed.ncbi.nlm.nih.gov/23395275/

  2. Antonio Martin-Morales, Josep Maria Haro, Anthony Beardsworth, Jordan Bertsch, Stathis Kontodimas (2007). Therapeutic effectiveness and patient satisfaction after 6 months of treatment with tadalafil, sildenafil, and vardenafil: results from the erectile dysfunction observational study (EDOS)Therapeutic effectiveness and patient satisfaction after 6 months of treatment with tadalafil, sildenafil, and vardenafil: results from the erectile dysfunction observational study (EDOS)Therapeutic effectiveness and patient satisfaction after 6 months of treatment with tadalafil, sildenafil, and vardenafil: results from the erectile dysfunction observational study (EDOS): https://pubmed.ncbi.nlm.nih.gov/17084518/

  3. S Doggrell (2006). Do vardenafil and tadalafil have advantages over sildenafil in the treatment of erectile dysfunction?: https://www.nature.com/articles/3901525

  4. Liang Chen, Sergej E.L. Staubli, Marc P. Schneider, Alfons G. Kessels, Sandra Ivic, Lucas M. Bachmann and  Thomas M. Kessler( 2015). Phosphodiesterase 5 Inhibitors for the Treatment of Erectile Dysfunction: A Trade-off Network Meta-analysis: https://www.europeanurology.com/article/S0302-2838(15)00250-X/abstract/phosphodiesterase-5-inhibitors-for-the-treatment-of-erectile-dysfunction-a-trade-off-network-meta-analysis

  5. Stephen H King, Maralyn Hallock, Jared Strote, Hunter Wessells (2005). Tadalafil-associated priapism: https://pubmed.ncbi.nlm.nih.gov/16051318/

  6. NBC News – Too much of a good thing: The 4-hour erection: https://www.nbcnews.com/healthmain/too-much-good-thing-4-hour-erection-1C9926694

  7. Reuters – Erectile dysfunction drugs vary in effectiveness, side effects: https://www.reuters.com/article/us-ed-drugs-profiles/erectile-dysfunction-drugs-vary-in-effectiveness-side-effects-idUSKBN0MY1TT20150407

  8. LEVITRA- vardenafil hydrochloride tablet, film coated: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a01def95-c0ef-43b9-bd9e-5565b2385ad3

  9. CIALIS- tadalafil tablet, film coated: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ebddb745-81f9-4b25-8739-b2886032ed26

  10. Sheila A Doggrell ( 2005). Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfunction: https://pubmed.ncbi.nlm.nih.gov/15709885/

While we've ensured that everything you read on the Health Centre is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.

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