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Levitra vs. Cialis: Which Is Better?

Kristin Hall, FNP

Reviewed by Kristin Hall, FNP

Written by Geoffrey Whittaker

Published 01/18/2021

Updated 07/27/2023

Whether it happens every once in a while or more often than you’d like, erectile dysfunction (ED) eventually becomes something many men seek treatment for. And like buying a car, most guys want to do their research before committing to a medication. 

Two of the best options on the market today are Levitra and Cialis and their generics, vardenafil and tadalafil, respectively. You’ve probably read about them already, and our guess is you’re trying to figure out which one’s right for you.

Cialis feels like it’s everywhere — including on some annoying banner ads that may have flashed across your screen. Getting your hands on Levitra isn’t actually possible today because the medication was discontinued by the manufacturer. However, generic producers are still plentiful, and the fact that Levitra isn’t being made by its creator anymore isn’t any sort of statement on its effectiveness or safety.

But when deciding between them, is there a “better” erectile dysfunction medication? 

We’re here to answer this question. We’ll touch on all the info you need to know when weighing your options below. This includes the key differences, track records, prices and risks of taking each medication.

Before we get too deep into the weeds, let’s look at the hard stats of these two medications — and the key differences they represent.

Choose your chew

Add a boost to your sex life with our new chewable formats

Choose your chew

Add a boost to your sex life with our new chewable formats

Erectile dysfunction is a complex problem. It can be a result of high blood pressure, issues with the function of certain blood vessels or simply a lack of sexual stimulation. 

ED can put considerable strain on your sex life. Whether you experience it every once in a while or it’s become a routine occurrence during sexual activity, getting the appropriate care to help achieve and maintain an erection should be a top priority.

Erectile dysfunction may be caused by a medical disease, such as diabetes or heart disease, or a psychological condition like depression. It could also be a side effect medication you’re taking.

And despite how much you’re probably beating yourself up over experiencing it, erectile dysfunction is pretty common, affecting millions of men in the United States alone. 

Most of these men may find that medications like Cialis and Levitra can help. So what makes one different from another?

Here’s what you need to know:

  • Active ingredients. Cialis is the brand-name version of tadalafil. Levitra, which isn’t made anymore, is available as a generic version called vardenafil hydrochloride. 

  • Uses. You’re most likely looking at both medications for the treatment of ED. But in addition to ED, tadalafil is used for the treatment of benign prostatic hyperplasia (BPH) and pulmonary arterial hypertension (PAH). Meanwhile, vardenafil has been shown to be useful in the treatment of PAH but is not yet FDA-approved for that use.

  • Dosage for ED. Both Levitra and Cialis are typically prescribed at an initial dose of 10 milligrams (mg). This might be increased to 20 milligrams or decreased to 5 milligrams depending on the individual patient’s needs. Cialis can also be prescribed as a daily medication (instead of an as-needed medication), starting at 2.5 milligrams and going up to 5 milligrams. Depending on your needs, this could mean Cialis offers more variety in the ways you can take it. For more information, check out our Levitra dosage guide and our Cialis dosage guide

  • Time to work. One of the main differences between Cialis and vardenafil is how long they take to work. Cialis usually starts working in 30 minutes, though it can take as long as two hours. You’ll begin feeling the effects of vardenafil about an hour after taking it.

  • How long they last. While both medications may start to work within the hour you take them, vardenafil lasts up to five hours. Cialis, on the other hand, can last up to 36 hours, depending on the dosage.

Levitra and Cialis are definitely different medications, but they’re both considered effective. Still, effectiveness will vary from person to person.

So even if we were to recommend Cialis (which we’re not doing), you’d still want to speak to a healthcare provider about your options. Why? Individual circumstances may change what works best for you.

That said, let’s look at each medication’s track record in detail.

Vardenafil Effectiveness

Vardenafil has been proven effective in men with ED, including those above age 65 — the most prevalent age group with erectile dysfunction.

A 12-week study was done on 580 men of various ages ranging from under 45 to over 65. The researchers discovered that vardenafil was effective in improving erectile function, regardless of age or the severity of erectile dysfunction.

In two randomized studies, men with erectile dysfunction associated with diabetes or following unilateral or bilateral nerve-sparing radical retropubic prostatectomy received 10 or 20 milligrams of vardenafil for 12 or 26 weeks.

At the end of the study, the men reported better improvements in penetration and the maintenance of erections than the placebo group. Participants in the study also recorded improved intercourse satisfaction and orgasms.

Vardenafil has also proven effective in treating ED in patients living with hypertension and diabetes. Vardenafil means business when it comes to managing erectile dysfunction.

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Cialis Effectiveness

Likewise, tadalafil (Cialis) is just as effective, as confirmed in a randomized study involving 1,112 men living with ED. The average age of participants was 59, and ED cases ranged from mild to severe.

Results of the study verified that Cialis enhances sexual activity for people living with ED, with a large number of participants reporting improved erections and successful intercourse attempts.

In another study involving patients with high incidents of severe erectile dysfunction and comorbid medical conditions, tadalafil was shown to significantly improve erectile function, leaving patients and their partners satisfied.

This was despite the patients being in a tertiary-care academic center where high incidents of severe, organic ED and concurring medical conditions were observed — all of which can complicate erectile function and treatment outcome.

Different internet sources put prices for Cialis and its generic tadalafil anywhere from $5 per pill to $70 per tablet. Meanwhile, generic vardenafil is offered between $3 and $4 per 20-milligram pill.
Given that information, vardenafil may seem like the more affordable option. But unfortunately, this information doesn’t take into account several factors — including whether your insurance will help pay for these medications (and how much they’ll cover).

A number of factors will affect what you pay for either medication, including:

  • Whether you have insurance coverage

  • Whether you pay cash

  • The pharmacy you’re using

  • If you’re using a manufacturer’s coupons

  • How often you plan to take the medication (daily Cialis will obviously require more doses per month than an as-needed option)

We offer both generics starting at $4 per use.

As is common with any medication, PDE5 inhibitors like Levitra and Cialis have known side effects. This includes headaches, color vision changes, flushing, indigestion, back pain, hypotension (low blood pressure), dizziness and nasal congestion in the form of a runny nose or a stuffy nose.

More serious adverse effects can include priapism, hearing loss and prostate cancer.

The adverse effects of these drugs can be dependent on dosage. Levitra’s generic vardenafil is popularly available in 2.5, 5, 10 and 20-milligram dosages. Cialis is available in the same doses.

Compared with Cialis, Levitra users experience more common symptoms of nasal congestion and flu-like symptoms. But these are fairly common PDE5 side effects, and they’re also listed as side effects of brand-name Cialis.

Adverse reactions will vary from person to person, and you may experience side effects in more pronounced ways with one medication than another.

Choose your chew

Another place where these medications are more similar than different is how they interact with other medications. Drug interactions can create serious health risks that shouldn’t be overlooked.

Cialis interacts problematically with certain other medications. So does Levitra. As PDE5 inhibitors, caution is necessary when taking other medications to prevent adverse effects.

Some drug combinations are a no-go, as they’re absolute contraindications to ED medications like Levitra and Cialis.

This includes nitrates and alpha-blockers. Combining these medications with ED medications may result in a significant drop in blood pressure. Fun fact: Grapefruit juice can have the same effect of increasing the intensity of these medications’ effects.

Caution is necessary when administering ED medications to patients experiencing difficulty in kidney function. Similarly, since PDE5 inhibitors are metabolized in the liver, it’s always best to consult your healthcare provider, who will consider your full health history to determine the appropriate dosing.

PDE5 inhibitors are highly effective and have an overall success rate of up to 76 percent.

Picking a “better drug” isn’t really the smartest way to discuss these medications. As noted, both Levitra and Cialis are effective for numerous uses and use cases. And since each person is different, you might see more benefit from one drug than the next person — and vice versa.

In other words, we can’t tell you which is better.

One thing that may matter is how eating habits can affect these medications. While a high-fat meal may affect the absorption of Levitra, Cialis is largely unaffected by food.

Vardenafil takes an average of an hour to take effect and lasts roughly four and a half hours. Tadalafil can take up to two hours to take effect and has a comparatively lengthy half-life of about 36 hours — the reason Cialis is sometimes called “the weekend pill.”

Cialis’s prolonged effect allows for some spontaneity in sexual activity, especially compared to drugs like Levitra that must be taken about an hour before sex.

What we can do is point out what we’ve already discussed: Cialis is prescribed and FDA-approved for a number of conditions, and vardenafil has only (so far) been approved for the treatment of ED. We can also point to study results showing user comparisons.

For instance, one 2007 study compared vardenafil, tadalafil and sildenafil (Viagra). Over six months, it looked at user satisfaction among more than 8,000 patients. The researchers found that, for most people, Cialis was considered more effective and delivered higher satisfaction scores than vardenafil. 

Will that be the case for you? Maybe. It’ll depend on various individual factors, which is why it’s so crucial to talk to a healthcare professional to get personalized, targeted treatment for ED.

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The Levitra/Cialis question is probably not the most important one for the average guy. 

Make no mistake — choosing the right medication is essential to getting the best results for ED treatment. But comparing two medications on paper will only tell you what should be the best medication for your needs.

Depending on various factors, a healthcare provider may believe one or the other is best for your needs. But the reality is, you might have to try more than one medication to find the right fit.

In other words, getting your erectile prowess back on track may be a journey instead of a choice. Making that choice is about having the right information, so remember the following:

  • If you’re looking for the best ways to manage erectile dysfunction, Levitra and Cialis are two erectile dysfunction treatment options that have absolutely earned their stripes.

  • Both ED drug types have been proven safe and effective, with similar side effects in the brand-name and generic versions.

  • Starting with lower doses of these medications and addressing health conditions associated with ED can help improve erectile function.

  • Both drugs work essentially the same way. And both can be misused, so get medical advice when you receive your prescription, and take heed.

  • Depending on what works best for you, you could opt for Levitra for guaranteed results and a quicker exit of the medication from your system.

  • Or you could pitch tents for longer with Cialis, which can increase your chances of unplanned sexual activity and improve overall satisfaction.

Want to learn about other erectile dysfunction drugs? Read our blog on Levitra vs. Viagra

We also offer two other phosphodiesterase enzyme-inhibiting medications: sildenafil (generic for Viagra) and avanafil (generic for Stendra). We even offer chewable ED meds hard mints for guys on the go who don’t love carrying pill bottles around.

17 Sources

  1. Martin-Morales, A., Haro, J. M., Beardsworth, A., Bertsch, J., Kontodimas, S., & EDOS Group (2007). Therapeutic effectiveness and patient satisfaction after 6 months of treatment with tadalafil, sildenafil, and vardenafil: results from the erectile dysfunction observational study (EDOS). European urology, 51(2), 541–550. https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(06)01131-6.
  2. Coward, R. M., & Carson, C. C. (2008). Tadalafil in the treatment of erectile dysfunction. Therapeutics and clinical risk management, 4(6), 1315–1330. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643112/.
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  5. HIGHLIGHTS OF PRESCRIBING INFORMATION: LEVITRA (vardenafil hydrochloride) tablets, for oral use . (n.d.-b). https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021400s020lbl.pdf.
  6. Sooriyamoorthy T, Leslie SW. Erectile Dysfunction. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562253/.
  7. Dhaliwal A, Gupta M. PDE5 Inhibitors. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/.
  8. Carson, C., Shabsigh, R., Segal, S., Murphy, A., Fredlund, P., Kuepfer, C., & Trial Evaluating the Activity of Tadalafil for Erectile Dysfunction-United States (TREATED-US) Study Group (2005). Efficacy, safety, and treatment satisfaction of tadalafil versus placebo in patients with erectile dysfunction evaluated at tertiary-care academic centers. Urology, 65(2), 353–359. https://pubmed.ncbi.nlm.nih.gov/15708052/.
  9. Brock, G. B., McMahon, C. G., Chen, K. K., Costigan, T., Shen, W., Watkins, V., Anglin, G., & Whitaker, S. (2002). Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. The Journal of urology, 168(4 Pt 1), 1332–1336. https://pubmed.ncbi.nlm.nih.gov/12352386/.
  10. Ishii, N., Nagao, K., Fujikawa, K., Tachibana, T., Iwamoto, Y., & Kamidono, S. (2006). Vardenafil 20-mg demonstrated superior efficacy to 10-mg in Japanese men with diabetes mellitus suffering from erectile dysfunction. International journal of urology : official journal of the Japanese Urological Association, 13(8), 1066–1072. https://pubmed.ncbi.nlm.nih.gov/16903931/.
  11. van Ahlen, H., Wahle, K., Kupper, W., Yassin, A., Reblin, T., & Neureither, M. (2005). Safety and efficacy of vardenafil, a selective phosphodiesterase 5 inhibitor, in patients with erectile dysfunction and arterial hypertension treated with multiple antihypertensives. The journal of sexual medicine, 2(6), 856–864. https://pubmed.ncbi.nlm.nih.gov/16422810/.
  12. Porst, H., Young, J. M., Schmidt, A. C., Buvat, J., & International Vardenafil Study Group (2003). Efficacy and tolerability of vardenafil for treatment of erectile dysfunction in patient subgroups. Urology, 62(3), 519–524. https://pubmed.ncbi.nlm.nih.gov/12946758/.
  13. Keating, G. M., & Scott, L. J. (2004). Spotlight on vardenafil in erectile dysfunction. Drugs & aging, 21(2), 135–140. https://pubmed.ncbi.nlm.nih.gov/14960129/.
  14. U.S. Department of Health and Human Services. (n.d.-a). Definition & Facts for erectile dysfunction - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts.
  15. Jing, Z. C., Jiang, X., Wu, B. X., Xu, X. Q., Wu, Y., Ma, C. R., Wang, Y., Yang, Y. J., Pu, J. L., & Gao, W. (2009). Vardenafil treatment for patients with pulmonary arterial hypertension: a multicentre, open-label study. Heart (British Cardiac Society), 95(18), 1531–1536. https://pubmed.ncbi.nlm.nih.gov/19549620/.
  16. HIGHLIGHTS OF PRESCRIBING INFORMATION: LEVITRA (vardenafil hydrochloride) tablets, for oral use . (n.d.-b). https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021400s020lbl.pdf.
  17. HIGHLIGHTS OF PRESCRIBING INFORMATION: CIALIS (tadalafil) tablets, for oral use . accessdata.fda.gov. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf.
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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