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Levitra® (which contains the active ingredient vardenafil) and Viagra® (sildenafil) are two of the most popular medications for the treatment of erectile dysfunction (ED) on the market, used by millions of men in the US and tens of millions worldwide.
Both drugs are designed to help treat erectile dysfunction by improving blood flow to the erectile tissue of the penis. While the effects of Levitra and Viagra are very similar, there are also a few key differences between the two medications that are worth knowing about.
Below, we’ve listed the main differences between Levitra and Viagra, from the best time to take each medication before sex to the different amounts of time that Levitra and Viagra will improve your sexual performance and provide relief from erectile dysfunction.
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Levitra and Viagra are very similar medications, but there are a few major differences between them that could make one a better choice for you than the other:
Levitra and Viagra are both oral medications that can be taken as needed before sexual activity. They’re both good choices for most men with ED, with studies showing a similar average level of effectiveness.
Both Levitra and Viagra are prescription medications, meaning you’ll need to talk to your healthcare provider before you can purchase and use either one.
Levitra and Viagra both work for a similar amount of time. Levitra typically provides relief from ED for four to six hours per dose, whereas Viagra provides relief from ED for about four hours.
Levitra is only slightly affected by food, meaning you can take it with a meal without any significant loss of effectiveness. In contrast, Viagra might take longer to work if it’s taken with a large, high-fat meal.
Overall, there’s no “best” erectile dysfunction medication for everyone. You’ll usually get the best results by working with your healthcare provider to choose the medication that’s best suited to your needs and preferences.
Before we go into more detail about the key differences between Levitra and Viagra, let’s briefly go over how both of these medications work.
Levitra, which contains vardenafil, and Viagra, which contains sildenafil, both belong to a class of medications referred to as PDE5 inhibitors.
As their name suggests, PDE5 inhibitors work by inhibiting the effects of the PDE5 enzyme, or phosphodiesterase-5. This enzyme is found in the smooth muscle cells of your blood vessels, where it’s involved in regulating blood flow.
Healthy erections are all about steady, consistent blood flow. When you feel sexually aroused, your nervous system causes the muscles in your penis to relax, increasing the flow of blood to the corpora cavernosa -- a pair of sponge-like chambers of tissue inside your penis.
This process usually begins in response to sexual stimulation, such as being touched by your partner or seeing sexual imagery.
As more blood flows to the corpora cavernosa, your penis becomes larger and firmer, creating an erection. A fibrous membrane called the tunica albuginea wraps around this tissue, helping you to maintain your erection during sexual intercourse.
After you reach orgasm and ejaculate, blood flows out from this tissue and your penis starts to become flaccid once again.
A range of issues can cause erectile dysfunction, but many cases of ED are caused by health issues that affect blood flow to your penis.
As PDE5 inhibitors, Levitra and Viagra increase the diameter of the blood vessels that supply your penis and improve blood flow, making it easier for you to get a penile erection.
The active ingredient in Levitra is called vardenafil. Under the brand name Levitra, vardenafil was approved by the FDA in 2003 as an erectile dysfunction medication. This makes Levitra the newer of the two drugs.
The active ingredient in Viagra is called sildenafil. As Viagra, sildenafil received approval from the FDA in 1998, making it the oldest oral medication that’s currently available to treat erectile dysfunction.
Because of its effects on arterial blood flow, sildenafil is also used as a treatment for pulmonary hypertension, a form of high blood pressure that affects the lungs.
Vardenafil, on the other hand, is used exclusively to treat ED and is not marketed or used as a treatment for any form of hypertension.
Levitra and Viagra both last for a similar amount of time inside the body. Both medications are intended to provide short-term relief from erectile dysfunction, usually for a few hours of sexual activity.
Levitra, as well as generic vardenafil, has a half-life of four to six hours, according to an article published by Boston University School of Medicine. This means it usually takes four to five hours for your body to metabolize and remove half of the active ingredient in the medication.
On average, vardenafil works for up to eight hours after you take it, according to an article published in the journal, European Urology. However, the drug’s effects usually start to fade after about four hours.
Viagra, as well as generic sildenafil, has a half-life of four hours. It works for at least four hours after you take it at a normal dose. Most men notice the effects of Viagra fading after about three to four hours.
In general, Levitra and Viagra both last for a similar amount of time. Neither drug is particularly long-lasting, meaning that if you take them after dinner, the effects will usually end right before you go to sleep for the night.
Cialis® (tadalafil), on the other hand, is designed to provide relief from erectile dysfunction for up to 36 hours per dose, making it the best option if you need a “weekend” ED drug that offers longer-lasting results or a regular-use medication that can be taken as a daily dose.
Overall, Levitra and Viagra both last for a similar amount of time, although Levitra has a slightly longer duration of action. Both medications are a good option if you want to enjoy relief from ED and improve your sexual performance for one night.
Levitra and Viagra are both very effective at treating erectile dysfunction. In clinical trials, around 80 percent of men affected by ED reported being able to get and maintain satisfactory erections after taking Levitra or Viagra.
In a clinical trial of Levitra published by the FDA, 80 percent of men with erectile dysfunction reported improvements in their ability to develop an erection sufficient for penetrative sex after taking 20mg of Levitra (the highest recommended dose), compared to 52 percent who used a placebo.
The same trials of Levitra also demonstrated that 65 percent of men treated using a 20mg dose were able to maintain their erection throughout sexual activity.
In a clinical trial of Viagra published in the International Journal of Impotence Research, 92 percent of men reported improved erections after using Viagra for 36 weeks on doses ranging from 25 to 100mg. 89 percent of men reported improved erections after using Viagra for 52 weeks on the same doses.
When it comes to treating erectile dysfunction, Levitra and Viagra are both equally effective. If you’re prone to ED, both medications should provide relief from ED and an improvement in your sexual performance, provided you take the correct dose for you.
Verdict: There is no statistically significant difference in effectiveness between Levitra and Viagra.
Levitra and Viagra are both fast-acting medications, meaning you usually won’t need to wait for long after taking either drug to have sex.
Taken at a standard dose, Levitra starts working after around 30 minutes. You’ll typically get the best results by taking your prescribed dosage of Levitra or generic vardenafil approximately one hour before you plan to have sex. However, hims now offers Vardenafil chewables which start working in as little as 15 mins.
Viagra can be taken as needed 30 minutes before sex. However, like with Levitra, it’s generally recommended to take your prescribed dosage of Viagra approximately one hour before you plan to engage in sexual activity for optimal results.
Overall, both medications take around the same time to start working and provide the best results after approximately one hour.
Levitra usually isn’t affected by food, meaning you can take it with or shortly after a meal without affecting the amount of time required for the medication to start working. It’s best to avoid highly fatty meals when using Levitra, as these may slow down absorption of the medication.
Viagra is affected by food and is designed to be taken on an empty stomach. If you take Viagra after eating, it might take longer than one hour for the medication to begin working, especially if you eat a large meal with a high fat content.
Overall, if you need an ED medication you can take at dinner without having to worry too much about effectiveness, Levitra is a better choice than Viagra, according to an article published in the Journal of Clinical Pharmacology. However, with both drugs, it’s best to avoid large, high-fat meals.
Because Levitra and Viagra are both PDE5 inhibitors that work in the same way to reduce the severity of erectile dysfunction, they have similar side effects.
However, there is one unique side effect of Levitra that’s important to know about if you have any medical conditions that cause irregular heartbeat, such as long QT syndrome.
The most common side effects of Levitra and Viagra are nasal congestion or stuffy nose, headache, back pain, flushing in the face, heartburn/indigestion or upset stomach. It’s also possible to experience serious side effects, like blurred/blue-tinted vision or vision loss and muscle aches after using either medication, especially if you take a relatively high dose.
The side effects of Levitra and Viagra usually develop two to three hours after you first take the medication. Certain side effects, such as headaches and/or indigestion, may persist for several hours after the effects of Levitra or Viagra wear off.
Although the side effects of Viagra and Levitra are generally similar, there is one side effect of Levitra that’s important to know about if you have any conditions that cause irregular heartbeat, such as long QT syndrome.
If you have long QT syndrome or any heart condition that can cause an abnormal heart rhythm and/or heart palpitations, you should not use Levitra.
Long QT syndrome can be caused by several medications, including cardiovascular drugs and antibiotics.
It’s also important to inform your healthcare provider if you have any other heart health issues, such as a prior heart attack, stroke, heart failure, heart surgery or risk factors for heart disease, before you use Levitra, Viagra or other erectile dysfunction drugs.
These conditions, as well as medications used to treat them, may affect the safety of Levitra or Viagra.
Concerned about the side effects of Levitra and Viagra? Our detailed guide to what you should expect from ED medication explains the most common side effects of Levitra, Viagra and Cialis, from heartburn and headaches to facial flushing and others.
Levitra and Viagra are both safe and effective medications for most men with sexual dysfunction. However, there are a few situations in which both erectile dysfunction medications have drug interactions, causing issues such as dizziness, hypotension (low blood pressure) and slow drug metabolization.
All PDE5 inhibitors, including Levitra and Viagra, can interact with nitrates (like nitroglycerin) and other drugs used to treat angina and/or high blood pressure. When used together, these medications can cause a sudden low blood pressure that may cause dizziness, fainting, heart attack or stroke.
In addition to prescription nitrate medications, Levitra and Viagra may interact with recreational drugs that contain nitrates, such as amyl nitrate, amyl nitrite or butyl nitrate “poppers.”
Make sure to inform your healthcare provider about any medications you currently use or have recently used, including heart or blood pressure medications, or any supplements you may be taking before taking any medication for erectile dysfunction.
According to an article published in the journal, Clinical Pharmacology and Therapeutics, grapefruit and grapefruit juice may interact with ED drugs such as Levitra and Viagra, causing your body to metabolize either medication slower than normal.
Make sure to avoid consuming any food or drinks that contain grapefruit before or while using Levitra, Viagra or other PDE5 inhibitors.
Although light alcohol consumption (one to two servings of wine, beer or other types of liquor) generally isn’t an issue while using PDE5 inhibitors, you should avoid drinking to excess if you have used Levitra or Viagra.
If you have any existing medical conditions, had a stroke, heart attack or other cardiovascular events, or if you have existing heart disease, you’ll need to seek medical advice from a healthcare provider before considering Levitra or Viagra.
Verdict: Levitra and Viagra are both safe for most people. However, you need to inform your healthcare provider about any other prescription medications you use, especially nitrates and other drugs used to treat hypertension.
Because erectile dysfunction can vary in severity, Levitra and Viagra are both prescribed at a range of dosages.
Levitra comes as a 5mg, 10mg or 20mg oral tablet. The recommended initial dose of Levitra is 10mg taken one hour prior to sex. If you have mild or moderate ED, your healthcare provider will likely probably be put on this dose to assess your results.
Levitra 20mg is the highest dose of Levitra. You may be prescribed this dose if you have severe or persistent erectile dysfunction that doesn’t improve with the 10mg dose of Levitra. You should not take more than 20mg of Levitra or generic vardenafil.
Levitra 5mg is the lowest available dose of Levitra. This lower dose of Levitra is typically used to treat mild erectile dysfunction, typically in younger men. Clinical trials of Levitra suggest that the 5mg dose is enough to cause an improvement in erections for most men.
Viagra is available as a 25mg, 50mg or 100mg oral tablet. The recommended dose of Viagra is 50mg, taken prior to sex. Your healthcare provider will likely prescribe this dosage of Viagra if you have mild to moderate erectile dysfunction.
Viagra 100mg is the highest dose of Viagra. Your healthcare provider may prescribe Viagra at this dosage if you have persistent or severe erectile dysfunction that doesn’t improve when you take Viagra at a lower dosage.
Viagra 25mg is the lowest recommended dosage of Viagra. It’s typically used to treat mild ED in younger men, or in men who have severe, persistent or bothersome adverse effects from Viagra at a dosage of 50 or 100mg.
In general, it’s easy to use Levitra or Viagra at the appropriate dose for you, letting you get all of the benefits of the medication with as few side effects as possible.
Levitra and Viagra are both available as brand-name and generic medications, meaning the cost of using either drug can vary significantly based on whether you select the original medication or the more affordable generic version.
The price of brand-name Levitra can vary based on your location, the dosage of medication you use and the amount of tablets you purchase. Many pharmacies offer brand-name Levitra tablets for $30 to $80+ each, depending on the dosage.
Generic vardenafil, the active ingredient in Levitra, is significantly more affordable, with tablets available from $5 to $10 each when purchased in quantities of 10 or more.
Similarly, the price of Viagra can vary significantly depending on whether you opt for the brand name medication produced by Pfizer or generic sildenafil.
We provide brand-name Viagra from $139 per use via our online platform, or generic sildenafil from just $3 per use.
Levitra and Viagra are very similar medications. They both work for around the same amount of time and show similar improvements for men with ED in clinical trials. If you have ED and need a reliable medication to help you become and stay erect, both drugs are great choices.
If you need an ED medication that you can take with dinner, Levitra might be the better choice out of the two. It’s less affected by food than Viagra, meaning you won’t notice any delay in its effects unless you eat a very fatty meal.
If you prefer a shorter-acting ED medication, or if you have long QT syndrome, Viagra might be a better choice. It’s out of your system slightly faster than Levitra and doesn’t increase your risk of ventricular arrhythmia.
Ultimately, it’s best to talk to your healthcare provider and work out which ED medication offers the best effects for your needs.
We offer several FDA-approved ED medications online, including sildenafil, tadalafil (the active ingredient in Cialis®) and Stendra®, a newer ED medication that’s fast acting and less likely to cause certain side effects.
You can also learn more about how Viagra, Levitra and other medications work in our full guide to the most common ED medications.
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Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown was previously Medical Director of a male fertility startup where she lead strategy and design of their digital health platform, an innovative education and telehealth model for delivering expert male fertility care.
She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.
Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.
Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.
Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.
Education & Training
Andrology Fellowship, Medical College of Wisconsin
Urology Residency, University of California San Francisco
M.D. Northwestern University Feinberg School of MedicineB.S. in Radiologic Science, Chemistry Minor, University of North Carolina at Chapel Hill
Published as Kelly Walker
Cowan, B, Walker, K., Rodgers, K., Agyemang, J. (2023). Hormonal Management Improves Semen Analysis Parameters in Men with Abnormal Concentration, Motility, and/or Morphology. Fertility and Sterility, Volume 118, Issue 5, e4. https://www.sciencedirect.com/journal/fertility-and-sterility/vol/120/issue/1/suppl/S
Walker, K., Gogoj, A., Honig, S., Sandlow, J. (2021). What’s New in Male Contraception? AUA Update Series, Volume 40. https://auau.auanet.org/content/update-series-2021-lesson-27-what%E2%80%99s-new-male-contraception
Walker, K., Shindel, A. (2019). AUA Erectile Dysfunction Guideline. AUA Update Series, Volume 38. https://auau.auanet.org/content/course-307
Walker, K., Ramstein, J., & Smith, J. (2019). Regret Regarding Fertility Preservation Decisions Among Male Cancer Patients. The Journal of Urology, 201(Supplement 4), e680-e681. https://www.auajournals.org/doi/10.1097/01.JU.0000556300.18991.8e
Walker, K., & Smith, J. (2019). Feasibility Study of Video Telehealth Clinic Visits in Urology. The Journal of Urology, 201(Supplement 4), e545-e545. https://www.auajournals.org/doi/10.1097/01.JU.0000556071.60611.37