Viagra vs. Cialis® vs. Levitra vs. Stendra: Which Is Best?

Viagra, Cialis, Levitra, and Stendra are FDA-approved medications for erectile dysfunction. Discover which is the best treatment option.

Dr. Kevin Huffman
By The Promescent Team Medically reviewed by Dr. Kevin Huffman Last updated 10/12/2023

Viagra, Cialis, Levitra, and Stendra are all medications designed to treat erectile dysfunction. The generic names they also go by are sildenafil, tadalafil, vardenafil, and avanafil respectively.

While various lifestyle changes can help improve the condition, the good news is that these ED medications are safe and effective treatments to try. Dr. Kevin Huffman of AmBari Nutrition notes that, “These drugs work by improving blood flow to the penis.”

Quick FAQs

Depending on which ED medication is chosen, they can last as little as 4 hours, or as much as 36 hours.

The most common side effects are headaches, muscle aches, and congestion.

Generic versions of ED meds are the most affordable treatment option.

It's estimated that up to 30 million men are impacted by erectile dysfunction, or ED, making it the most common sexual problem for men.

We’ll discuss whether Viagra, Cialis, Levitra or Stendra is the best option for treatment.

Viagra vs Cialis

Let's start by breaking down the key differences between Viagra and Cialis, starting with some similarities:

  • Viagra and Cialis are both PDE5 inhibitors used to treat erectile dysfunction.
  • Both are FDA-approved oral medications to help treat erectile dysfunction. 
  • Both can cause common side effects such as flushing, back pain, headache, muscle pain and nausea.

Now that we've gone over some of the key similarities between Viagra and Cialis, let's take a look at some of their differences.

Viagra:

  • Is the brand name for sildenafil.
  • Is taken on an as-needed basis and tends to work within about a half hour, though doctors suggest taking it at least 1 hour before anticipated sex.
  • The effects can last up to 8 hours after it's taken.
  • Food can decrease its effectiveness.
  • Is proven to be modestly more effective than Cialis, with a reported effective rate of about 84 percent.

Cialis:

  • Is the brand name for tadalafil.
  • Can be taken daily at smaller dosage limits or taken as needed.
  • Works within a range of 1 to 2 hours.
  • Works for about 36 hours, which is comparatively much longer than many other ED products on the market.
  • Food does not decrease its effectiveness.
  • Is proven to be slightly less effective than Viagra, with a success rate of about 81 percent.
    • Since Cialis lasts for up to 36 hours, dosage may need to be reduced over time - especially in men with liver or kidney disease.

    Stendra vs Levitra

    Now that we've gone over two of the more well-known ED brands in Viagra and Cialis, let's take a look at two more: Stendra and Levitra. Both are prescription medications available orally to treat erectile dysfunction issues.

    Key differences between Stendra and Levitra include the following:

      • Levitra is a medication that can be taken without food.
      • Stendra tends to last for up to six hours, while Levitra can last for up to 12 hours.
      • Levitra is a disintegrating tablet, which helps it work faster than the pill form of Stendra and other ED medications.

      Levitra vs Cialis

      Levitra and Cialis were both approved by the FDA in 2003, right at about the same time. While this was five years after Viagra received FDA approval, it made the ED medication market more competitive based on competition.

      Here's a look at some of the key differences between Levitra and Cialis:

      Cialis:

      The brand name for tadalafil, Cialis can be taken daily in smaller dosages or in one larger dose 30 to 60 minutes before sex. After it's consumed, it works for about 36 hours - longer than Levitra and most other ED medications.

      Levitra:

      Levitra is best taken prior to sexual intercourse and not on a low-dose daily basis like other ED medications. It lasts for about 4 hours after consumption.

      Viagra vs Levitra

      Viagra, the brand name for sildenafil, was the first ED drug that was FDA-approved. For this reason, it's the ED drug with arguably the best name and brand recognition.

      Viagra is intended to be taken 30 minutes to 4 hours before sex. It's designed to begin working after an hour, and works for about 4 to 8 hours after it is consumed.

      Levitra was FDA-approved in 2003. It works a little differently compared to Viagra in that it's a dissolving tablet. The effects of the tablet last for 4 to 6 hours.

      One similarity between Levitra and Viagra is that there are generic versions of both products available, which can help decrease costs.

      Viagra, Cialis, Levitra, Stendra Generic Versions

      Because it's the newest ED medication to hit the market, there is no generic version of Stendra currently available. 

      For this reason, it's often a bit more expensive than Viagra, Cialis and Levitra, which have generic versions of the medication that are priced at a fraction of the cost of the name-brand version.

      It is expected that a generic version of Stendra will become available in the near future.

      Viagra, Cialis, Levitra, Stendra Dosage

      Dosages for Viagra, Cialis, Levitra and Stendra depend largely on the medication and the individual man.

      Men should consult with their doctor about their erectile dysfunction issues to help decide on an appropriate dose to take prior to engaging in sexual intercourse. 

      When to Take

      The general timing for when to take each medication are as follows:

      • Viagra: 30 minutes to 4 hours before sexual intercourse
      • Cialis: 30 minutes before sexual intercourse.
      • Levitra: 25 minutes to 60 minutes before sexual intercourse.
      • Stendra: 15 to 30 minutes to work before sexual intercourse

      How Long Does it Last?

      How long ED medication lasts depends purely on the type of ED medication men are taking. Dr. Kevin Huffman states that, “The main difference among them lies in how long they remain effective.” Here’s how long each can last:

      • Viagra: The effect can last for 4 to 8 hours
      • Cialis: The effect can last for up to 36 hours.
      • Levitra: The effect can last for 4 hours.
      • Stendra: The effect can last for up to 6 hours after consumption.

      Dr. Huffman states that, “It is crucial to consult with a healthcare provider before starting any of these medications to discuss your medical history and potential interactions with other drugs you may be taking.”

      Side Effects

      All of the ED medications have side effects. However, it's worth noting again that Viagra, Cialis, Levitra and Stendra are all FDA-approved. 

      In order for a medication to become FDA-approved, the FDA must determine that its benefits outweigh its potential risks.

      While most men who experience side effects only report minor conditions, there is a risk of more serious side effects associated with taking such medication. 

      Severe side effects, while rare, include vision loss, priapism and even hearing loss. Some of the side effects associated with the brand-name ED medication are as follows:

      • Viagra: Headache, flushing, upset stomach, stuffy nose, dizziness, diarrhea
      • Cialis: Headache, congestion, indigestion, back pain, muscle aches
      • Levitra: Headache, dizziness, runny nose, flushing
      • Stendra: Back pain, headaches, diarrhea, constipation

      Again, men should consult with their doctor on potential side effects and their particular risk before any of the ED medications are prescribed.

      Cost of ED Meds With and Without Insurance

      According to Dr. Huffman, the cost can vary based on brand, dosage, and insurance coverage.

      For instance, for men who are paying out of pocket, name-brand versions of each drug can cost hundreds of dollars for one month. However, generic versions typically are only a fraction of this price.

      Does insurance cover ED medication? While it all depends on a man's particular health insurance plan, most medical plans cover the diagnosis of ED and any medically necessary treatments to some extent.

      The best thing a man can do if he's concerned or curious about cost is to familiarize himself with his insurance plan and what it covers to see how much - if any - he'll have to pay out of pocket for ED medication. 

      If insurance doesn't cover it, the cost is going to be more expensive. For all ED medications except Stendra, affordable generic versions are available.

      Dr. Huffman states that, “It’s important to talk about these considerations with your healthcare provider to determine the most suitable option that fits both your needs and budget.”

      Drug Interactions

      Drug interactions are changes in the way a medication acts in the body if it's mixed or taken with other medications or substances.

      Viagra, Cialis, Levitra or Stendra should not be taken with any nitrates, which are drugs that reduce blood pressure or alpha blockers. It can cause a significant drop in blood pressure, increasing the risk of heart attacks or strokes.

      It’s important for patients to discuss all the medications they’re taking to make sure they don’t interact with ED meds.

      Which ED Medication is Best?

      It's not necessarily a matter of what ED medication is the best, but which one works best for a man and his particular situation. There are a variety of scenarios where a doctor may recommend or prescribe one of the ED medications over the other.

      As Dr. Huffman puts it, “It’s important to note that there isn’t a one-size-fits-all answer as to which medication is superior, as the choice depends on individual preferences, lifestyle factors, and any underlying health conditions. Some individuals may find one drug more effective or better tolerated than others.” Here are a few scenarios where one durg may prescribed over another:

      • If there's a need for a fast-acting ED medication, Stendra may be the preferred choice, as the dissolving tablet tends to work faster than other name brands.
        • If there's a desire for long-lasting effects, Cialis might be what's suggested by a man's doctor. Cialis works the longest of the name-brand ED medications for up to 36 hours.
        • If there's a concern about side effects, Viagra or Levitra may be suggested, as the effects of these meds last for a shorter period of time.

        Takeaways

        The best erectile dysfunction treatment will vary based on what each man's specific needs.

        The four various ED medications all have their fair share of pros and cons. Consult with a doctor to come to a decision on which product to try.

        Factors to consider include overall effectiveness, cost, potential side effects, drug interactions, and more.

        After finding an effective ED med, men should also make sure they're able to last long in bed.

        Products such as Promescent Delay Spray can help with delaying ejaculation.

        Dr. Kevin Huffman

        Dr. Kevin Huffman

        Dr Kevin Huffman, D.O., is a board-certified bariatric physician as well as the CEO and Founder of Ambari Nutrition, a family-owned business that has dutifully served the medical weight loss and dieting community for the past 30 years. He has treated more than 10,000 obese patients over the course of his bariatric career and trained and mentored hundreds of physicians and allied healthcare providers. He is also the Founder and President of the American Bariatric Consultants.

        Sources:

        Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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        The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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