Cialis vs. Levitra

See how Cialis and Levitra compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Cialis is the only PDE5 inhibitor approved for once-daily use and for treating BPH symptoms, while Levitra is approved only for as-needed erectile dysfunction treatment.

  • Cialis effects can last up to 36 hours, much longer than Levitra's typical several-hour window, giving more flexibility around timing of sexual activity.

  • Both drugs list headache and dyspepsia among their most common side effects, but each also has its own distinct reactions noted on its FDA label.

Cialis vs. Levitra Drug Summary

Cialis

Cialis (tadalafil) is a PDE5 inhibitor approved for erectile dysfunction and for the urinary symptoms of an enlarged prostate (BPH). It can be taken daily at a low dose or as needed at a higher dose before sex, with effects lasting up to 36 hours.

Levitra

Levitra (vardenafil) is a PDE5 inhibitor approved only for erectile dysfunction. It's taken as needed before sexual activity at one of three dose strengths, with no daily-dosing option and no other FDA-approved use.

Cialis vs. Levitra Side Effects

Cialis

Most common
headache (up to 15%)
dyspepsia (up to 10%)
back pain (up to 9%)
myalgia (up to 4%)

Levitra

Most common
headache (up to 15%)
dyspepsia (up to 4%)
flushing (up to 11%)
rhinitis (up to 9%)

Cialis vs. Levitra Dosage

Cialis

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2.5 mg once daily At the start
Maximum dose 20 mg as needed If needed
Dose changes 3 increases As tolerated

Levitra

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily as needed At the start
Maximum dose 20 mg once daily as needed If needed
Dose changes 2 increases As tolerated

Cialis vs. Levitra Indications

Cialis

Cialis (tadalafil) is FDA-approved for erectile dysfunction, for the urinary symptoms of benign prostatic hyperplasia (BPH), and for both together. It's the only PDE5 inhibitor approved for once-daily use in BPH, and its effects can last up to 36 hours after an as-needed dose.

  • Erectile dysfunction

  • Signs and symptoms of BPH

  • ED and BPH symptoms together

  • Off-label: pulmonary arterial hypertension (as Adcirca)

Levitra

Levitra (vardenafil) is FDA-approved only for the treatment of erectile dysfunction. It's taken as needed before sexual activity, with no approved use for BPH or any other condition, and no daily-dosing option.

  • Erectile dysfunction

  • Taken as needed before sexual activity

  • Not approved for BPH or daily dosing

  • No branded off-label formulation

Cialis vs. Levitra Pros and Cons

Cialis

Cialis's long duration and daily-dosing option make it the most flexible PDE5 inhibitor, and it's the only one also approved for BPH symptoms. It requires planning around continuous low-dose use if taken daily, and its label carries hypotension warnings with certain blood pressure medications.

Pros

  • Longest duration of any PDE5 inhibitor, up to 36 hours

  • Only PDE5 inhibitor approved for daily BPH treatment

  • Same tablet can treat ED and BPH symptoms together

  • Daily dosing removes the need to time pills around sex

Cons

  • Longer duration means side effects can also last longer

  • Daily dosing means taking a pill every day even if not sexually active

  • Not designed for the rapid onset of as-needed-only options

  • Full effect on daily dosing can take several days to build up

Levitra

Levitra offers a straightforward as-needed option without a daily pill, but its label is limited to ED and carries added cardiac cautions around QT prolongation. Only generic vardenafil is available in the US since the branded version was discontinued.

Pros

  • Only meant to be taken as needed, no daily pill required

  • Available only as lower-cost generic vardenafil in the US

  • Simple, single-indication label with no other approved uses

  • Comparable onset speed to other as-needed PDE5 inhibitors

Cons

  • Only FDA-approved for ED, with no BPH indication

  • No once-daily dosing option available

  • Contraindicated with QT-prolonging drugs, an added restriction

  • No brand-name version currently sold in the US

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