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
Levitra
Cialis vs. Levitra Dosage
Cialis
Levitra
| 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 |
| 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
| 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
| 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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