Levitra vs. Sildenafil
See how Levitra and Sildenafil compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Levitra and sildenafil are both PDE5 inhibitors taken as needed before sexual activity to treat erectile dysfunction.
Levitra is now sold only as generic vardenafil in the US, while sildenafil is available as both a brand-name and generic tablet.
Sildenafil also has an FDA-approved use for pulmonary arterial hypertension, while Levitra is approved only for erectile dysfunction.
Levitra vs. Sildenafil Drug Summary
Levitra
Levitra (vardenafil) is a phosphodiesterase-5 (PDE5) inhibitor approved to treat erectile dysfunction. It is taken as an oral tablet on an as-needed basis before sexual activity, in doses of 5 mg, 10 mg, or 20 mg. The branded product has been discontinued, so only generic vardenafil is currently sold in the US.
Sildenafil
Sildenafil is also a PDE5 inhibitor and was the first oral medication approved for erectile dysfunction. It is taken as an oral tablet as needed, in doses of 25 mg, 50 mg, or 100 mg, and is sold as both a brand (Viagra) and a lower-cost generic. Under the brand Revatio, it is also approved to treat pulmonary arterial hypertension.
Levitra vs. Sildenafil Side Effects
Levitra
Sildenafil
Levitra vs. Sildenafil Dosage
Levitra
Sildenafil
| 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 |
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg as needed | At the start |
| Maximum dose | 100 mg as needed | If needed |
| Dose changes | 2 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 |
Sildenafil
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg as needed | At the start |
| Maximum dose | 100 mg as needed | If needed |
| Dose changes | 2 increases | As tolerated |
Levitra vs. Sildenafil Indications
Levitra
Levitra is FDA-approved solely for treating erectile dysfunction in men. It works by relaxing blood vessels in the penis to improve blood flow during sexual stimulation. It is not approved for use in women or children.
Treats erectile dysfunction
Taken as needed before sexual activity
Not approved for use in women or children
Available only as generic vardenafil in the US
Sildenafil
Sildenafil is FDA-approved for erectile dysfunction and, under the brand Revatio, for pulmonary arterial hypertension. It is sometimes used off-label for conditions such as Raynaud's phenomenon or high-altitude pulmonary edema prevention. It is not approved for use in women or for chronic use in children.
Treats erectile dysfunction
Treats pulmonary arterial hypertension (Revatio)
Taken as needed before sexual activity
Off-label use for Raynaud's phenomenon
Levitra vs. Sildenafil Pros and Cons
Levitra
Levitra offers a straightforward as-needed dosing option with three tablet strengths and effectiveness comparable to other PDE5 inhibitors. It is no longer sold under its brand name, so patients receive generic vardenafil. Coverage and cost can vary widely depending on pharmacy and insurance.
Pros
Not linked to the vision or hearing side effects reported with sildenafil
Simple three-strength dosing (5 mg, 10 mg, 20 mg) taken as needed
Only approved for ED, so its safety profile is well-defined without added off-label uses
Cons
Not recommended for patients on renal dialysis
Only available as a generic tablet, since the branded product was discontinued
No FDA-approved use beyond erectile dysfunction, unlike sildenafil's PAH approval
Sildenafil
Sildenafil has the longest track record among oral ED treatments and is available as both brand and generic tablets. It also carries an additional FDA approval for pulmonary arterial hypertension, giving it broader clinical use beyond ED. Its warning profile includes some drug interaction and vision-related precautions not listed for Levitra.
Pros
Also FDA-approved for pulmonary arterial hypertension under the brand Revatio
Available as both a brand-name and generic option, giving more purchasing flexibility
Longer track record, having been approved since 1998
Cons
Carries a risk of NAION (sudden vision loss) and sudden hearing loss noted on its label
Should not be combined with strong CYP3A4 inhibitors
Higher rate of dyspepsia reported (7%) compared with Levitra's rate
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