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

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

Sildenafil

Most common
headache (16%)
flushing (10%)
dyspepsia (7%)
nasal congestion (4%)

Levitra vs. Sildenafil Dosage

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

Sildenafil

Dosage
Dosage Table
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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