Viagra vs. Cialis vs. Other ED Meds - GoodRx (2024)

You’ve likely heard of Viagra, Cialis, vardenafil (previously sold as Staxyn and Levitra), and Stendra. These are commonly prescribed treatments for erectile dysfunction (ED) — when a person has regular difficulties getting or maintaining enough of an erection for satisfying sexual intercourse.

But with all of these choices, is there one “best” ED medication? Are there important differences to consider? We’re here to help you navigate the options.

Cialis vs. Viagra vs. other ED meds: What are the key differences?

The main differences between these medications have to do with:

• How you take them (with or without food)

• How long they last (4 to 36 hours, though the erection should not last that long)

• How often you plan to use it

• Which side effects they have

• How much they cost

Your healthcare provider might also recommend one over another depending on whether your ED is mild or more severe.

Sildenafil (Viagra), tadalafil (Cialis), vardenafil (formerly sold under the brand names Levitra and Staxyn), and avanafil (Stendra) belong to a class of drugs known as “PDE5 inhibitors.” PDE5 inhibitors increase the amount of blood that fills the penis, helping an erection last long enough for satisfying sex. They don’t affect arousal or libido.

All three medications have been proven to be safe and effective in the treatment of ED.

For occasional use, most people start with sildenafil. For regular use, tadalafil can be a better fit. Some people prefer to alternate between medications, depending on their lifestyle and relationship status.

Viagra (sildenafil)

Sildenafil (Viagra) was the first major medication the FDA approved for ED and has been available in the U.S. since 1998. It’s often the first medication prescribed for mild or moderate symptoms. Here’s an overview:

• How to take it: You should take Viagra on an empty stomach. If you really need to eat, then try waiting at least 1 to 2 hours after your meal before you take Viagra. It’s best to choose a light, low-fat meal since fatty meals and alcohol can slow down the time it takes Viagra to kick in by about 1 hour.

• How fast it works: It can start to take effect in as little as 30 minutes. But usually you’ll have to wait 45 to 60 minutes before it reaches maximum effect. Then it keeps working for up to 8 hours.

• Typical dose: The typical starting dose is one 50 mg tablet. If you’re getting side effects, it can be cut down to 25 mg. If it’s not fully working, it can be increased to 100 mg.

Cialis (tadalafil)

Cialis stands out by lasting longer than any of the other ED medications. It can also be taken on a daily basis. So it’s especially helpful for men who don’t respond as well to medications that are only taken “on demand.” Here’s an overview:

• How to take it: Food doesn’t affect Cialis. You can take it just when you need it or regularly — every day — if needed.

• How fast it works: It can start working in as quickly as 30 minutes, but you may have to wait up to 2 hours for it to reach the point when it’s most effective. The effects of Cialis last for up to 36 hours, helping you with erections at any point in that time period.

• Typical dose: The typical starting dose of Cialis for occasional use is one 10 mg tablet. It can be dropped to 5 mg or increased to 20 mg depending on how you respond. The daily dose for regular use is 2.5 mg to 5 mg.

Vardenafil (previously sold as Levitra and Staxyn)

Generic vardenafil was previously sold under the brand names Levitra and Staxyn, but those brands have been discontinued. It has been shown to be as effective as Viagra and gets to work faster. Here’s an overview:

• How to take it: Vardenafil can technically be taken with or without food. But high-fat foods can delay vardenafil's absorption and lower the peak concentrations in the blood. Ideally, try to wait 1 to 2 hours after eating before you take it. If that’s not possible, stick to a light, low-fat meal. You can take it as needed for occasional ED symptoms.

• How fast it works: It can start working in as quickly as 15 minutes, but peak effects can take up to 1 hour. Then, it will keep working for 4 to 5 hours.

• Typical dose: The typical starting dose of vardenafil is one 10 mg tablet. It can be cut back to 5 mg or increased to a maximum of 20 mg. Vardenafil is available as a traditional pill that you swallow and a rapidly dissolving pill (which gets to work faster).

Stendra (avanafil)

Avanafil is a newer ED medication that works similarly to Vagra, Cialis, and vardenafil. Here’s an overview:

• How to take it: Avanafil comes in a pill, which food doesn’t affect. You can take it as needed for occasional ED symptoms.

• How fast it works: Avanafil works a little faster on average than the other medications. The usual starting dose of 100 mg works within 15 minutes. With a lower dose, you’ll need to wait about 30 to 45 minutes.

• Typical dose: The recommended starting dose is 100 mg, but doses can range from 50 mg to 200 mg, depending on your need and response.

How effective are Viagra, Cialis, Staxyn, and Stendra?

Sildenafil (Viagra), tadalafil (Cialis), vardenafil, and avanafil (Stendra) are considered to work equally well. There are no studies that directly compare them against each other.

Existing studies have only looked at how well each medication compares with a placebo (a pill with no medication in it). This means no one can claim that one medication works better than the other for treating ED.

But a systematic review and meta-analysis of a few hundred studies found that sildenafil, tadalafil, and vardenafil resulted in improved erections in 67% to 89% of people with ED. In comparison, about 30% had improvement with a placebo. This analysis didn’t include avanafil.

How do side effects compare with Viagra, Cialis, Staxyn, and Stendra?

All PDE5 inhibitors share common side effects. Most of these are mild and can include:

• Headache

• Flushing

• Nasal congestion

• Indigestion (upset stomach)

• Vision changes

• Muscle pain

But there are some differences.

With Viagra, there is a higher risk of vision changes than with Cialis. Among people who take Viagra or sildenafil, 3% get blue vision that lasts a few hours. On the other hand, Cialis has a slightly higher risk of muscle pain than Viagra and vardenafil. Overall, the immediate side effects of these medications don’t last very long and aren’t much of a bother.

While the side effects of all PDE5 inhibitors are similar, the jury is still out on what the risks are of using these medications long term over several decades.

Are ED pills like Viagra, Cialis, Staxyn, and Stendra safe for the heart?

PDE5 inhibitors are generally safe for the heart, but there are two potentially serious side effects to know about:

1. All PDE5 inhibitors can lower your blood pressure. This won’t necessarily affect you, but it may be a problem if you also take a blood pressure medication. A sudden drop in blood pressure can make you feel dizzy, fall, black out, or even cause a heart attack.

2. Nitrate medications, such as nitroglycerin, can have dangerous interactions with PDE5 inhibitors. Nitrate medications are commonly given to people with heart issues. If you take a nitrate medication for conditions like angina or high blood pressure, you must never use any ED medications at the same time.

How to save on Viagra, Cialis, and other ED meds

There are many ways to save on ED medications:

• Save with GoodRx. GoodRx can help you save over 80% off the average retail price of the generic versions. Generic sildenafil at certain pharmacies is as low as $9.30 with a free GoodRx discount. You can also find generic tadalafil and vardenafil for as low as $9.30 and $37.99, respectively. What’s more, you can find brand-name Stendra for as low as $524.40.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 for Stendra using a savings card from the manufacturer. You can also save 50% off Viagra for up to 12 months using a different manufacturer savings card.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for various patient assistance programs, which offer the medications free of cost.

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