Erectile dysfunction (ED) is more common than you may realize and affects approximately 30 million men in the U.S.1 For many ED patients, medications have proven to be quite effective in improving their sex lives.
What ED Medications are Available?
The most prominent ED medications are a group of phosphodiesterase type 52 (PDE5) inhibitors. These medications help improve blood flow to the body’s tissues, including the genitals. The four most popular PDE5 inhibitors on the market are:
Sildenafil (Generic Viagra®)
Vardenafil (Generic Levitra®)
Many of the ED medications available work similarly within the body, but each has a few unique differences. It is important to talk to a licensed health professional about your options before deciding which ED medication will work best for your needs.For informational purposes, we’ve provided a detailed comparison for every ED medication.
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Sildenafil (Viagra) vs. Tadalafil (Cialis®)
Sildenafil and tadalafil are similar medications, as both are phosphodiesterase type 5 (PDE5) inhibitors.
Both sildenafil and tadalafil take approximately 30 minutes to take effect.3 The duration of effect is what sets the two medications apart. Tadalafil has the longest life of any PDE5 inhibitor and can remain effective for 24 to 36 hours after ingestion. Sildenafil generally only remains effect for approximately four hours but can last up to 12 hours.
Sildenafil (Viagra®) vs. Avanafil (Stendra®)
What sets avanafil apart from sildenafil is the quicker action and lower risk of side effects.
Avanafil takes an average of 15 to 30 minutes to take effect, while sildenafil takes an average of 30 minutes. In a review of clinical studies, avanafil showed a minor occurrence of side effects and negative interactions with other drugs.
A common side effect of all PDE5 inhibitors is reducing blood pressure. For some patients, this is a favorable side effect. However, for others, a drop in blood pressure could be dangerous. Avanafil has been shown to have less impact on blood pressure than sildenafil.
As of right now, sildenafil is available in generic forms and the name brand, Viagra®. Avanafil is still only distributed under the name brand Stendra®, making it more expensive than sildenafil.
Tadalafil (Cialis®) vs. Avanafil (Stendra®)
Choosing between tadalafil and avanafil for erectile dysfunction comes down to choosing speed or endurance. Avanafil is one of the fastest-acting PDE5 inhibitors and takes approximately 15 to 30 minutes for effects to start with a six to 12-hour window of effectiveness. Tadalafil can take approximately 30 minutes to 45 minutes to fully kick in but can remain effective for 24 to 36 hours.
Cost is also a factor when comparing tadalafil and avanafil. Tadalafil has been available in generic forms since 2018. Avanafil is currently only available under the brand name Stendra® at a higher price point.
Vardenafil (Levitra®) vs. Sildenafil (Viagra)
Vardenafil and sildenafil are very similar PDE5 inhibitors with only slight variances. Vardenafil can take up to an hour to take effect, while sildenafil can kick in closer to 30 minutes after ingestion. Both medications generally last around four to five hours.
The main difference between these two ED medication options is the side effects. With sildenafil, some users reported a shift in color perception while under the drug’s influence. No users of vardenafil have reported this unusual side effect. One study showed that vardenafil was slightly better tolerated than sildenafil. However, it was by a small margin.
Vardenafil (Levitra®) vs. Tadalafil (Cialis®)
As with many other PDE5 inhibitor comparisons, vardenafil and tadalafil are similar medications, with the main difference being the endurance of the drugs. Tadalafil effects last considerably longer and stay active for up to 36 hours. Vardenafil’s window of effectiveness is four to five hours.
The absorption of these two medications differs slightly as well. A high-fat meal (over 55% of calories) before ingestion has been shown in some studies to reduce the effectiveness and absorption of vardenafil. No evidence suggests that food significantly affects users of tadalafil.
Vardenafil (Levitra®) vs. Avanafil (Stendra®)
Vardenafil and avanafil are both good medications for spontaneous use. Avanafil kicks in a bit faster, with users feeling effects in 15 to 30 minutes on average. Vardenafil has an average time of impact of 30 to 60 minutes. Both medications will last approximately four to five hours.Results are pretty similar between vardenafil and avanafil, so the price is the main distinction between these two options. Currently, avanafil is only available in the name brand form, Stendra®. Vardenafil, on the other hand, is available in more modestly priced generic versions.
ED Medication Comparison Chart 4
| Medication | Average time to take effect | How long it lasts |
|---|---|---|
Sildenafil (Viagra®)* |
30 min. |
4-5 hours |
Taladafil (Cialis®)* |
30-45 min. |
24-36 hours |
Avanafil (Stendra®) |
15-30 min. |
6-12 hours |
Vardenafil (Levitra®)* |
30-60 min. |
4-5 hours |
*Available in Generic
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