Choosing between Viagra, Cialis, and Levitra: What to consider
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Viagra, Cialis, and Levitra are the three most popular drugs used to help treat the symptoms of erectile dysfunction.
They are used for the same function, yet have distinct differences. It is important to understand these differences in order to make the best choice about which to choose.
How Viagra, Cialis, and Levitra work
Viagra is the brand name for the drug sildenafil, Cialis is the brand name for tadalafil, and Levitra is the brand name for vardenafil. Each of these drugs works in much the same way.
The drugs are considered PDE5 inhibitors. This class of drugs helps to relax the muscles and increases blood flow to the body. This makes it easier for blood to get into the penis, and allows people with erectile dysfunction (ED) to experience a lasting erection during sexual activity.
The action of the drugs is relatively fast. Manufacturers of PDE5 inhibitors recommend that users take the pill at least 30 minutes to 1 hour before sexual stimulation.
How long these drugs last is one of the key differences between them:
Viagra is a drug that is used only when needed. The drug is taken 30 minutes to 1 hour prior to sexual activity, and the effects typically last for 3-5 hours.
Levitra may start working faster than Viagra, but lasts for about the same amount of time.
A similar dose of Cialis may be felt for up to 36 hours. For this reason, people looking for a long-lasting drug may choose Cialis.
Side effects and interactions
Viagra, Cialis, and Levitra drugs all come from the same class of chemicals and so have many similar side effects and interactions.
For instance, manufacturers recommend not taking PDE5 inhibitors with grapefruit or grapefruit juice, because the fruit may affect how the drugs work. Nitrates will also interact with these drugs and should be avoided.
There are some drug specific side effects to be aware of, however.
Viagra
Side effects
headaches
stomach pain
facial flushing
congestion
nausea or diarrhea
color blindness
blurred vision
Interactions and warnings
Interactions with Viagra do occur, and it is important for people to be aware of them before choosing a medication for ED. Any drugs for pulmonary hypertension may also interact with Viagra, causing blood pressure to drop to unsafe levels.
A recent study in JAMA Internal Medicine has suggested that Viagra could increase the risk of skin cancer. The study found that 3.7 percent of skin cancer cases in men who used the drug sildenafil might have been prevented by not taking it.
Cialis
Side effects
headaches
facial flushing
low blood pressure
congestion
dizziness
chest pain
Interactions and warnings
Cialis is also associated with some more serious side effects. Cialis should not be taken with guanylate cyclase stimulators or blood pressure medications, as this can cause an unsafe dip in blood pressure.
A person who is taking Cialis and has prostate problems should avoid prescription alpha-blockers, as Cialis serves the same function. Certain antifungal medications and antibiotics should also be avoided by people taking Cialis.
Anybody considering taking medications, such as Cialis, for ED should always involve their doctor in the decision. The doctor may ask if the patient has a history of any of the following:
heart problems
stroke
liver or kidney problems
stomach ulcers
abnormal penis shape
blood cell problems like sickle cell anemia
All of these conditions may affect the doctor's decision to prescribe Cialis.
Levitra
Side effects
headache
congestion
facial flushing
indigestion
upset stomach
dizziness
back pain
color blindness
Interactions and warnings
If a person has been told by their doctor to avoid sexual activity due to health problems, they should avoid Levitra. Sexual activity can put extra strain on the heart, especially if it is already weak from heart disease.
Like Cialis, people taking guanylate cyclase stimulators or blood pressure medications should not take Levitra as it can cause an unsafe dip in blood pressure that can lead to fainting. People with prostate problems should avoid alpha-blockers if they are taking Levitra. They should also avoid certain antifungal medications and antibiotics.
A doctor may ask a person if they have a history of any of the following:
heart problems
stroke
hearing problems
retinitis pigmentosa, an inherited eye condition
liver or kidney problems
stomach ulcers
abnormal penis shape
blood cell problems, such as sickle cell anemia
All of these conditions may affect a doctor's decision to prescribe Levitra. People who are taking drugs to treat abnormal heartbeat should also avoid taking Levitra.
All three medications may sometimes cause priapism, an erection that will not go away. If a person experiences an erection lasts for more than 4 hours, they should seek medical attention to avoid lasting damage.
In rare cases, these drugs can cause serious side effects, including sudden loss of vision in one or both eyes or sudden hearing loss. If a person experiences these symptoms, they should stop taking the drug immediately and call their doctor.
Cost and availability
The other thing a person might consider is the cost and availability of each of these drugs. Some drugs have been around longer and may be more widespread than others.
All three of these drugs are set to go generic by 2018, which could also have an impact on prescription prices.
Viagra
Viagra has been used since 1998, and is possibly the best-known drug for ED in the world. Its use in the United States is widespread and it is available in most pharmacies. There are currently no approved generics for Viagra on the market in the U.S.
Cialis
Cialis has been on the market since 2003. It is very widespread and also a cheaper option than Viagra. There are also no approved generics for Cialis on the market in the U.S.
Levitra
Levitra was approved in 2003, and is available in most pharmacies in the U.S.
A generic version of Levitra has also been approved by the U.S. Food and Drug Administration (FDA), which could possibly mean lower prescription costs. The generic version is not widely available, however.
Who are the drugs best suited for?
Every person is different and what drug suits one person may not suit another.
Cialis is the only drug of the three that is approved for use by people with benign prostatic hyperplasia (BPH) or enlarged prostate. So people with both ED and BPH should consider Cialis as their treatment option. Cialis also helps to improve urine flow.
Cialis can be taken on a daily basis to keep the body ready for sexual stimulation at any time. This allows for some sexual freedom that may be missing with the other options.
Viagra or Levitra may be better for people who don't engage in sexual activity at very regular intervals and would rather just take one pill each time they plan on having sex.
There are also personal reasons that may guide a choice. Each body reacts to medications differently. Side effects vary from person to person and the potential side effects may help an individual to decide which drug suits them best. For instance, if the nausea or dizziness caused by one drug makes someone unable to have sexual intercourse, they should consider another drug.
Outlook
Viagra, Levitra, and Cialis may provide many people with relief from symptoms of ED. There are many side effects and interactions to consider, but when used correctly these drugs show good results.
The only way to know which drug is best is often through trial and error. People should work directly with a doctor to track side effects and decide which drug is their best treatment option.