Viagra, Cialis and Levitra – which is best?

Part 1 of 6: Overview

Three of a Kind?

Tadalafil (Cialis), vardenafil (Levitra), and sildenafil (Viagra) are oral remedies for erectile dysfunction (ED). About half of all men over age 40 occasionally have a problem with erections, according to the Urology Care Foundation. When ED becomes an ongoing problem, many turn to oral ED medications. Results are generally favorable.

Cialis, Levitra, and Viagra are all in a similar class of drugs and work in much the same way. However, there are some differences. Read about their similarities and differences, understand their side effects, and find out if one may be right for you.

Part 2 of 6: How They Work

How They Work

Cialis, Levitra, and Viagra are all PDE-5 inhibitors. They work by blocking an enzyme called phosphodiesterase type 5 and by boosting a naturally occurring chemical called nitric oxide. This action encourages the muscles in your penis to relax. Relaxed muscles allow blood to flow freely so that when you’re aroused, you can get an erection —  and maintain it long enough to have sex.

Levitra and Viagra stay in your bloodstream for about four to six hours, while Cialis remains in your bloodstream for 17 to 18 hours or longer. The length of time a medication stays in your system may be important if you are taking other medications or have prolonged side effects.

A brand called Staxyn is another version of vardenafil (Levitra). It comes in tablet form and can be dissolved on your tongue.

All three medications have good results. However, it sometimes takes a little time and patience to get it right. If one drug doesn’t work or produces unpleasant side effects, you can try another. It may take a few adjustments to arrive at the correct dose of the correct medication. Tell your doctor if you take other over-the-counter or prescription medications or supplements. Be sure to mention any other health conditions.

Part 3 of 6: Admin Differences

How and When Comparison

Cialis, Levitra, and Viagra all require a doctor’s prescription and are available in different strengths, so you can start out with the lowest dose and adjust accordingly.

Cialis is available in a daily pill that can be taken with or without food. You should plan on taking it about 30 to 60 minutes before sex. It can stay active in your body for up to eight hours. Cialis is also available in a 24-hour dose; take it only once a day, with or without food. 

If your doctor prescribes Levitra, take it once a day on an empty stomach. It works best if you take it about 30 to 60 minutes before sex, and it can stay active for as long as eight hours.

Viagra works best on an empty stomach. Keep in mind that high-fat foods can interfere with Viagra, resulting in it taking longer to work. Take the pill about 30 to 60 minutes before sex. It usually stays active for about four to five hours. However, it can sometimes last eight hours or more.

All three medications are generally very effective when taken as directed.

Part 4 of 6: Side Effects

Side Effects

The side effects of these oral ED medications are similar. Most men have only mild side effects, but persistent problems should be reported to your doctor.

Potential side effects of Cialis include:

• back pain
• muscle aches
• headache
• upset stomach
• stuffy or runny nose

Potential side effects of Levitra and Viagra include:

• changes in vision
• flushing
• headache
• upset stomach
• stuffy or runny nose

Rarely, these medications can cause dizziness or fainting. Another rare complication is an erection that won’t go away (priapism). An erection lasting longer than four hours requires immediate medical intervention.

Part 5 of 6: Interactions

Interactions

Each drug comes with the possibility of negative drug interactions. As PDE-5 inhibitors that work on the body in similar ways, the drugs come with similar interactions. However, they also have some differences. Read about how other medications and chemicals may interact with each drug.

Nitrates

Viagra, Cialis, and Levitra are all contraindicated with nitrates. Contraindication means that mixing the two could lead to potential harm. Nitrates work by widening arteries. This increases blood flow and reduces strain on the heart. All three ED drugs increase the effects of nitrates, which can lead to a problematic decrease in blood pressure (hypotension).

Alpha-Blockers

Similar to nitrates, alpha-blockers improve blood flow. This class of drug helps to keep blood vessels relaxed and open. Alpha-blockers can be used to treat high blood pressure. Because they help relax other parts of the body, they can also be used to help urine flow in men with prostate cancer. All three ED medications can further lower blood pressure if used with alpha-blockers. The National Institutes of Health (NIH) urges caution if using PDE-5 inhibitors along with alpha-blockers.

Other Antihypertensives

Cialis, Levitra, and Viagra all dilate blood vessels, which can cause a drop in blood pressure. They all come with the risk of lowering blood pressure. According to the NIH, Viagra has been shown to further lower blood pressure when used with amlodipine. Furthermore, Cialis has been shown to further lower blood pressure when used with amlodipine, angiotensin II receptor blockers, bendrofluazine, enalapril, and metoprolol. The NIH states that, in general, Levitra may also further lower blood pressure when used with antihypertensives.

Alcohol

Alcohol is another chemical that dilates blood vessels. According to the NIH, neither Viagra nor Levitra strengthened the hypotensive effects of alcohol. However, when it’s mixed with substantial amounts of alcohol, Cialis could lead to potential low blood pressure symptoms when you stand up. These symptoms include dizziness and headache. The NIH also points out that Cialis and Levitra, when taken with alcohol, do not lead to a change in the levels of alcohol or the drug in the blood.

Ritonavir and CYP3A4 Inhibitors

According to the NIH, the amounts of Viagra in the blood are increased when taken with CYP3A4 inhibitors, including ritonavir. Ritonavir is an HIV medication used to reduce levels of the virus in a person’s blood. The NIHsuggests that a person taking Viagra and CYP3A4 inhibitors shouldn’t exceed a dose of 25 milligrams (mg) of Viagra in a 48-hour period.

Part 6 of 6: Outlook

Outlook

Each of these three popular ED medications has been shown to help men with ED when they’re used appropriately. Talk to your doctor about these medications. You and your doctor can make decision based on side effects, administration, drug interactions, and other factors that can help determine which drug may be best for you.

Source: http://www.healthline.com

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