Whether it happens every once in a while, or is perhaps a recurring event during sexual activity, erectile dysfunction is a condition that would prompt just about anyone, to go in search of immediate treatment.
Erectile dysfunction is a condition that can put considerable strain on your sex life. It doesn't matter if you experience it every once in a while, or if it has become a routine occurrence during sexual activity — getting the appropriate care to help achieve and maintain an erection should be a top priority.
It may be caused by a medical disease such as diabetes or heart disease, a psychological condition such as depression or a side effect of a medication.
And despite how much you’re probably beating yourself up over experiencing it, erectile dysfunction is pretty common, affecting millions of men in the United States alone.
In your effort to treat erectile dysfunction, you’ll undoubtedly come across medications like Cialis® and Levitra® — two of the most popular, FDA-approved treatments on the market.
But when deciding between them, is there a “better” erectile dysfunction medication?
That’s the question we’re looking to answer today.
But first, let's determine how either drug works.
How Does Cialis (Tadalafil) Work?
Since its approval by the FDA in 2003, Cialis (tadalafil) has been in popular demand.
To understand how Cialis works, we need to piece together the workings of ED.
Erectile dysfunction is the inability to produce and keep an erection firm enough to engage in sexual activity.
Sexual stimulation usually leads to the release of neurotransmitters that bring on an erection.
One of these neurotransmitters is nitric oxide (NO).
Nitric oxide stimulates the production of cyclic guanosine monophosphate (cyclic GMP) when it enters the smooth muscles of the penis.
This cyclic GMP helps in making the magic of erections happen. It puts motions in place that permit the relaxation of smooth muscle tissue for increased arterial flow. This causes a rigid erection with minimal blood flow into or out of the corpora when established.
The enzyme PDE5 however works to destroy cGMP, affecting the delivery to and exit of blood from the penis. That's where Tadalafil comes in as a PDE5 inhibitor.
Tadalafil prevents PDE5 from destroying cGMP, allowing the easy flow and removal of blood from the penis for prolonged erections.
PDE5 inhibitors are highly effective and have an overall success rate of up to 76 percent.
In addition to ED, tadalafil is also used for the treatment of benign prostatic hyperplasia (BPH).
How Does Levitra (Vardenafil) Work?
Like other oral therapies for the treatment of ED — Viagra (sildenafil) and Cialis (tadalafil), Tadalafil works as a PDE-5 inhibitor.
Vardenafil (the active ingredient in Levitra) works very similarly to tadalafil.
When nitric oxide is released following sexual stimulation, guanylate cyclase is activated, increasing the production of cyclic guanosine monophosphate (CGMP).
When CGMP levels are increased, an increased influx of blood is permitted into the penis, allowing for an erection to occur. Vardenafil works to prevent PDE5 from cGMP. However, In the absence of sexual stimulation, inhibiting PDE5 has no effect on the body.
When Levitra is in use, normal sexual stimulation will lead to increased levels of cGMP in the penis, allowing for better erections.
Which Is Better — Levitra or Cialis?
To begin the comparisons between Levitra and Cialis, we have to note that there is no doubt of their effectiveness in treating erectile dysfunction.
Vardenafil has been proven effective in men with ED, including those above the age of 65, which account for the most prevalent age group with erectile dysfunction.
In a 12-week study carried out on 580 men between ages which ranged from less than 45 to over 65, it was discovered that vardenafil was effective in improving erectile function, regardless of age or the severity of erectile dysfunction.
In two randomized studies, men with erectile dysfunction associated with diabetes or following unilateral or bilateral nerve-sparing radical retropubic prostatectomy received 10mg or 20mg of Vardenafil for 12 weeks or 26 weeks.
At the end of the study, the men reported improvements in penetration and the maintenance of erections, when compared with a placebo.
Subjects also recorded improved intercourse satisfaction and orgasms.
Vardenafil has also proven effective in treating ED in patients living with hypertension and diabetes. Vardenafil means business when it comes to managing erectile dysfunction.
Likewise, tadalafil (Cialis) is just as effective, as confirmed in a randomized study involving 1,112 men living with ED. The average age of participants was 59, and their ED cases ranged from mild to severe.
The results of the study verified that Cialis enhances sexual activity for persons living with ED, with a large number of participants reporting improved erections and successful intercourse attempts.
An additional study involving patients with high incidents of severe erectile dysfunction and comorbid medical conditions, tadalafil was shown to significantly improve erectile function, leaving patient and partner satisfied.
This was despite the patients being in a tertiary-care academic center where high incidents of severe, organic ED and concurring medical conditions were observed — all of which can complicate erectile function and treatment outcome.
So, with any questions of their effectiveness out of the way, it’s a good time to note that vardenafil has been shown to be useful in the treatment of the rare disorder — pulmonary arterial hypertension (PAH).
Likewise, tadalafil has received FDA approval for the treatment of the PAH.
They may also show promise in treating Raynaud's phenomenon.
However, while vardenafil takes an average of an hour to take effect, lasting around 4.5 hours, tadalafil can take up to t two hours to take effect, with a comparatively lengthy half-life of about 36 hours — the reason why Cialis is also sometimes called “the weekend pill.”
Cialis’ prolonged effect in the body allows for some spontaneity in sexual activity, especially when compared with drugs like Levitra that are required to be taken about an hour before having relations.
Also, while a high-fat meal may affect the absorption of Levitra, Cialis is largely unaffected by food.
To decide between both ED medications, it’s best to first consult a healthcare provider before making a choice.
ED treatments, delivered
Drug Interactions of Levitra and Cialis
Being PDE-5 inhibitors, some caution is necessary when taking other medications to prevent adverse effects.
Some drug combinations are a no-go, and will count as absolute contraindications to drugs ED medications like Levitra and Cialis. They include nitrates and alpha-blockers. Combining these medications with ED medications may result in a significant drop in blood pressure.
Caution is necessary when administering ED medications to patients experiencing difficulty in kidney function. Similarly, with PDE5 inhibitors being metabolized in the liver, it would be advisable to consult your healthcare provider, who will take a full history to determine the appropriate dosing.
What Are the Side Effects of Levitra and Cialis?
As is common with any medication, the PDE-5 inhibitors — Levitra and Cialis have known side-effects. Some of these include headaches, color vision changes, flushing, indigestion, back pain, dizziness and nasal congestion.
More serious adverse effects can include priapism, hearing loss and prostate cancer.
The adverse effects of these drugs can be dependent on dosage. Levitra is popularly available in 2.5mg 5mg, 10mg and 20mg. Cialis is also available in the same doses.
In Conclusion
If you're looking for the best ways to manage erectile dysfunction, you can find two treatment options that more than earn their stripes in Levitra and Cialis.
Depending on what works best for you, you could side with Levitra for guaranteed results and a quicker exit of the medication from your system — or, you could pitch tents with Cialis, and have increased chances of unplanned sexual activity and improved overall satisfaction.
With known side-effects, however, some of which can be dangerous, it is always advisable to consult a healthcare professional before making any choices on your ED medication.
If you'd like to read about another comparison between ED treatments, you can read our blog on Levitra vs. Viagra.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.