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Man filling a prescription at a pharmacy.

How to Choose Among Viagra, Cialis, Levitra, and Stendra

American men suffering from erectile dysfunction can choose from a number of tried-and-true ED medications. The drug that’s best for each of them depends to a very large extend on their individual priorities.

Introduction

American men today have a fairly broad selection of on-demand medications to choose from when treating their symptoms of erectile dysfunction. The brand-name drugs available include Viagra, Cialis, Levitra, Staxyn, and Stendra. We’ve excluded Staxyn from this article because it contains the same active ingredient as Levitra and is unique because it dissolves in the mouth and can be taken without water. Apart from that, it is virtually identical to Levitra.

Also conspicuously absent from our list is daily Cialis, which has the same active ingredient — but in lesser amounts — as on-demand Cialis but is designed to be taken daily to ensure the user is ready for romance whenever the need arises. And as a daily drug, it is not in the category of on-demand ED medications.

The drug that’s the best choice for you depends on a number of variables and your personal preferences, not the least of which is the drug’s price. However, apart from financial considerations, some men prefer an ED drug that takes action quickly, while others prefer one that is effective longer.

Side-by-Side Comparison

The accompanying table offers a side-by-side comparison of the major on-demand ED drugs in terms of both onset and duration of action, average price per recommended starting dose, and the availability of a generic alternative.

To calculate the average cost of a recommended starting dose (RSD) of each ED drug, we added up the prices charged for 10 tablets of maximum-dose at three major national retail pharmacies and also at eDrugstore.com, an online facilitator. This subtotal was then divided by four (the number of merchants) to produce the average cost for 10 tablets of each drug at maximum dose. Because 10 tablets of maximum dose produce 20 recommended starting doses when split in half, the average cost for 10 tablets was then divided by 20.

ED MEDICATION (ACTIVE INGREDIENT)ONSET OF ACTION DURATION OF ACTION AVG COST PER RSD*IS GENERIC AVAILABLE?
VIAGRA (sildenafil citrate)30 to 60 mins.3 to 4 hours$38.75YES
LEVITRA (vardenafil hydrochloride)30 to 60 mins.4 to 5 hours$28.99YES
CIALIS (tadalafil)60 to 120 mins.up to 36 hours$42.10YES
STENDRA (avanafil)15 to 20 mins.5 to 6 hours$34.53NO
*Recommended starting dose

The times for the average onset of action and duration of action are based on an amalgam of information from manufacturers and testimonials from men who’ve actually used the drugs. Because individual sensitivity to the drugs varies, these must be considered averages. Your personal experience may differ, although it’s unlikely to stray far from the averages provided here.

What These Drugs Have in Common

All of the ED drugs discussed here belong to a family of medications known as PDE5 inhibitors. They are so called because they temporarily sideline an enzyme known as phosphodiesterase-5, which can interfere with blood flow to the penis, particularly in men whose vascular function is already compromised to some degree.

While they all work in much the same way, each of these drugs has its own distinctive chemical makeup. For that reason, some men may find that Viagra works better for them than any of its competitors, while others may find Cialis, Levitra, or Stendra preferable. To truly determine which of these medications is the best fit for you, you will need to give all of them a try.

Onset of Action

If it’s a quick-acting drug you want, Stendra is probably the best bet for you. As you can see from the table, it takes effect in 15 to 20 minutes, although some men using Stendra report that they’re been ready to go only 10 minutes after popping the pill.

Both Viagra and Levitra are very similar in terms of onset of action, taking 30 to 60 minutes to reach maximum concentrations in the bloodstream, although here again some men find that these pills work faster for them. By contrast, Cialis can take up to two hours to reach maximum concentration, but as you’ll soon see, it makes up for a somewhat slower onset of action by a significantly longer duration of action.

Duration of Action

Far and away the most long-lasting of the ED drugs is Cialis on demand. Its effects last up to 36 hours, which makes it a perfect choice for a romantic weekend or a honeymoon. You might also note that Cialis, at $42.10 per recommended starting dose, is the most expensive of the ED drugs we’re comparing. If you’re not the type who’s likely to have sex more than once in a 36-hour period, you’ll be better served by choosing one of the less expensive options.

For the biggest bang for your buck, Levitra at $28.99 per RSD is your best buy. Its effects last four to five hours, which is a reasonable amount of time for a satisfying romantic interlude.

Man looking at a pill bottle label.

ED drug users need to take a number of factors into consideration when selecting the medication that’s the best fit for them.

What About Side Effects?

Like most prescription medications, these ED drugs can cause some side effects. There is a fairly common theme to the side effects reported by ED drug users. This probably arises from the fact that these drugs work in much the same way even though each has its own unique chemical formula.

All of the drugs have some side effects that are more commonly experienced, as well as a handful that are rare but more serious. The milder and more common side effects include headache, dizziness, facial flushing, nasal congestion, stomach upset, and back and muscle pain. You might experience none of these adverse effects or find that you’re feeling the effects of two or more. Switching from one ED drug to another could ease the severity of the side effects.

Far less common but much more serious are priapism, a painful erection that persists for four hours or more, and a sudden decrease or loss of hearing and/or vision. Should you experience one of these side effects, seek medical attention immediately.

Of the four ED drugs compared here, anecdotal evidence indicates that Cialis and Stendra cause fewer side effects than Viagra or Levitra. Those reports also indicate that the side effects from Cialis and Stendra generally tend to be milder.

Availability of Generic Equivalents

As you can see from the accompanying table, Viagra, Levitra, and Cialis all have generic equivalents that are now available to U.S. consumers. These generics are sold under the name of each drug’s active ingredient. For Viagra, the generic equivalent is sold as sildenafil citrate, while the generic version of Levitra is marketed as vardenafil hydrochloride. Generic Cialis is marketed as tadalafil.

As the most recent ED drug approved by the U.S. Food and Drug Administration, Stendra does not yet face direct generic competition and probably won’t for a few more years at least. Its active ingredient is avanafil, which will also be the name of its eventual generic equivalent.

These generic equivalents offer a lower-cost alternative to the brand-name drugs they copy. They contain the same amount of active ingredient and must be produced in manufacturing facilities that meet the FDA’s strict standards. So if you’d like to keep your costs as low as possible, opt for a generic.

Ordering Your ED Drugs Online

Many men are hard pressed to find the time to visit a doctor’s office and then drop off and pick up a prescription at the local pharmacy, where waiting times can be fairly lengthy. To save time, you should consider ordering your drugs from longtime online facilitator eDrugstore.com.

Headquartered in Tempe, Arizona, eDrugstore has been in business since the late 1990s and stocks all brand-name ED medications, as well as the generic equivalents of Viagra, Cialis, Levitra, and Staxyn. If you don’t yet have a doctor’s prescription, eDrugstore can set up a complimentary online consultation with a licensed U.S. physician who can authorize a prescription if appropriate. To learn more, visit eDrugstore’s Erectile Dysfunction page.