Levitra vs. Viagra: differences and similarities

If you have erectile dysfunction (ED), you may have wondered what the difference is between Viagra (sildenafil) and Levitra (vardenafil). This article reviews these two commonly prescribed ED medications, including their duration, side effects, and costs.

Both Viagra and Levitra are effective at treating ED. However, there are a few key differences to consider when choosing between them.

• Both Viagra and vardenafil are intended to be short-term treatments for ED taken on an as-needed basis. However, vardenafil may last slightly longer than Viagra. Research suggests vardenafil may work for up to 8 hours after taking the medication. The effects of Viagra typically last for at least 4 hours after taking the medication.

• If Viagra is taken with a high-fat meal, it may take longer to feel its effects. Vardenafil, however, is not as significantly affected by food. This means vardenafil can be taken with a high-fat meal with less impact on how long it takes for the medication to work.

• Viagra is available in 25 mg, 50 mg, or 100 mg oral tablets, and vardenafil in 2.5 mg, 5 mg, 10 mg, and 20 mg oral tablets.

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Viagra and vardenafil are similarly effective medications for treating ED. When taken as prescribed, both medications may improve the strength and duration of erections.

In a clinical trial of Viagra, 92% of participants with ED reported that sildenafil improved the strength, duration, and frequency of erections, as well as overall satisfaction with their sex lives, at week 36. Similarly, in a clinical trial of Levitra, 84% of participants reported improvements in erections at week 12. Vardenafil has demonstrated good first-dose success when prescribed at 20 mg.

A healthcare provider can help determine which medication may be the best fit.

Viagra and vardenafil take approximately the same amount of time to work. 

Viagra

Viagra may be effective in as little as 30 minutes, but can take up to two hours. Many people find that it starts working around 60 minutes after taking it. For this reason, it is typically taken about 60 minutes before sexual activity, though it can be taken anywhere from 30 minutes to 4 hours beforehand.

Viagra with food or on an empty stomach is an option. However, taking it with a high-fat meal may take longer to start working.

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Levitra

For most people, vardenafil starts working in about one hour, although it may start working in as little as 30 minutes. Like Viagra, it can be taken with or without food, but a high-fat meal may cause it to take longer to work.

Vardenafil generally lasts longer than Viagra, with effects that may extend up to 8 hours compared with Viagra's typical duration of around 4 hours.

Viagra

Viagra has a half-life of 4 hours. That means it takes around 4 hours for half of the concentration of Viagra to leave the body. Research suggests the effects of Viagra typically last for at least 4 hours.

Levitra

Vardenafil has a half-life of 4–5 hours, so it will typically take around 4–5 hours for half of the concentration of vardenafil to leave the body. One small study found that participants with erectile dysfunction who took vardenafil 8 hours before sexual activity maintained significant improvements in erectile function compared with the placebo group.

This suggests vardenafil may have a longer duration of action than Viagra. Duration can also be affected by additional factors, such as medical history, lifestyle, eating habits, age, and other considerations.

Vardenafil and Viagra differ in available dosage strengths and maximum daily dosage.

Viagra

Viagra is available in 25 mg, 50 mg, or 100 mg oral tablets. 

Most healthcare providers will prescribe a starting dose of 50 mg, taken 30–60 minutes before sexual activity. However, a lower dose may be recommended depending on individual medical history. The maximum daily dose for Viagra is 100 mg.

Viagra can be taken with or without food. However, eating a high-fat meal may make the medication take longer to work.

Levitra

Vardenafil hydrochloride (Levitra) is available in 2.5 mg, 5 mg, 10 mg, and 20 mg oral tablets. 

The recommended starting dose of vardenafil is 10 mg. However, a lower dose may be recommended depending on individual medical history.

Vardenafil should be taken around 60 minutes before sexual activity. While both vardenafil and Viagra can be affected by high-fat meals, research suggests vardenafil may be slightly less impacted than Viagra. The maximum daily dose for vardenafil is 20 mg.

The side effects of Viagra and Levitra are very similar and may depend on dosage, medical history, and other factors. Serious side effects include priapism (a painful erection lasting more than 4 hours) and low blood pressure.

The most common side effects of Viagra and vardenafil include:

• Headaches

• Facial flushing

• Indigestion/heartburn 

• Back pain

• Stuffy nose

• Nausea 

For further information about their side effect profiles, refer to the FDA drug labels.

People with a history of heart conditions — such as high blood pressure, coronary artery disease, or heart attack — should discuss this with their healthcare provider before starting either medication.

Viagra and vardenafil are both considered safe and effective options for treating ED. However, certain circumstances, such as heart conditions or taking interacting drugs, may make either medication inappropriate for some people.

As with all prescription medications, consulting a healthcare provider before starting Viagra or vardenafil is essential. Discussing medical history, as well as any over-the-counter supplements or prescription medications being taken, can help prevent potential drug interactions.

Viagra vs. Levitra interactions 

Since both Viagra and vardenafil are PDE5 inhibitors, they have similar drug interaction warnings. 

One of the most serious risks with PDE5 inhibitors is a severe drop in blood pressure. This can occur when Viagra or vardenafil is taken with nitrates. Nitrates are often used to treat chest pain (e.g. nitroglycerin) or other heart conditions. Amyl nitrites, also called “poppers,” are another example of nitrates. Combining nitrates with PDE5 inhibitors can cause blood pressure to fall dangerously low, with potentially fatal consequences.

People taking alpha-blockers to lower blood pressure or treat prostate conditions — such as benign prostatic hyperplasia (BPH) — should use caution when also taking Viagra or vardenafil. Alpha-blockers lower blood pressure, as do PDE5 inhibitors, so combining the two medication classes can lead to dangerously low blood pressure.

Taking Viagra or vardenafil alongside riociguat (and similar medications) for pulmonary hypertension can also cause a drop in blood pressure.

Certain medications may disrupt how the liver processes other medications by affecting the CYP3A4 enzyme system. Medications that inhibit the CYP3A4 enzyme may change the concentration of Viagra or vardenafil in the body, increasing the risk of side effects. Examples include ketoconazole, ritonavir, indinavir, and erythromycin. Grapefruit juice may also block this enzyme and affect sildenafil or vardenafil levels.

There may be other potential interactions with Viagra or vardenafil. If you have questions or concerns about whether either medication is appropriate, consult a pharmacist or healthcare provider, or visit the Viagra is safe resource for more information.

The cash price of vardenafil is typically significantly lower than that of name-brand Viagra.

Viagra is available in name-brand form and as the generic medication sildenafil (which is also priced lower than its brand-name counterpart). The cash price of Viagra varies depending on insurance coverage, whether name-brand Viagra or its generic counterpart is chosen, pharmacy, region, and other factors.

The name-brand form of Levitra was discontinued in 2021. However, the generic version, vardenafil, is still available. Generic medications are typically less expensive than brand-name medications. The cash price of vardenafil can vary depending on insurance coverage, pharmacy, region, and other factors.

A healthcare provider can help determine whether Viagra or vardenafil may be the better option.

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Viagra and vardenafil are commonly used ED medications that work similarly. There are a few key points to consider when deciding between the two.

• Viagra and vardenafil are both considered effective ED medications that may help improve the strength and duration of erections.

• Vardenafil may last a little longer than Viagra. Research suggests vardenafil may last up to 8 hours, while Viagra typically lasts around 4 hours.

• Viagra and vardenafil cause similar side effects, and both interact with several other medications.

• Because vardenafil is a generic medication, its cash price is typically significantly less than that of Viagra; though generic Viagra (sildenafil) is also lower cost.