Alternative medicine (1)
- Erectile dysfunction herbs: A natural treatment for ED?
Causes (1)
- Male hypogonadism
Complications (1)
- Erectile dysfunction: A sign of heart disease?
Risk factors (1)
- Senior sex: Tips for older men
Symptoms (1)
- Symptom Checker
Treatments and drugs (5)
- Erectile dysfunction and diabetes: Take control today
- Erectile dysfunction: Viagra and other oral medications
- Erectile dysfunction herbs: A natural treatment for ED?
- see all in Treatments and drugs
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Erectile dysfunction: Viagra and other oral medications
Wondering about drugs to treat erectile dysfunction? Find out how Viagra, Levitra and Cialis compare with each other.
By Mayo Clinic staffViagra, Levitra and Cialis are often the first treatment tried for erectile dysfunction — the inability to achieve or sustain an adequate erection for sexual activity. For most men with erectile problems, they work well and have few side effects. All three medications improve erectile function in the same basic way, but the effects of tadalafil (Cialis) last longer. This and a few other minor differences among these medications may make one a better choice over another for some men.
Viagra, Levitra and Cialis: How they work
Viagra, Levitra and Cialis increase levels of nitric oxide, a chemical produced by your body during sexual stimulation that causes blood vessels in the penis to relax and open. This allows you to achieve and maintain an erection. These medications don't automatically trigger an erection; sexual arousal is needed to start the whole process.
Which is best for you?
Viagra, Levitra and Cialis each have a slightly different chemical make up. These minor differences affect the way they work, such as how quickly they take effect and wear off; how they interact with other medications; and side effects. Your doctor will consider these factors when deciding if one of these medications is a good choice for you. Your doctor will also consider any other health problems you have and whether any of your current medications could cause problems when taken with Viagra, Levitra or Cialis.
| Viagra (sildenafil) | Levitra (vardenafil) | Cialis (tadalafil) |
|
|---|---|---|---|
| How to take | Without food, no more than once a day | Without food, no more than once a day | With or without food, no more than once a day |
| When to take | 30 to 60 minutes before sex | 30 to 60 minutes before sex | 30 minutes before sex |
| Time an erection is possible | Up to four hours | Up to four hours | Up to 36 hours |
Not safe for everyone
Although these erectile dysfunction medications can help many people, not all men can safely take them. Viagra, Levitra and Cialis may not be a good choice if you have:
- Heart problems, including a recent heart attack, heart pain (angina) during sex, heart failure, heart rhythm problems (arrhythmias)
- High or low blood pressure (hypertension or hypotension) that isn't controlled
- A history of stroke within the last six months
- Relatives with retina disorders, including retinitis pigmentosa
- Sickle cell anemia, leukemia or other health conditions that can cause an erection that won't subside (priapism)
Interactions with other medications
Tell your doctor about all medications you take, including herbal remedies. A number of other drugs, including certain antibiotics, anti-seizure medications, blood thinners and anti-arrhythmic heart medications can affect how well Viagra, Levitra or Cialis work and cause other side effects.
A few medications should never be taken with Viagra, Levitra or Cialis, or should be used with caution:
Never take Viagra, Levitra or Cialis if you take nitrate drugs to treat chest pain due to heart problems (angina). Like Viagra, Levitra and Cialis, nitrates dilate blood vessels. Their combined effects can cause dangerous low blood pressure and loss of consciousness. Medications that contain nitrates include:
- Nitroglycerin (Nitro-Bid, Minitran, others)
- Isosorbide dinitrate (Dilatrate-SR, Isordil, others)
- Isosorbide mononitrate (Imdur, Monoket, others)
- Recreational drugs such as amyl nitrite or nitrite ("poppers")
Talk to your doctor if you take alpha blockers, medications often used to treat an enlarged prostate. Alpha blockers can cause dangerously low blood pressure when combined with drugs for erectile dysfunction. Examples of alpha blockers include: tamsulosin (Flomax), terazosin (Hytrin) and doxazosin (Cardura).
- Don't use Viagra, Levitra or Cialis within four hours of taking an alpha blocker.
- If you do use an alpha blocker, never take sildenafil (Viagra) in doses above 25 milligrams.
- There's one exception to the rule about not taking alpha blockers with medications for erectile dysfunction: Tadalafil (Cialis) has been approved for use with the alpha blocker tamulosin (Flomax).
Erectile dysfunction medications for other health problems
Viagra, Levitra and Cialis all belong to a type of medications called phosphodiesterase-5 (PDE-5) inhibitors, which improve erectile function by affecting blood pressure. Experts are investigating whether these drugs may be useful to treat certain heart or blood flow problems. Revatio, the same medication as sildenafil (Viagra) was recently approved by the Food and Drug Administration as a treatment for pulmonary hypertension, a rare condition affecting blood flow to the lungs.
Next page(1 of 2)
