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Searching for a simple answer to how to treat your ED can feel a bit like Alice in Wonderland.

You chase after the one answer you need, but it takes a turn just as you’re about to grasp it. Suddenly you’re down the rabbit hole—in this case, the Internet rabbit hole—and more confused than ever about what treatment is right for you. You’ve likely run into multiple names of medicines, like Viagra, Cialis, Levitra, and sildenafil, but you’re no closer to a clear answer.

It’s a common experience, especially since between 3 and 76.5% of men experience erectile dysfunction globally, according to a 2019 study (Kessler, 2019).

Younger men aren’t immune to erectile dysfunction, more commonly known as ED, either. Roughly 8% of men 20–29 and 11% of men age 30–39 have erectile dysfunction, according to one study that looked at 27,000 men from eight different countries (Rosen, 2004). But this may only give us a limited idea of the true scope of the common condition sildenafil citrate tablets price as Rosen and his fellow researchers found that in men with ED in their study, only 58% had ever sought help from a medical professional for the condition.

If prescription medication is needed to treat erectile dysfunction—which isn’t always the case, as things as simple as dehydration can cause ED—those same names pop up: Viagra, Cialis, Levitra, and sildenafil.

It’s a lot easier to keep straight once you know that all of these fall into the same class of drugs called phosphodiesterase-5 inhibitors (PDE-5 inhibitors), which just means they all work in a similar way.

Although erections are surprisingly complicated, these drugs do something simple to help: They all relax muscles in the penis and improve blood flow in order to treat ED.

A real, U.S.-licensed physician will review your information and get back to you within 24 hours. Movies and TV shows would have you believe it’s easy, maybe even too easy at times, to get an erection.

But a lot of systems have to work together properly to make one happen, meaning there’s actually nothing easy or simple about it.

Ignoring the emotional and psychological aspects of arousal, even the biology of an erection is complex.

But there’s one step in the process where things tend to go wrong, and that’s where these medicines come in.

Before an erection can happen, a messenger called cGMP tells erectile tissue to relax, which allows blood to flow in. But at the same time, the blood vessels that take the blood back to your heart get compressed so that more blood is trapped in the penis. The penis is able to relax thanks to an enzyme called phosphodiesterase-5 (PDE-5) that breaks down cGMP, ending the signal to the erectile tissue.

If you have too much phosphodiesterase or it takes over too soon, cGMP can’t do its job.

PDE-5 inhibitors block this enzyme from breaking down this important messenger that kick starts the blood flow needed to get and maintain an erection. That’s the goal of all of these sildenafil citrate tablets price medications, though their exact chemical structure and the way that you take them differ.

Viagra is a brand name for sildenafil, which is just one type of PDE-5 inhibitor.

The active ingredient is sildenafil citrate, and Viagra comes in three doses (25 mg, 50 mg, and 100 mg). The Food and Drug Administration (FDA) approved Viagra in 1998, and by the end of 2005, more than 27 million men worldwide (17 million of them in the United States) had been prescribed sildenafil for the treatment of ED (McMurray, 2007).

Viagra is an oral medication taken in anticipation of sex. It can be taken anywhere between 30 minutes and four hours ahead of sexual activity.

Though Viagra can start to take effect and help achieve an erection in just 12 minutes, the medication reaches peak levels in your body after 30–120 minutes (Eardley, 2002).

It can last in your body for up to four to five hours, but your age, health, and diet all affect the exact amount of time it will work. Viagra is also most effective when taken on an empty stomach. The most common side effects of Viagra include indigestion, headaches, facial flushing, back pain, and stuffy nose.

Although not as common, it can potentially cause priapism, a persistent and painful erection that can last more than four hours. Other serious, but less common, side effects include hearing loss (

which

can be sudden), severe low blood pressure, and vision loss, which can be in one or both eyes. You should not take Viagra if you have low blood pressure, heart problems such as a history of heart attack or chest pain, or uncontrolled high blood pressure.

As mentioned, Viagra is the brand name for sildenafil. “Genuine” Viagra is the medication sold under the brand name, while “generic Viagra” is another term for sildenafil. Sildenafil became available as a generic medication in December of 2017. Until then, only two companies (Pfizer and Teva Pharmaceuticals) could create this medication.

Now that more companies can produce it, the price of generic sildenafil has been driven down even lower.

Just like the branded version, generic Viagra comes in three doses: 25 mg, 50 mg, and 100 mg.

But Viagra isn’t the only brand name prescription medication that uses sildenafil.

Revatio, which comes in 20 mg doses, is approved by the FDA for a completely different purpose than Viagra, though the active ingredient is the same.

Revatio treats pulmonary arterial hypertension (PAH), a condition in which the pressure in blood vessels that carry blood from your heart to your lungs is higher than normal, and some patients with more general pulmonary hypertension (PH) (Barnett, 2006). Although this may sound more complicated, it’s actually beneficial for people who may benefit from sildenafil.

Generic Revatio comes in more dose sizes than the brand-name version. In addition to the 20 mg dose, it may be prescribed in 40 mg, 60 mg, 80 mg, and 100 mg doses. This allows more flexibility for patients to work with their healthcare providers to find the right dose that provides for the most benefit in facilitating erections

and

causes the least amount of side effects.

Cialis (generic name tadalafil) is another common prescription medication used to treat erectile dysfunction.

Similarly to Viagra, Cialis works by blocking phosphodiesterase-5 (PDE-5), making it easier to get and keep an erection, but also improves blood flow. Cialis comes in doses sildenafil citrate tablets price of 2.5 mg, 5 mg, 10 mg, and 20 mg. Unlike Viagra, the effects of Cialis may take 1–2 hours to kick in but may last up to 36 hours. There’s also a generic version of Cialis (tadalafil) now available, which may be more affordable than the version sold under the brand name.

Though Cialis can be taken as an as-needed treatment for ED at any of the doses, there’s another option for treatment with this prescription.

Daily Cialis is the only treatment of erectile dysfunction that’s taken daily instead of in anticipation of sexual activity.

Only 2.5 mg and 5 mg are used as daily doses to treat sexual dysfunction. Taking the medication daily integrates it into your routine and eliminates the need to plan for sex. Like Viagra, it also should be taken on an empty stomach and may cause side effects such as priapism or sudden vision loss in one or both eyes.

Levitra (generic version vardenafil) is another common erectile dysfunction treatment.

Similar to the other PDE-5 inhibitors, Levitra is taken as needed before sexual activity and comes in four doses (2.5 mg, 5 mg, 10 mg, and 20 mg). Although half of the medicine leaves your system after four to five hours, the effects of Levitra may last for up to eight hours. Levitra is also the only ED medication that can be taken with food, although a high-fat meal is not advised.

A high-fat meal (fat content at or above 55%) can delay the absorption of the medication by about an hour and also decreases maximum blood flow.

Levitra has similar potential side effects to Viagra.

Common side effects include headaches, facial flushing, nasal congestion, and upset stomach.

Priapism is a potential side effect, as is sudden vision loss in one or both eyes. Levitra also increases the likelihood of QT prolongation (a change seen on an EKG), which can sometimes be followed by irregular heartbeats.

Although all of these medications are PDE-5 inhibitors, they all have subtle differences in action. That means a healthcare professional may suggest one over the other for reasons specific to an individual’s health.

It’s also important to discuss the medicines you’re taking with a medical professional as all of these treatments have potential drug interactions such as nitrates.

Daily Cialis allows for more spontaneity in someone’s sex life over oral medications that require planning around

sexual

activity. Levitra has a longer duration of action, but you may prefer a short-acting medication if you experience some of the side effects of these prescriptions.

Cost is another factor that may sway your decision.

Sildenafil is the most inexpensive of the treatments, while Levitra tends to cost more.

Overall, the decision comes down to many individual factors. Sildenafil and Tadalafil are the most well-known of all the ED medications. They are both in a class of medications called ‘phosphodiesterase type 5 (PDE5) inhibitors’ and work in a very similar way.

These medicines work in the presence of sexual stimulation. Once aroused, a natural chemical is released, which the PDE5 inhibitors rely on to work with.

Once this natural chemical is released, a chain reaction begins, relaxing the smooth muscle inside the penis.

There is then an increase in blood flow into the penis allowing the penis to can become erect. What’s the difference between Sildenafil and Tadalafil? Sildenafil has been around since 1998, which means a lot is known about the positive effects and also the side effects. It works within an hour of taking the medication and for its full effect, should be taken on an empty stomach.

The effects of Sildenafil generally last for four to five hours. Viagra was developed by the pharmaceutical company Pfizer and they sildenafil citrate tablets price were the only company that could legally manufacture it until 2013.

In 2013, their patent expired which meant that other companies could produce

their

own erectile dysfunction medications containing the active ingredient sildenafil.

When you see the medication ‘Sildenafil’, you can be assured that it contains exactly the same active ingredient as Viagra. However, as it is a generic version rather than the brand, it is considerably cheaper. The more common side effects of Sildenafil can include headache, nausea, stuffy nose, flushing and indigestion. There are also some rarer side effects; you should always read the accompanying leaflet that comes with any medicine before taking it.

Sildenafil is taken on an as needed basis, usually at a dose of 50mg.

These may be increased to 100mg if the standard dose is ineffective, or lowered to 25mg if mild side-effects are experienced.

The dosing may be different depending on your medical history, so your doctor should discuss an appropriate starting dose with you.

In

2003

, a company named Eli Lilly introduced Cialis as an alternative ED medication.

The company had the patent on Tadalafil until November 2017. Similarly to Viagra, now that the patent has expired, other companies are permitted to make their own version of Tadalafil, the active ingredient in Cialis.

Again, as it is a generic version of the brand, Cialis, the medication is considerably cheaper. Tadalafil has two formulations – one that can be taken 'as required', and one that can be taken daily. The 'as required' Tadalafil (generic Cialis) has an advantage over Sildenafil in that it lasts a lot longer – up to 36 hours (compared with 4-5 hours for Sildenafil). Some men prefer this as it allows for more spontaneity.

Tadalafil also works faster than Sildenafil – it generally works within 30 minutes, though for some men it can take up to an hour. The action of Tadalafil is not affected by food, and this is another reason why some men may prefer it. The standard 'as required' Tadalafil dose is 10mg, which may sildenafil citrate tablets price be increased to a maximum of 20mg if the medication is ineffective.

This dose also depends on your medical history, so your doctor will discuss the appropriate starting dose with you. The daily version of Tadalafil known by its brand name Cialis Daily, is recommended for those who have sex more than twice a week. The medication is taken every day and after approximately 5 days, should have its full effect. By taking the medication in this way, there is a steady, constant dose in the body. The initial dosing is 2.5mg once daily, which can be increased to 5mg if the initial dosing is ineffective. One of the disadvantages of Tadalafil is that as the medication lasts in the body for longer, if you get side effects with the medication, these can last longer as well.

The side effects are similar to all ED medications - headache, nausea, stuffy nose, flushing, indigestion, but as mentioned before there can be some other rarer side effects; you should always check the leaflet that comes with the medication before taking it. Different ED medications suit different people so it is difficult to tell which would work best for you until you’ve tried each one. In our experience, men often prefer Tadalafil as it lasts longer, works faster and can be taken with food. Having said that, some men find that Tadalafil does not suit them, so they prefer to stick with Sildenafil. You can request both Sildenafil and Tadalafil safely online through the LloydsPharmacy’s Online Doctor service. If appropriate, our GPs ca prescribe you treatment for Same-Day Collection, Next-Day delivery or FREE Standard Delivery.

If you’re unsure which ED treatment will be best for you then take our free ED assessment and our clinicians will help you decide. Sildenafil is the active ingredient in Viagra and is sold without the brand name, sometimes called “generic Viagra” or simply “sildenafil.” These medicines have the same active ingredient and act the same way in the body. The biggest difference when choosing is the dose and cost of these medications. If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

It’s just one of many options, including generic versions, and yet it’s as synonymous with ED as Kleenex is with runny noses. But while ignoring the generic facial tissue for Kleenex will only cost you a couple of bucks, there can be over a $50 difference—per pill—between Viagra and its generic alternative.

Erectile dysfunction causes issues getting or maintaining an erection. Viagra is the most well-known prescription medication that treats ED.

Sildenafil is the active ingredient in Viagra and is sold without the brand name, sometimes called “generic Viagra” or simply “sildenafil.” These medicines have the same active ingredient and act the

same

way in the body.

The biggest difference when choosing is the dose and cost of these medications.

Viagra, and its generic version, are just a couple of the prescription medications available to treat erectile dysfunction.

Researchers involved with one study that looked at 27,000 men from eight different countries found that only 58% of participants

with

ED had ever sought help from a medical professional for the condition. So, though they found that roughly 8% of men 20–29 and 11% of men age 30–39 have erectile dysfunction, the true numbers of men experiencing this common condition may be higher (Rosen, 2004).

A 2019 study found that between 3 and 76.5% of men experience erectile dysfunction globally (Kessler, 2019). Although Viagra, or “the little blue pill,” reigns supreme in people’s minds as the go-to ED medication, you’ve likely seen other popular names such as Cialis (generic name tadalafil) and Levitra (generic name vardenafil). All of these ED treatments belong to a class of drugs called phosphodiesterase-5 inhibitors (PDE-5 inhibitors), which just means they all work in a similar way.

Each of these medications helps by relaxing muscles in the penis and improving blood flow in order to treat ED. A real, U.S.-licensed physician will review your information and get back to you within 24 hours. Viagra is the brand name of sildenafil, which is manufactured and sold by Pfizer. The active ingredient is sildenafil citrate, and Viagra comes in three doses: 25 mg, 50 mg, and 100 mg. This ED treatment is taken as needed between 30 minutes and 4 hours before sexual activity.

Though Viagra tablets can start to take effect and help achieve an erection in just 12 minutes, the medication reaches peak levels in your body after 30–120 minutes (Eardley, 2002).



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