Which drug is better than sildenafil ?

Which is the best: Viagra, Cialis or Levitra? I will also add Spedra, which is Avanafil , and which is the fourth oral medication available in Spain, although perhaps the least well-known.
Which is the best? I have been asked thousands of times. And the answer is… it depends. There is no medicine better than another a priori . There are drugs that, due to their profile, are more useful in some patients than in others or in some situations than in others.
Oh, one other thing. Before continuing, I want to comment on two points: this article is not paid for by anyone at all. It is my opinion 100%. Therefore, what I tell you is my point of view, although I may be wrong at some point.

The second comment is that I will refer to medications by their best-known trade name, even though I am referring to the active principle. I do it for the sake of making it easier for people to understand me, not because I have a predilection for that brand of that compound and not another.

Viagra (Sildenafil)
The first of these erectile dysfunction drugs that was invented back in 1998 was sildenafil , Viagra® for friends. This blue drug that comes in doses of 25, 50 (recommended for initiation) and 100 mg , is effective between 30 and 60 minutes after taking it . Its effectiveness can last up to 12 hours (efficacy, not erection duration!) and 56%, 77% and 84% of patients treated with the respective doses had better erections. In diabetic patients the efficacy is 63% in terms of successful intercourse attempts.

Cialis (Tadalafil)
Tadalafil , marketed as Cialis® , was approved in 2003. The effect begins 30 minutes after taking it and can be effective for up to 36 hours . Unlike Viagra ® , its absorption is not altered by consumption with food. The tablet is yellowish, comma-shaped, and only has two preparations: 10 mg (recommended starting dose) and 20 mg . 67% and 81% of patients treated with the doses described have better erections. Its effectiveness in diabetics is similar to that of Viagra®.

In addition, there is a 5 mg dose of this drug for erectile dysfunction that can be used daily with good results in cases where couples want to have spontaneous sexual relations that do not depend on the time from taking the drug.

Levitra (Vardenafil)
In 2003 the third drug in question also arrived from the hand of Bayer®: vardenafil or Levitra® . Its effectiveness also starts after 30 minutes although in some cases it can appear after 10 minutes . Its effect may be diminished if consumed together with heavy fatty food. The orange, round tablet may contain 5, 10 (starting dose), or 20 mg . The rates with respect to an improved erection are 66%, 76% and 80% with each of the respective doses. It is the drug with a higher percentage of satisfactory erections (72%) in diabetics. It also presents a formulation in the form of an orodispersible (instead of a coated tablet) whose absorption is independent of the diet, with better bioavailability. Its effectiveness is comparable to the traditional formulation.

Spedra (Avanafil)
Avanafil ( Spedra® ) appeared in 2013 and is a highly selective phosphodiesterase 5 inhibitor . The yellow pill can come in doses of 50, 100 (recommended starting) and 200 mg . Its effects are also noticeable between 15 and 30 minutes after taking it, and 64, 67 and 71% of satisfactory sexual relations are achieved with the corresponding doses. Like the orodispersible, avanafil is also not affected by food intake.

Comparative Viagra, Cialis, Levitra and Spedra.
I will give you a one by one comparison of all the combinations between these 4 drugs.

Viagra or Spedra: differences and which is better.
In my opinion, Viagra would gain slightly in efficacy, while Spedra produces fewer side effects. Regarding the speed of action, both are the same, with an onset of action at 30 minutes, although Spedra prolongs its effect for approximately 10 hours. In my opinion -and I think it is the general feeling in urology- Spedra is somewhat less effective than the rest, but it has fewer side effects. Therefore, Spedra is often used when one of the other three is used, and although the efficacy is good, it produces too many side effects.

Viagra or Cialis: differences and which is better.
They are probably the two best-known and most prescribed erection medications. This comparison is easy, because Viagra is faster (30 minutes) while Cialis takes between 60 and 120 minutes to reach maximum effectiveness. Cialis does not interact with fat or alcohol, and prolongs its effect for 36 hours. That’s why Viagra would be -for me- the pill for tonight, and Cialis the pill for this weekend.

Viagra or Levitra: differences and which is better.
This is the most difficult comparison, because viagra and levitra are the two most similar drugs to each other. For many years Levitra was considered the most potent drug, although that doesn’t translate clinically. In fact, the studies are controversial, and in the European clinical guidelines Sildenafil 100mg and Tadalafil 20mg appear as the most effective treatment alternatives.

Viagra and Levitra are two short-acting drugs, with an onset of action at 30 minutes, and whose effect lasts up to 6 hours approx.

Cialis or Spedra: differences and which is better.
Cialis takes 1-2 hours to reach maximum effect, while Spedra is faster. As I told you before, Cialis is the weekend pill, and it is more effective than Spedra, so my advice would be to use Spedra if Cialis gives you a lot of side effects or if you don’t want a drug that lasts that long.

Levitra or Cialis: differences and which is better.
The comparison is similar to Sildenafil and tadalafil. Levitra wins in speed and Cialis in duration, so for me the former would be my choice if I want something that works fast, and the latter if I want it to work for a long time. It must also be taken into account that vardenafil interacts with fatty foods and alcohol, so it must be taken into account if the situation is very festive.

Levitra or Spedra: differences and which is better.
They are two very similar drugs. Spedra remains active longer than Levitra (10h vs 6h), although the speed of action is similar. Vardenafil is more effective than Spedra, although Spedra has fewer side effects. Possibly my first option would be Levitra and I would reserve Spedra in case the patient has many side effects.

  • Comparison Viagra, Cialis, Levitra, Spedra: things you have to keep in mind.
    Do you want the medicine to work fast? Viagra, Levitra and Spedra are better than Cialis.
  • Do you prefer the medicine to act for a long time? Cialis is better than the rest.
  • Do you need the medicine to be very effective? The best options are Viagra, Cialis and Levitra (the order is not related to greater effectiveness).
  • Do you want the drug to have few side effects? Spedra, without discussion.
  • Find that the drug does not interact with alcohol? Cialis.

I hope I have answered the question “Which is the best: Viagra, Cialis or Levitra?” As you can see, it is not easy or direct, but there are points in favor of each one. That’s why I always say that my job is to find the best medication for you .