Overview

Viagra (Sildenafil):

• Active Ingredient: Sildenafil citrate
• Time to Take Effect: It takes about 30 minutes to 1 hour to start working.
• Effective Duration: Effects last for about 4 to 6 hours.
• Considerations: It's recommended to take Viagra on an empty stomach for the best efficacy. Food, especially fatty food, can delay its absorption and effects.
• Dosage: 25mg, 50mg, 100mg

Cialis (Tadalafil):

• Active Ingredient: Tadalafil
• Time to Take Effect: Begins working in as little as 30 minutes.
• Effective Duration: Its most notable difference is the long duration of effect, lasting up to 36 hours, which has earned it the nickname “The Weekend Pill.”
• Considerations: Cialis can be taken with or without food, and a daily low-dose option is available for those who prefer more spontaneity rather than planning sexual activity around medication timing.
• Dosage: 2.5mg, 5mg, 10mg, 20mg

Levitra (Vardenafil):

• Active Ingredient: Vardenafil
• Time to Take Effect: Starts working within 25 to 60 minutes.
• Effective Duration: Effects last for about 4 to 5 hours.
• Considerations: Similar to Viagra, the effectiveness of Levitra can be decreased by the intake of high-fat foods before its use.
• Dosage: 5mg, 10mg, 20mg

Which Gets You Harder Longer?

While Cialis lasts the longest (up to 36 hours), the effectiveness of Viagra, Cialis, and Levitra in terms of achieving a harder erection can vary among individuals, depending on several factors including the underlying cause of erectile dysfunction, overall health, and specific body response to the medication. Each of these medications works by inhibiting an enzyme called phosphodiesterase type 5 (PDE5), which results in an increase in blood flow to the penis and thereby facilitating the achievement and maintenance of an erection in response to sexual stimulation. However, there's no definitive answer to which of these medications will make you harder as it varies from person to person.

Timing Peak Effectiveness

Understanding when each erectile dysfunction (ED) medication reaches its peak effectiveness can help individuals plan for maximum efficacy in response to sexual stimulation.

• Viagra (Sildenafil) typically reaches its peak concentration in the blood approximately 1 hour after ingestion. However, it can start working in as little as 30 minutes for some men.
• Cialis (Tadalafil) generally reaches its peak effectiveness between 2 to 3 hours after taking the pill. Its onset can be as early as 30 minutes post-dose.
• Levitra’s (Vardenafil) peak concentration occurs around 1 hour after taking the medication, similar to Viagra. The onset of action can be as soon as 25 minutes for some individuals.

Post-Ejaculation Effects:

After ejaculation, it's normal for the penis to return to its flaccid state, even when using these medications. However, the recovery period, known as the refractory period, can be influenced by many factors including age, general health, and psychological factors.

• Viagra (Sildenafil) and Levitra (Vardenafil) generally help to reduce the refractory period, potentially allowing for quicker recovery and the ability to achieve another erection with sexual stimulation within the medication's effective window, which is typically 4 to 6 hours for these medications.
• Cialis (Tadalafil), with its longer duration of action (up to 36 hours), may also support the ability to achieve subsequent erections more easily within this extended period after ejaculation, given its prolonged window of efficacy.

The extent to which these medications can help maintain an erection after ejaculation varies significantly among individuals. Factors such as the underlying cause of erectile dysfunction, psychological state, and overall health play crucial roles in determining the effectiveness of these medications. Some individuals may find that they can maintain an erection after ejaculation with little to no difficulty, especially if they are still within the effective period of the medication and continue to experience sexual arousal.

Since the response to these medications can be highly individual, healthcare providers often recommend trying each medication several times under different circumstances to determine which works best. This trial and response approach can help identify the medication that not only works effectively but also has the most satisfactory results in terms of erection hardness and duration, with the least side effects.

Side Effects

The side effects of erectile dysfunction (ED) medications are generally similar due to their similar mechanisms of action. However, individual responses can vary, and some users may experience different side effects or intensities with each medication.

Viagra (Sildenafil) Side Effects:

• Common: Headache, flushing, indigestion, nasal congestion, dizziness, blurred vision, and changes in color vision.
• Less common: Rash, diarrhea, and urinary tract infection.
• Rare but serious: Priapism (prolonged erection), sudden vision loss in one or both eyes, and sudden hearing decrease or loss.

Cialis (Tadalafil) Side Effects:

• Common: Headache, indigestion, back pain, muscle aches, flushing, and stuffy or runny nose. The muscle aches and back pain can occur 12 to 24 hours after taking the medication and usually disappear within 48 hours.
• Less common: Acid reflux, burping, and stomach discomfort.
• Rare but serious: Priapism, sudden vision loss, and sudden hearing decrease or loss. Additionally, because of its longer duration in the body, some side effects may be prolonged.

Levitra (Vardenafil) Side Effects:

• Common: Headache, flushing, stuffy or runny nose, indigestion, upset stomach, dizziness, and back pain.
• Less common: Changes in vision, including increased sensitivity to light, blurred vision, or trouble telling blue and green colors apart.
• Rare but serious: Priapism, sudden vision loss in one or both eyes, and sudden hearing decrease or loss.

Important Considerations - When to talk to a doctor:

Risk Factors: Individuals with certain health conditions (e.g., heart disease, high or low blood pressure, kidney or liver disease) and those taking certain medications (e.g., nitrates, alpha-blockers) may have a higher risk of experiencing serious side effects.

Interactions: All PDE5 inhibitors can interact with other medications, leading to potentially dangerous effects. Common Drug Interactions:

• Nitrates: Used to treat chest pain (angina), nitrates and ED medications can cause a severe and dangerous drop in blood pressure. This combination can lead to dizziness, fainting, and even heart attack or stroke.
• Alpha-Blockers: Prescribed for prostate problems or high blood pressure, alpha-blockers can also lead to a significant drop in blood pressure when taken with ED medications, resulting in dizziness, fainting, or falling.
• Riociguat (Adempas): Used to treat pulmonary arterial hypertension, combining this medication with PDE5 inhibitors can lead to hypotension.
• HIV Protease Inhibitors: These medications can increase the levels of ED medications in the blood, potentially leading to increased side effects.

Response to Side Effects: Mild side effects may not require medical attention and might go away as the body adjusts to the medication. However, if you experience severe or persistent side effects, it’s crucial to seek immediate medical attention, especially for symptoms like priapism or sudden loss of vision or hearing.

Taking with Alcohol

Moderate alcohol consumption may be safe for some individuals taking ED medications but it’s important to be aware that alcohol itself can cause erectile dysfunction, and its interaction with these medications warrants careful consideration.

Effects on Blood Pressure:

• Hypotension: Both alcohol and ED medications can lower blood pressure. When combined, they may cause an excessive drop in blood pressure, leading to symptoms such as dizziness, fainting, or even heart problems, especially in individuals with cardiovascular conditions.

Impact on Effectiveness:

• Reduced Efficacy: Alcohol consumption can interfere with the body’s ability to achieve an erection, counteracting the purpose of ED medications. High levels of alcohol intake can diminish the effectiveness of these medications in facilitating an erection.

Increased Risk of Side Effects:

• Enhanced Side Effects: Alcohol can increase the likelihood of experiencing side effects associated with ED medications, such as headaches, flushing, and dizziness. This is because both alcohol and ED medications have vasodilating effects, which can compound these symptoms.

Dosing Back-to-Back

Taking erectile dysfunction (ED) medications back-to-back or in close succession is generally not recommended without medical guidance. Here’s an important overview regarding the use of these medications in close intervals:

Risk of Side Effects:

• Increased Side Effects: Combining or taking ED medications in close succession can significantly increase the risk of side effects. Common side effects include headaches, flushing, indigestion, nasal congestion, dizziness, and visual changes. More severe risks involve sudden drops in blood pressure, prolonged erections (priapism), which can be damaging to penile tissue, and heart problems, especially in those with existing heart conditions.

Interactions and Overdose Potential:

• Overdose Risks: Taking multiple doses of ED medications or mixing them can lead to overdose, which can exacerbate side effects and lead to serious health risks.
• Interaction with Other Medications: ED medications can interact with other medications, such as nitrates (used for chest pain) and alpha-blockers (used for high blood pressure or prostate problems), leading to potentially dangerous drops in blood pressure.

Effects on Semen & Ejaculation

ED medication’s impact on semen characteristics is relatively minimal and indirect.

• Semen Volume: Studies have generally shown that ED medications have little to no significant effect on semen volume. The primary function of these medications is to improve blood flow to facilitate erections, not to directly alter semen production or ejaculation volume.
• Sperm Motility and Quality: Research on the impact of ED medications on sperm motility and quality has yielded mixed results. Some studies suggest minimal or no significant adverse effects on sperm parameters, including motility and morphology. However, the overall consensus is that these medications do not have a detrimental impact on sperm health that would be concerning for male fertility.
• Ejaculation Timing: While not directly affecting semen, ED medications can influence the timing of ejaculation in some men. Some users report delayed ejaculation, which could indirectly affect sexual satisfaction and experience but does not directly alter semen characteristics.

Cost & Generics

All three of these ED medications are by prescription only in Canada. At TeleTest, we only charge for the secure messaging consultation with a physician. The price you pay can vary depending on the pharmacy and whether the purchase is covered by insurance or paid out-of-pocket. Generics in general offer the same active ingredient and efficacy while being a bit cheaper. You can expect to pay approximately the following prices per pill:

• Cialis: $13 - $20
• Tadalafil (Generic Cialis): $11 - $18
• Viagra: $9 - $15
• Sildenafil (Generic Viagra): $5 - $9
• Levitra: $14 - $20
• Vardenafil: $11 - $18

Choosing the Best Option

The best choice depends on an individual's specific health situation, their response to the medication, and personal preferences regarding how quickly they want it to start working, how long they want the effect to last, and what side effects they might be willing to tolerate. It is important to consult with a healthcare provider to consider any underlying health issues, potential side effects, and interactions with other medications being taken.

Here are some factors to consider:

• Duration of action: If longer duration is preferred, Cialis might be more suitable.
• Spontaneity: Cialis offers a daily dose option, which might be preferred for those seeking more spontaneity.
• Food interactions: Viagra and Levitra's effectiveness can be reduced by food, especially high-fat meals, whereas Cialis is less affected by food intake.

Ultimately, the decision should be made in consultation with a healthcare provider who can provide guidance based on individual health status, potential side effects, and interaction with other medications. A healthcare provider can also provide guidance on starting doses and the best way to take these medications to improve their effectiveness.