There are lots of erectile dysfunction tablets to choose from but which one is best? In this blog, we look at the top four big brands:

We’ll compare the two most popular – Cialis vs. Viagra – and ask, how do these erectile dysfunction treatments stack up against one another?

Viagra (Sildenafil)

Viagra is the most well known of the four big brands, but since the patent expired on this product, it’s now available to buy in its generic form – Sildenafil.

It takes between 30 to 60 minutes to work, so we recommend taking it at least an hour before you plan to have sex. Viagra works best on an empty stomach, like most of the other ED medications. You can expect its effects to last for around four to five hours.

Most people start off taking a 50mg dose, but it’s also available in 25 mg and 100 mg for those who need something weaker or stronger to suit them.

Cialis (Tadalafil)

Cialis lasts the longest of all the erectile dysfunction (ED) tablets currently on the market. You can expect it to stay in your system for up to 36 hours, but that doesn’t mean you’ll have a permanent erection; you need to be aroused for it to work.

Cialis is the branded version of tadalafil, which is also available in its generic form. The active ingredient takes just 30 minutes to work and is less sensitive to food. So, while it’s best taken on an empty stomach, you can eat with it.

For men who expect to have sex at least two to three times a week, there is Cialis Daily, which is taken every day at a low dose (2.5mg and 5mg), so it stays in your system.

Levitra (Vardenafil)

Levitra contains the active ingredient vardenafil, which can be bought separately in its generic form. It’s available in strengths of 5mg, 10mg, and 20mg, and in an orodispersible form (melt in the mouth) for those who find it hard to swallow tablets.

It gets to work in 25 minutes, but you should take it at least an hour before you plan to have sex. Like most of the other tablets, it’s best taken on an empty stomach.

You can expect the effects of Levitra to last for around four to five hours.

Spedra (avanafil)

Spedra (known as Stendra in the United States) is a relatively new product on the market, having only been introduced in 2013. It contains the active ingredient, avanafil, but there is no generic alternative available to buy yet.

This ED treatment is considered to be the fastest on the market – a 100mg dose works in just 15 minutes. The pharmaceutical company behind Spedra recommend taking it at least 15 to 30 minutes before you plan to have sex.

The effects of Spedra can last up to four hours, but for it to work you must have sexual stimulation, so don’t expect to have a permanent erection for this amount of time.

Are the side effects the same?

The risks associated with these treatments are broadly the same.

Most men tolerate the ingredients used to treat erectile dysfunction very well, but some people have reported similar side effects. The most common include:

  • Headache
  • Flushing
  • Nasal congestion
  • Indigestion
  • Muscle aches and pains

Viagra also adds visual disturbances, nausea, and dizziness to its list of common side effects.

All medicines come with a certain level of risk, so you should always read the patient information leaflet that comes with your ED treatment before you start taking it.

woman giving a viagra tablet

Which is the most cost effective?

The price for a pack of four tablets at the standard strength for each brand is:

  • Viagra – £29.99 (50mg tablets)
  • Cialis – £39.49 (10mg tablets)
  • Levitra – £42.49 (10mg tablets)
  • Spedra – £24.99 (100mg tablets)

Spedra is the cheapest to buy from Post My Meds at £24.99, but is it the most cost effective? If you plan to have sex at least three times a week, it might be worth investing in a daily dose tablet. Cialis Daily costs £69.49 for 28 tablets, which works out at just £2.48 per tablet – cheaper than any other big-brand treatment.

It’s also worth considering the generic versions of these branded drugs. You can save up to £16.00 by buying four tablets of Sildenafil instead of 4 tablets of Viagra as prices for Sildenafil 50mg tablets start from £13.99.

Which is the most effective?

The four big-brand treatments all work in the same way. They are part of a group of medicines known as PDE5 inhibitors, which relaxes smooth muscle cells and dilates the blood vessels at the base of the penis to increase blood flow for a firm erection.

Though they work in the same way, there are differences in their performance.

Cialis vs. Viagra 

While Viagra has years of marketing under its belt, Cialis works in half the time and lasts longer (up to 36 hours). However, this is reflected in the price – Cialis is more expensive than Viagra when you buy from Post My Meds.

Levitra vs. Cialis 

Levitra and Cialis both take around the same time to work – 25 to 30 minutes, but the manufacturers of Levitra still recommend taking it at least an hour before sex. Again, Cialis lasts longer, but this time it’s Levitra that is the most expensive to buy.

Spedra vs. Levitra

Spedra is a relatively new addition to the market but it’s the cheapest of all four big brands. It works the fastest (15 minutes), though again it should be taken at least 30 minutes before sexual activity, just like Levitra.

The key takeaway

What works for one person may not work for another – the only way of knowing is to try for yourself. This doesn’t mean taking more than one tablet consecutively, but if you’ve been using the same treatment for a while and you’re not getting the results you would like, consider switching to another brand.

Speak to your doctor or pharmacist about this first so they can advise accordingly and look at any potential drug interactions and chat to you about any other health conditions you have.

Although all of our content is written and reviewed by healthcare professionals, it should not be substituted for or used as medical advice. If you have any questions about your health, please speak to your doctor.

Authored Oct 19, 2021 by Joseph Issac, MPharm
Reviewed Oct 19, 2021 by Prabjeet Saundh, MPharm