Vardenafil Vs Tadalafil Vs Sildenafil- ED Treatments Compared for Effective Solutions

When it comes to managing erectile dysfunction (ED), understanding the various treatment options available can be overwhelming. Three of the most commonly prescribed medications- Sildenafil, Tadalafil, and Vardenafil, offer effective solutions, but they each have unique properties that may make one more suitable for your needs than the others. 

In this blog, we will compare these three erectile dysfunction medications, exploring their working mechanism, onset of action, duration of effect, and potential side effects. 

What Are Sildenafil, Vardenafil, And Tadalafil?

Sildenafil, Vardenafil, and Tadalafil are medications commonly used to treat erectile dysfunction (ED). 

Sildenafil

Commonly known by its brand name Viagra and Cenforce, Sildenafil Citrate is the first medication to be approved for treating erectile dysfunction (ED). It works by relaxing blood vessels in the penis, facilitating increased blood flow during sexual arousal [1].
The Sildenafil medication is often prescribed for men experiencing difficulties achieving or maintaining an erection. The action of Sildenafil starts within 30 minutes of intake, and its action lasts for about 4 hours.

Vardenafil

Tadalafil

Known by the brand name Cialis and Vardenafil, Tadalafil is also used to treat erectile dysfunction. Its mechanism of action is similar to that of Sildenafil and Vardenafil, promoting increased blood flow to the penis.
Tadalafil is also indicated for benign prostatic hyperplasia (BPH), providing relief from urinary symptoms associated with an enlarged prostate [3]. The action of Tadalafil takes about 30 minutes and it has one of the longest duration of action, lasting up to 36 hours.

Tadalafil Vs. Sildenafil Vs. Vardenafil- Key Similarities 

The key similarities between these three medications include- 

Clinical Uses

Sildenafil, Tadalafil, and Vardenafil are commonly prescribed medications for treating erectile dysfunction (ED), offering effective solutions for men facing challenges in achieving or maintaining an erection. They can help improve confidence and enhance overall sexual experiences, contributing to better intimate relationships.

Drug Class

Tadalafil, sildenafil, and vardenafil all belong to the same drug class known as phosphodiesterase type 5 (PDE5) inhibitors. Thus, they have similar benefits and mechanisms of action. 

Working Mechanism

All three medications work in a similar way to help treat erectile dysfunction (ED). 

• Release of Nitric Oxide– When a man is sexually stimulated, the body releases a substance called nitric oxide (NO) in the penis. This is a natural response that starts the process of getting an erection.
• Increase in cGMP– Nitric oxide helps produce a molecule called cyclic guanosine monophosphate (cGMP). This causes the blood vessels in the penis to relax and widen, allowing more blood to flow in. This flow of blood to the lower abdomen helps in getting and maintaining an erection. 
• Inhibition of PDE5– In people with ED, an enzyme called phosphodiesterase type 5 (PDE5) breaks down cGMP, reducing blood flow and making it difficult to maintain an erection. Tadalafil, Sildenafil, and Vardenafil inhibit this enzyme, which means they help keep cGMP levels higher for longer and help with getting an erection. 

Need For Sexual Stimulation 

A key similarity among these erection pills is that all three medications require sexual stimulation to be effective. This means that while they help with getting an erection, they do not automatically induce one without sexual arousal [4]. 

Administration

These medications are provided in oral tablet form and are intended to be taken with water. They should be taken as a whole without breaking or crushing. 

Difference Between Sildenafil, Tadalafil, And Vardenafil

Differences between these three popular ED medications include- 

Duration Of Action

The duration of action of Vardenafil and Sildenafil is similar, with Vardenafil lasting approximately 5 to 6 hours and Sildenafil around 4 hours. In contrast, Tadalafil has a significantly longer duration of action, with effects lasting up to 36 hours [5].

Food Interaction

Sildenafil and Vardenafil are best taken on an empty stomach, as high-fat meals can delay their absorption and effectiveness [6,7]. In contrast, Tadalafil is more flexible; it can be taken with or without food without major impact [8]. 

Dosage Strengths 

Tadalafil and Vardenafil tablets come in the dosage strength of 2.5mg, 5mg, 10mg, and 20mg [9,10]. Sildenafil is available as oral tablets with 25 mg, 50 mg, 100mg, and 200 mg dosage strengths. 

Brand Names 

• Sildenafil- Viagra, Cenforce, Aurogra, and Malegra. 
• Vardenafil- Vitara, Vilitra, and Levitra. 
• Tadalafil- Cialis, Vidalista, and Tadalista. 

Onset of Action

The onset of action for Tadalafil and Sildenafil is comparable, commonly occurring within 30 minutes of administration. 

Vardenafil starts working within 30 to 60 minutes after intake [5]. 

Price Comparison For Sildenafil, Vardenafil, And Tadalafil

Note– Please note that the listed medication cost for IyrinHealth Care refers specifically to the brand-name product and does not apply to the generic version. In addition, the cost of these medications may vary depending on the pharmacy and pill package. 

Tadalafil Vs. Vardenafil Vs. Sildenafil- Side Effects

The common and severe side effects of each of these three effective ED treatments are listed in the table below. 

Potential Drug Interactions 

Sildenafil, when taken with other medications and supplements, can cause drug interaction, lowering its effectiveness and increasing the risk of side effects. Some of the medications that should be taken with Sildenafil are listed below. 

• Sildenafil Major Drug Interactions– amprenavir, atazanavir, berotralstat, ciprofloxacin, cenobamate, diltiazem, erythromycin, etravirine, fluvoxamine, imatinib, ketoconazole, lorlatinib, mephobarbital, mitotane, nevirapine, phenobarbital, ritonavir, tucatinib [15]. 
• Sildenafil Moderate and Mild Interactions– acebutolol, anisindione, bumetanide, citrulline, dipyridamole, eprosartan, fentanyl, guanfacine, hydromorphone, iloprost, lomitapide, modafinil, perindopril, triamterene [15]. 

According to the information provided on the Drugs website, Vardenafil is associated with a higher risk of drug interactions compared to Sildenafil. It is important to avoid certain medications while using this erectile dysfunction treatment, as listed below.

• Major Drug Interaction Of Vardenafil– amyl nitrite, bedaquiline, bepridil, cabozantinib, cisapride, citalopram, disopyramide, dolasetron, erythromycin, etrasimod, fexinidazole, gatifloxacin, grepafloxacin, halofantrine, haloperidol, indinavir, itraconazole, lefamulin, mifepristone, moxifloxacin, nitroglycerin, ozanimod, quinidine, ritonavir, sodium nitrite, thioridazine, vericiguat [16].
• Moderate Drug Interaction Of Vardenafil– acebutolol, arginine, betaxolol, clofazimine, disulfiram, eribulin, goserelin, gepirone, hydroxyzine, iloprost, macimorelin, mavorixafor, miconazole, nelfinavir, norfloxacin, ondansetron, oxytocin, pitolisant, prazosin, pindolol, quinine, ramipril, rifapentine, somatropin, tramadol [16]. 

Tadalafil is known for having a lower risk of drug interactions compared to Vardenafil and Sildenafil. However, there are certain medications and supplements that should be avoided while taking Tadalafil. Here are a few notable ones-

• Major Drug Interaction Of Tadalafil– Adagrasib, avanafil, clarithromycin, delavirdine, erythromycin, isosorbide, itraconazole, ketoconazole, lonafarnib, miconazole, nefazodone, nitroglycerin, riociguat, sodium nitrite, sildenafil, telaprevir, vericiguat [17]. 
• Moderate Drug Interaction Of Tadalafil– alfuzosin, bexarotene, ciprofloxacin, diltiazem, dronedarone, ertugliflozin, fluconazole, grepafloxacin, indinavir, lorcaserin, minoxidil topical, modafinil, nevirapine, procarbazine, rifabutin, verteporfin [17].

It is important to understand that this is not a complete list of all potential drug interactions with these erectile dysfunction medications. We recommend consulting a healthcare professional before combining any medications or supplements with them.

Factors For Choosing Between Sildenafil, Vardenafil, And Tadalafil

A few key factors that should be taken into consideration before choosing between these ED medications include- 

Severity of Erectile Dysfunction

Individuals with mild ED may respond well to Sildenafil and Vardenafil, while those with severe ED might benefit more from Tadalafil’s longer duration.

Frequency of Sexual Activity

If sexual activity is infrequent, a shorter-acting option like Sildenafil or Vardenafil might be suitable. For more frequent intercourse, Tadalafil may be more beneficial.

Age and Health Status

Older adults may have different tolerances and interactions; thus, is is always advisable to consult a doctor to understand the best treatment option for you.

Lifestyle Factors

Alcohol consumption and smoking can influence the effectiveness of these medications. So, it is advisable to choose Sildenafil, which has a shorter duration of action if you have a plan to get a drink or smoke later. 

Which Is Better- Sildenafil Or Tadalafil Or Vardenafil: Our Final Thoughts

Choosing between Sildenafil, Tadalafil, and Vardenafil depends on individual needs and preferences. Sildenafil and Vardenafil are often effective for short-term use and have a quicker onset, making them perfect for spontaneous sexual intercourse. Tadalafil, with its longer duration, offers more flexibility, allowing for planned intimacy over a more extended period. 

Cost is another important factor when choosing your ED treatment. Tadalafil is generally the most affordable, followed by Sildenafil. Vardenafil is comparatively more expensive at IyrinHealth Care than the other two ED pills. Additionally, it is also crucial to consider the risk of drug interactions. Vardenafil has the highest risk, followed by Sildenafil, while Tadalafil presents a lower risk profile. 

However, it is essential to consult a doctor to determine which option best suits your health profile, lifestyle, and treatment goals. By understanding the unique benefits and characteristics of each medication, you can make an informed decision.