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Levitra (vardenafil) and Cialis (tadalafil) belong to a class of drugs called PDE5-inhibitors and are used to treat erectile dysfunction. However, there are differences between the two drugs that help define which of them is more appropriate for a particular patient. This article focuses on these differences and reviews the possibility of taking Cialis and Levitra together.

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Levitra (Vardenafil)/ Cialis (Tadalafil) Comparison

As-Needed vs Daily Regimen

Levitra: Taken as needed, 30-60 minutes before the expected intercourse

Cialis: Taken either as needed, 30 minutes before the expected intercourse OR every day. The daily regimen is prescribed to patients suffering from benign prostatic hyperplasia, a condition caused by prostate gland enlargement.

Duration of Effect

Levitra: Up to 4 hours

Cialis: Up to 36 hours

The extended duration of effect of Cialis allows for greater spontaneity in choosing the time of the intercourse. Both medications reduce the refractory period between erections, so it’s possible to have sex more than once after taking the pill.

Efficacy

Levitra: 69% of the patients report improved erection

Cialis: 71-84% of the patients report improved erection

Contraindications

Both medications:

Blood conditions: multiple myeloma, leukemia, sickle cell anemia, bleeding disorders;

Cardiovascular conditions: hypertension, hypertrophic cardiomyopathy, narrowing of the aortic heart valve, angina, arrhythmia, chronic heart failure, history of stroke;

Eye conditions: pigmentary retinopathy, sudden vision loss;

Hearing conditions: sudden hearing loss;

Liver conditions: severe liver function impairment;

Gastrointestinal conditions: stomach ulcer;

Penile malformations: Peyronie’s disease, fibrous tissue in the penis.

Specific for Levitra: Prolonged QT interval on EKG

Specific for Cialis: alcohol intoxication, hypotension, renal impairment, seizures, restrictive cardiomyopathy.

Use in BPH

Unlike Levitra, Cialis is FDA-approved for the treatment of benign prostatic hyperplasia occurring alone or concomitantly with erectile dysfunction.

Taking Cialis and Levitra Together

Taking Cialis and Levitra at the same time is not recommended. Since both of these medications affect the same chemicals in the body, taking them together would be similar to taking an overdose of either of the two. This increases the risk of suffering from severe side effects, including such conditions as heart attack, permanent blindness and priapism.

According to DrugStats data for 2017, tadalafil (Cialis) is prescribed to patients in the US more often than vardenafil (Levitra). This is due to the drug’s higher efficacy, longer duration of effect and the fact that it is used to treat both ED and BPH. Levitra, in its turn, has fewer side effects. It is also a second-line option for patients non-responsive to treatment with Cialis or other PDE5 inhibitors.

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