ED Medication Comparison Tool
Medication Comparison Table
| Medication | Active Ingredient | Typical Dose | Onset Time | Duration | Common Side Effects | Price Range (CAD) |
|---|---|---|---|---|---|---|
| Viagra | Sildenafil | 50 mg | 30–60 min | 4–6 hrs | Headache, flushing, dyspepsia | $30–$50 per tablet |
| Cialis | Tadalafil | 10 mg | 30–120 min | Up to 36 hrs | Back pain, muscle aches, indigestion | $35–$60 per tablet |
| Levitra | Vardenafil | 10 mg | 15–30 min | 4–5 hrs | Headache, flushing, rhinitis | $40–$65 per tablet |
| Stendra | Avanafil | 100 mg | 15–30 min | 6–12 hrs | Headache, dizziness, nasal congestion | $45–$70 per tablet |
| Generic Sildenafil | Sildenafil | 50 mg | 30–60 min | 4–6 hrs | Same as brand | $5–$15 per tablet |
When it comes to treating erectile dysfunction, Viagra is a brand name for the oral phosphodiesterase‑5 inhibitor sildenafil, introduced in 1998 and still widely prescribed worldwide (often just called Viagra). It works by relaxing the smooth muscle in the penis so blood can flow in when sexual excitement triggers nitric oxide release. But Viagra isn’t the only pill on the market, and many patients wonder how it measures against newer options or even over‑the‑counter supplements. This guide breaks down the science, dosage, side‑effects, price and real‑world practicality of Viagra compared with its most common alternatives.
Key Takeaways
- Viagra (sildenafil) remains the most studied PDE5 inhibitor with a solid safety record.
- Cialis (tadalafil) offers the longest duration (up to 36hours) - ideal for spontaneous plans.
- Levitra (vardenafil) and Stendra (avanafil) have faster onset (15‑30minutes) but similar duration to Viagra.
- Generic sildenafil provides the same effectiveness as brand‑name Viagra at a fraction of the cost.
- Natural supplements such as L‑arginine lack the consistent clinical evidence that prescription pills have.
How Viagra Works - The Basics
Sildenafil belongs to the phosphodiesterase‑5 (PDE5) inhibitors class. By blocking the PDE5 enzyme, it prevents the breakdown of cyclic guanosine monophosphate (cGMP), a molecule that keeps penile blood vessels dilated. The result is an erection that can be maintained for about 4‑6hours after taking a dose, provided sexual stimulation occurs.
Viagra’s standard tablet strength is 25mg, 50mg, or 100mg, usually taken about an hour before sexual activity. Food-especially high‑fat meals-can delay absorption, so many clinicians advise a light snack beforehand.
Top Prescription Alternatives
Four other prescription drugs dominate the ED market. Below is a quick snapshot of each, followed by a detailed comparison table.
Cialis contains the active ingredient tadalafil, discovered in 2003. It’s famous for its "weekend pill" reputation because a single 10mg dose can work for up to 36hours.
Levitra (vardenafil) was approved in 2003 and shares a similar onset to Viagra but is sometimes preferred by men who experience visual disturbances with sildenafil.
Stendra (avanafil) entered the market in 2012. Its rapid onset-often within 15minutes-makes it a good option for couples who like spontaneity.
Generic sildenafil is chemically identical to Viagra but sold under many brand names (e.g., Sildenafil Teva, Sildenafil Mylan). Cost savings are the main driver for its popularity.
| Medication | Active Ingredient | Typical Dose | Onset | Duration | Common Side Effects | Price Range (CAD) |
|---|---|---|---|---|---|---|
| Viagra | Sildenafil | 50mg | 30‑60min | 4‑6hrs | Headache, flushing, dyspepsia | $30‑$50 per tablet |
| Cialis | Tadalafil | 10mg | 30‑120min | Up to 36hrs | Back pain, muscle aches, indigestion | $35‑$60 per tablet |
| Levitra | Vardenafil | 10mg | 15‑30min | 4‑5hrs | Headache, flushing, rhinitis | $40‑$65 per tablet |
| Stendra | Avanafil | 100mg | 15‑30min | 6‑12hrs | Headache, dizziness, nasal congestion | $45‑$70 per tablet |
| Generic Sildenafil | Sildenafil | 50mg | 30‑60min | 4‑6hrs | Same as brand | $5‑$15 per tablet |
Dosage, Timing & Practical Tips
Choosing the right dose often starts low. For most men, 50mg of Viagra is a safe middle ground; those who experience side‑effects may drop to 25mg, while men who need extra potency can try 100mg. Cialis offers a daily low‑dose (2.5mg) regimen that maintains a steady blood level, useful for men who value spontaneity over planning.
All PDE5 inhibitors require sexual arousal to work-none are aphrodisiacs. If you’re on nitrates (common in heart disease), you must avoid these drugs because the combination can cause a dangerous drop in blood pressure.
Alcohol in moderation (one‑two drinks) usually won’t interfere, but heavy drinking can blunt the drug’s effect and increase the risk of dizziness.
Safety Profile & Side‑Effect Management
Serious adverse events are rare, but each medication carries its own nuance.
- Viagra: Headache is the most common complaint; taking it with a full glass of water can help.
- Cialis: Back pain usually appears 12‑24hours after dosing and fades within a day.
- Levitra: Some men notice a mild pink‑tinted vision, which is harmless and resolves quickly.
- Stendra: Slightly higher incidence of dizziness-stand up slowly.
All PDE5 inhibitors are contraindicated for men with severe cardiovascular disease, uncontrolled hypertension, or a recent history of stroke. A brief cardiac assessment by a physician is standard before prescribing.
Cost Considerations in 2025 Canada
Brand‑name Viagra remains the priciest option, largely because of marketing and brand‑recognition premiums. Generic sildenafil has reshaped the market; a 30‑day supply can cost under $50, making it accessible for most insurance plans.
Cialis’ longer duration may justify its higher price for men who dislike timing pills. Stendra, being newer, carries a premium that some patients are willing to pay for the 15‑minute onset.
Many provincial drug plans cover at least one PDE5 inhibitor for patients with documented erectile dysfunction, but coverage criteria vary. Checking with a pharmacist can reveal eligible discounts or patient‑assistance programs.
Choosing the Right Option for You
Think of the decision like picking a tool for a specific job. Ask yourself:
- Do I prefer a quick‑acting pill or a longer‑lasting one?
- Is cost a major factor?
- Do I have any health conditions that limit my choices?
- How often do I anticipate sexual activity?
If spontaneity wins, Stendra or a low‑dose daily Cialis may feel best. If you’re on a budget and don’t mind planning an hour ahead, generic sildenafil gives you the same results as Viagra without the brand markup.
Always start with a low dose, monitor how you feel, and discuss any concerns with a healthcare professional. A single follow‑up visit can fine‑tune the regimen and keep side‑effects in check.
Frequently Asked Questions
Can I take Viagra and Cialis together?
No. Combining two PDE5 inhibitors can cause a severe drop in blood pressure and increase the risk of serious side‑effects. Stick to one medication at a time and follow your doctor’s dosing instructions.
Is it safe to buy online without a prescription?
In Canada, prescribing Viagra or any other PDE5 inhibitor without a valid prescription is illegal. Unregulated online sellers may provide counterfeit drugs, which can be ineffective or dangerous. Use a licensed pharmacy.
Do natural supplements work as well as prescription pills?
Supplements like L‑arginine or yohimbine have limited, mixed evidence. They may help mildly in some men, but they don’t match the proven efficacy of sildenafil, tadalafil, vardenafil or avanafil. Talk to your doctor before mixing them with prescription meds.
What should I do if I experience a painful erection lasting >4hours?
Seek emergency medical care immediately. A prolonged erection (priapism) can damage penile tissue. Prompt treatment is essential, regardless of which PDE5 inhibitor you used.
Can I use Viagra if I have high blood pressure?
Often yes, as long as blood pressure is controlled and you’re not on nitrate medications. Your physician will check your cardiovascular status before prescribing.
Next Steps & Troubleshooting
If you’ve decided on a medication but the first dose doesn’t work as expected, try these quick fixes:
- Take the pill on an empty stomach or after a light meal.
- Give it a full hour before intimacy-some men need a bit more time.
- Check for interacting substances (e.g., certain antibiotics, antifungals, or grapefruit juice).
- Consider a dose adjustment with your doctor’s guidance.
When side‑effects feel too strong, reduce the dose or switch to an alternative with a different side‑effect profile-for example, moving from Viagra to Cialis if you experience frequent headaches.
Remember, the right drug is the one that fits your lifestyle, health status, and budget. With the right information and a little trial‑and‑error under medical supervision, you’ll find an effective solution that helps you enjoy intimacy again.
