Compare Viagra (Sildenafil) with Alternatives: What Works Best for You
ED Medication Comparison Tool
Find the Best ED Medication for You
Based on your needs, preferences, and health factors, we'll help you determine which medication might work best for you.
Answer a few questions
Select your preferences to get personalized recommendations based on the latest medical evidence.
Your Recommendation
If you're looking at Viagra (Sildenafil) for erectile dysfunction, you're not alone. Millions of men use it every year. But it’s not the only option-and it’s not always the best fit. Some people can’t take it because of side effects. Others find it doesn’t last long enough. Some just want something that works faster or doesn’t need to be taken on an empty stomach. The good news? There are real alternatives, each with their own pros and cons. This isn’t about marketing hype. It’s about what actually works in real life, based on how these drugs behave in your body.
What Sildenafil (Viagra) Actually Does
Viagra is the brand name for Sildenafil. It’s a PDE5 inhibitor. That means it helps relax blood vessels in the penis so more blood can flow in during sexual arousal. It doesn’t cause an automatic erection-you still need stimulation. The standard dose is 50 mg, taken about an hour before sex. It can work as early as 30 minutes, but food, especially fatty meals, can delay it by up to an hour. Its effects last about 4 to 5 hours.
Side effects? Common ones include headaches, flushing, indigestion, and nasal congestion. Less common but serious: sudden vision or hearing loss (rare, but reported). It also can’t be mixed with nitrates (like nitroglycerin for heart issues), because that combo can drop your blood pressure dangerously low.
Cialis (Tadalafil): The Long-Lasting Option
If you want flexibility, Cialis (Tadalafil) might be your best bet. It lasts up to 36 hours-hence the nickname "the weekend pill." That means you don’t have to time it right before sex. You can take it once a day at a lower dose (2.5 mg or 5 mg) for ongoing use, or a higher dose (10 mg or 20 mg) as needed.
Studies show Tadalafil works just as well as Sildenafil for improving erections. But it’s less affected by food, so you can take it with a meal. Side effects are similar: headache, back pain, muscle aches. Some men report lower back discomfort, especially at higher doses. It’s also the only ED drug approved for treating benign prostatic hyperplasia (BPH), so men with both ED and enlarged prostate often choose it.
Levitra (Vardenafil): Faster, But Shorter
Levitra (Vardenafil) kicks in faster than Viagra-sometimes in 25 minutes. It’s also less affected by food, though high-fat meals still slow it down a bit. Its duration is about 4 to 5 hours, similar to Sildenafil. The standard dose is 10 mg, taken 60 minutes before sex.
One advantage? It might be better tolerated by men with diabetes or after prostate surgery. A 2018 study in the Journal of Sexual Medicine found Vardenafil had slightly higher success rates in men with diabetes compared to Sildenafil. Side effects are similar: headache, stuffy nose, dizziness. But it’s not recommended for men with severe liver disease.
Stendra (Avanafil): The Speed Demon
Stendra (Avanafil) is the newest oral ED medication approved in the U.S. (2012). It starts working in as little as 15 minutes-faster than any other pill. It’s also less likely to cause visual side effects like blue-tinted vision, which can happen with Sildenafil. Doses range from 50 mg to 200 mg, taken 15 to 30 minutes before sex.
It’s not affected by food, so you can eat normally. It lasts about 6 hours. Clinical trials show it’s effective in men with ED after prostatectomy. Side effects are mild: headache, flushing, nasal congestion. But it’s more expensive than generics, and insurance doesn’t always cover it.
How Do They Compare? A Quick Breakdown
| Medication | Active Ingredient | Start Time | Duration | Food Impact | Typical Dose |
|---|---|---|---|---|---|
| Viagra | Sildenafil | 30-60 minutes | 4-5 hours | High-fat meals delay it | 25-100 mg |
| Cialis | Tadalafil | 30 minutes | up to 36 hours | Minimal | 5-20 mg (daily or as needed) |
| Levitra | Vardenafil | 25-60 minutes | 4-5 hours | Moderate delay with fatty meals | 5-20 mg |
| Stendra | Avanafil | 15-30 minutes | 6 hours | No impact | 50-200 mg |
Which One Should You Choose?
There’s no single best drug. It depends on your life, your body, and your goals.
- If you want spontaneity and don’t want to plan sex around a pill, go with Cialis.
- If you need something fast and don’t want to wait an hour, try Stendra.
- If you have diabetes or had prostate surgery, Levitra might work better for you.
- If cost is a big factor and you’re okay with timing it, Sildenafil (generic Viagra) is the cheapest and most tested.
Also, consider your health. If you have heart disease, liver issues, or take other medications, talk to your doctor. Some ED drugs interact badly with alpha-blockers (used for high blood pressure or BPH) or certain antifungals. Your doctor can help you avoid dangerous combos.
What About Natural Alternatives?
Online ads promise miracle cures: L-arginine, ginseng, horny goat weed, pomegranate juice. Some of these have tiny studies behind them, but none have the same level of proof as prescription PDE5 inhibitors. A 2020 review in European Urology found no natural supplement consistently outperformed placebo for ED.
That doesn’t mean lifestyle changes don’t help. Losing weight, exercising, quitting smoking, and cutting back on alcohol can improve erectile function as much as medication-for some men. In fact, men who combine healthy habits with low-dose Cialis often see better results than those who rely on pills alone.
What If Nothing Works?
Oral meds don’t work for everyone. About 20-30% of men don’t respond to PDE5 inhibitors. Reasons include nerve damage from diabetes, low testosterone, or psychological factors.
If pills fail, other options exist:
- Injections (alprostadil) directly into the penis-work fast, effective even if pills don’t.
- Urethral suppositories (MUSE)-inserted into the urethra.
- Penile implants-surgical, permanent solution for men who want reliability.
- Vacuum pumps-non-invasive, FDA-approved, work for most men.
These aren’t "last resorts." They’re valid tools. Many men who tried pills first and switched to injections say they wish they’d tried them sooner.
Prescription and Cost: What You Need to Know
Viagra (brand) can cost $70 per pill in the U.S. Generic Sildenafil? Around $10-$15 per pill. Cialis brand is $15-$20 per pill. Generic Tadalafil? As low as $2-$4. Prices vary by pharmacy and insurance. Online pharmacies can be cheaper-but only use ones that require a prescription and are verified by the National Association of Boards of Pharmacy (NABP).
Don’t buy from sites that don’t ask for a prescription. Fake ED pills are common. Some contain hidden doses of Sildenafil or even toxic substances. The FDA has warned about pills laced with methamphetamine, rat poison, or heavy metals.
Final Thoughts: It’s Not One-Size-Fits-All
Viagra (Sildenafil) is a proven, effective treatment. But it’s not the only one-and it’s not always the best one. The right choice depends on how quickly you need it to work, how long you want it to last, what else you’re taking, your budget, and your lifestyle.
Don’t just take the first prescription you’re given. Talk to your doctor. Ask about alternatives. Try one. If it doesn’t work, try another. ED is treatable. You just need to find the right tool for your body.
Can I take Viagra and Cialis together?
No. Never mix different PDE5 inhibitors like Viagra, Cialis, Levitra, or Stendra. They all work the same way. Taking more than one increases your risk of dangerous side effects like low blood pressure, dizziness, fainting, or priapism (a painful, prolonged erection). Stick to one at a time, and only as directed by your doctor.
Is generic Sildenafil as good as brand-name Viagra?
Yes. Generic Sildenafil contains the exact same active ingredient as Viagra. The only differences are the inactive fillers, shape, color, and price. The FDA requires generics to meet the same standards for effectiveness and safety. Many men save hundreds per month by switching to generic.
Why does my ED medication stop working over time?
It’s rarely the drug itself. More often, it’s changes in your health. Weight gain, worsening diabetes, new medications (like antidepressants), or increased stress can reduce effectiveness. Low testosterone is another common cause. If your ED med isn’t working like it used to, talk to your doctor. You might need a different dose, a different drug, or to address an underlying condition.
Can I take ED meds if I have heart problems?
It depends. If you take nitrates for chest pain, you cannot take any PDE5 inhibitor-it’s dangerous. If you’ve had a heart attack, stroke, or severe heart failure in the past 6 months, you should avoid them until cleared by your cardiologist. Many men with stable heart disease can take ED meds safely, but only under medical supervision.
Do these drugs increase libido or sexual desire?
No. None of these medications increase sex drive. They only help you get and keep an erection when you’re sexually aroused. If you’re lacking desire, that’s a different issue-possibly linked to low testosterone, depression, or relationship stress. Talk to your doctor about testing your hormone levels or exploring therapy options.
Next Steps
Start by talking to your doctor. Bring up all your concerns: what’s working, what’s not, what side effects you’ve noticed. Ask for a trial of another medication if one didn’t work. Keep a simple log: date, dose, food eaten, time to effect, duration, side effects. That helps your doctor adjust your treatment.
If cost is a barrier, ask about patient assistance programs. Many manufacturers offer discounts for generic versions. Some pharmacies have $4 prescription lists. Don’t risk your health with unverified online sellers.
ED is common. It’s treatable. And you don’t have to settle for a pill that doesn’t fit your life. There’s another option out there-and it might be closer than you think.
