Over the past 20 years, awareness of erectile dysfunction, and the treatments for it, have risen exponentially; and now, men are more ready to seek help for the condition than they previously have been.

Consequently, the treatment market has grown, as has the range of medicines available for the condition. 

In fact, there are so many medicinal solutions for erectile dysfunction now that, when comparing ED treatments, it can be daunting to know which direction to head in.

While other forms are being introduced onto pharmacy shelves and explored by medicine developers, pills remain the preferred choice for many. However, even if you’ve managed to narrow it down to this form, you’re still faced with a choice. 

Viagra, Spedra, Cialis and Levitra: What’s the Difference?

For men wondering whether to take Cialis or Levitra, or Spedra or Viagra, it can be tricky to know which might work best for them. They are all viable PDE5 inhibitor tablet options for those looking to tackle their erectile dysfunction. But what are the fundamental differences between these products? Do they do the same job, or does each pill have its own individual advantages?

To help, we thought it might be useful to compare the particular characteristics of each erectile dysfunction pill, and the situations they are more suited to. 

Comparing different ED pills

Let’s start with Cialis. 

Cialis uses the active ingredient tadalafil, an effective PDE5 inhibitor. 

Benefits of Cialis

Duration and timing 

Benefits of CialisThis drug has been developed by Lilly in two forms: as a daily pill, and as a ‘weekend’ pill.

So what’s the main difference between Cialis and Viagra? The regular or ‘weekend’ pill is so-called because one dose lasts for up to 36 hours after being taken, in comparison with Viagra’s mere five hours. So, while you’ll need to take it around 30 minutes before you plan to have sex, it will remain active for a day and a half afterwards, enabling spontaneity during this period.

Furthermore, those who take Cialis Daily, which contains a smaller dose but is designed to be taken once a day, do not have to wait 30-60 minutes for the tablet to work. This medicine works 24 hours a day, and is suitable for those men who plan to have sex three (or more) times over the course of a week. 

That doesn’t mean that you’ll have a constant erection all the time, but rather that the drug will kick into action when you’re sexually stimulated.

Cialis vs Viagra: Efficacy 

Cialis is a strong performer especially when pitted against its close competitor Viagra. Study results indicate only a slight percentage difference between the two when assessing erections for vaginal penetration. 

Cialis may be less likely to cause some side effects, such as tachycardia and blurred vision in comparison to Viagra or Levitra. However, some of the more common side effects experienced when taking Cialis include headache, back pain, blocked nose, indigestion, reflux and muscular pain.

There is now a generic version of Cialis, called Tadalafil, which is available as both a weekend and a daily pill. This tends to be cheaper to buy than the branded version.

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Verdict: The daily version is great for those who don’t mind taking a pill every day, and plan to have sex around two to three times a week.

Next up: Levitra. This ED tablet contains the active substance known as Vardenafil, another PDE5 inhibitor which dilates blood vessels in the penis in order to encourage blood flow. 

Benefits of Levitra

Duration and timing 

Benefits of LevitraLevitra is an on-demand treatment, much like Viagra. You take it as and when you need it and can expect to notice the effects in around 25 to 60 minutes. 

The drug stays active for up to five hours, offering plenty of time to enjoy its effects. 

Levitra vs Viagra, Cialis and Spedra

One advantage Levitra has over other ED drugs is that you can also get it in orodispersible form. This is a special type of tablet, which dissolves discreetly on the tongue, without the need for water; ideal for those looking to pop their treatment in their mouth with minimal fuss, and without disrupting the mood.


Levitra is a popular ED medication and produces good erection results in the majority of men that use it. Levitra can cause side effects in some of its users, the most common being headaches, indigestion, a stuffy or runny nose, dizziness and flushing.

Levitra isn’t the cheapest ED drug around, but there is a licensed generic version (Vardenafil) that should cost a little less.

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Verdict: Those looking for a subtle option might find the orodispersible pill is the best choice for them.

Spedra is one of the newer PDE5i products to enter the market.

Spedra benefits

Benefits of SpedraSpedra uses the active ingredient avanafil, a different PDE5 inhibitor to those found in Viagra, Cialis or Levitra, although it works in much the same way. Clinical trials found the median and higher doses of the drug were effective in over half of recorded cases

Spedra vs Viagra and Cialis: Speed 

One of the main differences between Spedra and its competitors is its speed. Spedra is reported to give results for some men in as little as 15 minutes of taking it. In comparison to Viagra, Levitra and even Cialis, which may take around half an hour or in some cases even longer to produce results.

So, while it is not as quick as Cialis Daily, which effectively works immediately, it is reported to be the fastest among the other one-dose options.

You can expect to notice the effects of Spedra for around four to six hours, much like you would with Viagra or Levitra. 

The list of common side effects for Spedra is shorter in comparison with Viagra or Cialis. It includes headaches, flushing and nasal congestion. 

Generics: Spedra vs Levitra and other ED drugs

One important fact to note about Spedra is that it isn’t yet available as a generic medication, like other treatments are. So there isn’t currently a cheaper option than the branded version.

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Verdict: Ideal for users looking for speedy, on-demand results.

And finally: Viagra.

Viagra is the most well known treatment for erectile dysfunction. Manufactured by Pfizer, a well-established and trusted pharmaceutical brand, it has been used by millions of men over the course of close to 20 years. During this time it has established itself as the leading brand for the effective treatment of impotence.

But what are the advantages of using Viagra over other erectile dysfunction treatments?

Viagra benefits


Benefits of ViagraThe effects of Viagra can last for up to four hours.

However this doesn’t mean that an erection is sustained by the individual for four consecutive hours; The drug remains active in the body for up to four hours, but Viagra still needs sexual stimulation to work. 

Non-tablet ED treatments such as MUSE, Caverject and Vitaros tend to remain active for shorter periods of time (anywhere between 30 minutes and two hours). This shorter timescale might be viewed as an inconvenience for some men.


The majority of men that use Viagra are able to achieve an erection within 30-60 minutes of taking the tablet, when sexually stimulated.

If the tablet is taken following a large meal, the effects can take a little longer to develop.

Viagra is not the quickest acting ED medication available but it still suits many men.

Easy to take blue pill

The blue pill form of Viagra is perhaps one of its best known characteristics. Swallowing a tablet is an easy, discreet and convenient way to take medicine for lots of people.


Viagra remains a popular choice for men experiencing erectile difficulties because it is a highly effective medication. 

The treatment is available in three different dosage strengths (25mg, 50mg and 100mg). All three dosages have shown in clinical trials to provide positive erection results suitable for sexual intercourse (63 percent, 74 percent and 82 percent respectively).

A report which appeared in New York Daily News in 2015 stated that Viagra was ‘the most effective treatment for erectile dysfunction’.[1] It was based on a study of over 150 separate trials.

A patient’s Viagra dose usually starts at 50mg but can be increased or decreased by a doctor depending on the results it provides. Doing so can also reduce the likelihood of side effects. 

Years of clinical studies and trials have revealed Viagra to be a safe drug which is only likely to provoke mild to moderate side effects in a small proportion of its users. 

Price: Viagra vs Levitra, Cialis and Spedra

The branded version of Viagra might not be significantly cheaper than other branded options, but the generic version (Sildenafil) does the same job in the body and is usually the cheapest oral ED tablet treatment at most pharmacies. The price for four tablets is just under £10, which works out at around a third of the price of the branded version. 

There’s also a non-prescription version of this treatment called Viagra Connect. This doesn’t need to be issued by doctor or prescriber: a pharmacist can issue this drug after a short health screening with a patient. So in some cases, this version of Viagra may be more accessible to men than other alternatives (which require a doctor’s prescription).

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Verdict: Tried and tested by millions worldwide, Viagra is the most established erectile dysfunction treatment out there.

Pills are of course not the only option. Other forms of treatment are available for erectile dysfunction.

Page last reviewed:  29/09/2021