Ask the Doc :: Viagra vs. Levitra

Question:
Dear Doctor Jason,

What's the difference between Levitra and Viagra? Are they really the same?

Signed, Hard Up

Doctor Jason's Response:

Viagra (sildenafil) and Levitra (vardenafil) are medications in the class of medications called phosphodiesterase inhibitors, used to increase the size of the blood vessels that lead to the penis, allowing for erections to take place.

That's the technical explanation, anyway. :-)

The primary differences between them are their half-lives and their prices, with Levitra having a little longer of an effect and costs more. The other drug in this class is Cialis (tadalafil), which has the longest half-life, and it also costs more than Viagra does. All of them have similar side effects, such as headache and facial flushing.

Those are the official side effects, anyway. :-)

There have been reports of Viagra causing a bluish visual disturbance; this is limited to the length of the activity of the drug, so you won't continue thinking you're living in a Smurf universe. Based on how they work, these medications also have the risk of causing heart attacks, especially if you are already taking a nitrate medication (e.g., Nitroglycerin or Isosorbide).

One dreaded adverse effect is called priapism, which is a sustained erection. Although initially it sounds like a great idea, it is quite dangerous as the blood gets stuck within the penis, and if the blood doesn't flow, it clots. If the blood clots or is not flowing, then the tissue of the penis is not getting any oxygen. This will result in dead tissue, which cannot be regenerated and has to be removed.

And I think we all know what that means.

So... if your erection remains solid for more than 4 hours, then you should seek emergent medical care. Like, right away.

Otherwise, the choice between these meds is up to you; there's no "hard" distinction beyond what I've described above.

Stay healthy,
Doctor Jason

Dr. Faulhaber is a graduate of Tulane University in Psychology and Cellular and Molecular Biology and received his medical degree from the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School. He performed his residency training in Internal Medicine and Pediatrics at Saint Vincent's Hospital in Manhattan, where he then served as a Chief Resident in Internal Medicine. He completed his fellowship in Infectious Diseases at New York University, where he specialized in HIV/AIDS, Hepatitis, and fungal infections. Since fellowship, he has been working as an Internal Medicine/Infectious Diseases physician at Fenway Community Health in Boston. He is a Clinical Instructor in Medicine at Harvard Medical School, and he is affiliated with Beth Israel Deaconess Medical Center. He has been the lead author or co-author of several journal articles and textbook chapters on infections with HIV, other viruses, bacteria, and fungi. He is also accredited by the American Academy of HIV Medicine.

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