The split I actually stamp on the blotter
Head-to-head efficacy in decent trials sits in the same neighborhood when each drug is at a labeled evening dose. Men who swear one is magic and the other is water are usually describing food, headache, a blue tinge, or a rhythm drug - not a secret potency ranking. I start there so a price shopper stops treating 10 mg as a dare against 100 mg.
Shared holds first, always. Nitrates. Guanylate-cyclase stimulators. Sex that the heart cannot afford. Priapism past four hours. Sudden vision or hearing change. Those are class stamps. They do not pick a winner. They can disqualify both. The vardenafil vital and the sildenafil vital repeat that on purpose.
What remains is trim. Clock after a heavy plate. QT and class IA or III antiarrhythmics. PDE6 flicker. Orodispersible Staxyn versus no standard sildenafil ODT in the US. Cost and which generic the pharmacy actually stocks. That is a real conversation. It is not a forum poll.
Two dinner clocks, not one shared hour
| Hold on the chart | Levitra 10 mg (vardenafil) | Viagra tablet (sildenafil) |
|---|---|---|
| Median Tmax, fasted | About 60 min (30 min-2 h) | About 60 min |
| Useful evening | About 4-6 h | About 4-6 h |
| High-fat plate | Cmax down 18-50% | Larger Cmax cut, Tmax later |
| Usual labeled steps | 5 / 10 / 20 mg | 25 / 50 / 100 mg |
| QT paragraph | Yes - avoid IA/III, congenital LQTS | No matching caution |
| PDE6 visual flicker | Less often the story | Blue tinge is the classic |
| ODT in US | Staxyn 10 mg, not mg-equal | No standard ODT |
Both labels allow food. Both high-fat meals still move the peak. Vardenafil film-coated 10 or 20 mg: Cmax down 18 to 50 percent after a high-fat meal. Sildenafil's classic food story is a roughly 29 percent Cmax cut and about an hour of Tmax delay after a heavy plate. I treat sildenafil as the more food-sensitive evening and vardenafil as the milder - not the absent - food hold.
If a man eats like a banquet and then blames the cheaper tablet, I do not switch molecules first. I move the plate. A lighter dinner keeps either median Tmax nearer the hour they planned. Alcohol stacks flush and hypotension on both. That is not a tie-breaker. That is evening hygiene.
Tadalafil is the long clock if the complaint is the calendar, not the plate. Different half-life, different daily option. Do not drag a 17-hour molecule into a 10-versus-50 milligram argument. The tadalafil vital is a separate strip.
I will say this once more because comparison shoppers skip it: a banquet plus either tablet is a peak hold. Switching brands to outrun dinner is the expensive way to learn what a lighter plate would have taught. Clock first. Molecule second.
QT lives on the Levitra line
The thorough QT work put 10 mg and 80 mg vardenafil against placebo and moxifloxacin. At one hour, 10 mg added about 8 msec on Fridericia. Eighty milligrams added about 10. Moxifloxacin 400 mg looked similar. A later combination study showed additivity with another QT-active drug. That is why congenital long QT and class IA or III agents are avoid, not watch-and-see.
Sildenafil does not carry that paragraph. If a man is already on amiodarone or sotalol and cardiology still wants a PDE5, I do not pick Levitra 10 mg to be clever. I pick the molecule without the QT stamp - or I pick no PDE5. Rhythm plus nitrate plus sex workload is how charts get ugly.
Small msec in a healthy volunteer is not a parlor trick you ignore because you feel fine. Torsades is a rare, ugly vital. I would rather lose a sale of a cheap 10 mg order than pretend the split is theoretical. Full cardiac order: heart reviews before you buy 10 mg.
Blue tinge lives on the Viagra line
Sildenafil's PDE6 activity at the retina is the reason some men get a blue or hazy wash for a few hours. It is usually transient and annoying. It is not NAION. NAION is a sudden vision-loss emergency on the whole class. Do not let a color wash talk you out of a same-day exam if a field actually goes dark.
Vardenafil is less of a PDE6 story for most people. That can be a reason to try 10 mg if the blue tinge ruined sildenafil evenings that otherwise worked. It is not a reason to ignore headache, flush, or the QT list. Cross-selectivity is a preference lever. It is not a safety waiver.
How the hold works on the vardenafil side is how 10 mg holds cyclic GMP. I will not re-teach the cascade here. Comparison pages that reprint the whole monograph are how sites start to clone themselves.
Milligrams are not a strength contest
Ten milligrams of vardenafil is a usual start. Fifty milligrams of sildenafil is a usual start on many labels; this network's sildenafil vital locks 25 mg for SERP, which is a real labeled step, not a slight. Twenty milligrams vardenafil is the film-coated ceiling. One hundred milligrams sildenafil is that drug's common ceiling. None of those numbers mean one tablet is twice as virile.
In-vitro IC50 gaps got translated into smaller vardenafil tablets so clinical AUC would rhyme. A man who swallows 20 mg Levitra next to 25 mg Viagra and declares a winner is comparing unmatched exposure. I shut that game down in clinic. Match the labeled evening, then compare how the night felt and what the side-effect vital looked like.
Cost will swing with which generic is on contract. Reviews that start with price and never mention QT or dinner are advertisements. I will mention price. I will not let it pick a rhythm-drug patient's molecule.
Staxyn is not a 10 mg film-coated swap
Staxyn is vardenafil 10 mg as an orodispersible tablet. It is not bioequivalent to a swallowed Levitra 10 mg. Different curve. Different prescribing decision. Dissolve on the tongue. Do not invent a water chase the label did not write. Do not break a film-coated 10 mg and call it Staxyn.
Sildenafil has no everyday US ODT twin in the same way. That is a convenience split, not an efficacy crown. If a man cannot swallow tablets, we talk formulations with a prescriber. We do not crush and hope.
Dose-adjustment holds - age, Child-Pugh B, alpha-blockers, CYP3A4 - still apply to the vardenafil family. They are not erased because the tablet melts. Clock detail: when to take cheap 10 mg around dinner.
When I pick one tablet over the other
I lean sildenafil when the QT list is dirty or the man already knows that molecule and only needs a food talk. I lean vardenafil 10 mg when sildenafil's blue tinge or food cliff was the actual problem and the ECG and med list are clean. I lean tadalafil when the complaint is the calendar.
Headache on one agent is not a promise the other is gentle. Class vasodilation is class vasodilation. A lower dose, water, and less alcohol are cheaper experiments than a brand hop. Persistent headache at a dose that works still needs a prescriber, not a second anonymous bottle.
Unstable angina, a fresh infarct, or a nitrate that cannot be retired: I pick neither. The comparison ends. AE noise versus signal: flush after 10 mg is usually noise.
What I leave after the split
Same brake. Two clocks. One QT line. Buy or order whichever labeled tablet survives those stamps - Levitra 10 mg or a Viagra-strength sildenafil - only after a clinician has seen the list. Cheap is allowed. Careless is not.
The FDA Levitra label and the sildenafil insert are the texts I trust when a review site compresses this into a winner graphic. I do not sign winner graphics.
Reader consultation
Your questions, answered by Dr. Raymond Osei, MD
Urology - signs the PDE5 vitals
Comparison consults here are clock, QT, and PDE6 - not milligram trophies. If your question is which pill is stronger, I will rewrite the question.
Anton G., 58, asks: Viagra gives me a blue wash. Is Levitra 10 mg the automatic switch?
Often a reasonable trial if nitrates are out and the QT list is clean. Vardenafil is less of a PDE6 story for most men. Automatic is the word I will not use. You still need a prescriber who has seen the list.
If the blue wash was actually a dark field or a sudden drop in vision, that is NAION territory - class emergency, not a color preference. Stop the drug and get same-day eyes, not a brand hop.
Rina S., 64, asks: He is on amiodarone. A friend said Levitra is stronger so we should buy that.
Amiodarone is class III. Vardenafil's QT paragraph says avoid. Stronger is a meaningless word here. I would not pick Levitra 10 mg to impress a friend.
If cardiology still wants a PDE5, sildenafil is the molecule without that QT stamp - and nitrates still exclude the whole class. Bring both inserts to the visit. Do not let a friend dispense rhythm advice.
Pavel M., 50, asks: Is 10 mg Levitra equal to 100 mg Viagra? I want the stronger one cheap.
No. Usual clinical rhyme is closer to 20 mg vardenafil with 100 mg sildenafil, and even that is a teaching approximation, not a conversion calculator. Ten milligrams is a start, not a ceiling match.
Cheap is fine. Unmatched milligrams are how men overdose one agent while calling the other weak. Pick a labeled evening, try it fairly, then titrate with a clinician.
Helen C., 47, asks: We eat late. Which tablet forgives the plate?
Neither fully forgives a banquet. Vardenafil's high-fat Cmax cut is 18 to 50 percent. Sildenafil's food hit is usually the steeper one. If late dinner is the lifestyle, I still move the plate or move the swallow - I do not promise a food-proof PDE5.
A lighter plate plus a 60-minute lead is the experiment that should happen before you pay for a second brand. Tadalafil is the conversation if the real wish is less clock-watching, not a greasier steak.
Diego L., 61, asks: Can I keep Viagra in the house and use Levitra 10 mg when I want a change?
Not as a cocktail and not as two tablets in one 24-hour window. Class labeling warns against combining ED therapies. Switching on different nights is a prescriber plan, not a drawer buffet.
If you do switch under advice, keep the holds identical - nitrates, QT list, alcohol. A brand change is not a holiday from the chart.
Sable W., 55, asks: Reviews say Levitra works faster. Is that why I should order it?
Median Tmax values sit in the same hour-ish neighborhood when both are fasted. Faster is often a food story or a memory of one good night. I will not sell a clock that the PK tables do not show.
Order the tablet that survives QT, cost, and how your last agent felt. Speed as a marketing word is how people swallow too late, then swallow again. That is a frequency-hold violation.
Kenji T., 49, asks: Staxyn 10 mg versus a swallowed Levitra 10 mg - which wins the comparison?
They are not interchangeable. Staxyn has its own absorption. Winning is the wrong verb. If you cannot swallow, discuss ODT with the prescriber. If you can swallow, I default to the film-coated 10 mg we have PK language for on this strip.
Do not substitute them milligram for milligram because the boxes both say 10. That is how ODT and tablet mix-ups happen at the cabinet.
Lila H., 52, asks: His headache on sildenafil was brutal. Will vardenafil spare him?
Maybe. Individual vasodilation differs. Maybe not. Headache is a class AE. Water, a lower dose, and less alcohol are the first holds I stamp before I spend money on a hop.
If 10 mg vardenafil still splits his skull at a dose that works, that is a tolerability fail. We look at other classes or other ED paths. We do not keep climbing milligrams to outrun a headache.
Boris E., 70, asks: I am 70. Should the comparison start at 5 mg Levitra or 25 mg Viagra?
Age 65 and older: vardenafil concentrations run higher - about 34 percent Cmax and 52 percent AUC in the elderly study - so a 5 mg Levitra start is the labeled consideration. Sildenafil also has age and interaction stories. I do not start either man at a ceiling because he wants a bargain.
The comparison at 70 is still QT, nitrates, and workload. Milligram shopping comes last. A clinician who has met you picks the first tablet.
General education from a clinician, not personal medical advice. Bring your own history to your own prescriber.