Levitra vs Cialis

Levitra and Cialis are drugs used in the management of erectile dysfunction manufactured by Bayer Limited and Lilly ICOS limited respectively. Even though they have the same major clinical indication, they a number of differences, and these are highlighted below.

Active Constituents

levitra_vs_cialisThe active constituent in Levitra is a Phosphodiesterase-5 (PDE5) inhibitor known as Vardenafil while in Cialis, the active constituent is a PDE5 inhibitor known as Tadalafil. In Levitra, the vardenafil molecule is usually derivatized to a hydrochloride salt, primarily to improve on the solubility of the molecule, whereas in Cialis, the tadalafil molecule is not derivatized to any compound, and is used just as it is.

Clinical Indications

Primarily, the major indication for Levitra is in the management of erectile dysfunction. This is attributable to its PDE5 inhibition properties that result in the build up of cyclic guanosine monophosphate that causes penile arterial vasodilatation leading to increased blood flow to the corpus carvenosum resulting in erection. In addition, this drug has also been found useful in the management of premature ejaculation.

Primarily, the major indication for Cialis is the in the management of erectile dysfunction. It’s mechanism of action is similar to the one elucidated for Levitra. Cialis has also been approved for use in the management of benign prostatic hyperplasia, and the active constituent, tadalafil, has also been used in the management of pulmonary arterial hypertension.

Pharmacokinetics

Vardenafil_structureLevitra has been formulated as a round orange tablet, available in for different dosing ranges, that is, 2.5 mg, 5 mg, 10 mg and 20 mg. It has a duration of action of about 4 to 5 hours, can be taken with or without food, and optimally should be take 1 to 2 hours before the commencement of sexual activity. It should be taken a maximum of once daily and taken pro re nata (as needed).

Cialis has been formulated as an almond-shaped yellow film-coated tablet, available in four different dosing ranges, that is 2.5 mg, 5 mg, 10mg and 20 mg. It has a very long duration of action, about 18 hours, and as such it has been coined as ’The Weekend Pill’. Cialis can be taken with or without food, and for the management of erectile dysfunction, it should be taken pro re nata(as needed) or once daily, and for the management of benign prostatic hyperplasia, it should be taken once daily only.

Side Effects

Due to the fact that these two drugs are PDE5 inhibitors, they share most of the side effects caused by vasodilatation arising from the PDE5 inhibition such as running or stuffy nose, muscle pain, joint pain, flushing and gastrointestinal disturbances such as dyspepsia, burping, and acid reflux.

However, it has been noted that Levitra is especially associated with nausea.

Selectivity of the Phosphodiesterase IsoenzymesIn addition to PDE5, these agents inhibit other PDE enzymes. Levitra inhibits PDE6, found in the eye, more as compared to Cialis. This causes the users of Levitra to develop a bluish tinge perception and may also develop increased photosensitivity.

Levitra also inhibits PDE1, found in the vascular smooth muscle, more as compared to Cialis. As such there is more vasodilatation, flushing and tachycardia associated with Levitra.

On the other hand, Cialis inhibits PDE11, found in the skeletal muscles, more as compared to Levitra.

In conclusion, both the drugs are equally effective. However the selection of which drug to use should depend on the presence of co-morbid conditions, e.g. if BPH coexists then Cialis should be chosen and if premature ejaculation exists, Levitra should be chosen, the desired duration of action, the patient’s tolerance to nausea and the concomitant drugs that the patient is on.

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