✓ Medically reviewed by · Last reviewed: May 2026
Pharmacy Researcher · 8 years experience
Pharmacy researcher with 8 years reviewing clinical drug information, generic formulation equivalence, and international pharmaceutical standards. Focuses on patient-facing accuracy in medication education.
- Fastest onset: Kamagra Oral Jelly (sildenafil) — 15–20 min, from $14.90
- Longest duration: Tadalafil (Vidalista, Tadarise) — up to 36 hours, from $11.70
- Lowest price per tablet: Fildena / Cenforce (sildenafil) from $7.00
- ED + premature ejaculation: Super P-Force (sildenafil + dapoxetine) from $8.50
- Absolute contraindication: All PDE5 inhibitors + nitrates (GTN, poppers) = dangerous hypotension
ED Pills Online: Sildenafil, Tadalafil, Vardenafil & Dapoxetine Compared (2026)
Last updated: May 2026 · Reviewed by the MedsBase Medical Team
Sildenafil ·
Tadalafil ·
Vardenafil ·
Dapoxetine ·
ED+PE Combos ·
Comparison Table ·
How to Choose ·
Safety & Contraindications ·
FAQ
There are now four distinct molecular classes of oral ED medication available as generics — sildenafil, tadalafil, vardenafil, and avanafil — plus the PE-specific molecule dapoxetine, which is often combined with an ED drug into a single tablet. All four PDE5-inhibiting molecules work by the same fundamental mechanism: they prevent the breakdown of cGMP in penile smooth muscle, which allows increased blood flow and sustained erection in response to sexual stimulation. The differences between them are duration, onset speed, food interactions, and side-effect profiles — not fundamental efficacy.
This guide covers each class, the generic brands available at MedsBase, and a head-to-head comparison table so you can pick the right molecule and formulation for your situation.
Sildenafil — The Original PDE5 Inhibitor
Sildenafil was the first PDE5 inhibitor to reach market (Viagra, 1998) and remains the most widely prescribed ED molecule worldwide. Its patent expired in 2013 in most markets, making it the most affordable option in generic form.
Pharmacology: Sildenafil is a selective PDE5 inhibitor with a plasma half-life of 3–5 hours. Peak plasma concentration (Tmax) occurs at 30–120 minutes after oral dosing. A high-fat meal delays absorption by up to 60 minutes and reduces peak concentration — take on an empty stomach or with a light meal for fastest, most reliable onset. The drug is metabolised primarily by CYP3A4 (and partly CYP2C9) in the liver; grapefruit juice can increase plasma levels by inhibiting intestinal CYP3A4.
Standard dose: 50 mg on-demand; adjust to 25 mg (tolerability) or 100 mg (efficacy). Do not exceed 100 mg per 24 hours.
Duration: 4–6 hours of enhanced erectile response when sexually stimulated.
Generic brands at MedsBase:
- Cenforce (Centurion Remedies) — the market-leading sildenafil generic globally. Standard 100 mg tablets. From $12 per pack.
- Fildena (Fortune Healthcare) — sildenafil in film-coated tablets. From $7 per pack. Available in multiple strengths.
- Kamagra Oral Jelly (Ajanta Pharma) — sildenafil 100 mg in flavoured gel sachets. Onset 15–20 minutes (faster than tablets due to oral mucosal absorption). From $14.90 per pack. Ideal for those who dislike swallowing tablets or want faster onset.
- Kamagra Effervescent — dissolves in water; fast onset, smooth absorption. From $12.
- Super P-Force — sildenafil 100 mg + dapoxetine 60 mg for simultaneous ED and premature ejaculation treatment. From $8.50.
Tadalafil — The 36-Hour Option
Tadalafil (originator: Cialis) is the only PDE5 inhibitor with a 17.5-hour half-life — long enough to provide a full 36-hour window of erectile enhancement, earning it the “weekend pill” label. This duration fundamentally changes the use pattern: instead of timing a tablet to an anticipated sexual encounter, you take tadalafil and remain ready for the next day and a half.
Pharmacology: Tadalafil is more selective for PDE5 vs PDE6 than sildenafil (which matters for visual side effects) and minimally affected by food or alcohol at moderate intake. It inhibits PDE11 to a modest degree — which has led to muscle ache in some users (a distinguishing side effect from sildenafil and vardenafil). Metabolised by CYP3A4.
On-demand dose: 10 mg (start) or 20 mg. Can be taken 30 minutes to 12 hours before sex — timing is flexible precisely because of the long half-life. Do not exceed 20 mg per 48 hours.
Daily dose: 2.5 mg or 5 mg taken every day at the same time, regardless of sexual activity. Achieves steady-state plasma levels that maintain constant erectile readiness. Preferred by men who want fully spontaneous sex without any pill-timing logistics.
Generic brands at MedsBase:
- Vidalista (Centurion Remedies) — the most-ordered generic tadalafil. Available in 10 mg, 20 mg, 40 mg, 60 mg, and daily 2.5/5 mg. From $11.70.
- Tadarise (Sunrise Remedies) — tadalafil in multiple strengths. From $12.
- Tadalista (Fortune Healthcare) — tadalafil 10/20/40 mg. From $14.
- Super Vidalista — tadalafil 20 mg + dapoxetine 60 mg for ED+PE. From $19.
Vardenafil — Highest PDE5 Selectivity
Vardenafil (originator: Levitra) has the highest in-vitro potency of the three first-generation PDE5 inhibitors — roughly 10× more potent than sildenafil by IC50. In clinical practice, this translates to effective doses at 5–20 mg, with a narrower dose range than sildenafil. Its PDE5/PDE6 selectivity is higher than sildenafil, which means a lower rate of visual side effects (blue-tinge, photosensitivity).
Key clinical advantage: Vardenafil performs better than sildenafil in two specific populations — men with type 2 diabetes (where sildenafil has lower relative efficacy due to altered cGMP pathways) and men who have had nerve-sparing radical prostatectomy. If sildenafil has failed in these contexts, vardenafil is the recommended PDE5 inhibitor switch before escalating to non-oral options.
Caution: Vardenafil has mild QTc-prolonging effects. Avoid in men taking Class Ia or III antiarrhythmics (quinidine, procainamide, sotalol, amiodarone). Less of a practical concern for otherwise healthy men than for those on cardiac medications.
Food: High-fat meals moderately delay absorption; a low-fat meal has minimal effect.
Duration: 4–5 hours.
Generic brands at MedsBase:
- Vitara-V (Healing Pharma) — vardenafil 20 mg tablets. From $26.
- Vitara-V Oral Jelly — vardenafil in gel sachet form for faster onset. From $32.
- Snovitra (RSM Enterprises) — vardenafil 20 mg. From $48.
Dapoxetine — Premature Ejaculation Specifically
Dapoxetine is the only oral medication specifically licensed for premature ejaculation (PE). It is a short-acting SSRI — unlike antidepressant SSRIs taken daily, dapoxetine is taken on-demand (1–3 hours before sex) and cleared rapidly (half-life ~1.5 hours). Its mechanism is inhibition of serotonin reuptake in the ejaculation reflex pathway in the brainstem, delaying ejaculation and extending IELT (intravaginal ejaculation latency time) by 2–3× in clinical trials.
Important: Dapoxetine does not treat erectile dysfunction and has no effect on erection quality. Men with both ED and PE should use a combination tablet.
Dose: 30 mg or 60 mg taken 1–3 hours before sex. Do not take more than once per 24 hours.
Side effects: Nausea (most common, 11–20%), headache, dizziness, dry mouth. The nausea is usually taken with food and a full glass of water. Orthostatic hypotension (dizziness on standing) is the clinically important effect — do not drive for 12 hours after taking.
Standalone dapoxetine at MedsBase:
- Poxet (Sunrise Remedies) — dapoxetine 30 mg / 60 mg. From $29.
- Priligy — the originator dapoxetine brand (Janssen). From $29. Available for those who specifically want the branded version.
- Duralast — dapoxetine 30 mg / 60 mg generic.
ED + PE Combination Tablets
Combination tablets pair a PDE5 inhibitor with dapoxetine in a single tablet, treating both erectile dysfunction and premature ejaculation simultaneously. This is a clinically validated approach — approximately 30–50% of men with ED also report PE, and treating one without the other often gives unsatisfactory outcomes.
- Super P-Force — sildenafil 100 mg + dapoxetine 60 mg. Fastest-onset combo. From $8.50.
- Super Vidalista — tadalafil 20 mg + dapoxetine 60 mg. Longer 36-hour ED window with PE control. From $19.
- Extra Super Tadarise — tadalafil 40 mg + dapoxetine 60 mg. Higher-strength tadalafil for treatment-refractory cases. From $18.
- Super Vilitra — vardenafil 20 mg + dapoxetine 60 mg. For the vardenafil responder who also has PE. From $19.50.
Head-to-Head Comparison
| Molecule | Onset | Duration | Food effect | Standard dose | From price | Best for |
|---|---|---|---|---|---|---|
| Sildenafil Cenforce, Fildena, Kamagra | 30–60 min (jelly: 15–20 min) | 4–6 h | High-fat meals slow absorption | 50–100 mg on-demand | $7 | Cost-conscious users, jelly/faster onset needed |
| Tadalafil Vidalista, Tadarise, Tadalista | 30–120 min | Up to 36 h | Minimal effect | 10–20 mg on-demand 2.5–5 mg daily | $11.70 | Spontaneous sex, flexible timing, daily option |
| Vardenafil Vitara-V, Snovitra, Zhewitra | 25–60 min | 4–5 h | Low-fat meal minimal impact | 10–20 mg on-demand | $26 | Diabetes, post-prostatectomy, sildenafil non-response |
| Dapoxetine Poxet, Priligy, Duralast | 1–3 h before sex | ~12 h | Take with food (reduces nausea) | 30–60 mg on-demand | $29 | PE only — no ED effect |
| Sildenafil + Dapoxetine Super P-Force | 30–60 min | 4–6 h | Light meal preferred | 100/60 mg | $8.50 | ED + PE, best value combo |
| Tadalafil + Dapoxetine Super Vidalista | 30–120 min | Up to 36 h | Minimal | 20/60 mg | $19 | ED + PE, long window preferred |
How to Choose the Right ED Pill
- You want the cheapest option that works → Fildena or Cenforce (sildenafil, from $7)
- You don’t want to time a pill closely → Vidalista or Tadarise (tadalafil, 36-hour window)
- You want fully spontaneous sex, no timing at all → Vidalista 2.5/5 mg daily
- You want the fastest possible onset → Kamagra Oral Jelly (sildenafil jelly, 15–20 min)
- You have both ED and premature ejaculation → Super P-Force (fastest) or Super Vidalista (longest window)
- Sildenafil didn’t work well for you → Try vardenafil (Vitara-V) or switch to tadalafil
- You have diabetes or had prostate surgery → Vardenafil or tadalafil preferred
Starting dose guidance: Most guidelines recommend starting sildenafil at 50 mg and tadalafil at 10 mg for on-demand use. Titrate up if efficacy is insufficient (to 100 mg and 20 mg respectively) or down if side effects occur. The most common reason PDE5 inhibitors appear “not to work” is insufficient sexual stimulation, taking too soon after a heavy meal (sildenafil), or patient expectation of spontaneous erection (these drugs require arousal — they are not aphrodisiacs).
Safety, Contraindications & Interactions
Common side effects (all PDE5 inhibitors): Headache (most common, 10–20%), facial flushing, nasal congestion, dyspepsia. Usually mild and resolve within 2–4 hours. Tadalafil additionally causes muscle/back ache in ~5% due to PDE11 inhibition in muscle tissue.
Visual side effects: Sildenafil inhibits PDE6 in retinal photoreceptors at therapeutic doses — transient blue-tinge vision, photosensitivity, or blurred vision in ~2–5% of users. Vardenafil and tadalafil have much lower PDE6 affinity and are preferred in men with pre-existing retinal conditions.
Cardiovascular safety: Large post-marketing studies confirm PDE5 inhibitors do not increase the risk of myocardial infarction or cardiovascular death in men with stable coronary disease. The concern is drug-drug interaction with nitrates (see above) and additive hypotension with alpha-blockers (give 4 hours between tamsulosin/doxazosin and any PDE5 inhibitor). Sexual activity itself requires moderate cardiovascular exertion — men who cannot tolerate the equivalent of walking two flights of stairs without symptoms should be assessed before starting PDE5 inhibitors.
Priapism: Erection lasting more than 4 hours is a medical emergency — seek immediate care. Risk is very low with standard doses but increases with overdose, use of recreational drugs (cocaine, MDMA), or sickle cell disease.
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Frequently Asked Questions
What is the difference between sildenafil, tadalafil, and vardenafil?
All three are PDE5 inhibitors that work by the same mechanism — blocking PDE5 to increase cGMP in penile smooth muscle, enhancing blood flow and erection in response to arousal. The key practical differences are duration (sildenafil 4–6 h; vardenafil 4–5 h; tadalafil up to 36 h), food interaction (sildenafil affected by high-fat meals; tadalafil and vardenafil less so), and side-effect profiles. Tadalafil’s 36-hour window is its defining advantage. Vardenafil’s higher PDE5 selectivity and better performance in diabetes/post-prostatectomy are its differentiators.
How quickly do ED pills work?
Sildenafil tablets: 30–60 minutes. Kamagra Oral Jelly (sildenafil): 15–20 minutes. Tadalafil: 30–120 minutes, but timing is much more flexible because of the 36-hour window. Vardenafil: 25–60 minutes. All require sexual stimulation — they do not produce an automatic erection.
Can I take ED pills with alcohol?
Moderate alcohol (1–2 drinks) is generally acceptable. Heavy alcohol amplifies hypotensive effects (dizziness, headache) and independently impairs erectile function. If an ED pill appears not to work after drinking, test it again without alcohol before concluding it’s ineffective.
Are ED pills safe with blood pressure medication?
Most antihypertensives (beta-blockers, ACE inhibitors, ARBs, CCBs) can be combined with PDE5 inhibitors with modest additive hypotension — space alpha-blockers (tamsulosin, doxazosin) by at least 4 hours. The absolute contraindication is nitrates: combining any PDE5 inhibitor with any nitrate preparation can cause severe fatal hypotension.
What is dapoxetine and is it different from other ED pills?
Dapoxetine is a short-acting SSRI for premature ejaculation — it delays the ejaculation reflex, not erectile function. It is not a PDE5 inhibitor and does not treat ED. Combination tablets (Super P-Force: sildenafil + dapoxetine; Super Vidalista: tadalafil + dapoxetine) treat both conditions simultaneously.
What is the cheapest effective ED pill?
Fildena and Cenforce (generic sildenafil) start from $7 per pack — approximately $0.70 per tablet. Kamagra Oral Jelly starts from $14.90. These contain the same active ingredient at the same dose as Viagra (which retails at $15–25 per tablet in US pharmacies without insurance).
How do I choose between daily tadalafil and on-demand sildenafil?
On-demand sildenafil is ideal when sexual activity is predictable and cost matters most. Daily tadalafil (2.5–5 mg) is ideal for fully spontaneous sex or when on-demand dosing causes bothersome peak side effects. On-demand tadalafil (10–20 mg) is the middle ground — wide timing window without the daily tablet overhead.
Are generic ED pills from India safe?
Generic ED medications from WHO-GMP certified manufacturers (Cipla, Centurion, Aurochem, Fortune Healthcare) are bioequivalent to their originator counterparts — same active ingredient, same dose, same efficacy and safety profile. The risk is in supply chain provenance, not the molecule. MedsBase sources exclusively from WHO-GMP certified manufacturers.
Written by
Sophie ChenPharmaceutical Content Researcher · 8 years experience
Sophie Chen is a pharmaceutical content researcher with 8 years covering generic medication access and clinical pharmacology. She specialises in international regulatory frameworks, bioequivalence standards, and patient-facing education on therapeutic drug classes. She is not a clinician.