Three uses, one overlay
This sheet is a compare of labelled uses, not a shop. Cash for each INN lives on that plan page. The class block below is literacy only.
Cialis, Viagra, and Levitra share one contraindication that this overlay will not soften: organic nitrates and riociguat. Swapping the brand on the blister does not retire a GTN spray.
The uses question men actually ask is which tablet matches their evening. Daily 5 mg tadalafil answers spontaneity and, uniquely among this trio, labelled BPH. 100 mg sildenafil answers a short, familiar ceiling after a 50 mg chapter. 10 mg vardenafil answers a potent start with a QT gate in front of it.
Never combine two columns the same day. A class switch waits long enough for the first half-life to matter - about a day after sildenafil or vardenafil, longer after a tadalafil 20 mg PRN night.
When a switch between uses is reasonable
Meal failures on sildenafil after a fasted retry: tadalafil is the food-agnostic column, or vardenafil if a short window is still wanted and QT is clean.
Timer fatigue on any PRN drug: tadalafil 5 mg daily is the only daily ED use in this trio. That is a habit change, not a one-night rescue.
BPH symptoms arriving on top of ED: tadalafil 5 mg daily is the dual-label member. Sildenafil folklore about the prostate is not a BPH indication.
New class IA/III antiarrhythmic: vardenafil leaves first. The other two still need a cardiology sentence; they are not automatically innocent.
Headache on every column after fair low-tier trials: the class may be the wrong tool. Urology has other paths. An overlay cannot invent a fourth oral PDE5.
Washout math when leaving a column
Leaving sildenafil or vardenafil for another short column: a calendar day is the starting conversation in ordinary livers. Inhibitor lists stretch that. Ritonavir plus vardenafil stretched half-life to 26 hours in the study - that man is not on a one-nap washout.
Leaving a tadalafil 20 mg PRN night: think in a couple of days, not in a morning. Leaving daily 5 mg: the trough is the point; you cannot 'skip Friday and add Viagra Saturday' without leftover exposure.
Entering vardenafil from any column: re-check QT drugs before the first 10 mg. Entering sildenafil: re-check the meal plan and the 25 mg special-population list. Entering tadalafil daily: re-check BPH plus alpha-blocker dual-therapy cautions and the CrCl under 30 footnote.
Insurance that switches the INN at the window is still a washout event. The new blister does not erase the old half-life. Ask the pharmacist to name both dates. This overlay will not invent a class coupon to make the switch prettier.
Food and clock differences that change uses
Sildenafil is the meal-sensitive workhorse. A high-fat meal delays Tmax by about 60 minutes and cuts Cmax by about 29%. Men who test 100 mg after fondue are testing dinner. Details sit on the sildenafil meal markup.
Vardenafil may be taken with or without food, and high-fat meals still cut Cmax by 18-50% in the food-effect studies. Moderate fat was kinder. The onset plan markup is the place for the fast-peak claim.
Tadalafil may be taken without regard to food. That is why travel drafts often prefer it, and why the weekend draft markup talks about a 36-hour PRN tail rather than a skipped peak. Daily 5 mg removes the timer altogether - see the daily plan markup.
Half-lives: tadalafil about 17.5 hours; sildenafil about 4 hours; vardenafil about 4-5 hours unless ritonavir stretches it toward 26 hours. Duration of a useful erection is not the same number as half-life, but the order of the three clocks follows that rank.
What each labelled use is actually for
Tadalafil (Cialis) is licensed for erectile dysfunction, for BPH symptoms, and for both together. The lock on the tadalafil plan is 5 mg once daily. As-needed 10-20 mg with a 36-hour labelled window remains on the same document and is a different pattern. Adcirca PAH doses do not belong in this overlay's ED cells.
Sildenafil (Viagra) is licensed for ED. The lock on that plan is 100 mg, the ceiling. The usual start on the Pfizer label is still 50 mg. Revatio PAH dosing is a different brand block.
Vardenafil (Levitra) is licensed for ED. The lock is 10 mg, the labelled start. Staxyn ODT 10 mg is another product. Congenital long QT and class IA/III antiarrhythmics can retire this column before a first fill.
None of the three treats low desire, partner pain, or a relationship argument. If the erection is not the problem, the overlay is the wrong sheet.
| Use question | Tadalafil | Sildenafil | Vardenafil |
|---|---|---|---|
| Licensed ED | Yes - daily 2.5-5 mg or PRN 5-20 mg | Yes - 25-100 mg PRN | Yes - 5-20 mg PRN |
| This site's lock | 5 mg daily | 100 mg ceiling | 10 mg start |
| Licensed BPH | 5 mg daily | No | No |
| PAH brand on the same INN | Adcirca - keep out of ED cells | Revatio - keep out of ED cells | No PAH brand in this trio |
| Daily ED option | Yes | No (PAH TID is not ED daily) | No |
BPH, diabetes, and who owns which use
BPH LUTS as a labelled target: tadalafil 5 mg daily only, among this trio. Solo use is licensed. Dual therapy with an alpha-blocker for BPH is not recommended on the Cialis label. That caution is not a ban on tadalafil in men who have prostates.
Diabetes often needs the top PRN tier or daily tadalafil after a shared decision. The overlay hint is not an automatic 100 mg sildenafil. Document 50 mg fasted failures first if that is the column.
Post-prostatectomy cohorts appear in subsets of the ED trials. Expectations stay tempered. Devices and injections are not overlay failures; they are other tools.
Severe renal impairment footnotes are deepest on the tadalafil daily line (daily use not recommended under 30 mL/min). Sildenafil asks for a 25 mg conversation in that range. Read the plan, not a class average.
| Situation | First overlay question | Not the first move |
|---|---|---|
| Heavy dinners, short notice | Tadalafil daily or PRN | Sildenafil 100 mg with the fondue |
| Familiar generic, one evening | Sildenafil - start was 50, lock is 100 | Two agents 'to be sure' |
| Fast peak, QT list clean | Vardenafil 10 mg | Skip the QT gate |
| ED plus LUTS | Tadalafil 5 mg daily | Sildenafil as a prostate drug |
| Ritonavir on the HIV page | The cap row, then the HIV prescriber | Any ceiling strip from a shop |
CYP caps that differ by column
All three are CYP3A4 substrates. The caps are not interchangeable, which is why this overlay exists beside the three plans.
Tadalafil with a potent inhibitor: daily maximum 2.5 mg; PRN maximum 10 mg once every 72 hours.
Sildenafil with ritonavir: 25 mg and not again for 48 hours (AUC about 11-fold). With erythromycin or other strong inhibitors, consider a 25 mg start.
Vardenafil with ritonavir: 2.5 mg every 72 hours (AUC about 49-fold, half-life 26 hours). With indinavir: 2.5 mg every 24 hours.
| With a strong CYP3A4 story | Tadalafil | Sildenafil | Vardenafil |
|---|---|---|---|
| Daily ED | 2.5 mg max | Not an ED-daily drug | Not an ED-daily drug |
| PRN cap (ritonavir-level) | 10 mg / 72 h | 25 mg / 48 h | 2.5 mg / 72 h |
| Who must co-sign | HIV / azole prescriber | HIV / azole prescriber | HIV / azole prescriber |
What this overlay will not price
There is no honest single cash number for 'PDE5.' A 5 mg x 30 tadalafil board, a 100 mg x 10 sildenafil board, and a 10 mg x 30 vardenafil board are different NDCs. This sheet will not average them.
Counterfeit triple packs in travel retail bypass Swiss traceability. The overlay assumes a pharmacy product with a real INN. Airport colour and a low sticker are not a uses argument.
Insurance switches happen for cost. The pharmacology still has to match the new column's food line and CYP cap. A cheaper INN that lands on ritonavir at the old milligram is not a saving.
Sildenafil opens oral ED use.
Vardenafil and tadalafil join; 10 mg and PRN tadalafil enter labels.
Tadalafil daily ED use.
Tadalafil 5 mg daily for BPH and ED+BPH.
Generics shift cost; interaction rules do not retire.
This overlay locks 5 mg daily / 100 mg / 10 mg and stays literacy-only on cash.
How long nitrates stay off after each column
The class ban is absolute for planned use. The leftover question is what an emergency team does if chest pain arrives after a tablet. Those hours differ.
After tadalafil, the Cialis label wants at least 48 hours before a medically necessary nitrate in a life-threatening situation, with monitoring. Daily 5 mg means the last dose may have been this morning, so the 48-hour clock is not a weekend loophole.
After sildenafil, the Viagra label will not name a safe hour. Plasma at 24 hours after 100 mg is about 2 ng/mL versus a peak near 440 ng/mL in healthy men, and still the document refuses a blessing. Older, hepatic, renal, and inhibitor patients keep more drug at that mark.
Circulation reviews have discussed a supervised 24-hour interval after sildenafil or vardenafil and 48 hours after tadalafil. That is review language. It does not override the Viagra 'unknown' sentence or the Cialis 48-hour sentence. Tell ambulance staff the INN and the clock. Do not self-spray.
How milligrams do not translate
Vardenafil 10 mg is not a tenth of sildenafil 100 mg. Clinic talk often treats vardenafil 10 mg as nearer sildenafil 50 mg, and vardenafil 20 mg as nearer the sildenafil ceiling. Those are rough tiers, not a conversion factor you can write on a napkin.
Tadalafil 10 mg PRN is not 'weaker' because onset can feel slower. The labelled PRN prize is duration, up to 36 hours. Daily 5 mg is a trough, not a small PRN.
Titrate inside one column before you hop. Document a fair failure - timing, food, stimulation, one agent - before you call the class dead.
| Rough clinic tier | Tadalafil | Sildenafil | Vardenafil |
|---|---|---|---|
| Low | 2.5 mg daily | 25 mg PRN | 5 mg PRN |
| Standard / this site's lock where it fits | 5 mg daily | 50 mg start (lock is 100) | 10 mg start |
| High | 20 mg PRN | 100 mg PRN | 20 mg PRN |
Partners, fake packs, and what arousal still means
Every column needs sexual stimulation. A 36-hour tadalafil tail is not a 36-hour erection. A 100 mg sildenafil ceiling is not an automatic event at 60 minutes. A 10 mg vardenafil start is not stronger than arousal.
Partners asking about drug in semen get a tiny-fraction answer on the labels (tadalafil under 0.0005% of a dose; vardenafil a similarly small semen recovery). Pregnancy planning still routes to the prescriber, not to this overlay.
Airport triple packs that mix colours and INNs are not a compare. They are a counterfeit and stacking risk. Swiss MA stock is the assumption under every cell on this sheet. A cheap online 'Cialis Viagra Levitra kit' is the opposite of literacy.
Female partners do not have a licensed Viagra, Cialis, or Levitra use on these brands. Curiosity is not an indication. Do not share tablets.
Where a class fill is quoted
This overlay will not invent a compare dollar or a class coupon. Each INN's cash block lives on that plan page. The ledger below is literacy: ask for the labelled INN and strength, and keep the nitrate hold on every row.
GoodRx stays out of the row links. Each name is that chain's pharmacy page. Yvessa does not dispense.
If a shop offers a blister with two INNs 'for the weekend,' that is not a use on this sheet. One agent.
| Pharmacy | Strength / count | Plan note | Official page |
|---|---|---|---|
| CVS | Ask labelled INN | Tadalafil, sildenafil, or vardenafil - not a combo blister | CVS pharmacy |
| Meijer | Ask labelled INN | No invented class coupon or compare dollar | Meijer pharmacy |
| ShopRite | Ask labelled INN | Nitrate hold still gates every member | ShopRite pharmacy |
| Hy-Vee | Ask labelled INN | Price the strength on the e-script | Hy-Vee pharmacy |
How to read the three plan sheets after this
Open the tadalafil plan if the use is daily 5 mg, BPH, or a 36-hour PRN window. Open the sildenafil plan if the use is a short ceiling night and dinner is the variable. Open the vardenafil plan if the use is a 10 mg start and someone has already looked at QT drugs.
Confirm one PDE5, a nitrate list of zero, and the CYP cap that matches the column you actually fill. Partner counselling: arousal is required on every row; duration and potency are different questions.
Dose or agent changes go through a prescriber or a Geneva pharmacist. [email protected] is for overlay corrections. 144 for collapse, chest pain, priapism past four hours, or sudden vision or hearing loss. Reviewed 21 August 2026.
Sources
- Lilly Cialis PI - daily 5 mg uses, 36-hour PRN claim, CYP caps, nitrate ban.
- DailyMed Viagra - 50 mg start, 100 mg ceiling, high-fat delay, ritonavir 25 mg / 48 h.
- DailyMed Levitra and Bayer Levitra PI - 10 mg start, QT study, food, class IA/III avoid.
- Cross-column PK reviews (half-life, food) - supporting clocks only; IIEF tables in each label are not a head-to-head gospel.
Checked against the current label and reviewed by Dr. Amélie Laurent. See Survey, Draft, Peer-check, Stamp.