Erectile dysfunction (ED) is more common than most people think – over 30 million Americans have been diagnosed with some form of ED.
But with the multitude of treatment options currently available, individuals with ED may find their heads spinning, mainly when their doctor prescribes an ED medication for them to take.
Now, you might be wondering what the differences exist between sildenafil and tadalafil, two of the most commonly prescribed ED drugs known under the brand names Viagra® and Cialis®, respectively.
Let’s compare sildenafil and tadalafil’s similarities and differences in this article.
What are sildenafil and tadalafil, and what do they do?
Sildenafil and tadalafil, more commonly known by their respective brand names Viagra® and Cialis®, are both PDE5 inhibitor drugs used to treat erectile dysfunction (ED) effectively.
ED affects as many as 50 million American men, making it one of the most common sexual dysfunctions globally. ED is defined as the difficulty of producing and maintaining an erection or experiencing no erections in the morning. Some men experience a complete and total lack of erections altogether.
Consequently, ED can prevent men from enjoying a pleasurable, satisfying sex life and, in doing so, potentially affect relationships with their partners.
Sildenafil and tadalafil work to increase blood flow to the penis, allowing patients to experience better erections. They belong to a category of drugs referred to as phosphodiesterase type-5 enzyme (PDE5) inhibitors, which include vardenafil (Levitra®) and avanafil (Stendra®), which essentially share the same mechanism of action.
However, these medicines aren’t silver bullets – they require sexual stimulation and arousal to deliver their erection-enhancing effects.
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How effective are sildenafil and tadalafil?
Clinical studies comparing sildenafil and tadalafil as Viagra® and Cialis® show that both medicines are comparably effective in boosting erection quality.
How fast do sildenafil and tadalafil’s effects kick in?
Most men who take sildenafil note that its effects begin to kick in around 30 minutes to an hour after taking it. Some individuals might experience its effects faster, some longer (as much as 2 hours later), depending on whether they take it with food or on an empty stomach. Taking sildenafil with high-fat meals might delay its effect.
On the other hand, tadalafil starts working around 30 minutes and can be taken with or without food.
How long do the effects of sildenafil and tadalafil last?
One of the main differences between sildenafil and tadalafil is the duration of its effects on the body.
Sildenafil peaks in effects around 2-3 hours after taking it, and its erection-boosting effect subsides after the four-hour mark. It entirely leaves the body in around 8-12 hours. However, this time frame might be longer depending on factors such as the size of the dosage, other concurrent medications, and a person’s overall state of health.
Meanwhile, tadalafil’s effects may last as long as 24 to 36 hours, allowing patients to take it on an as-needed basis or once daily. Taking it once a day may be preferred by individuals who enjoy spontaneous sex or those who are used to engaging in sexual activity several times a week. Just like sildenafil, however, other factors might interfere with its presence in the bloodstream and influence how long its effects last.
What doses are sildenafil and tadalafil available in?
Another key difference between generic Viagra® and generic Cialis® includes their available dosages. The dosage for these two drugs is another area where they differ.
Sildenafil citrate (Viagra®) is available in 25 mg, 50 mg, and 100 mg oral tablets. In general, most men are started on a 50 mg dose, and doctors may adjust the dose based on how effective the current one is. The maximum daily dose for sildenafil is 100 mg and should only be taken more than just once a day.
Tadalafil (Cialis®) is available in 2.5, 5 mg, 10 mg, and 20 mg oral tablets. On the other hand, most men prescribed this ED drug are started on a 2.5 mg dose daily for symptoms of ED, taken at around the same time. The maximum daily dose for tadalafil is 20 mg a day.
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What are some side effects of sildenafil and tadalafil?
It shouldn’t come as a surprise that sildenafil and tadalafil share similar side effects since they belong to the same category of drugs. However, the risk or severity of the following side effects may depend on the dosage, underlying conditions, and the patient’s overall health.
- Priapism. Priapism is a painful condition where a prolonged erection lasts longer than four to six hours. Priapism is a severe but infrequent side effect that requires immediate medical attention. Otherwise, it may cause permanent, irreversible damage to the penis. All drugs under the PDE5 inhibitor category, including sildenafil and tadalafil, run the risk of increasing a person’s priapism.
- Low blood pressure. PDE5 inhibitors work by relaxing the blood vessels and arteries that transport blood to the penile muscles, thereby increasing blood flow and permitting firmer and more satisfying erections. However, sildenafil and tadalafil’s vasodilatory effects impact the entire circulatory system. Whenever blood vessels dilate, it causes a decline in blood pressure. This is exactly how PDE5 inhibitors treat ED. But if a patient is on anti-hypertensive medicine, extremely low blood pressure can be life-threatening.
- Changes in vision. Another rare side effect is blurry vision due to a condition called non-arteritic ischemic optic neuropathy (NAION). Individuals at a higher risk for NAION may experience vision changes that may or may not be temporary. Before going on an ED medication like sildenafil or tadalafil, consult your doctor if you are at risk for developing symptoms of NAION.
- Cardiovascular effects. It is unclear whether any new cardiovascular effects have been reported in clinical trials resulting from sildenafil or tadalafil use, frequency of sexual activity, or other factors. Thus, patients with pre-existing risk factors for cardiovascular disease should consult their doctors before taking sildenafil or tadalafil.
Sildenafil vs. Tadalafil – Which one is better?
One thing’s for sure about sildenafil and tadalafil: both can be said to be effective, successful ED treatments that can help enhance an ED patient’s quality of life and improve the quality of their relationships.
No one drug is better than the other – however, some patients may prefer one over the other depending on whether they engage in more frequent sexual activity if they wish to be more spontaneous in their engagements, if they take prescription medicines that may interfere with their choice of ED medication, and if they prefer to use ED drugs only when needed.
