Oral medicines such as Viagra® (sildenafil), Cialis® (tadalafil), Levitra® (vardenafil), and Stendra® (avanafil) – belonging to the category of drugs known as PDE5 inhibitors – are the first line of treatment for men with erectile dysfunction (ED).
They all share the same mechanism of action and physiological pathways in the human body. PDE5 is an enzyme in the penile tissue that signals the body to wrap up an erection and thus prevent it from occurring.
Every oral ED treatment works to inhibit this particular enzyme, thus earning the “PDE5 inhibitor” moniker.
Most ED drugs, while sharing the same mechanism of action that helps men with ED produce erections, differ in one aspect: their level of specificity for the PDE5 enzyme. Another aspect that distinguishes ED drugs is how long they last in the system (known as bioavailability), their ability to be taken with or without food, and their profile of side effects.
Let’s go on a deep dive on these topics as related to sildenafil (generic Viagra®) and tadalafil (generic Cialis®), two of the most widely-prescribed drugs for ED. Which is the better choice – sildenafil or tadalafil? Let’s find out.
What is the difference between sildenafil and tadalafil?
ED patients need to be aware of the key differences that set sildenafil and tadalafil apart since choosing the right treatment ultimately leads to the best outcomes.
Sildenafil, the active ingredient (and generic name) of Viagra®, was a revolutionary treatment for ED when it was first introduced by Pfizer in 1998. It was the first time men struggling with ED could improve their erectile function by just taking a little blue pill.
It must be mentioned that Viagra® was accidentally discovered since Pfizer was initially conducting studies on sildenafil citrate as a treatment for chest pain.
Researchers noticed that men were reporting improved erectile function after the clinical trials. This led the company to study sildenafil as a treatment for ED, and thus Viagra® was born. Since then, Viagra® has enjoyed monumental success, having since been taken by over 30 million men in over 120 countries worldwide.
Sildenafil works at its best when taken one hour before sex and lasts up to four to six hours in the body. Sildenafil reaches peak concentrations in the body around 30 minutes to two hours after ingesting it orally. Moreover, the sildenafil should be taken on an empty stomach, as the presence of food hinders its absorption and may lead to delays in its effects.
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In contrast, Cialis®, also known by its generic name and active ingredient tadalafil, is a second-generation ED medication released by Eli Lilly and Co on the heels of Viagra’s success.
Tadalafil differs from sildenafil in several ways. One of the most noteworthy differences is that tadalafil can be taken with or without food. That is, food doesn’t hinder its absorption.
This is a noteworthy finding because most sexual activity happens from around 9 PM to 2 AM, which is usually after dinner.
Tadalafil makes it easier for men to enjoy spontaneous sexual activity without worrying about food intake interfering with their drug use.
Yet another key difference is that tadalafil works for up to 36 hours, as opposed to sildenafil (4-6 hours).
More men find this longer duration more enticing since the ability to produce one to multiple erections is easier to sustain within that 36-hour time frame.
Now, this doesn’t mean you’ll get erect for 36 hours straight. Instead, this means you could produce one to several erections within a 36-hour window, a much longer duration than sildenafil.
Lastly, tadalafil can be taken daily. Low-dose tadalafil (2.5 mg to 5 mg) is widely available for men who wish to enjoy even more spontaneity in their sexual affairs and not feel anxious or pressured about taking medicines before engaging in sexual activity.
This greater freedom makes tadalafil more attractive to men with more frequent sex as an ED treatment than sildenafil. Taking daily tadalafil also improves not just ED but also urinary symptoms of prostate enlargement.
Should I take tadalafil (Cialis®) or sildenafil (Viagra®)?
Now that we have distinguished tadalafil and sildenafil’s most salient differences, which ED drug should you pick?
It all depends on your lifestyle and how often you engage in sexual activity.
For instance, tadalafil might be a more enticing option for an individual who has sex several times a week and doesn’t plan his sexual engagements in advance.
On the other hand, sildenafil might be a better option for a man who plans sexual activity in advance or for men who prefer to use an ED pill only when they need to.
In general, more men slightly prefer tadalafil over sildenafil. A survey showed that around 74% of ED patients preferred Cialis® over Viagra®, largely due to the spontaneity and the various dosing options that the former provides.
Couples who anticipate more sexual activity prefer tadalafil because it can be taken at low doses daily, allowing for more frequent, more spontaneous sex that requires less planning in advance. This means less pressure to perform, less urgency, less negotiation, and less planning before and after sexual romps when taking tadalafil over sildenafil.
On the other hand, men who use sildenafil tend to rank higher in self-confidence and tend to enjoy firmer erections.
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Sildenafil or tadalafil: How do I choose the right ED drug for me?
Sildenafil and tadalafil produce different effects in every individual taking them. Some men might find one ED drug more effective than another. Some may find that a particular ED drug produces greater side effects than others. Your mileage may vary depending on which drug you choose.
Another aspect that weighs heavily in your decision is your lifestyle. Do you prefer an ED drug that works for you all weekend long? Or do you prefer an ED drug that does its job for you when you need it to? The choice is yours.
The bottom line on sildenafil and tadalafil
Ultimately, your lifestyle and frequency of sexual activity will determine your ED drug of choice and how well you respond to them.
The effects of sildenafil and tadalafil are comparable, and the presence and severity of their side effects are subjective. Each case is different.
However, tadalafil was developed to last longer than sildenafil, and it is thought to produce fewer side effects than sildenafil.
Which is better – sildenafil or tadalafil? Simply put, there’s no one-size-fits-all answer. It’s all about what works best for you based on your preferences. Consult your doctor to determine whether sildenafil or tadalafil (or other ED drugs) might work for your ED or if alternative, non-pharmacological treatments might be able to help you overcome this common medical condition affecting millions of men worldwide.
