Sildenafil (Viagra®) and tadalafil (Cialis®) are among the most renowned erectile dysfunction (ED) medications. Both belong to a category of medicines known as phosphodiesterase type 5 (PDE5) inhibitors, and both work similarly.
PDE5 inhibitors work upon sexual stimulation. Once reaching a state of sexual arousal, a naturally-occurring chemical is released, allowing PDE5 inhibitors to begin a chain reaction leading to a relaxation of the smooth muscles within the penis. This reaction increases blood flow into the penis, ultimately leading to an erection.
What is erectile dysfunction (ED)?
Erectile dysfunction is defined as regular difficulties in achieving and maintaining an erection sufficient to enjoy vigorous, satisfying sexual activity.
It’s perfectly normal for men to experience occasional problems getting “wood,” so to speak; it’s another thing when healthy, successful erections become the exception rather than the rule. It’s a problem when they entirely stop happening altogether.
That’s a serious signal of textbook erectile dysfunction – and that could be an indicator of something going awry.
But while ED can be really bothersome, it isn’t usually a serious health condition. However, in approximately 1 out of 5 cases, ED can indicate an undiagnosed medical condition such as cardiovascular disease, hypertension, diabetes, or depression.
ED may also be caused by other health conditions brought on by obesity, smoking, drinking, stress, anxiety, hormonal problems, or relationship issues.
Your primary healthcare provider will run some simple tests to determine the cause of your ED and to figure out whether it is reversible. If so, treating said underlying medical issues might improve your ED without needing a prescription.
Although such causes of ED aren’t easily reversible, it must be noted that ED medications are safe, effective, and readily available for the majority (70%) of cases.
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How do ED medications work?
Sildenafil and tadalafil belong to a class of medicines known as PDE5 inhibitors, and they all have a similar mechanism of action; they boost blood flow and relax muscles, allowing blood to freely enter the penis. This action is what allows people with ED to experience a more satisfying erection while engaging in sexual activity.
What’s the difference between Sildenafil and Tadalafil?
Sildenafil was first marketed in 1998, making it one of the most well-known and effective treatments for ED. It usually works within an hour of taking it, and its effects generally last as long as four to eight hours, depending on the dosage.
Sildenafil citrate is the active ingredient found in Viagra®, developed by pharmaceutical manufacturer Pfizer. Until 2013, Pfizer was the only company legally permitted to manufacture and distribute the product.
However, Pfizer’s patent expired in 2013, meaning other pharmaceutical companies could begin manufacturing their versions of ED medications using the same active ingredient that made Viagra® so successful. That means each time you see a medicine labeled with sildenafil as its ingredient, you can be 100% sure that it contains the same active ingredient as Viagra® – the only difference is that as it is a generic version, it is significantly more affordable without being any less effective than its branded counterpart.
Common side effects of sildenafil may include headaches, nasal congestion, gastrointestinal discomfort, nausea, and indigestion. Less common but more severe ones include priapism, a painful condition involving an erection lasting more than four hours, which requires immediate medical attention.
Sildenafil (generic Viagra®) is usually prescribed at a 50 mg dose, taken on an as-needed basis. Doses might be increased if your doctor deems the standard dosage as ineffective or likewise reduced if you experience mild side effects.
Your doctor will determine the appropriate starting dose based on your medical history.
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Tadalafil, on the other hand, was introduced in 2003 by pharmaceutical company Eli Lilly and marketed as Cialis®. As with Pfizer’s case, Eli Lilly’s patent on tadalafil expired in 2017, opening up its manufacturing and distribution by other pharmaceutical companies to create their own generic medicine equivalent to Cialis®.
And, just like generic sildenafil, generic tadalafil is much cheaper than branded Cialis®, with no difference as far as efficacy is concerned, apart from the brand.
Tadalafil (generic Cialis®) is available in two formulations: one that can be taken as needed and one that can be taken daily.
Generic, ‘as-needed’ tadalafil does have an advantage over sildenafil since it lasts much longer – while sildenafil’s effects last for 4-8 hours, tadalafil’s effects last up to 36 hours.
Men who prefer spontaneity in their sexual activity tend to gravitate towards tadalafil. Another advantage tadalafil has is that its action isn’t affected by food intake, meaning you can take tadalafil on a full stomach.
Another difference from standard, ‘as-needed’ tadalafil is its dosage: generic Cialis® is available in 10 mg, which may be increased to a maximum dosage of 20 mg if your physician determines that you need a higher dose. As with sildenafil, dosages may vary based on your medical history. Therefore, consulting your doctor will help you determine and prescribe a suitable starting dose.
On the other hand, Cialis Daily®, the branded version of tadalafil meant to be used daily, is generally prescribed for individuals who engage in sexual activity more than twice a week. These come in 2.5 mg doses, which can be extended to 5 mg by your doctor if you require a higher dosage. The daily version of generic tadalafil, like its branded counterpart, is taken every day to achieve its full effect after five days for optimal spontaneity.
However, tadalafil isn’t strictly better than sildenafil. Since the medication lasts in the bloodstream for a more extended period of time, so can the side effects you might experience from taking it. As with practically most ED medications, the side effects include the usual suspects: nasal congestion, headaches, nausea, malaise, flushing, and gastrointestinal discomfort, and the less common but more severe side effects that require immediate medical attention.
Always refer to the medical leaflet included with the medicine and consult your doctor to determine whether tadalafil is suitable for you.
Sildenafil vs. Tadalafil: Which one should I use?
Different ED medications are tailored to different individuals. Therefore, it’s hard to determine which one is best suited for you until you’ve tried them for yourself. Some men prefer the spontaneity that tadalafil offers, apart from the fact that you can take it on a full stomach; however, some men find out that tadalafil isn’t suited for them and thus prefer to stick with good old sildenafil. Your mileage may vary, but your doctor will help you determine the best ED medication to take based on your medical history.
