When erectile dysfunction (ED) treatments are discussed, two of the best known medications are Viagra and Cialis (cheaper to buy as tadalafil). Both are oral drugs that are medically approved, clinically trialled and widely used, and often it’s assumed they are more or less interchangeable.
However, they are not the same. Here’s a look at the main differences between them, and how to decide which one would suit you best.
What are sildenafil and tadalafil?
Both drugs are classed as PDE5 inhibitors, which is a type of medication that helps to relax blood vessels and improve blood flow. This makes it easier to get and maintain an erection. The differences lie in how fast they act, how long they last, and how flexible they are to use.
How fast do they act?
Both medications start to work about 30 to 60 minutes after they have been taken, although tadalafil tends to work a little sooner for many men. However, it’s important to note that sexual arousal is necessary first; just as in any other sexual situation.
It’s not advisable to take sildenafil directly after a heavy meal, particularly one high in fat, because this can delay the effects. Tadalafil isn’t affected by food, so if you like to enjoy dinner before an intimate date, then this is a more flexible option.
How long do they last?
This is one of the main differences between the two drugs: the effects of sildenafil will last for about four to six hours, while tadalafil can stay active for up to 36 hours. This doesn’t mean that you’ll have a days-long erection, it just means that responding to sexual stimulation will be easier within this window.
In fact, a popular nickname for tadalafil is “The Weekend Pill”, because it allows men who are living with ED to have a spontaneous romantic weekend with a partner without being restricted to a particular window of time.
Dosage
Sildenafil is always taken as needed, so basically once a day at the most. The dosage can be adjusted to give the required amount of effectiveness. Tadalafil has two dosage options: a lower daily dose or a higher dose that can be taken as needed.
A daily dose of tadalafil is a good option for men who prefer spontaneity in their sex life and dislike planning ahead; or who are sexually active more than twice a week.
Side effects and safety
Both medications have a similar list of potential side effects, including:
- Headache
- Flushing
- Nasal congestion
- Upset stomach
- Dizziness
- Back pain (more common with tadalafil)
Most side effects are mild and temporary. Neither medication causes an erection without arousal, and they don’t affect your sex drive—they simply make it easier to get and maintain an erection when the time is right.
Both drugs are generally safe, but they should not be taken with nitrates, which are found in some heart medications, or with certain blood pressure medications. Always speak to a healthcare provider if you’re unsure.
Cost
The cost of both medications can vary depending on the dose size and branding. Generic versions are generally cheaper and widely available to buy online. You can even set up a subscription service with an online pharmacy, and the medication will be delivered to your door in discreet packaging. This avoids the inconvenience of queuing at the pharmacy.
So which is right for you?
There’s no right or wrong answer, and it might be the case that you want to experiment with both medications before making a final decision, because everyone’s response will be slightly different.
If you prefer to take medication only when needed and you don’t mind slightly planning ahead, sildenafil may be the best choice for you. If you prefer more spontaneity, don’t want to worry about meal timings, or you are more frequently sexually active, tadalafil could fit your lifestyle better.
If you feel unsure, it’s helpful to discuss your options with a doctor or pharmacist. They may also be able to advise about lifestyle changes that can enhance your sexual health, and may also want to check for any underlying causes for the ED. This will ensure that the medication is safe and effective for you to use, and that any other health conditions are addressed.
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