Comparing Viagra (generic: Sildenafil) and Cialis (generic: Tadalafil)

When patients start to lose their erectile function, it can be a tough time in their lives. For many, the first thought is toward natural remedies like saw palmetto that they believe may help them avoid prescription drugs. However, once they realize that these options don’t typically work, they come around to prescription drugs. The most common brand names are Viagra and Cialis, and their generic forms are Sildenafil and Tadalafil, respectively, which have similar efficacy concerning regaining sexual function. These drugs are proven effective and are safe for the millions of men who take them regularly.

When discussing which is best, we often suggest that patients get a prescription for each of the two major generics and see which works best with the fewest side effects. While both drugs work in similar ways in that they are five alpha-reductase inhibitors that allow for the dilation of blood vessels and thus increase the amount of blood that enters the penis, each has slightly different characteristics and qualities. The same patient may respond to one of the drugs while not responding to the other. And this highlights that there are some differences. So, let’s dive into their various uses and in what circumstances you would choose one over the other.

For Men on the Dating Scene

For someone single or divorced and dating, daily Cialis/Tadalafil may be preferable to Viagra/sildenafil. The reasons here are twofold. First, the dating scene is relatively unpredictable, so longer-lasting Cialis can keep you ready for longer (up to 36 hours). On the other hand, Viagra is shorter acting and requires a bit more planning. Also, Viagra is less effective after you’ve consumed a fatty meal. This is not an issue with Cialis and, therefore, is preferable to someone who will often have dinner with their date before sexual intercourse.

For the Married/Committed Long-Term Relationship

Here, there is some room to use either medication; these patients may prefer Viagra because their sex life is more predictable, and they may not want to have the longer-acting properties of Cialis.

Practically, both medications are safe and effective and can be used interchangeably. For some, one medication will work better; therefore, if one drug is not working for you, don’t fret, as we can try the other.

Duration of Action

The duration of action for Viagra is just a few hours, while Cialis can last up to three days. Cialis is also approved for low-dose daily use and can help keep a baseline dose. There is little risk in taking the maximum dose, and often, we will prescribe the highest dose, giving patients the option to cut the pill in half if they find a lower dosage just as effective.

Safety Profile

Sildenafil and Tadalafil are safe but are contraindicated for patients taking nitrates for heart problems or recreationally for enhanced sexual pleasure. Each has some minor side effects, including flushing. Viagra can cause a blue tint to the eyesight. Typically, these symptoms go away after stopping the drug. There are scattered reports of priapism caused by excess doses of Viagra/Sildenafil, though this is exceedingly rare.

What These Drugs Are Not

These drugs do not offer instant erections. Instead, they improve blood flow systemically, including to the penis, by dilating blood vessels. They will not substitute for desire or interest in one’s partner or sex in general.

It’s also important to understand that these drugs will not remain effective indefinitely. This is not due to tolerance but rather to the progression of atherosclerosis in the penile arteries. A patient whose medication effectiveness is starting to wane should visit Dr. Natale to discuss this progression and understand their options. Typically, this includes an injection of trimix or quadmix, offering virtually immediate erections that last for the duration of the sexual encounter.

Most importantly, patients should understand that they do not have to live with untreated mild to moderate ED (erectile dysfunction). There are minimally invasive options to treat the condition effectively. The most important concept is not to be embarrassed or ashamed to visit a urologist and get care. Erectile dysfunction is as normal as aging and thus should be treated as its earliest signs. Contact us today to discuss what is best for you!