Erectile dysfunction (ED) is a taboo topic for many men, but it’s a condition that needs attention and understanding. This condition can be a sign of underlying health issues and can affect quality of life. We’ll go into the causes, treatments and lifestyle changes that can improve erection health, and why you need professional guidance from our clinic.
Cialis and Viagra are both PDE5 inhibitors for ED.
Cialis is the brand name for tadalafil and Viagra is the brand name for sildenafil.1,2 Both are PDE5 inhibitors. PDE5 inhibitors work only when a man is sexually stimulated as they rely on the natural release of nitric oxide (NO), a chemical only released during sexual arousal. NO in turn activates other substances to relax the smooth muscle inside the penis to allow blood to flow in and an erection to happen.1,2,3 PDE5 inhibitors enhance the effect of NO.1,2
March 27th, 1998, Viagra was the first oral pill and first PDE5 inhibitor to be approved by the FDA for ED.4 A generic for Viagra was approved in March 2016 5 and released in December 2017.
Cialis was approved for ED on November 21st, 2003.6 It was the third PDE5 inhibitor to market (after Levitra [vardenafil]).7
Cialis has an advantage over Viagra and Levitra in that it lasts for a lot longer – 36 hours compared to 4-5 hours for Viagra and Levitra.1,2 A generic for Cialis was approved in May 2018 and released in September 2018.
Cialis works in 16 to 45 minutes and is not affected by food.
Viagra works in 30 minutes and its effect may be decreased if taken soon after a high fat meal (which may also delay how fast it works). So Viagra is best taken on an empty stomach.1,2,7
Effectiveness of all PDE5 inhibitors is similar; although reported effectiveness of Viagra at 84% is slightly higher than that of Cialis at 81%.7 But more men prefer Cialis because of its longer duration of effect.7
Cialis can be taken as needed or daily.1 Generally daily doses are smaller than as needed doses.8 Typically Cialis is taken as 10mg before sexual activity. The effect will last for 36 hours. The dose may be increased to 20mg if 10mg is not effective or reduced to 5mg if side effects are intolerable.1
When taken daily, the recommended initial dose is 2.5mg once daily or 5mg for those who also have BPH. Timing of daily dose does not matter for those who use it for ED only; but for those with BPH, it’s best to take it at the same time every day. Do not take more than one dose a day but your doctor may consider an increase in dose from 2.5 to 5mg if not effective. Side effects of Cialis include headache and indigestion.1Viagra is taken as needed, 50mg, about 1 hour before sexual activity (although can be taken 30 minutes to 4 hours before). The dose may be increased to 100mg if 50mg is not effective or decreased to 25mg if side effects are intolerable.2 Viagra should only be taken once a day even though the effect wears off after about 4-5 hours. The main side effects are headache, flushing and indigestion.2 Rarely, color perception may be altered with Viagra. This side effect does not happen with Cialis.7
Cost of Viagra varies by tablet strength but is about $80 per tablet for 50mg or 100mg. Cialis is about $12 for 5mg and $70 for 20mg per tablet.
All PDE5 inhibitors are contraindicated with nitrates.1,2 The longer duration of action of Cialis means it is at higher risk for drug interactions,1 and dosages may need to be reduced in men with kidney or liver disease. Cialis is not recommended for men who have had a heart attack or stroke in the last 6 months, with uncontrolled high blood pressure or severely low blood pressure, unstable angina, or other conditions that make sexual activity not advisable.1,6
Phone/Video consultations are FREE. In person consultations are $200 and count towards the cost of medication/surgery.
.svg){kind=icon}