If you have never been prescribed a PDE5 inhibitor medication before, this is the complete guide for you! In our article, we will go over sildenafil vs tadalafil and which is better, along with their differences, similarities, and price comparison. Keep reading on for more information!
In this article, we talk about the following:
Sildenafil is the generic version and primary active ingredient in Viagra. Revatio is another brand-name drug that uses sildenafil. Viagra and sildenafil are the same medication with similar mechanisms of action.
This medication falls under the umbrella term: phosphodiesterase type 5 (PDE5) inhibitor. PDE5 inhibitors act on smooth muscle cell walls. Sildenafil, developed by Pfizer, was first researched for entirely different purposes than helping with erection quality.
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Otherwise known as the "little blue pill," it is arguably the most popular PDE5. It was initially discovered when researchers examined how sildenafil affected high blood pressure and angina. Instead, they found it affected penile vascularity more efficiently.
So, how does sildenafil work?
PDE5 is an enzyme in smooth muscle cellular walls. Sildenafil works by:
Most blood vessel dilation occurs in penile arteries, leading to prolonged erections. Sildenafil's mechanism of action also affects pulmonary artery vasodilation and has different prescription uses than penile artery dilation.
In studies examining physical causes of difficulty achieving erections, it was effective at reducing symptoms in approximately 70% of participants.
Tadalafil is the active ingredient in Cialis and its generic version. Like sildenafil, it is a PDE5 inhibitor with similar action mechanisms. Although, there are some slight variations outside of its differing active ingredient.
There are two different prescriptions for tadalafil:
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Most PDE5 inhibitors are "as needed" medications taken within a couple of hours before sexual intercourse. As-needed tadalafil dosages usually start at 10 mg and increase or decrease from that point. Daily use is a much lower starting dosage point at 2.5 mg.
Depending on how your body responds, your doctor may increase it to 5 mg. The recommendation for daily tadalafil is to take it around the same time daily.
Is tadalafil effective? Yes - studies found that it improved erectile dysfunction scores by nearly 2.4 points.
Tadalafil & sildenafil are two popular medications that many will most likely recognize on the internet as Cialis vs Viagra. They are both PDE5 inhibitors but differ in their PDE isozyme selectivity.
While the medical term sounds complicated, it is fairly straightforward. Isozymes have the same chemical reaction but different amino acid sequencing.
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For example, sildenafil is listed as PDE6, while tadalafil is PDE11. Since they have slightly different cross-reactivity, their side effects could also differ.
Sildenafil has different dosages ranging from 25 mg to 100 mg. Tadalafil drug dosages are lower, fluctuating from 5 mg to 20 mg. Both are oral medications and are available in generic and brand versions.
Read more: Cialis vs. Viagra
Sildenafil and tadalafil don't specifically target PDE5. Since they choose slightly different isozymes, they will have cross-reactivity. In return, the side effects typically arise from cross-reactivity, especially with higher dosages.
The most common sildenafil side effects are:
Read more: Tadalafil Warnings & Precautions
In clinical studies, the side effects that occurred in more than 10% of patients using Viagra were skin flushing, diarrhea, extremity pain, and headaches. Both drugs could result in severe adverse reactions or allergic reactions.
Sildenafil and tadalafil will also have different inactive ingredients. Federal agencies typically don't regulate inactive ingredients between medications. This is also primarily why generic and brand-name drugs could have different reactions.
If you have an allergic reaction to an inactive ingredient, you may need to try another PDE5 inhibitor. The main inactive ingredients in Viagra are:
Viagra has dyes that turn the oral medication blue, labelled as FD&C blue no. 2 on its inactive ingredients. Cialis has some identical inactive ingredients, but the slight chemical makeup changes could make someone more receptive.
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An important reminder is that these medications are not effective without sexual stimulation. While it is possible to achieve more spontaneous erections with daily tadalafil, stimulation plays a critical role in erection quality.
With that in mind, the sildenafil should be taken at least thirty minutes before initiating sexual intercourse. If you have struggled to get an erection within that timeframe, it is likely your body metabolizes it slower.
Try waiting up to two hours. If you still aren't noticing symptom relief, you may want to talk to your doctor about dosage changes or other treatments.
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If you have an as-needed Cialis or tadalafil prescription, try taking it two hours before.
Do not break the pills; instead, swallow them whole with a full glass of water. Avoid drinking alcohol with either medication.
It can exacerbate side effects, such as drops in blood pressure. Although drinking alcohol may seem tempting to spice up the mood, it can inhibit sexual performance.
This is where the primary difference between tadalafil and sildenafil shines. Sildenafil remains in your system for up to five hours. On average, it should start working within two hours.
Most men take the medication in prep for sexual activity 30 minutes to one hour beforehand. Tadalafil is a longer-acting medication, and traces of the drug are still noted after 36 hours.
It may take longer to work, although it is still recommended to take it within one to two hours of sexual intercourse. Since tadalafil is a long-acting medication, you should exercise extreme caution by combining it with other medications.
In most cases, you should never combine two PDE5 inhibitors. Why?
One of the more serious side effects is priapism, a long-lasting and usually painful erection. Priapism is a medical emergency since it can impair blood flow and cause permanent erectile dysfunction.
Although definitions may vary, most experts agree that priapism is an erection lasting longer than four hours. The most common cause of priapism is ischemic. PDE5 inhibitors fall under ischemic causes of priapism and account for approximately 25% of cases.
This can occur from combining two similar medications or increasing dosages without medical consultation.
Another difference between tadalafil and sildenafil is how you take the medication. Experts recommend that these medications are taken without high-fat meals. Since tadalafil is a long-acting PDE5 inhibitor, it is less affected by this guideline.
Sildenafil should be taken with food, but avoid heavy and greasy meals. While it shouldn't completely stop sildenafil from working, it will dampen its effectiveness or take longer.
For the best results, if you take tadalafil, you should follow suit. Daily tadalafil is taken around the same time and has a longer half-life, meaning a high-fat meal won't have the same implications.
You should avoid taking grapefruit juice with both medications. CYP3A4 is a protein that helps metabolize PDE5 inhibitors, so it is excreted in the urine or feces. Proper metabolization is vital to avoiding a build-up of the drug in your bloodstream and leading to medical problems.
Grapefruit inhibits CYP3A4, directly impacting metabolization. Unfortunately, consuming both could lead to priapism.
Have you wondered which is better, tadalafil or sildenafil? Unfortunately, the answer is more complex than simply choosing one versus the other. Everyone reacts different to medications, and the effects of sildenafil or tadalafil are dependent on:
Talk to your doctor and take their direction on what medication to take for ED.
Another critical point that is important to remember is sildenafil is meant for short-term use. If you have long-term issues with getting or maintaining an erection, tadalafil may be a better option.
Cost is another determinant when deciding which one is better for you (more on that below). Medical experts compiled various studies and found that sildenafil, tadalafil, and vardenafil were effective in 65% to 80% of participants who participated in penetrative sex.
Let's break down the tadalafil vs sildenafil difference and the benefits of one over the other. Before getting started, both medications require a physician's prescription. You cannot purchase either medication over-the-counter.
The requirement of a prescription is inclusive of brand and generic PDE5 inhibitors. Once you and your physician have decided on the medication and dosage, prices will fluctuate based on:
As a general rule of thumb, brand-name medications will cost more than their generic counterparts. Brand-name medications are the initial drug cleared by federal agencies and typically have strongholds on the market and can set high prices. Once generic medications come out, they increase market competition and help lower prices.
So, sildenafil and tadalafil will usually be cheaper than Viagra and Cialis. Does insurance cover PDE5 inhibitor prescriptions?
In two words: not usually. However, coverage is entirely dependent on your insurance. Save your receipt and submit it to your insurance provider.
Is Sildenafil or Tadalafil More Expensive?
Shopping through a local pharmacy could lock you into higher prices. Online pharmacies like UpGuys provide generic medications at affordable prices. Sildenafil costs $11 per tablet, and daily tadalafil costs $4.25 per tablet.
When you visit the site, you will note two different tadalafil prescription options. Daily tadalafil is a longer-acting prescription, while standard tadalafil is used similarly to sildenafil. These prices will fluctuate depending on:
The prices on UPGUYS are based on specific mg and drug amounts, with daily tadalafil, offered in 28 tablet supplies.
Now that you know some of the key differences and similarities between tadalafil and sildenafil, you may wonder if there is another alternative. There are four main PDE5 inhibitors on the market:
Stendra is the newest medication and might cost more than the other three. Levitra or vardenafil is another popular medication that has similar mechanisms of action as tadalafil and sildenafil. Vardenafil has a shorter half-life than tadalafil.
You may find more similarities between vardenafil and sildenafil. It should remain in your system for up to five hours and contains similar side effects. However, because it differs in its active and inactive ingredients, it should be considered if you haven't responded to other medications!
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As an online pharmacy, UPGUYS offers virtual practitioner visits that can help with your difficulties getting an erection.
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