So your doctor has handed you a prescription saying: “This is tadalafil; we could try sildenafil instead.” All of a sudden, you are the judge and jury of which pill works better than the other, out of two you’ve vaguely heard the name of.
Does this sound familiar?
Because it should.
Erectile dysfunction, it happens very, very commonly, and there is no shame in having no immediate insight into the difference between the two medications prescribed for it. According to Healthymale, ED affects roughly one in five men in Australia over the age of 40. Erectile Dysfunction is just an average daily medical conversation that takes place across telehealth appointments.
This is where things get a bit tricky: usually, tadalafil and Viagra (sildenafil) get conflated. Often you will be prescribed tadalafil or viagra, under the assumption that you understand the nuances of each.
When in reality they are fundamentally different, though both serve the same overall purpose to help combat ED.
Let’s break down what you need to know when comparing tadalafil and viagra different ways that their actions can interact with your daily routine.
How They Really Work – the Similar Ground
First, the similarities – understanding this really is critical. Tadalafil and sildenafil share a class of medication – PDE5 inhibitors, according to NIH. Simply put, both inhibit (turn off) an enzyme which would normally restrict the blood flow to the penile blood vessels – making it easier for the blood to flow into and stay there when you are sexually aroused.
It isn’t a case of either drug just “turning something on” – you still have to be aroused to benefit from either of them.
Both medications have been well researched and are registered on the TGA (Australia’s medicines regulator). Both have excellent and well-documented safety and efficacy data over many decades.
Difference Between Tadalafil vs Viagra: Comparison
Feature | Tadalafil (Cialis) | Viagra (Sildenafil) |
Duration | ||
Onset of Action | ||
Food Effect | ||
Daily Use | Yes (2.5 mg or 5 mg daily) | No, taken only as needed |
Additional Uses | Treats ED and BPH | Primarily treats ED |
Where Sildenafil Works Well?
Sildenafil (Viagra) was the first-ever drug in this class to arrive on the scene, and it is probably still one of the most famous. The real trick with sildenafil is its speed – 30-60 minutes, usually. On the flip side, it’s not exactly known for its staying power; its half-life is from 4-6 hours. Being particularly sensitive to food can impact things here – studies indicate a heavy, fatty meal can decrease blood sildenafil peak levels by almost a third, and can slow down the speed of onset too.
Where Tadalafil (Cialis) Exceles
Unlike sildenafil, tadalafil’s action happens over a bit longer of a span. It can begin working between thirty minutes and two hours after taking it, and even though that isn’t a tremendous time difference from sildenafil, where tadalafil wins is the way long it stays alive for the duration of the body up to thirty-six hours, for which it is commonly named the “weekend pill.”
Moreover, taking tadalafil is not similarly affected by foods as taking sildenafil is, making dinner plans less of a prerequisite. It is likewise sold in an "on-demand" and low daily dosage version (similar to sildenafil), which ensures a steady level of medicine in the blood.
What the Research Actually Showed
A systematic review of the 16 clinical trials that had direct head-to-head comparisons between the two medications showed that tadalafil and sildenafil were more or less identical in efficacy and the overall number of side effects. But what the studies did show in an aggregate fashion is that the medications differed in patient and sexual partner preference, with tadalafil coming out as more often favoured, and that tadalafil also seemed to provide greater benefits for psychological outcomes and the sexual confidence questionnaire scores.
This does not make tadalafil better, however; in fact, some studies have demonstrated harder peak erections in a group of men from sildenafil, and a specific man may develop a reaction to one medication that he would not get from the other. What tadalafil does have the edge in is that the broader window of operation and less interference from food will give it a better chance at fitting into your daily life.
Dosage: Larger differences than you would assume
The largest allowable doses for both medications aren't particularly close to each other:
Sildenafil goes as high as 100mg per dose, while 20mg is the upper limit for on-demand tadalafil use (or, considerably less, between 2.5mg and 5mg, for the daily version).
None of that means either drug is "better" or "stronger," per se - only that the same amount is not required for either medication to have a similar effect due to differences in their body processing.
In the study, it was found that the majority of the patients and their partners preferred tadalafil over Viagra (Sildenafil).
Are There Any Side Effects of Tadalafil and Viagra?
As the mechanisms of both tadalafil and viagra are similar to each other, the side effects of both are also the same. Here are the side effects of sildenafil and tadalafil:
Headache, nasal congestion, facial flushing, indigestion, dizziness. There are a few distinctions, however. Sildenafil is more frequently the culprit behind temporary changes in vision, like what some call “blue vision.” Back and other muscle pain are side effects More associated with tadalafil than sildenafil; as we touched upon, this was supported in the meta-analysis too. Since tadalafil hangs around longer than sildenafil, its effects – good and bad - tend to linger much longer too.
Cost and Access for Aussie Men
The issue of price is often the most practical consideration for our blokes:
Sildenafil (Viagra) and tadalafil (Cialis) both come as generics in Australia, which are significantly less expensive than the original brand-name product. With telehealth for prescription, you can easily get both drugs in the comfort of your own living room with an online consultation by a local AHPRA-registered doctor and an e-script without leaving the house or stepping into a clinic or GP's office. Price also depends on dosage and the amount of drugs that you are buying, as well as whether you require usage either as-needed or daily.
There are 3 surprisingly cheap options at DirectMeds; DM Ready is available from $1.60/dose, DM Lasting is available from $2.80/dose and DM Steady is available from $1.50/dose.
Regardless of which plan you select, you’ll receive a free online assessment with an Australian registered medical professional, as often as you need it, and then the treatment will be posted to you discreetly in the post to receive at home.
Which One You Can Choose?
The choice really is a matter of what is best for you. With the facts it's easier to decide.
Choose sildenafil if:
- You are okay taking a dose on an empty stomach and just before a meal.
- You'd rather take something just when you know you're going to need it.
- You only want an hour or so of effect, and don't care about other time restriction limitations.
Choose tadalafil if:
- You want spontaneity and you don't want to 'plan' ED for an evening's activities.
- You want a daily pill and would prefer not to worry about a prescription pill for use, but don't want an extremely long lasting ED medication.
- You want more time flexibility, and less concerns about foods interfering with the ED drug working properly.
It is of course entirely reasonable to take one and if it’s not really working for you to swap over to the other – sometimes it takes finding what works best for your individual circumstances and your body and lifestyle.
Frequently Asked Questions for Tadalafil vs Viagra:
Are tadalafil and Viagra the same medications?
No, not exactly. Viagra is the brand name for the generic sildenafil. Tadalafil is another PDE5 inhibitor that functions the same as sildenafil, but has different timing regarding when it should be taken, its half life, and potential side effects.
How long does tadalafil last vs. Viagra?
The half-life of sildenafil (Viagra) is 4-6 hours. However, tadalafil has a half-life of up to 36 hours, giving it the moniker of “the weekend pill.”
Can mixing tadalafil and Viagra work better?
No. It is not a good idea to mix tadalafil and Viagra, as per the study from PubMed Central. Mixing two PDE5 inhibitors can raise the risk of side effects, specially dangerous drop in your blood pressure. You can ask your doctor about swapping instead of mixing them together.
Does food make these medicines less effective?
Yes – but it mainly applies to sildenafil. If you take a high-fat meal, then it can blunt and delay absorption. Tadalafil absorption is largely food-unaffected.
Which of the two would you take for daily use?
Of the two medications, only tadalafil comes in a low-dose daily formulation which is specifically intended to maintain a level of effect over the day, without needing to co-ordinate dosing with sexual activity.
Are tadalafil and Viagra listed on the PBS in Australia?
Generally no – neither medication is currently subsidised on the PBS specifically for treating ED. Most men would need to pay a private prescription price; however, the generic equivalent to the patented drugs is substantially cheaper than the brands.
