When it comes to treating erectile dysfunction (ED), two of the most well-known medications are Tadalafil and Sildenafil. While they share similarities, there are key differences that may influence which one is best for you or your patients.
How They Work
Both Tadalafil and Sildenafil belong to a group of drugs called PDE5 inhibitors. They work by relaxing blood vessels, increasing blood flow to specific areas of the body, and helping to maintain erections.
Time to Take Effect
- Sildenafil starts working 30 to 60 minutes after taking it and reaches peak effectiveness in about an hour. However, taking it with a high-fat meal can delay its absorption.
- Tadalafil also takes 30 to 60 minutes to work, but it can take up to two hours for peak effects. Unlike Sildenafil, food has little impact on its absorption, making it more predictable.
Duration of Effect
This is where Tadalafil and Sildenafil differ the most:
- Sildenafil lasts for 4 to 6 hours, meaning its effects wear off within the same day.
- Tadalafil can last up to 36 hours, which is why it’s sometimes called “the weekend pill.” A single dose can stay effective for more than a day, allowing for more spontaneity.
- Tadalafil is also available in a low-dose daily version (5mg) for continuous effect, removing the need for planned dosing.
Dosing Schedules
- Sildenafil is typically taken as needed, with a dose of 50 to 100 mg around 30-60 minutes before sexual activity. It should not be taken more than once per day.
- Tadalafil can be taken as needed (10-20 mg) or as a daily 5 mg dose for consistent effects. The daily dose builds up in the system within a week, allowing for more natural timing.
Can You Take Them Together?
No, Tadalafil and Sildenafil should not be taken together. Since they work similarly, combining them can lead to low blood pressure, dizziness, fainting, and prolonged erections that require emergency medical attention. There is no added benefit to combining them, only increased risks.
Which One is Better?
There is no universal “better” option—it depends on personal preference, medical history, and lifestyle.
- If flexibility and spontaneity are important, Tadalafil may be a better choice due to its long-lasting effects.
- If you prefer a shorter duration or want a more predictable timeframe, Sildenafil could be the right fit.
Final Thoughts
Both Tadalafil and Sildenafil have proven to be effective and safe for most people. If one doesn’t work as expected, a doctor may recommend switching to the other. If you’re considering either medication, it’s always best to consult a healthcare professional to find the most suitable option.
