Asked

29 Mar 2016

Active

29 Mar 2016

Topics

faq, cialis, viagra, benign prostatic hyperplasia (bph), erectile

dysfunction, sildenafil, tadalafil, sexual dysfunction, ssri induced
Which is better viagra or cialis? Find out below...

Answers (1)

Official Answerby Drugs.com 29 Mar 2016

Short answer….
Cialis and Viagra are both PDE5 inhibitors used for the treatment of erectile
dysfunction (ED). Both only work when a man is sexually aroused. Cialis lasts
for around 36 hours compared with only 4 to 5 hours for Viagra. Food does
not affect the activity of Cialis, whereas food may decrease the effectiveness
of Viagra. Cialis can be used once daily, at a smaller dosage, and is also
effective at treating benign prostatic hyperplasia (BPH). Dosage of Cialis may
need to be reduced in men with liver or kidney problems and risk of
interactions may be higher than with Viagra.

Long answer
What ingredients are contained in Cialis or Viagra and how do
they work?
Cialis is the brand name for tadalafil and Viagra is the brand name for
sildenafil.1,2 Both belong to a class of medicines known as phosphodiesterase
type 5 (PDE5) inhibitors. PDE5 inhibitors work only in the presence of sexual
stimulation, 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 the inflow of blood and an
erection to occur.1,2,3 PDE5 inhibitors enhance the effect of NO.1,2

Which drug was first approved and which one lasts for longer?
On March 27, 1998, Viagra became the first oral pill, and the first PDE5
inhibitor, to be approved by the FDA to treat ED.4 A generic for Viagra is
expected to be available December 2017.5
Cialis was first approved for ED on November 21st, 2003.6 It was the third
PDE5 inhibitor to come onto the market (after Levitra [vardenafil]).7 Cialis has
an advantage over Viagra and Levitra in that it lasts for a lot longer – 36
hours, compared with 4-5 hours for Viagra and Levitra.1,2,7 There is no generic
for Cialis.

How quickly do Cialis and Viagra work and does food have any
effect
Cialis generally works within 16 to 45 minutes, and its activity is not affected
by food. Viagra generally works within 30 minutes, and its effect may be
diminished if taken soon after a high fat meal (which may also delay how fast
it works). For this reason, 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 However, more
men prefer Cialis because of its longer duration of effect.7

What is the usual dosage of Cialis or Viagra?

Cialis can be taken on an as needed basis, or daily.1Generally, daily dosages
are smaller than as needed doses.8 Typically, Cialis is taken as a 10mg
starting dose, prior to sexual activity. The effects of Cialis will last around 36
hours. The dosage may be increased to 20mg if 10mg is ineffective or
reduced to 5mg if side effects are intolerable.1

When Cialis is taken for daily use, the recommended initial dosage is 2.5mg
once daily, or 5mg for people who also have BPH. Timing of the daily dosage
does not matter in people using it solely for ED; however, those with BPH are
advised to take it at the same time each day. Do not take more than one dose
a day but your doctor may consider an increase in dosage from 2.5 to 5mg if
ineffective. Side effects of Cialis include headache and indigestion.1

Viagra is taken on an as needed basis, at a dose of 50mg, approximately 1

hour before sexual activity (although can be taken from 30 minutes to 4 hours
before). The dose may be increased to 100mg if 50mg is ineffective or
decreased to 25mg if side effects are intolerable.2 Viagra should only be taken
once a day even though the effects wear off after approximately 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 depending on tablet strength but is approximately $24

per tablet for the 50mg strength and $35 for the 100mg strength.9 Cialis costs
approximately $8.50 for the 5mg strength and $28 for the 20mg strength, per
tablet.10

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 reducing in men with kidney or liver disease. Cialis is not
recommended in men who have had a heart attack or stroke within the past 6
months, with either uncontrolled high blood pressure or severely low blood
pressure, unstable angina, or other conditions that make sexual activity
inadvisable.1,6

References

1. Cialis (tadalafil) [Package Insert] Eli Lilly and Company 12/2015 https://www.drugs.com/pro/cial
is.html

2. Viagra (sildenafil citrate) [Package Insert] Pfizer Laboratories Div Pfizer Inc 11/2015 https://ww
w.drugs.com/pro/viagra.html

3. Wright PJ. Comparison of Phosphodiesterase Type 5 (PDE5) Inhibitors. Int J Clin Pract. 2006;6
0(8):967-975. http://www.medscape.com/viewarticle/542736_4

4. Historical Information on Sildenafil citrate (marketed as Viagra). US Food and Drug Administrati
on. Updated 08/2013 http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationf
orPatientsandProviders/ucm162847.htm

5. Megan Brooks. First Generic Version of Viagra Clears FDA Medscape News and Perspectives.
March 11, 2016 http://www.medscape.com/viewarticle/860281

6. Cialis (tadalafil). Center Watch 2016. http://www.centerwatch.com/drug-information/fda-approv

ed-drugs/drug/845/cialis-tadalafil

7. Doggrell SA. Comparison of clinical trials with sildenafil, vardenafil and tadalafil in erectile dysfu
nction. Expert Opin Pharmacother. 2005 Jan;6(1):75-84.

8. Cialis® for Once Daily Use Now FDA-Approved to Treat Men with Signs and Symptoms of Beni
gn Prostatic Hyperplasia (BPH) and Men with Both Erectile Dysfunction (ED) and Signs and Sy
mptoms of BPH. Lilly. https://investor.lilly.com/releasedetail2.cfm?releaseid=648234

9. Viagra Prices, Coupons and Patient Assistance Programs. Drugs.com. https://www.drugs.com/

price-guide/viagra

10. Cialis Prices, Coupons and Patient Assistance Programs. Drugs.com. https://www.drugs.com/p
rice-guide/cialis
Votes: +0