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What is the difference between Cialis (tadalafil) and Viagra (sildenafil)

    • Cialis (tadalafil) and Viagra (sildenafil) are phosphodiesterase-5 (PDE5) inhibitors used for treating impotence (erectile dysfunction, or ED). Adcirca is another brand name of tadalafil.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.  PDE5 inhibitors enhance the effect of NO.
    • Common side effects of Cialis and Viagra that are similar include flushing (redness or warmth of the face, neck, or chest), headaches, stomach pain or upset, flu-like symptoms (such as stuffy nose, sneezing, or sore throat), memory problems, muscle or back pain, blurred vision and changes in color vision (such as an inability to differentiate between the colors green and blue), dizziness, diarrhea, nausea, low blood pressure, abnormal ejaculation, and prolonged erections (priapism), loss of hearing, and ringing in the ears.
    • One difference between the drugs is how long they stay in your system. Cialis provides penile hardness (the ability to obtain an erection) over a longer period than Viagra because it lasts up to 18 hours, while Viagra only lasts for about 4 to 6.
    • The difference between the approval time: On March 27 th, 1998, Viagra became the first oral pill, and the first PDE5 inhibitor, to be approved by the FDA to treat ED.  A generic for Viagra was approved in March 2016  and released in December 2017. Cialis was first approved for ED on November 21st, 2003. It was the third PDE5 inhibitor to come onto the market (after Levitra [vardenafil]).  A generic for Cialis was approved in May 2018  and released in September 2018.
    • Effective time: 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.

What is the usual dosage of Cialis or Viagra?

Cialis can be taken on an as needed basis, or daily.

Generally, daily dosages are smaller than as needed doses.  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. 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.

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.

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. Rarely, color perception may be altered with Viagra. This side effect does not happen with Cialis.

Cost of Viagra varies depending on tablet strength but is approximately $24 per tablet for the 50mg strength and $35 for the 100mg strength.

The Costs Difference Between Viagra and Cialis ?

Cialis costs approximately $8.50 for the 5mg strength and $28 for the 20mg strength, per tablet.10All PDE5 inhibitors are contraindicated with nitrates. The longer duration of action of Cialis means it is at higher risk for drug interactions, 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.

Does generic Viagra work just like regular Viagra?

Viagra is the brand name for a medicine known as sildenafil which has been proven to be effective for the treatment of erectile dysfunction.

The generic drug contains the same active ingredient as the branded drug, in this case sildenafil citrate, and is therapeutically equivalent to the branded medicine Viagra.

The main difference between a branded and a generic product is mainly price, with the generic usually being cheaper.

Is generic Viagra available in the U.S.?

Yes, generic Viagra is available in the U.S. The original patent for Viagra was set to expire in 2020; however, Pfizer entered into an agreement to allow Teva Pharmaceuticals to launch the generic.

In 2020, other generic manufacturers will be able to enter the market with generic Viagra. Pfizer is also offering its own generic that ditches the blue color (it’s white) and half of the $65-a-pill retail price. Generic Viagra has been available in Canada since 2012.

In Europe, Viagra became available generically in 2013. The lower dose form of Revatio (sildenafil) became available generically in the U.S. in November 2012 because it is used for a different condition (pulmonary arterial hypertension).

In the U.S., doctors may legally prescribed generic Revatio “off-label” to patients preferring a lower priced form of Viagra for ED; however, multiple tablets may be needed as the dose form of Revatio only comes in a 20 milligram (mg) tablet.

However, doctors are under no obligation to prescribe Revatio off-label.The recommended dose of Viagra is 50 mg, as needed, approximately 1 hour before sexual activity.

Doses may vary between 25 and 100 mg. The dose may be adjusted based on doctor recommendations, but it should not exceed 100 mg per dose or be taken more than once per day.

Prices for generic Revatio (sildenafil 20 mg) will vary, too, and discount coupons for the generic Revatio may be found online to be used at your local pharmacy.

What drugs interact with Cialis and Viagra?


The breakdown and elimination of tadalafil from the body may be decreased by erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), indinavir (Crixivan) and ritonavir (Norvir). Therefore, these drugs may increase the levels of tadalafil in the blood. If these drugs are being used at the same time as tadalafil, the dose of tadalafil should be reduced to 10 mg every 72 hours when used as needed or 2.5 mg when used daily in order to avoid side effects from high levels of tadalafil.

Rifampin, carbamazepine (Tegretol, Tegretol XR, Equerto, Carbatrol), phenytoin (Dilantin, Dilantin-125), and phenobarbital may decrease blood levels of tadalafil, possibly reducing the effect of tadalafil.

Tadalafil exaggerates the increases in heart rate and lowering of blood pressure caused by nitrates, for example, nitroglycerin, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating heart pain (angina). In patients who take nitrates for angina, tadalafil could cause heart pain or possibly even a heart attack by exaggerating the increase in heart rate and the lowering of blood pressure. Therefore, tadalafil should not be used with nitrates.

Tadalafil also exaggerates the blood pressure lowering effects of some alpha-blocking drugs for example, terazosin (Hytrin) that primarily are used for treating high blood pressure or enlargement of the prostate (BPH). Individuals who take these alpha-blockers should be on a stable dose of the alpha-blocker before tadalafil is started. In such situations, tadalafil should be started at the lowest dose. If the patient is already taking tadalafil, the alpha-blocker should be started at the lowest dose. Combining tadalafil with alpha-blockers for treatment of BPH is not recommended.

Tadalafil and alcohol both lower blood pressure. Therefore, combining tadalafil with alcohol may cause excessive drops in blood pressure and cause dizziness, headaches, and increased heart rate.

PDE5 inhibitors may affect platelet function and therefore prolong bleeding. Tadalafil should be used cautiously in patients with bleeding disorders or active ulcers. Tadalafil should not be combined with Adcirca (another form of tadalafil) or other PDE5 inhibitors, for example, vardenafil (Levitra) or sildenafil (Viagra, Revatio).


Viagra increases the effects of the blood pressure lowering medications. It also increases the blood pressure lowering effects of nitrates, for example, isosorbide dinitrate (Isordil), isosorbide mononitrate (Imdur, Ismo, Monoket), nitroglycerin (Nitro-Dur, Transderm-Nitro) that are used primarily for treating angina. Patients taking nitrates should not receive Viagra.

Patients should not combine Viagra with other PDE5 inhibitors (for example, vardenafil [Levitra], tadalafil [Cialis]).

Cimetidine (Tagamet), erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), atazanavir (Reyataz), and mibefradil (Posicor) can cause marked increases in the amount of Viagra in the body. Patients taking these medications should be observed carefully if sildenafil is used.

It is expected that rifampin will decrease blood levels of Viagra and probably reduce its effectiveness.

Are Cialis and Viagra safe to use while pregnant and breastfeeding?


Tadalafil is not approved for women and has not been evaluated in women who are breastfeeding.


Although extensive testing in animals has demonstrated no negative effects on the fetus, Viagra has not been studied in pregnant women. There is no effect on sperm count or motility of sperm in men.

It is not known whether sildenafil is excreted into breast milk.

Which one should I use?

Different ED medications suit different people so it is difficult to tell which would work best for you until you’ve tried each one.In our experience, men often prefer Tadalafil as it lasts longer, works faster and can be taken with food. Having said that, some men find that Tadalafil does not suit them, so they prefer to stick with Sildenafil.

Conditions treated by Cialis vs. Viagra.

Cialis is primarily used to treat ED. However, it is also approved to treat signs and symptoms from an enlarged prostate also called benign prostatic hyperplasia (BPH). Tadalafil, the active ingredient in Cialis, is available as Adcirca, which is used to treat pulmonary arterial hypertension (PAH), or high blood pressure in the lungs. Cialis can also be used off-label for Raynaud’s phenomenon, a rare blood vessel disorder. Viagra is only FDA-approved to treat ED. Sildenafil citrate, the active ingredient in Viagra, is also manufactured as Revatio to treat pulmonary arterial hypertension (PAH).

Viagra is sometimes used off-label to treat Raynaud’s phenomenon and female sexual arousal disorder. Both Cialis and Viagra have also been prescribed to treat the different problems surrounding ED. For instance, Viagra may also help men who experience early ejaculation so they can have better control. Cialis has been shown to help men experiencing other sexual dysfunctions involving ejaculatory and orgasmic functions.

Is Cialis or Viagra more effective?

Compared to placebo or using no medication, both Cialis and Viagra are effective at treating erectile dysfunction. Most of the differences between the two drugs have to do with how long the drug lasts, how it is taken, and the medical history of the person taking it. Although they are both effective, Cialis may be preferred for its once-daily dosing and it’s used for treating BPH.

Viagra may be preferred for its shorter half-life for those who only use it sparingly as needed. In a meta-analysis pooling 16 different trials and analyzing over 5000 patients, Cialis and Viagra showed similar effectiveness and safety. These results were based on the International Index of Erectile Function (IIEF)-EF scale which is widely used to assess erectile function.

Both drugs had similar incidences of side effects. However, those taking Cialis experienced improved sexual confidence and preferred it over Viagra due to feeling less pressure about planning with its longer-acting effects. Another trial showed that the active ingredients in Cialis and Viagra were comparable in effectiveness.

There were no significant differences between the two drugs. Cialis, however,  was suggested to offer more flexibility with its longer half-life. If you have ED, it’s important to consult a doctor to determine which treatment option may be best for you. One medication may be more effective or preferred over the other depending on your situation.

What health benefits does Cialis bring?

  • It is not only good for potency restoration, but also advantageous for getting sexual relations back on track.
  • Initial and further applications do not cause any discomfort for a patient; the long-term intake doesn’t build up tolerability or weakening of action.
  • The remedy takes its action very fast – in 20-25 minutes after the intake.
  • Cialis takes advantage over its other analogues (Levitra and Viagra) in regards to duration of action: a pill may work within the course of 36 hours.
  • It is not prohibited to take Cialis in combination with fatty food and alcohol.
  • The drug is considered to be safe for health: it can be taken by men suffering from diabetes. Besides, Cialis administration is allowed to men with hepatic or renal diseases; no dose correction is required.

Like other analogous medicines, Cialis takes its action only in case a man sees and feels sexual irritant, since sexual stimulation is an indispensable prerequisite for Cialis effect. While administering a tablet, a man needs to take into account that causes of penile blood supply cannot be eliminated by Cialis – its action is limited by definite amount of time.