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Viagra vs. Cialis: which is better for treating ED?

Written and medically reviewed by Dorcas Morak, Pharm.D

Viagra and Cialis are common brands of drugs for the treatment of erectile dysfunction. Once you've read this article, you will know how they are different and have confidence to make the best choice when speaking with your doctor.

What is erectile dysfunction?

Men with erectile dysfunction (ED) find it challenging to keep their erections long enough to engage in sexual activity. While occasionally being unable to keep an erection is natural, it becomes erectile dysfunction if the condition persists. It may be a symptom of underlying health issues such as depression, diabetes, high blood pressure, high cholesterol, heart disease, or stress. It can also be a side effect of certain medications, excessive alcohol use, a relationship problem, or a hormone imbalance.

What are Viagra and Cialis?

Viagra is a brand of sildenafil, while Cialis is a brand of tadalafil. They are two medications from the phosphodiesterase-5 inhibitor class indicated for erectile dysfunction.

How do Viagra and Cialis work?

Nitric oxide signals the penile smooth muscle to relax and promotes the dilation of blood vessels, which is necessary for erection. The erection ends when phosphodiesterase-5 (PDE5) enzymes are released. Cialis and Viagra work by reducing phosphodiesterase-5 enzymes, thus prolonging the erection long enough for sexual activity.

How is Viagra different from Cialis?

The significant differences between Viagra and Cialis are their duration of action, side effects, cost, and dose.

How fast do Viagra and Cialis work?

The effect of Viagra peaks about 1 hour after use and lasts for 3 to 5 hours, while Cialis peaks approximately 2 hours after use and lasts for about 17 hours.

What are the doses of Viagra and Cialis?

50 mg of Viagra is often the first dosage. You can lower the dose to 25mg if the adverse effects bother you. Also, if 50 mg isn't doing the job, you can increase the amount to 100 mg.

While the initial dose of Cialis is typically 10 mg, you may decrease to 5 mg or increase to 20 mg depending on your response. The typical daily dose of Cialis for everyday use is 2.5 mg.

Which is more effective?

Viagra and Cialis have similar effectiveness. However, many people prefer Cialis because of its longer duration of action.

Does food compromise the effectiveness of Viagra or Cialis?

Fatty meals and alcohol affect the efficacy of Viagra, while Cialis is not affected by food.

What are the common side effects of Viagra and Cialis?

The following side effects are common to all phosphodiesterase five inhibitors:

  • headache
  • flushing
  • nasal congestion
  • indigestion
  • muscle pain
  • vision changes

Viagra has a higher risk of vision change, while Cialis has a higher risk of muscle pain. These side effects are transient and not typically of concern to the users.

Can I use Cialis or Viagra if I am taking blood pressure medications?

If you are on blood pressure medications, using Viagra or Cialis could cause problems. It can make you dizzy, fall, black out, or even cause a heart attack. Nitrate drugs, like nitroglycerin, pose the highest risk. Ask your doctor before using either Viagra or Cialis.

Are there drug interactions with Viagra or Cialis?

The following medicines may interact with both Viagra and Cialis. The list is not all-inclusive, so if you take any medications, ask your pharmacist or doctor if you can take them with Viagra or Cialis.

Which is cheaper, Viagra or Cialis?

On average, Viagra costs $70 per pill, while Cialis costs $73.50 per pill. But by switching to the generics sildenafil or tadalafil, you can save up to 98% off the retail price with the rxless prescription discount card. The card is accepted in over 70,000 pharmacies nationwide including CVS, Rite Aid, and Walgreens.