Tadalafil vs Sildenafil: Which is Better for ED?

Sildenafil and Tadalafil are two commonly prescribed medicines for Erectile Dysfunction (ED). Both belong to a group of medicines called Phosphodiesterase type 5 (PDE5) inhibitors. They work in a similar way by improving blood flow to the penis when a person is sexually aroused. However, they are not exactly the same.

The biggest difference is how long they work. Tadalafil can improve the ability to achieve an erection for up to 36 hours after a dose, while Sildenafil is generally used for a shorter period around the time of sexual activity. Tadalafil can also be taken once daily, while Sildenafil is generally taken as needed.

In this article, we will discuss the Tadalafil vs Sildenafil differences and which one you should choose.

Tadalafil vs Sildenafil at a glance

Although Tadalafil and Sildenafil work in a similar way, they differ in several important areas, including how long they last, how often they may be taken, their approved uses, and how food affects them. Cost may also play a role when choosing between the two.

Generic Sildenafil is much more affordable than generic Tadalafil. Among brand-name options, Viagra (brand-name of Sildenafil) typically costs more than Cialis (brand-name of Tadalafil). Generics have the same active ingredient as their respective brand medicines but usually cost less.

The table below highlights the main differences between Tadalafil and Sildenafil to help you understand how the two medicines compare.

Approved uses

Both medicines have established clinical uses, but they differ in the conditions they are approved to treat. Their specific uses also depend on the formulation and brand under which they are prescribed.

• Tadalafil: Approved to treat ED and the signs and symptoms of BPH, a condition that can cause urinary symptoms. It may also be prescribed for men who have both ED and BPH.

• Sildenafil: When sold as Viagra (brand name), it is approved for ED. Sildenafil is also used under other brand names for PAH, but that is a different use and should not be confused with Viagra treatment for ED.

Therefore, Tadalafil may offer an advantage for men who have ED with BPH, while Sildenafil’s use for ED is more specifically focused on treating erectile difficulties.

Onset and duration

Duration and how quickly they start working are two clear differences between Cialis and Viagra.

• Tadalafil: Usually starts working within 30–60 minutes and remains effective for up to 36 hours after a dose. This longer window is why it is sometimes informally called the weekend pill.
• Sildenafil: Usually starts working within 30–60 minutes and has a shorter duration of 4–6 hours, so it is generally taken closer to the time of sexual activity.

Tadalafil offers a longer duration of action, while Sildenafil provides a shorter window that may suit someone who prefers treatment for a specific occasion. Neither medicine causes an automatic erection. Sexual stimulation is still needed for either medicine to work.

Dosing

Tadalafil and Sildenafil differ in how often they are taken for Erectile Dysfunction, with each offering a different dosing schedule. Their dosing is as follows:

• Tadalafil: For ED, it can be taken as needed or once daily. The usual starting dose is 10 mg when taken as needed or 2.5 mg once daily, which may be increased to 5 mg based on response and tolerability.

• Sildenafil: It is generally taken as needed. The starting dose is 50 mg, which may be decreased to 25 mg or increased to 100 mg based on effectiveness and tolerability. It should not be taken more than once a day.

Therefore, Tadalafil may be more convenient for someone who prefers a daily treatment option, while Sildenafil may suit someone who wants to take a medicine only when needed.

Available strengths

The available strengths differ between the brand-name and generic versions of Tadalafil and Sildenafil:

• Tadalafil: Cialis is available in strengths including 2.5 mg, 5 mg, 10 mg, 20 and up to Cialis 60 mg. Generic Tadalafil is also available in several strengths, including 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg and higher strengths such as 80 mg for specific medical uses.
• Sildenafil: Viagra is available in 25 mg, 50 mg, and 100 mg strengths. Generic Sildenafil is available in these strengths as well as higher-strength products such as 120 mg, 150 mg, and 200 mg, including products such as Cenforce 200.

The higher generic strengths are not part of the standard recommended dosing for ED and should only be considered when lower doses do not provide adequate results and a doctor recommends a higher dose.

Overall, Sildenafil offers more dosing options and flexibility as compared to Tadalafil because generic versions are available in higher strengths.

Cost and affordability

The cost of Tadalafil and Sildenafil varies depending on whether you choose a generic or brand-name medicine.

• Viagra: Typically costs around $65–$140 per pill without insurance.
• Cialis: Starts at around $60–$70 per pill without insurance.

Generic versions offer a much lower-cost alternative to both brand-name medications, with only a small difference in price between them.

• Generic Viagra: Generic Sildenafil starts at around $0.52 per pill.
• Generic Cialis: Generic Tadalafil starts at around $0.56 per pill.

Overall, generic Sildenafil is slightly more affordable than generic Tadalafil, while brand-name Viagra is considerably more expensive than brand-name Cialis.

Effect of food

Tadalafil’s working or absorption is not affected by food. So you can take it with or without meals. Sildenafil can also be taken with or without food. However, taking it after a high-fat meal can make the medicine take longer to start working.

Therefore, Tadalafil may offer more flexibility around meals, while Sildenafil may work more predictably when taken without a heavy, high-fat meal. This may be important for someone planning to take Sildenafil with a meal.

Side effects

Tadalafil and Sildenafil may cause some similar side effects because they belong to the same drug class. Side effects vary from person to person. A doctor may consider previous reactions and other medicines when deciding which treatment is appropriate. They usually go away on their own as your body adjusts to the medicine. These include:

• Headache
• Flushing
• Indigestion
• Nasal congestion

Tadalafil is also associated with back pain and muscle aches, while Sildenafil may cause visual changes. Dizziness may also occur with Sildenafil.

Overall, Tadalafil may be a better fit for people concerned about vision-related side effects, while Sildenafil may be preferable for those seeking to avoid back pain. Seek immediate medical help for an erection lasting more than 4 hours (Priapism) or sudden vision or hearing changes.

Conclusion

Tadalafil and Sildenafil can both effectively treat ED, but their differences make each one better suited to certain situations. Tadalafil may be a better option if you want a longer duration of action (36 hours), the convenience of daily dosing, treatment for ED with BPH, or less concern about taking it around meals. Sildenafil may be more suitable if you prefer an as-needed medicine with a shorter duration of action.

Generic Sildenafil is slightly more affordable at $0.54 per pill than generic Tadalafil ($0.56 per pill), although brand-name Viagra is more expensive than Cialis. Sildenafil also has generic products available in higher strengths, but doses above 100 mg are not standard for ED and should only be used if specifically recommended by a doctor.

Tadalafil is more commonly associated with back pain and muscle aches, while Sildenafil may cause visual changes and dizziness. Ultimately, when comparing Tadalafil vs Sildenafil, neither medicine is universally better. The better choice depends on your dosing preference, desired duration, cost considerations, and your tolerance to the treatment.