Introduction
Millions of men worldwide have erectile dysfunction (ED). This problem often increases as men get older. Thankfully, pills like Viagra and Cialis have really helped. They are now the most common ways to treat ED.
Both pills work well. But they are different in key ways. They last for different amounts of time. They start working at slightly different speeds. They also have different side effects and ways to take them. This guide will help you understand these differences. Then you can have better chats with your doctor.
Key Differences at a Glance
Here’s a quick look at the main differences:
| Feature | Cialis | Viagra |
| Main Ingredient | Tadalafil | Sildenafil |
| How Long It Works | 24-36 hours | 4-5 hours |
| Time to Start | 30-60 minutes | 30-60 minutes |
| Food Effect | Works with or without food | Fatty meals slow it |
| How to Take It | Daily or as-needed | As-needed only |
| Generic Available | Yes | Yes |
| Starting Dose | 10mg (as needed) | 50mg |
| 2.5mg (daily) |
How They Work
Cialis and Viagra belong to a group of drugs called PDE5 inhibitors. Here’s how they help you get an erection:
- When you get aroused, your body releases a chemical messenger in the penis.
- This messenger helps make another substance (cGMP).
- cGMP relaxes muscles in the penis. This lets more blood flow in.
- Usually, an enzyme called PDE5 breaks down cGMP. This makes the erection fade.
- These drugs block PDE5. This keeps cGMP working longer.
- More blood stays in the penis, helping you keep your erection.
Even though they work the same basic way, their chemical makeup is different. This leads to the key differences in how they affect your body.
Duration: The “Weekend Pill” vs. The “4-Hour Option”
Cialis
People often call Cialis the “weekend pill.” It lasts the longest of all ED pills.
- How long it works: 24 to 36 hours.
- What this means: You have more freedom. You don’t need to time sex so precisely.
- Daily option: You can take low doses (2.5mg or 5mg) every day. This keeps a steady level of the drug in your blood.
Dr. James Elist, a men’s health expert, says: “My patients tell me they like Cialis because it gives them more freedom. They don’t have to watch the clock, which helps them feel more relaxed and enjoy sex more.”
Viagra
Viagra works for a shorter time.
- How long it works: 4 to 5 hours.
- What this means: You need to plan your timing more carefully.
- How to use it: Take it about 30 to 60 minutes before sex.
How Quickly They Work and Food Effects
Cialis
- Time to work: Usually starts working in 30 to 60 minutes.
- Food effects: Works well even if you take it with food.
- Why this matters: You can take it around mealtimes without worry.
Viagra
- Time to work: Also starts working in about 30 to 60 minutes.
- Food effects: Heavy, fatty meals can slow it down. It might take an extra hour to work. Fatty meals can also make it a bit less strong.
- Why this matters: Viagra works best on an empty stomach. Or, take it after a light meal.
A 2013 study showed fatty meals reduced how much Viagra the body absorbed by nearly 30%. Food didn’t really affect Cialis.
Side Effects: What to Expect
Both pills share some common side effects. But they also have some unique ones.
Common Side Effects of Both:
- Headache
- Flushing (face feels warm and looks red)
- Stuffy nose
- Upset stomach
- Muscle aches
Cialis-Specific Effects:
- Back pain and muscle aches are more common with Cialis. They usually show up 12 to 24 hours later.
- Side effects might last longer because the drug stays in your body longer.
- Side effects are usually milder if you take the small daily dose.
Viagra-Specific Effects:
- Vision changes happen more with Viagra. This can include seeing a blue tint or being more sensitive to light.
- Side effects usually go away within 4 to 5 hours as the drug leaves your system.
- Viagra might cause slightly larger drops in blood pressure.
One large study found headaches happened about the same amount with both drugs (10-16% of users). Back pain was seen more with Cialis (4-9% vs. 1-3% with Viagra).
Cost and Availability
Good news! Both pills now have cheaper generic versions.
Cialis / Tadalafil
- Brand name Cialis costs about $13-20 per pill.
- Generic tadalafil costs about $3-8 per pill.
- Insurance coverage varies. Check your plan.
- Available as regular pills and low-dose daily pills.
Viagra / Sildenafil
- Brand name Viagra costs about $70-80 per pill.
- Generic sildenafil costs about $1-6 per pill.
- Insurance coverage varies. Check your plan.
- Available as regular pills in different strengths.
Medical Concerns and Drug Interactions
Both Cialis and Viagra have important safety rules. They can also interact badly with other medicines.
Never take these ED pills if you:
- Take nitrate drugs (like nitroglycerin for chest pain).
- Use “poppers” (recreational drugs containing nitrates).
- Have serious chest pain, or recently had a heart attack or stroke.
- Have severe liver problems.
- Have severe kidney problems (your doctor might need to adjust the dose).
Watch out for these drug interactions:
- Alpha-blockers (used for prostate issues or high blood pressure). Taking them together can cause a dangerous drop in blood pressure.
- Certain antifungal pills (like ketoconazole).
- Certain antibiotics (like erythromycin).
- Drugs used to treat HIV.
- Other ED medicines. Don’t mix them!
Dr. Marianne Rochester, a urologist, warns: “Always tell your doctor about all meds you take before starting ED treatment. The mix with nitrates can cause dangerous, even deadly drops in blood pressure.”
Special Groups and Concerns
Older Adults
- Doctors usually start older men on lower doses.
- They might feel side effects more strongly.
- They are more likely to take other drugs that could interact.
Heart Health Risks
- These pills might be risky for men with certain heart conditions.
- Your doctor may check your heart health before prescribing them.
- Cialis lasts longer. This needs extra thought for men with heart problems.
ED Caused by Stress or Anxiety
- Both pills work well when ED is caused by worry or stress.
- They have similar success rates for this type of ED.
- Cialis lasts longer. This might reduce “performance pressure” for some men.
A 2018 study found men with performance anxiety often preferred Cialis. They liked not having to worry so much about timing sex.
How Well They Work
Studies show both pills are effective for most men.
- Success rates: Around 60-80% of men report better erections with either pill.
- Dose effects: Higher doses usually work better. But they also cause more side effects.
- Direct comparisons: Studies comparing them directly show similar results. Men often choose based on how long the pill lasts and its side effects.
A 2017 review of 16 studies found no big difference in how well they treat ED. But many men preferred Cialis because it works longer.
Daily Cialis vs. As-Needed Options
Cialis offers a daily low-dose option. Viagra does not.
Daily Cialis (2.5mg or 5mg)
- Benefits: Keeps a steady level of the drug in your body. No need to plan ahead.
- Best for: Men who have sex often (more than twice a week).
- Added bonus: Can also help with symptoms of an enlarged prostate.
- Side effects: Usually milder than with higher, as-needed doses.
As-Needed Dosing (Both Pills)
- Benefits: You take the drug less often overall.
- Best for: Men who have sex less often or prefer not to take a daily pill.
- Planning needed: You need to time your dose, especially with Viagra.
Other Uses
These pills are mainly for ED. But they can treat other conditions too.
Cialis / Tadalafil
- FDA-approved for: ED, enlarged prostate symptoms, and high blood pressure in the lungs.
- Also studied for: Poor circulation in fingers/toes (Raynaud’s), urinary issues.
Viagra / Sildenafil
- FDA-approved for: ED, and high blood pressure in the lungs (under the name Revatio).
- Also studied for: Poor circulation (Raynaud’s), altitude sickness, exercise ability.
Making the Right Choice
Choosing between Cialis and Viagra depends on you. Talk with your doctor to decide. Consider these points:
- Your lifestyle: How often do you have sex? Is it planned or spontaneous?
- Your health: Do you have other health issues? What other medicines do you take?
- Past experience: Have you tried either pill before? How did it work?
- Cost and insurance: What can you afford? What does your plan cover?
- Your partner: Does your partner have preferences about timing?
Dr. Abraham Morgentaler from Harvard Medical School advises: “The best ED med isn’t always the newest or most advertised one. It’s the one that fits best with your lifestyle, health needs, and personal preferences.”
Recent Research
Studies keep teaching us more about these pills:
- Long-term safety: Research over 10+ years shows they remain safe to use.
- Using with other treatments: Doctors are exploring using them with testosterone for men with low T levels.
- Heart benefits: Some studies hint they might even help protect the heart.
- Quality of life: Evidence shows they boost mental well-being, not just erections.
A 2020 long-term study followed men using these drugs for over 10 years. It found they didn’t have more heart problems than similar men not taking the drugs. Users also reported a better quality of life.
Common Questions
Q: Can I take Cialis and Viagra together?
A: No. Don’t mix ED pills. It increases side effect risks and doesn’t work better. Stick to one pill as your doctor prescribed.
Q: Which one should I try first?
A: Talk to your doctor. Many suggest Viagra first because it’s been around longer and its safety is well-known.
Q: Can women take these pills?
A: No, they aren’t approved for women. Studies haven’t shown much benefit for female sexual problems, but research continues.
Q: Will these pills work the first time I take them?
A: Maybe not. It might take 2 or 3 tries to get the best results. Feeling nervous about performance can sometimes interfere at first.
Q: Can I drink alcohol with these pills?
A: A drink or two is usually fine. But heavy drinking can increase side effects. It can also make the pills less effective. Plus, alcohol itself can cause ED.
Q: Do these pills increase my sex drive?
A: No. They help with the physical part of getting an erection. They don’t boost your desire for sex. Desire depends more on your mind and hormones.
Conclusion
Both Cialis and Viagra work well for ED. They have important differences, though. Think about how long they last, timing, and side effects.
Cialis lasts longer and offers a daily option. This makes it good if you want more spontaneity. Viagra has a shorter action time. This might suit those worried about long-lasting side effects or drug interactions.
The best choice depends on your life, health, and what you prefer. Talk openly with your doctor about your goals and any concerns. This will help you find the right ED treatment for you.