Both Cialis and Viagra are phosphodiesterase inhibitors (PDE5) and have been approved by the US Food and Drug Administration (FDA).
Cialis (tadalafil)
As a PDE5 inhibitor, Cialis (tadalafil) boosts blood flow to the penis, leading to sexual arousal.
You have two dosage options with Cialis. The low-dose once-a-day option builds up and stays in the blood system to prepare the body for sexual activity.
The second dosage option involves taking Cialis 30 minutes before sex and can last upwards of 36 hours.
Viagra (sildenafil)
Viagra (sildenafil) was the first PDE5 inhibitor to enhance blood flow to the penis.
A major difference between Cialis and Viagra is that Viagra doesn't last as long. It must be taken 30 minutes before you anticipate sex.
You can only take Viagra once every 24 hours. If you take it daily, there is no guarantee that it will still be in your system when you gear up for sexual activity.
Viagra tends to be an ideal ED solution for men who enjoy occasional sex.
How do Cialis and Viagra work?
Both Cialis and Viagra are part of the PDE5 inhibitor drug family that also includes vardenafil and avanafil.
Neither ED medication will directly cause an erection and does not cure erectile dysfunction. Cialis and Viagra require sexual arousal to work.
Instead, the ED pills address the symptoms of erectile dysfunction by increasing blood flow to the penis by reducing the PDE5 chemical in your body.
Emmel stated, ““They block an enzyme (PDE-5) that degrades a substance called cyclic guanosine monophosphate (cGMP). cGMP is the molecule that facilitates the relaxation of smooth muscle cells. When smooth muscle cells lining the blood vessels supplying the penis relax, blood flow in the area creases. This increased blood flow facilitates an erection.”
Pro Tip:VitaFLUX Nitric Oxide Booster can help to relax blood vessels and allow more blood flow through increased nitric oxide production.
How long does it take Viagra to work?
Viagra is meant to work fast. For most men, it takes 30 to 60 minutes for Viagra to kick in.
One of the drawbacks of Viagra working fast, it doesn't work for long. The effects only last for about four to eight hours.
How long does it take Cialis to work?
Cialis takes about 1 to 2 hours before it starts working. But the benefit of this drug compared to viagra is that it lasts longer.
Cialis can be effective for up to 36 hours when taken.
Can you take Viagra and Cialis Together?
According to Emmel, “ There is no data supporting the combination of two separate PDE-5 inhibitors.”
You should not take Cialis and Viagra in the same 24-hour period. The main reason for this is that Cialis stays in the body for up to 36 hours.
It’s best to wait at least 36 hours after taking Cialis before taking Viagra or another dose of Cialias.
If you’ve taken a dose of Viagra, wait at least 24 hours before taking Cialis or another dose of Viagra.
Taking Cialis and Viagra together can increase the risk of side effects associated with these medications.
Side effects
There are a variety of potential side effects with taking ED meds. A few of them include:
Emmel stated, “It would be expected that combining drugs like Cialis and Viagra would increase the propensity for side effects. These could include headaches, visual changes, flushing, and most concerning a dangerous drop in blood pressure.”
Can you overdose?
While rare, an overdose is possible on either Cialis or Viagra. Taking them together only ups the chances of an overdose that can lead to a fatal drop in blood pressure.
If an overdose of PDE5 is suspected, contact a healthcare professional immediately and call poison control for support until help arrives.
What's the difference between Cialis and Viagra?
One of the big differences between Cialis and Viagra is how long it lasts.
Cialis can last for up to 36 hours, which allows for spontaneity and flexibility. In contrast, Viagra only lasts between 4 to 6 hours.
Is one better than the other?
One can take Cialis or Viagra 30 or so minutes before engaging in sexual activity, and they will work the same way.
For those looking for more flexibility in their sex life, Cialis may be the better choice. The low 5mg to 10mg dosage once daily builds up in the body so men can have more spontaneous sex.
Both alcohol and PDE5 inhibitors widen the blood vessels and decrease blood pressure. The combination of the two is typically not life threatening, but it’s strongly recommended to limit alcohol consumption when taking a PDE5 inhibitor.
Additionally, alcohol can reduce the effectiveness of Viagra and Cialis.
What drugs interact with Cialis or Viagra?
Whether you take Cialis daily or Viagra every once in a while, there are potential risks of drug interactions.
When we asked Emmel he explained, “The most concerning drug interactions with PDE-5 inhibitors is the use of nitrates such as nitroglycerin. These may be used for angina or heart failure. The combination of these can lead to a dangerous drop in blood pressure.”
He also added, “The same interaction can be seen with alpha-blockers, but to a lesser extent. There are a few drugs that may decrease the metabolism and therefore increase the effects and risk of side effects from PDE-5 inhibitors, including some antifungal and antiviral medications, as well as grapefruit.”
Two other possible drugs that may cause interactions include:
Blood pressure medication. ED medication may react with particular blood pressure medicine. Consult with your physician.
Recreational drugs. Mainly stimulants can decrease blood flow and cause a heart attack or stroke.
Emmel noted that, “There is some evidence that combining PDE-5 inhibitors with antioxidants, propionyl-l-carnitine or l-arginine, results in more improvements in erectile dysfunction than PDE-5 inhibitors alone.”
Additionally, there may be other issues that need to be resolved in order to heal ED. Here are a few possible reasons to consider.
Underlying health conditions
Specific health conditions can stop the body's ability to achieve an erection.
Heart disease
High cholesterol
High blood pressure
Peyronie's disease
Diabetes
Obesity
Parkinson's disease
Multiple sclerosis
Low testosterone
Surgery or injury
The causes of ED do not have to be physical, either. Psychological and emotional issues can cause a man to struggle with erectile dysfunction.
Depression
Stress
Anxiety
Relationship woes that cause stress
A change in lifestyle
It's proven that cigarette smoking is often associated with ED. Quitting smoking may make achieving an erection more likely.
Alcohol dependency is also a factor in some men struggling with erectile dysfunction, including problems with desire, arousal, and function.
Another lifestyle risk factor is obesity. Exercise and the proper diet can do a lot to improve a person's sex life. In one study, 79% of men with ED have a BMI of 25kg or more.
Alternative treatment options for ED
You may decide PDE5 inhibitors are not for you, or you've found that they aren't doing what you need them to.
You have other erectile dysfunction treatment options.
Testosterone therapy. Low testosterone (hypogonadism) is one of the leading causes of ED.
Therapy and counseling. Addressing psychological issues can sometimes help with erectile dysfunction.
Sexual health supplements. Supplements that contain L-Arginine, like ڤَيتا فلَكس, are proven to help address low testosterone, energy levels, and libido.
Takeaways
Avoid taking Cialis in the morning and Viagra at night. Taking more than one PED5 inhibitor daily can increase the likelihood of serious side effects.
Cialis comes with two choices in dosage. A low-dose daily dose that gives you flexibility in when you have sex, and a higher dose that acts like Viagra.
Viagra is taken 30 minutes before you anticipate having sex, and it can help with an erection for up to a few hours. Consult with your doctor on the best treatment option.
If ED meds don’t work, a supplement with L-Arginine, like VitaFLUX, may be worth considering.
Dr. Emmel is a Board Certified Pharmacy Specialist with over 15 years of clinical and academic experience. He is also the Director of Educational Programs at Pharmacy Tech Scholar.
Sources:
Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can find out more about how we ensure our content is accurate and current by reading our editorial policy.
Gong B, Ma M, Xie W, Yang X, Huang Y, Sun T, Luo Y, Huang J. Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. Int Urol Nephrol. 2017 Oct;49(10):1731-1740. doi: 10.1007/s11255-017-1644-5. Epub 2017 Jul 24. PMID: 28741090; PMCID: PMC5603624. Accessed on Mar, 14, 2023.
"Should you take a daily erectile dysfunction pill? - Harvard Health Publishing." Health.harvard.edu, 2022, www.health.harvard.edu/mens-health/should-you-take-a-daily-erectile-dysfunction-pill. Accessed on Mar, 14, 2023.
"Sildenafil - MedlinePlus." Medlineplus.gov, 2018, www.medlineplus.gov/druginfo/meds/a699015.html. Accessed on Mar, 14, 2023.
Keating GM, Scott LJ. Vardenafil: a review of its use in erectile dysfunction. Drugs. 2003;63(23):2673-703. doi: 10.2165/00003495-200363230-00010. PMID: 14636086. Accessed on Mar, 14, 2023.
Katz EG, Tan RB, Rittenberg D, Hellstrom WJ. Avanafil for erectile dysfunction in elderly and younger adults: differential pharmacology and clinical utility. Ther Clin Risk Manag. 2014 Aug 27;10:701-11. doi: 10.2147/TCRM.S57610. PMID: 25210457; PMCID: PMC4155803. Accessed on Mar, 14, 2023.
"Questions and Answers for Cialis (tadalafil) - U.S. Food & Drug Administration." Fda.gov, 2015, www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-cialis-tadalafil. Accessed on Mar, 14, 2023.
"PTCB Recognized Training Program - Pharmacy TechScholar." Pharmacytechscolar.com, 2023, https://www.pharmacytechscholar.com/. Accessed on Jul, 10, 2023.
Silberman M, Stormont G, Leslie SW, et al. Priapism. [Updated 2022 Dec 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459178/. Accessed on Mar, 14, 2023.
Kim JN, Oh JJ, Park DS, Hong YK, Yu YD. Influence of Alcohol on Phosphodiesterase 5 inhibitors Use in Middle- to Old-Aged Men: A Comparative Study of Adverse Events. Sex Med. 2019 Dec;7(4):425-432. doi: 10.1016/j.esxm.2019.07.004. Epub 2019 Aug 20. PMID: 31444051; PMCID: PMC6963111. Accessed on Mar, 14, 2023.
"Viagra and nitrates don’t mix, so how are some men still taking both? - NBC News." Nbcnews.com, 2022, www.nbcnews.com/health/mens-health/viagra-nitrates-dont-mix-are-men-still-taking-both-rcna24788. Accessed on Mar, 14, 2023.
Kovac JR, Labbate C, Ramasamy R, Tang D, Lipshultz LI. Effects of cigarette smoking on erectile dysfunction. Andrologia. 2015 Dec;47(10):1087-92. doi: 10.1111/and.12393. Epub 2014 Dec 29. PMID: 25557907; PMCID: PMC4485976. Accessed on Mar, 14, 2023.
Skrypnik D, Bogdański P, Musialik K. Otyłość--istotny czynnik ryzyka zaburzeń potencji u mezczyzn [Obesity--significant risk factor for erectile dysfunction in men]. Pol Merkur Lekarski. 2014 Feb;36(212):137-41. Polish. PMID: 24720114. Accessed on Mar, 14, 2023.
Rajfer J. Relationship between testosterone and erectile dysfunction. Rev Urol. 2000 Spring;2(2):122-8. PMID: 16985751; PMCID: PMC1476110. Accessed on Mar, 14, 2023.
Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The Daily Therapy With L-Arginine 2,500 mg and Tadalafil 5 mg in Combination and in Monotherapy for the Treatment of Erectile Dysfunction: A Prospective, Randomized Multicentre Study. Sex Med. 2020 Jun;8(2):178-185. doi: 10.1016/j.esxm.2020.02.003. Epub 2020 Mar 16. PMID: 32192966; PMCID: PMC7261690. Accessed on Mar, 14, 2023.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Viagra (sildenafil)
How do Cialis and Viagra work?
How long does it take Viagra to work?
How long does it take Cialis to work?
Can you take Cialis and Viagra To...&media=//www.promescent.com/cdn/shop/articles/Can-You-Take-Cialis-in-the-Morning-and-Viagra-at-Night_grande.jpg?v=1678811919)
