When patients begin to lose their erectile function, it can be a difficult time in their lives. For many, the first thought is toward natural remedies like saw palmetto that they believe can help them avoid prescription drugs. However, once they realize that these options usually don’t work, they turn to prescription drugs. The most common brand names are Viagra and Cialis and their generic forms are Sildenafil and Tadalafil, respectively, which have similar effectiveness in restoring sexual function. These drugs are proven effective and safe for the millions of men who take them regularly.
When discussing which is better, we often recommend that patients get a prescription for each of the two main generics and see which works best with the fewest side effects. While both drugs work in a similar way, being five alpha-reductase inhibitors that allow blood vessels to dilate and thus increase the amount of blood entering the penis, each has slightly different characteristics and qualities. The same patient may respond to one drug while not responding to the other. And this highlights that there are some differences. So, let’s dive into their various uses and under what circumstances you would choose one over the other.
For men on the dating scene
For someone single or divorced and dating, daily Cialis/Tadalafil may be preferable to Viagra/sildenafil. The reasons here are twofold. First, the dating scene is relatively unpredictable, so longer-lasting Cialis can keep you going for longer (up to 36 hours). On the other hand, Viagra is shorter acting and requires a bit more planning. Also, Viagra is less effective after you have eaten a fatty meal. This is not an issue with Cialis and is therefore preferred by someone who will often dine with their date before intercourse.
For Married/Committed Long Term Relationship
Here, there is some scope for using any medicine. These patients may prefer Viagra because their sex lives are more predictable and they may not want the long-acting properties of Cialis.
Practically, both drugs are safe and effective and can be used interchangeably. For some, a drug will work better. So if one drug doesn’t work for you, don’t worry as we can try the other.
Duration of Action
The duration of action for Viagra is only a few hours, while Cialis can last up to three days. Cialis is also approved for low-dose daily use and can help maintain the baseline dose. There is little risk in taking the maximum dose and often, we will prescribe the highest dose, giving patients the option of cutting the pill in half if they find a lower dose just as effective.
Security Profile
Sildenafil and Tadalafil are safe, but are contraindicated in patients taking nitrates for heart problems or recreational drugs for enhanced sexual pleasure. Each has some minor side effects, including flushing. Viagra can cause a blue tint to the vision. Usually, these symptoms go away after the drug is stopped. There are scattered reports of priapism caused by Viagra/Sildenafil overdoses, although this is extremely rare.
What these drugs are not
These drugs do not provide an instant erection. Instead, they improve blood flow systemically, including to the penis, by dilating blood vessels. They will not replace desire or interest in a partner or sex in general.
It is also important to understand that these drugs will not remain effective indefinitely. This is not due to tolerance but rather to the progression of atherosclerosis in the penile arteries. A patient whose medication effectiveness begins to decline should see Dr. Natale to discuss this development and understand their options. Typically, this involves a trimix or quadmix injection, essentially delivering instant erections that last for the duration of intercourse.
Most importantly, patients should understand that they do not have to live with mild to moderate ED without treatment (erectile dysfunction). There are minimally invasive options to effectively treat the condition. The most important idea is not to be embarrassed or ashamed to see a urologist and get care. Erectile dysfunction is as normal as aging and should therefore be treated as its first signs. Contact us today to discuss what is best for you!
