Viagra and Cialis are the most commonly prescribed erectile dysfunction (ED)medications. Healthcare providers order these prescription drugs to help patients achieve and maintain an erection firm enough for sex.
But which drug, Viagra or Cialis, is the best choice for you? Let’s break down the key differences between them so you can get a better sense for your treatment options.
How do Cialis and Viagra work?
Both Cialis (tadalafil) and Viagra (sildenafil) belong to a class of drugs known as phosphodiesterase type 5 enzyme (PDE5) inhibitors. These medications work by intensifying the effects of nitric oxide (NO), a molecule that helps the blood vessels in the penis expand. This action helps promote more blood flow to the penis, leading to an erection.
Cialis and Viagra also only work with sexual stimulation, which means they won’t cause random or constant erections. While both medications are FDA-approved for ED treatment, Cialis is also prescribed for benign prostatic hyperplasia (BPH), or enlarged prostate. If you have BPH and ED, Cialis may be the better option for you.
Which medication lasts for longer?
Cialis lasts significantly longer than Viagra, staying effective for up to 36 hours. Viagra, on the other hand, typically lasts for about 4 to 6 hours.
This makes Cialis a better option for men who are looking for more spontaneity in their sex life, since users do not need to time the medication precisely before sexual activity.
Which medication works fastest?
Viagra usually starts working in about 30 minutes. However, if you eat a high-fat meal (like a cheeseburger and fries) right before taking it, it might take longer to kick in and may not work as well. That’s why it’s best to take Viagra on an empty stomach for the best results.
Cialis also takes about 30 minutes to begin working, but it can take up to 2 hours for the medication to fully take effect. The good news is that food doesn’t affect how well or how quickly it works, so you can take it with or without a meal.
What’s more effective, Viagra or Cialis?
Though some studies have mixed results, Cialis and Viagra are considered to have similar effectiveness for treating erectile dysfunction.
However, tadalafil (Cialis) had a few advantages. In an analysis of 16 studies, tadalafil improved patients' mental well-being and sexual confidence more than sildenafil (Viagra), likely because it has a longer duration of action (36 hours) that allows for more flexibility and less pressure to plan sex around a medication schedule.
And while tadalafil caused more back pain and muscle aches, it also caused less facial flushing than sildenafil. As a result, both patients and their partners tended to prefer tadalafil.
Which medication was approved first?
Viagra was approved in 1998 and was the first-ever oral medication approved by the FDA to treat erectile dysfunction. The generic version of Viagra, sildenafil, was approved in 2017.
Cialis was approved by the FDA in 2003 (5 years after Viagra), and the generic version of Cialis, tadalafil, was approved in 2018.
Generic options for both Cialis and Viagra are considered to be just as safe and effective as the name-brand version.
Which medication is more affordable?
The price of both Cialis and Viagra can depend on dosage, how often you take it, your pharmacy’s pricing, and whether or not you have insurance coverage. Not all insurance companies cover medications for erectile dysfunction, so even with insurance, it may be worth checking around for the best price.
With Cialis, men have the option to take a lower daily dose (2.5-5mg) or a higher dose that’s only taken as needed (5-20 mg, taken 30 minutes before sex). If taken daily, the price for Cialis without insurance is around $180 for a monthly supply of 5 mg tablets. If taken as needed, the price for Cialis without insurance is around $700 for 30 tablets (20mg). While the upfront price for 30 tablets of 20mg Cialis is higher than 30 tablets of 2.5mg Cialis, it may be lower in the long run since you’re not taking the medication every day.
Viagra comes in 3 different strengths – 25, 50, or 100mg tablets – and is taken as needed; there is no daily option. Without insurance, the price of a 30-day supply can range from around $2,800 to $3,200 depending on the dose.
Luckily, generic versions of Cialis and Viagra are available (and more affordable) than the brand name medications:
- A 30-day supply of 25mg generic Viagra tablets costs around $900 without insurance, compared to $3,200 for name-brand Viagra.
- A 30-day supply of 5mg generic Cialis tablets costs around $50 without insurance, compared to $180 for name-brand Cialis.
Discount cards and manufacturer savings programs can also help you save on both medications.
Does one make you harder than the other?
No. Despite common myths, neither medication makes you “harder” than the other. Both Cialis and Viagra work to increase blood flow, and their potency is equally powerful when taken in the correct dose.
Are side effects the same for both medications?
Serious side effects (though rare) may include chest pain, low blood pressure, or prolonged erection (priapism). Both medications can interact with nitrates, such as nitroglycerin, and should not be used by men with certain heart conditions, such as angina or heart disease.
Always consult a healthcare professional and discuss your medical history before starting ED treatment.
Here’s a chart that compares the key differences between Cialis and Viagra:
| Comparison points | Cialis (Tadalafil) | Viagra (Sildenafil) |
|---|---|---|
| Time to take effect | 30 minutes (can take up to 2 hours to fully take effect) | 30 minutes |
| Effect duration | Up to 36 hours | 4-6 hours |
| Dosing schedule | Daily or as needed | As needed |
| Interactions with food | Can be taken with or without food | Should be taken on an empty stomach |
| Common side effects | Headache, indigestion, back pain, muscle aches | Headache, flushing (face, neck and/or chest), indigestion, nasal congestion |
| Less common side effects | Vision changes, limb pain | Vision changes, blue-tinged vision, dizziness |
| Brand-name cash price (without insurance) | $180 for a 30-day supply of 5mg tablets | $3,200 for a 30-day supply of 25mg tablets |
| Generic cash price (without insurance) | $50 for a 30-day supply of 5mg tablets | $900 for a 30-day supply of 25mg tablets |
| FDA-approval date | November 21, 2003 | March 27, 1998 |
Are there alternatives to Cialis and Viagra?
Yes. Alternative PDE5 inhibitors that work similarly to Cialis and Viagra include:
If you’re not a candidate for PDE5 inhibitors, there are other options available to you. Non-PDE5 inhibitor treatments for ED include penile injections (alprostadil), testosterone therapy, intraurethral suppositories, and more. You can talk to a healthcare provider about these treatment options to determine the best prescription for you and your sex life.
How Sesame can help
If you're dealing with erectile dysfunction and exploring treatment options, a healthcare provider on Sesame can help today during an online ED visit.
These quick video appointments allow you to discuss your symptoms and potential treatment options with a licensed healthcare provider.
If appropriate, providers on Sesame can prescribe ED meds and other forms of therapy to help you get your sex life back on track. Any prescriptions will be sent to your preferred pharmacy for pickup.
