(First (unedited version) published by Regenex Health December 2019)
Commonly asked questions by men with Erectile Dysfunction (ED) or Performance Anxiety:
- What is the difference between Tadalafil vs Sildenafil?
- What medication should I take, Tadalafil vs Sildenafil?
- Which ED medication is best for me?
We will address each question, but first, let’s discuss a little about ED meds and the first-line treatment for ED.
The first line of treatment for men with ED is an oral medication. Oral ED medications such as Sildenafil and Tadalafil are both phosphodiesterase type 5 inhibitors (PDE5i). They all act on the same physiological pathway in the human body. PDE5 is an enzyme in the penis (corpora cavernosa tissue) that prevents an erection from occurring. All oral ED medications work to inhibit this enzyme and are therefore called PDE5 inhibitors.
The difference between all the ED medications is their specificity for the PDE5 enzyme. There are many PDE enzymes in the body. The level of specificity for the PDE5 enzyme is different for all ED meds. Other aspects of ED medications that are different include bioavailability (how long it lasts in the body for use), ability to be taken with or without food, and side effect profile. Let’s address these topics as they relate to Sildenafil and Tadalafil.
1) “What is the difference between Tadalafil vs Sildenafil?”
There are very several important differences between Tadalafil and Sildenafil that patients should be aware of because choosing the right medication will ultimately lead to the best result.
Sildenafil was the first ED medication to enter the market. It was a ground-breaking achievement in the field of medicine that men could improve their erectile function with just a tablet. Sildenafil was actually discovered by accident, as researchers at Pfizer were originally investigating the drug for the treatment of angina (chest pain). They noticed that men had improved erectile function during their follow-up visits during the clinical trials. With this information, they changed the trial to investigate the drug for erectile dysfunction purposes and so began the birth of Sildenafil (then given the brand name Viagra). On March 27, 1998, Pfizer received FDA approval for Sildenafil for the treatment of ED at 50mg and 100mg dosages. Sildenafil has since been used by over 20 million men in over 110 countries and is one of the best-studied pharmacological substances available.
Sildenafil is best used when taken 1 hour prior to sexual activity and will last in the body for 4-5 hours. Sildenafil reaches peak levels in the body approximately 30min – 2 hours after oral ingestion. Sildenafil must be taken on an empty stomach, as food will impair its absorption. Side effects of Sildenafil include blurry vision and dizziness among others.
In comparison, Tadalafil is a second-generation ED medication. Tadalafil is different than Sildenafil in the following ways.
First, and most noteworthy, Tadalafil can be taken with food. Food does not impair the absorption of Tadalafil. This is important to note because in clinical studies the majority of sexual activity occurs after dinner between the hours of 9 pm-1 am. Tadalafil makes it easier for men to be more spontaneous and not have to worry about food intake with medication usage.
Second, Tadalafil has a duration of action of 36 hours, compared to Sildenafil of only 4-5 hours. Many men find this longer duration of action more appealing because the ability to get multiple erections becomes easier to sustain within than 36-hour window. This does not mean you will have an erection lasting 36 hours, but rather the window period of 36 hours makes it much easier to obtain, achieve and sustain an erection much longer than Sildenafil.
Third, Tadalafil has a lower side effect profile than Sildenafil. The main side effects of Tadalafil include congestion and slight back pain among others.
Fourth, Tadalafil can be taken daily. The FDA approved Tadalafil for erectile dysfunction and BPH (Benign Prostatic Hyperplasia). A low dose of 5mg Tadalafil, can be taken daily to provide men more spontaneity with their sexual activity and not have to worry about taking medication before sex. This sense of freedom makes Tadalafil more attractive for men as an ED tablet compared to Sildenafil. The daily Tadalafil can also help improve symptoms of an enlarged prostate such as waking up at night to urinate, straining to urinate, or frequency and urgency of urination.
2) “What medication should I take, Tadalafil vs Sildenafil?”
Now that we have discussed the main differences between Tadalafil and Sildenafil, which one should you choose? It really depends on your lifestyle and the amount of sexual activity you are having. For instance, for a man who has sex multiple times per week and does not plan sexual activity, then Tadalafil is a more attractive option. For a man who plans his sexual activity, such as a married couple who goes out to dinner and then plans to engage in sex, then Sildenafil can be a better option.
Most men, including the partners of men, prefer Tadalafil over Sildenafil. 73% of patients prefer Tadalafil over Sildenafil, and 63% of men preferred the freedom and dosing instructions Tadalafil provides. Couples who are anticipating more frequent sexual activities and spontaneity prefer Tadalafil. With Tadalafil you don’t have to link sex with medication because Tadalafil can be taken daily. This feature is preferred by most men and provides greater freedom and less planning.
In studies of men using Tadalafil, men felt less time pressure, less sense of urgency, and less planning before and during sexual intercourse when taking Tadalafil compared to Sildenafil. Men who take Tadalafil state they have the “ability to get an erection long after having taken Tadalafil” and the “ability to get an erection every time.”
Men who use Sildenafil score higher in sexual self-confidence domains. Men on Sildenafil feel the “ability to get an erection every time” and the erections are firmer.
3) “Which ED medication is best for me – Tadalafil vs Sildenafil?”
When it comes to choosing the right erectile dysfunction medication it’s important to take into account lifestyle and frequency of sexual activity. Some men respond better to Tadalafil than Sildenafil and vice versa. If you are having sex often, Tadalafil is enjoyed by most men. Sildenafil may be better for a more planned sexual activity.
Non-coated tablets dissolve fast under the tongue. Absorption is across the mucus membrane in the mouth, bypassing the gut, and going directly into circulation. A more active ingredient is available and the onset of an erection to occur is much faster. A study from 2003 evaluated the velocity by which sildenafil acted when the film-coated tablets were crushed. Crushed tablets were taken under the tongue and allowed to dissolve. Researchers noted a faster onset of activity. The benefits of oral dissolving ED tablets include:
- Higher Bioavailability (less breakdown of the drug by the stomach or gut)
- Discrete intake since no water is needed
- Elimination of any swallowing issues
- Faster time to peak concentration
- Shorter duration of time of onset (faster acting)
For more information, contact Vitality Express directly.
