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Are Viagra and Cialis Interchangeable, and Does One Work Better?

Man pouring blue pills into hand

In the world of erectile dysfunction or ED and men’s sexual health, there are few words that are more recognizable than Viagra and Cialis. These two drugs revolutionized the treatment of erectile dysfunction and became synonymous with several very positive (and sometimes negative) connotations. Today, both drugs are off-patent; as such, there are generic forms, including Sildenafil and Tadalafil, respectively.

When we prescribe one of these medications, some patients are concerned because they experience side effects, most often mild. Some of the most common include headaches, flushing, and other generally mild issues associated with systemic blood flow increases. Other patients see blue when taking Viagra, though this resolves after discontinuing the medication. A minimal number of patients may experience a four-hour erection, known as priapism. However, there is some debate about whether the medication causes this or if an overdose or the patient’s other habits are at fault.

Are the Medications Interchangeable?

The short answer is yes. Cialis and Viagra can be used separately without much of an issue. It’s essential, however, to understand the dosages. The maximum dose of Sildenafil is 100 mg, while the maximum dose for Tadalafil is 20 mg. You wouldn’t want to get those numbers mixed up. Beyond the actual doses, both drugs work in a substantially similar way. However, Cialis/Tadalafil remains in your body for up to 36 hours, while Viagra only lasts for a few hours – enough to have an extended sexual encounter and no more.

Viagra/sildenafil is also affected by what you eat. Therefore, if you typically go out for a large meal prior to having sexual relations, the effectiveness of the drug may be diminished. This is not the case for Cialis/Tadalafil.

Ultimately, if one drug does not seem to offer the expected outcome or if you are experiencing side effects associated with its use, speak to your urologist or men’s health specialist to discontinue that medication and try the other – you may achieve better results.

What if neither Medication Works?

Some patients will not experience the erection they expect with either medication, and this is typically a result of vascular concerns that have limited the amount of blood that can enter the penis. Of course, there is also the potential for psychogenic erectile dysfunction or lack of desire, both of which cannot be managed by these medications. However, if it is a mechanical issue, the next step is to try injections known as Trimix – a compounded injectable drug.

These injections offer a very strong and virtually immediate erection. Eventually, however, erectile dysfunction does persist and worsen.

If this is the case and injections no longer work, most patients find that a penile prosthesis is an excellent option that allows for both discretion and erections on demand. This solution may also help treat co-occurring Peyronie’s Disease (PD) patients.

Next Steps

To cut through all the hype associated with advertising and men’s health clinics that may or may not have your best interest in mind, it’s important to come to a qualified men’s health urologist like Dr. Natale to understand your options. After a consultation, we can discuss the best treatment options for your circumstance and find a solution that makes you happy.

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