A common issue affecting 50% of men over 40, erectile dysfunction (ED) is when a man struggles to get or maintain an erection. This condition can be frustrating, and upsetting, and impact personal relationships. But luckily there are treatments available.

How To Treat Erectile Dysfunction

Lifestyle changes are one of the most effective ways to improve ED. Examples include losing weight, stopping smoking, exercising more, and managing anxiety. Psychological therapies can also help many men with erectile dysfunction. For men who are still struggling with ED, medications are usually the next step. In rare cases, medication alone isn't enough to achieve an erection - other treatments like vacuum pumps or penile implants are an option in these situations.

Sildenafil and Tadalafil are the two most common types of medication used to treat erectile dysfunction. Both work in similar ways, but have subtle differences. Let's explore these medications used to treat erectile dysfunction in more detail.

What is Sildenafil?

Commonly known as Viagra (the first brand name for the drug), sildenafil has been around since 1998 and was first trialled as a treatment for angina. The men in the trials noticed they were getting more erections, and since then, it has been used to treat ED.

Taking sildenafil increases blood flow. Specifically, it improves blood flow to the penis by relaxing the smooth muscle in the blood vessels. However, you still need to feel sexually aroused to get an erection.

Sildenafil is sometimes also used to treat pulmonary hypertension (high blood pressure in the lungs) - usually, this involves taking a smaller dose more regularly.

What is Tadalafil?

Tadalafil (most commonly known as Cialis) works similarly to sildenafil: Cialis increases blood flow to the penis by relaxing the muscles in the vessels.

Scientists at a different pharmaceutical company were investigating tadalafil when they learned that sildenafil could be used to treat erectile dysfunction. As tadalafil works similarly to sildenafil, they started testing tadalafil as an ED treatment. Tadalafil was licensed to treat erectile dysfunction in Europe in 2002.

Tadalafil is also used in the treatment of pulmonary hypertension and benign prostatic hyperplasia (an enlarged prostate that's not due to cancer). A different dose is used to treat these conditions than when treating ED.

Now, Let's Compare the Two

We've mentioned that both drugs work to improve blood flow to the penis. This is because tadalafil and sildenafil belong to a drug family called the phosphodiesterase 5 (PDE5) inhibitors.

PDE5 is found in the smooth muscle of the blood vessels and normally works to break down chemical messengers involved in muscle relaxation. By blocking PDE5 with these drugs, there are more of these chemical messengers in the muscle and, therefore, more muscle relaxation. More blood is then able to flow through the blood vessels into the penis.

Structurally, tadalafil (Cialis) and sildenafil (Viagra) are fairly similar, but there are some differences between the two. Tadalafil is broken down more slowly by the body than sildenafil, so the positive effects may last longer. Tadalafil may also work more quickly to start with.

When it comes to side effects, it's rare to experience serious side effects with either tadalafil or sildenafil. The side effects with each medication vary slightly, however, and may last longer with tadalafil as it stays in the body for longer. We'll explore the side effects in more detail later in the article.

But what about buying them? Sildenafil is available over the counter at a 50mg dose under the brand name Viagra Connect, whilst you'll need a prescription to buy tadalafil (Cialis) or other strengths of sildenafil/Viagra.

How Effective Are They?

Most evidence shows that both medications are similarly effective at treating erectile dysfunction. However, some studies have found that patients prefer taking tadalafil, although there were similar improvements in blood flow with men taking either drug.

Tadalafil usually starts to work 30 to 60 minutes) after taking it, and requires sexual stimulation for it to work. It should continue to work for up to 36 hours. This doesn't mean you'll have an erection for all this time, but that you'll be able to get an erection (or several) during this time. Sildenafil can be taken up to 4 hours before sexual activity. While the effects can last for up to 4 hours, they usually last around 2 hours. Again, similarly to tadalafil, sexual stimulation is still required to achieve an erection.

Side Effects and Safety

Some of the most common side effects are similar with both types of medications, including headaches, indigestion, and a blocked nose.

With both sildenafil and tadalafil, fewer than 1 in 1000 men may experience a prolonged erection lasting more than 2 hours, seizures, or chest pain. In these situations, it's important to attend A&E or call an ambulance. Rarely, those taking sildenafil may experience side effects such as changes in hearing or vision e.g. blurred vision, and should seek medical help quickly.

Not everyone can take these types of erectile dysfunction medications. Men who've had a severe heart attack in the last 90 days, with low blood pressure, high blood pressure, and with certain eye conditions and heart disease should avoid both tadalafil and sildenafil. It's important to seek advice from a medical professional before starting either medication.

Dosage and Administration

With both types of medication, you need to swallow the tablet whole with a drink but avoid grapefruit juice which may interact with the drugs. Sildenafil should be taken on an empty stomach for the best results, but this is less important for tadalafil.

The standard dose of tadalafil is a 10mg tablet, but this may be increased to 20mg. For sildenafil, the starting dose is 50mg, which can be increased up to 100mg or decreased to 25mg depending on response. Doses may also be changed depending on age, other health conditions, and other medications. It's important not to change the dose yourself of sildenafil or tadalafil, but to consult a doctor or pharmacist.

Buying Sildenafil and Tadalafil Safely Online Through QuickMeds

Both types of erectile dysfunction medication can be purchased from a traditional pharmacy, but many men opt to buy them from an online pharmacy. Having ED medication delivered to your door is more convenient, easy, and discreet.

When buying Sildenafil and Tadalafil online, it's important to choose a reputable online pharmacy. In the UK, all legitimate pharmacies are registered with the General Pharmaceutical Council (GPhC) and the Medicines and Healthcare Products Regulatory Agency (MHRA).

QuickMeds is a UK-based online pharmacy that is both GPhC- and MHRA-registered. QuickMeds offers convenience, discretion, and professional support through our online consultation and prescription delivery services.

You may have a preference when it comes to your erectile dysfunction medication (including a particular brand name like Viagra), or you may be looking for advice on which one to choose. Either way, Quick Meds can help.

Start your free online consultation. During the consultation, a member of our prescribing team will discuss your individual needs in detail, including your medical and medication history. They'll then prescribe the ED medication most suited to you, at the dose that's best for you (taking your preferences into account). The prescription will be filled, securely packaged and delivered discreetly to your door.

In Summary

Both sildenafil and tadalafil are effective ED treatments for many men, and the choice is usually a personal preference. However, seeking a healthcare professional before taking any prescription medication is important.

Looking to purchase either tadalafil (Cialis) or sildenafil (Viagra) online? Quick Meds offers flexible online consultations and discreet ED medication delivery.


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Aliysha Parveen

Pharmacist Independent Prescriber

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