Skip to main content
ED Treatment Spot

Medications

Sildenafil vs. tadalafil: which one should you ask for?

These are the two drugs almost every man ends up choosing between. They work by exactly the same mechanism and neither is stronger than the other. The real decision is about how you want sex to fit into your life.

7 min read · Last reviewed July 2026 · How we write this

The short version

  • Sildenafil lasts 4 to 6 hours and needs an empty-ish stomach. Tadalafil lasts up to 36 hours and ignores food.
  • Low-dose daily tadalafil removes the planning entirely — and treats prostate urinary symptoms at the same time.
  • Side effect profiles differ: sildenafil is more likely to affect vision, tadalafil to cause back and muscle ache.
  • Both are cheap as generics. Price should rarely be the deciding factor.

The comparison

Sildenafil (generic Viagra)Tadalafil (generic Cialis)
Starts working30–60 minutes30–60 minutes
Lasts4–6 hoursUp to 36 hours
Effect of foodA fatty meal delays it noticeablyLittle to none
Effect of alcoholBest kept to one or two drinksBest kept to one or two drinks
Common doses25, 50, 100 mg as needed10, 20 mg as needed, or 2.5–5 mg daily
Daily optionNoYes — the main advantage
Distinctive side effectBlue tinge to vision, light sensitivityBack and muscle ache, often next day
Nitrate waiting periodAt least 24 hoursAt least 48 hours

Why the duration matters more than it sounds

On paper, 36 hours versus 6 hours is a specification. In practice it changes the character of the thing.

With sildenafil there is a clock. You take it, you wait, and there is a window. For some couples that is completely fine. For others — particularly where one partner is not aware of the medication, or where sex tends to happen when it happens — the scheduling becomes its own source of pressure, and pressure is the last thing this needs.

Tadalafil's long tail decouples the tablet from the event. Take it Friday evening and Saturday is simply available. Many men over 50 describe this as the thing that made sex feel normal again rather than medicated.

The daily dose, and the prostate bonus

Low-dose daily tadalafil — 2.5 or 5 mg — keeps a steady level in your blood so there is no dosing decision at all. You are simply someone who takes a small tablet each morning.

It is also approved for the urinary symptoms of an enlarged prostate: the weak stream, the getting up at night, the sense of not finishing. A great many men over 50 have both problems, and one small daily tablet addressing both is genuinely efficient. If that describes you, this is the option to raise by name.

Side effects, compared honestly

Both cause headache, flushing and a blocked nose, at broadly similar rates. Where they differ:

  • Sildenafil is more associated with visual effects — a blue or bright tinge, light sensitivity — because it has some cross-activity with an enzyme in the retina. It is temporary and harmless, but it puts some men off.
  • Tadalafil is more associated with back and muscle aching, often turning up twelve to twenty-four hours later and lasting a day or two. Nobody is entirely sure why. It usually settles with continued use.

Both share the serious warnings: an erection over four hours is an emergency, and sudden vision or hearing loss means stopping and seeking care. And both share the absolute contraindication with nitrates. Full safety detail.

So which one?

If you want a straight answer: for most men over 50, low-dose daily tadalafil is the better starting point, particularly if you also have urinary symptoms. It removes the timing problem, which is the part men actually find difficult.

Choose sildenafil instead if you want sex rarely enough that daily dosing feels wasteful, if cost is genuinely tight, or if you have tried tadalafil and the muscle ache was intolerable.

And if the first one you try does not work, trying the other is a reasonable next step before concluding this whole class has failed. Response is not perfectly consistent between them.

A note on what this is

This article is general health information, reviewed July 2026. It is not a diagnosis and not advice about your situation. Talk to a clinician before starting, stopping or changing any treatment. Full medical disclaimer.

Read next

6 min read

How to bring up ED with your doctor

A script, the questions worth asking, and what to expect from the appointment. Most of the awkwardness comes from not knowing how it goes.

Read more

8 min read

What actually causes ED after 50

Age itself is rarely the problem. Here is what is usually going on underneath, and how to work out which cause applies to you.

Read more