A comparative guide to Cialis and Viagra

Contents

1 Difference between Cialis and Viagra
2 Mechanism of Action
3 Comparative analysis of Cialis and Viagra
3.1 Speed of Action
3.2 Dosage and Administration
3.3 Side Effects
3.4 Limitations and Substitutes
3.5 Cognitive Behavioural Therapy
3.6 Concluding Section

Erectile dysfunction is a major issue that gets people depressed and ruins their lives. It is a problem for a vast number of men around the world. In simple terms, erectile dysfunction means that a man is unable to achieve erection or maintain it properly, which makes sexual intercourse impossible. Several treatment options exist, but the most common one is the use of respective drugs. Two of the most widely used medications of this class are Cialis and Viagra.

You may have already heard the names if you were ever looking for an effective solution to your erectile dysfunction problem. In this article, we tried to describe the differences and similarities between these two drugs and speculate on which one is better in a specific situation.

Difference between Cialis and Viagra

Simply put, the difference range can be described as follows:
Effect: Same
Effect occurs:
Cialis: in ~1-3 hours
Viagra: in ~20-60 minutes
Duration:
Cialis: ~36 hours
Viagra: ~4-6 hours
Side effects:
Cialis: milder than Viagra
Viagra: stronger than Cialis

Mechanism of Action
Both Cialis and Viagra are essentially PDE5 inhibitors. This designation means that these block an enzyme called phosphodiesterase type 5 in one’s smooth muscle tissue. PDE5 is thus inhibited as it breaks down another substance, termed as “cGMP”. cGMP (cyclic guanosine monophosphate) is responsible for the contraction and dilatation of blood vessels flowing blood to the penis. Thus, the breakdown of cGMP by PDE5 can terminate the state of erection. Having the same effect, both Cialis and Viagra help one develop an erection and make it firmer and lengthier.

Apart from that, this effect on PDE5 increases one’s nitric oxide levels. Nitric oxide is a vasodilatory substance. The word “vasodilatory” means that it widens blood vessels, conducing the flow of blood.

This is relevant to our case, as erection is basically a state when the body fills the penis with extra blood. Its areas filled with blood become harder and more responsive to tactile stimulation. The increased flow of blood induced by PDE5 inhibitors fills up cavernous bodies in the penis, causing erection. These parts of the penis are often referred to in Latin as corpora cavernosa.

There are two corpora cavernosa and one corpus spongiosum. These stretch along the penis longitudinally, and the cavernosa lies along the shaft from the pubis to join at the tip. The tissue that forms these bodies is somewhat similar to a sponge, and is able to contract and expand. When the erection wears off after orgasm or due to loss of sexual arousal, these are drained of extra blood, thus returning the penis to its usual flaccid state.

As you might have heard, ED treatments only work during sexual arousal. The explanation behind this fact is that sexual arousal causes synthesis of nitric oxide, with is required to trigger the effect of ED drugs.

Comparative analysis of Cialis and Viagra
Cialis and Viagra are, in fact, brand names; the actual names of the substances are, respectively, Tadalafil and Sildenafil. Acting in the same manner as PDE5 inhibitors, these two substances have some differences as well.

Background
Viagra was the first marketed drug of the kind. In particular, this was the first instance of a drug using PDE5 inhibitors to treat erectile dysfunction to be approved by the U.S. Food and Drug Agency. This was also the first medicine of this kind intended for peroral administration. These events took place in 1998; the pharmaceutical formulation remained patent-protected for a considerable period of time in order to allow the developer to recoup its costs. Following the expiration thereof, Viagra generics received approvals in 2016 and launched on the market in 2017. In the meantime, Cialis was authorised just 5 years later, i.e. in 2003. After Viagra and Levitra, it became the 3rd PDE5 inhibition drug to become available to consumers.

Half-life

In practical terms, the main difference between Cialis and Viagra is the half-life (the time for reduction to half of the initial value); this parameter is 2-25 hours for the latter, that is, quite low compared to that of Cialis (~18 hours). For the consumer, it means that Cialis would not wear off for 36 hours or so, while Viagra would only last some 4 to 6 hours. Reminder: PDE5 inhibitors are triggered by nitric oxide, a substance that is commonly synthesised in the body due to sexual arousal. To lighten the mood – don’t worry; you won’t be strolling around overexcited for 1.5 days. You will just have an easier time achieving and maintaining your erection when the time is right.

Speed of Action

Another difference is how long does it take for each drug to act. Depending on your physical parameters, metabolism and other personal factors, it may take somewhere between 1 and 3 hours for a Cialis pill to work, while Viagra would offer a more readily available effect in 30 minutes or so. However, one should keep in mind that the effect of Viagra could be hindered by high-fat food. Having a fatty meal to go with the drug may have an adverse effect on the performance of Viagra. Occurrence of the effect may also be delayed for a while. Thus, common sense says that Viagra is best taken on an empty stomach.

Efficacy

Naturally, this would be the most important parameter for a consumer. Generally speaking, the efficacy of Cialis and Viagra is roughly the same. Those who advocate strict adherence to numbers may point out that there is a slight difference in favour of Viagra – 84%, while Cialis shows a subtly smaller factor of 81%.

Dosage and Administration
Cialis can be taken when it is due. In other words, you don’t have to take it when you don’t need it. Dosage can be increased if no effect is achieved by the initial therapy. As with many drugs, it is advised to start with the minimum dose of 10 mg. The drug is taken in advance before the expected intercourse. If the desired effect is not achieved, the dose can be increased to 20 mg. Inversely, some people may find the effect to be too strong. Then the dose may be lowered to just 5 mg. A vital rule to remember is not to take more than a single dose within a 24-hour period. Daily consumption of 10-20 mg doses should be avoided as well.

Viagra, on the other hand, comes in larger doses, but can still be taken on an as-necessary basis. The common dose is a 50 mg pill to be taken some 60 minutes before sex. You can try to achieve a stronger or milder effect by increasing or decreasing the dosage to 100 mg or 25 mg respectively. Viagra may be taken daily, but the limitation of one pill per 24 hours must still be observed. Another precaution is to consult a physician if you intend to take Cialis or Viagra along with other medicinal products. In particular, blood pressure adjusters and vasodilators (including, without limitation, the widely used Aspirin), can cause combinational effect, dilating the blood vessels to an even greater extent and causing exaggerated side effects, which can be very dangerous.

Side Effects
Both Viagra and Cialis have similar most frequently occurring side effects. These include flushing, headache and digestion disorder. All these are caused by the alteration of blood flow and vessel width. In rare instances, Viagra may also cause some patients to perceive colours in a different manner. The mechanism is rather simple: blood vessel dilatation reduces blood pressure. It can be compared to sipping a drink through a narrow or, conversely, a very wide straw. In this setting, it takes blood a little longer to reach the upper areas of the body, the brain, in particular, as the pressure is lower while the influence of gravity remains the same.

This is also true that penis is filled with blood diverted to a certain extent from other areas of the body. That is why PDE5 inhibitors can be the cause of temporary indigestion. For sustainable erection, extra blood to fill the penis is taken from the digestive system. Less blood means somewhat impaired operation of the digestive organs, possibly causing reflux or other inconvenient symptoms. These are not dangerous in general. Consult your general practitioner if you have any doubts or concerns in this regard, however.

Limitations and Substitutes
Even though both Viagra and Cialis proved to be effective and suitable for most people, everything has its disadvantages. About one half of the users choose to discontinue such treatments after a certain time, as they feel dissatisfied with the situation. This is why alternative means of erectile dysfunction treatment solutions are sought. Examples may include topical gels developed to cause similar effects. One of the most efficient solutions for ED patients, however, is psychological treatment.

While erection can be adversely affected by diseases, physical impairment and other physical or biological factors, impotence is much more often caused by reasons of psychological nature. Psychological stress is in fact the major cause of erectile dysfunction. The mechanism is, once again, rather simple: release of stress-related hormones causes your blood vessels to constrict, impeding the flow of blood to your genitals.

Cognitive Behavioural Therapy
Our body naturally responds to stress by making the heart beat faster, readying up the muscles for defence and boosting its overall energy level. Characteristic for just about any organism, this response is hard-coded by nature to help us fight or evade threats and dangers at the expense of non-defensive functions like digestion and bowel movements, as these are “suspended” for a short time while the blood and energy is diverted to the muscles and brain.

Blood flow to the genital region is minimised in this case as well, as the area constricts to give more blood to the muscles. In fact, blood supply to muscles during stress can be up to 20 times greater than normal!

The downside to this otherwise extremely useful response is, unfortunately, that stress is just what many people feel right before or during an intercourse – and the situation becomes grave when their concern is actually about their potency. Thus, a person is entangled in a vicious cycle of sorts: he starts worrying -> stress impedes erection -> the person worries even more -> erection is lost -> the person is in panic, and erection becomes impossible. Psychological treatment schemes, such as the Cognitive Behavioural Therapy (CBT), use mental techniques and psychosomatic methods like breathing exercises to put the patient in control of his autonomic nervous system. These also approach the problem from the opposite side by teaching patients to identify destructive thoughts and to block and replace these with positive ideas and strategies. Psychologists refer to this process as “cognitive restructuring.” Given the large percentage of mentally induced cases of erectile dysfunction, such techniques can produce great results, especially in combination with PDE5-inhibition therapy.

Concluding Section
The choice between Cialis vs Viagra The above can be summarised in the inference that both drugs are capable of delivering the desired benefit. The main difference are the half-life period and speed of effect, as described in the preceding sections. These parameters are the reason why many choose Cialis over Viagra. In the long-term perspective, however, the best results are achieved when medicinal therapy is combined with an expert’s help in resolving the psychological aspect of the problem. Such synergic approach helps many people do away with their ED issues without developing dependence on medications.