Treatment for Erectile Dysfunction with Cialis vs Viagra: What’s Better?

by Alex Shteynshlyuger MD


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation and other sexual concerns. He helps men of all ages who experience impotence to regain confidence and erections.


What’s More Effective: Cialis vs Viagra?

Penis Pump compared to ViagraCialis and Viagra are somewhat different even though both are used for the treatment of erection problems in men.

Some men find Viagra more effective than Cialis. Other men find that Cialis is more effective than Viagra.  This may be a result of genetic differences between men.

Studies show that some men do not respond to particular medications as a result of what is known as genetic polymorphisms (small differences in genes).

Overall, when Cialis is taken daily as a small dose, it is more effective than medications that are taken on as needed basis, even when Cialis is taken as-needed basis. There is no overall difference in effectiveness between Cialis and Viagra when both are used 1-2 hours prior to sex as needed,

When Cialis 5 mg is taken every day, it is more effective than taking Viagra on as needed basis for many men.

When Cialis is taken as needed (1-2 hours before sex) is compared to Viagra, they both work similarly well.  However, Cialis is more effective than Viagra if Cialis is taken as a daily medication.

A study that looked at Viagra (sildenafil) taken as needed versus Cialis (tadalafil) taken daily versus Cialis taken as needed found that adherence to treatment was substantially more with Cialis because of its longer window of action. Another study reported greater sexual confidence with Cialis because of fewer time concerns and greater spontaneity. Men who switch from Viagra to Cialis will find that they can substantially increase the time between taking the pill and intercourse.

How are Viagra and Cialis Used?

Viagra is always used on as needed basis.  Typical doses of Viagra used are 25, 50 or 100 mg.  For men with mild ED, 25 mg or 1/2 of 25 mg pill may also work well.  Generic Viagra (Sildenafil) is available in doses of 20 mg.

With Cialis, men have 2 options: use the larger dose of 10 mg or 20 mg on as needed basis or use 5 mg dose every day.  For men with mild ED, 5 mg on an as-needed basis of Cialis may work just as well.

What Works Longer Viagra or Cialis?

Because of the effects of Cialis last considerably longer (18 hours) than Viagra (8 hours), Cialis is preferred if sexual spontaneity is your priority.  Viagra is preferred if you want to minimize side effects as it gets out of your system faster.

Both Viagra and Cialis can be taken with or without food but work better if taken without food. Both erection medications work in a similar fashion – they take effect in about an hour and produce erections in the context of erotic stimulation. They have a similar safety profile as well.

What Works Faster Cialis or Viagra?

Viagra works a bit faster than Cialis but the differences are not dramatic.

Side Effects: Viagra vs Cialis

Cialis and Viagra have similar side effects.  Most common side effects include headaches, upset stomach, muscle pains.

It is important to understand that while side effect is similar not every man gets side effects.  In addition, if a man gets side effects to one medication, he may not experience the same side effects or any side effects when taking another medication.  In general, when a man experiences a side effect of Viagra or Cialis, we might try to change to a different medication which may avoid side-effects.

If you experience side effects from medications, they will last longer with Cialis than with Viagra because Cialis stays longer in your system.

The Bottom Line: Cialis or Viagra?

Both Cialis and Viagra work well for most men.  Some men find Viagra more effective while other men find Cialis more effective.  Cialis daily is a good treatment option for men who have significant problems with erections and has better efficacy than either Cialis or Viagra taken as needed.

An additional benefit of Cialis taken daily is that it may help men with enlarged prostate with urinary symptoms.


Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido.

We see patients from all parts of New York City (Manhattan, Brooklyn, Queens, Bronx, Staten Island), Long Island, Westchester and New Jersey as well as other parts in the USA, Canada, South America and the Caribbean and other international patients. We also offer emergency care for men with urological problems.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call 1-(646) 663-5211.


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