Erectile dysfunction: Can I combine Viagra and Cialis?

June 28, 2023
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9 minute read

Managing erectile dysfunction (ED) can be frustrating, but you’re not alone. In fact, ED is a common issue that affects men of all ages, and especially those over 40.  

It can be easy to rush straight into medication, but sometimes lifestyle changes can be effective. Keep reading as we discuss the root causes of ED and explore how popular medications such as Viagra and Cialis work, including key differences. And, if you're finding your current ED medication isn't effective enough, we’ll look at what to do next.

What is erectile dysfunction and what are the causes?

Men suffering from ED are either unable to achieve an erection, or unable to sustain an erection for a sufficiently long period of time.

Everyday factors like stress, tiredness and excess alcohol consumption or smoking can all have a negative impact on erectile function. It’s normal to experience occasional difficulties, however, if this starts to become a recurring problem, it’s usually a sign of an underlying condition, and a visit to your GP should be considered.  

In many cases, lifestyle interventions are effective in producing an improvement and resolving the majority of ED challenges. Medication for ED can also be provided under the guidance of a healthcare professional, and this is proven to be safe and effective for the majority of people.

However, some men don’t respond to medications such as Viagra and Cialis. This can be due to a number of factors; such as underlying medication conditions, other physiological factors, or the presence of medications that interfere with the effectiveness of oral ED medications.  

So, what can you do if lifestyle interventions and ED medications are still not enough? If the thought of combining multiple medications such as Viagra or Cialis has crossed your mind - in the hope of achieving a better effect- stop and read on. We’ll look at how these medications work, and what to do if you’re finding their effectiveness to be insufficient.  

How do Viagra and Cialis work?  

Let’s take a closer look at the two most popular ED medications - Viagra and Cialis - also known by their generic names sildenafil and tadalafil. Interestingly, sildenafil was originally developed to treat angina. Its effectiveness on ED was discovered during clinical trials, and ultimately led to the first oral medication approved for the treatment of ED.

Both drugs belong to a class of medications called PDE5 inhibitors. As the name suggests, both drugs work by inhibiting the PDE5 enzyme, which relaxes blood vessels and increases blood flow.

This effect occurs in specific areas of the body, primarily in regions such as the penis and lungs. Blood vessels in other parts of the body can be affected, although to a lesser extent.  

Keep in mind that, like most other medications, sildenafil and tadalafil come with side effects, which can include:  

  • Headaches  
  • Flushing  
  • Dizziness  
  • Nasal congestion  
  • Digestive issues  

What are the differences between Viagra and Cialis?

Though Viagra and Cialis are prescribed for the same purpose, there are several differences between the two medications.  

  1. Duration of effectiveness: While Viagra is generally effective for up to four or five hours after ingestion, Cialis lasts for much longer, usually up to 36 hours.
  1. Onset of effects: Viagra typically kicks in within 30 to 60 minutes, while Cialis may take a bit longer, around 30 minutes to two hours.
  1. Dosage flexibility: Viagra comes in strengths of 25, 50 and 100mg, while Cialis comes in strengths of 10 and 20mg for as-needed use. Additionally, lower doses of 2.5 and 5mg are available for daily use, regardless of sexual activity.
  1. Interactions with food: Viagra can be less effective when taken with food. Its absorption is particularly delayed by dietary fat, which is why it’s recommended to take it on an empty stomach. Cialis, on the other hand, is not impacted by the presence of food in the stomach and can be taken with or without food.  
  1. Timing of use: Due to their differences in duration of action, Viagra is generally taken on an as-needed basis, right before anticipated sexual activity. Cialis can be taken daily to ensure continuous effectiveness. Neither medication produces erections without sexual stimulation, so there’s no need to worry about potential surprises.  

Can I combine Viagra and Cialis?

While some research suggests that combining PDE5 inhibitors can result in enhanced effectiveness in certain groups of men, it’s crucial to acknowledge that attempting to combine these medications without the guidance of your healthcare professional is not recommended at all.

Doing so increases the risk of adverse effects and can lead to serious complications.  

If you’re currently prescribed Viagra or Cialis and you are still experiencing ED, talk to your doctor or pharmacist. They can explore options such as adjusting the dosage or considering alternative ED medications like alprostadil.  

Remember, and never combine ED medication without speaking to a healthcare professional.

Read more in this handy NHS guide: Erectile dysfunction (impotence), Sildenafil (Viagra).  

Do you have any additional questions about ED treatment? Get in touch with our friendly, professional pharmacy team who can offer you guidance and advice.

Content last reviewed on:
June 28, 2023
Next review date:
June 28, 2025
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