Tadalafil and Sildenafil for Erectile Dysfunction
Gui í a de Salud Masculina
tadalafil (tadalafil) and Sildenafil (sildenafil) are both drugs used to treat male erectile dysfunction (ED). Here is a comparison between them:
I. Pharmacological properties
1 、Mechanism of action
Identical point
-both of them belong to type 5 phosphodiesterase (PDE5) inhibitors, which inhibit the activity of PDE5, reduce the degradation of cyclic guanosine monophosphate (cGMP), relax the smooth muscle of penile sponge and flow blood into penile tissue, thus promoting penile erection.
Differences
-Tadalafil has a relatively higher selectivity for PDE5, which may mean that it is theoretically more specific in the treatment of erectile dysfunction, and the side effects associated with PDE5 inhibition may be relatively more predictable.
2 、Effective time
Sildenafil
-it usually takes effect 30-60 minutes after oral administration on an empty stomach, and can produce an erectile response in the case of sexual stimulation. if taken with a high-fat food, the onset time may be delayed, about 1-2 hours.
Tadalafil
-the effect is relatively slow, about 1-2 hours after oral administration, but its effect lasts for a long time, and the food has little effect on the onset time.
3 、Efficacy duration
Sildenafil
-short-acting drugs with a duration of about 4-5 hours.
Tadalafil
-long-acting drugs, which can last for about 36 hours, which means that patients are more likely to have an erectile response to sexual stimulation for a longer period of time.
II. Security
1 、Adverse reaction
Identical point
Common adverse reactions of both drugs include headache, facial flushing, nasal congestion, indigestion, etc. These side effects are usually mild to moderate and disappear gradually after the drug metabolism.
Differences
-Tadalafil may be relatively easier to cause back pain and muscle pain, and Sildenafil may sometimes lead to visual abnormalities, such as blurred blue-green vision, because it has a certain (though weak) inhibitory effect on PDE6 in the retina, while Tadalafil rarely has this visual adverse reaction.
2 、Drug interaction
Identical point
-both have serious interactions with nitrates (such as nitroglycerin) and are prohibited from being used at the same time, as simultaneous use can lead to a sharp drop in blood pressure and may cause serious cardiovascular events.
Differences
When-Tadalafil is used in combination with alpha-adrenoceptor blockers (used in the treatment of diseases such as hypertension and benign prostatic hyperplasia), the dose may need to be adjusted more carefully to avoid the risk of hypotension. When Sildenafil is used with some antifungal drugs (such as ketoconazole, itraconazole, etc.), its blood concentration may increase significantly, increasing the risk of adverse reactions.
III. Clinical application
1 、intended for
-Tadalafil may be a better choice for patients who want to have long-term drug coverage and irregular sexual life, because of its long-term characteristics and do not need to take drugs frequently, such as some elderly patients or patients with low but unpredictable sexual frequency.
For those patients who have a relatively regular sex life and want the drugs to take effect relatively quickly, Sildenafil may be more appropriate, especially those who can better control their diet (avoid high-fat diet affecting drug absorption) and hope to improve their erectile function in a short period of time.
2 、Dose and frequency of use
Sildenafil
It is generally recommended that the initial dose is 50mg. According to the efficacy and tolerance, the dose can be adjusted to 25mg or 100mg, taking up to once a day.
Tadalafil
-the common initial dose is 10mg, which can be adjusted to 5mg or 20mg according to individual response, and its frequency is relatively low. For example, it can be used up to 2-3 times a week when taking it on demand, and there is also a low-dose regimen.