Fact Checked

Generic Cialis: What is it? Uses, Costs, Benefits, Doses

With the introduction of Viagra to treat erectile dysfunction in the late 90s, drug manufacturers began clamoring to come up with their own spin on erectile dysfunction medications. One of the drug’s most successful competitors, Cialis, was released in 2003, and this expensive (but effective) medication quickly became a heavy hitter in the list of treatment options for erectile dysfunction. Generic version Cialis, called tadalafil, was finally released in October 2018, opening the door for other manufacturers to begin marketing their formulas. Today, more than 16 different manufactures produce tadalafil, bringing lower prices to consumers. Although tadalafil is most commonly used to treat erectile dysfunction, which affects more than 30 million men in the United States alone, there are also other uses for the drug.

What is tadalafil?

Tadalafil, sold under the brand names Cialis and Adcirca, is a medication that relaxes the blood vessels and increases blood flow to particular areas of the body, including the penis. Tadalafil is used to treat erectile dysfunction and benign prostatic hyperplasia (enlarged prostate) under the brand name Cialis, while Adcirca is used to treat pulmonary arterial hypertension and can also improve exercise capacity when used in both men and women. 

What is tadalafil used to treat?

While Cialis and its generic forms are most commonly associated with the treatment of erectile dysfunction in men, there are other useful applications of the drug. Tadalafil treats erectile dysfunction, also known as male impotence, as well as benign prostatic hyperplasia, also known as an enlarged prostate, when marketed as Cialis. Benign prostatic hyperplasia is a common condition that occurs for many men as they get older. When an individual has an enlarged prostate, they can experience uncomfortable urinary symptoms, such as the blocking of urine flow from the bladder. Men suffering from benign prostatic hyperplasia may experience a frequent or urgent need to urinate, increased frequency of urination at night, difficulty urinating, a weak urine stream, a urine stream that stops and starts, or inability to completely empty the bladder. Bladder, urinary tract, and kidney problems may also occur. When used under the brand name Adcirca, tadalafil treats pulmonary arterial hypertension, a serious condition that causes high blood pressure in the lungs. The condition occurs when the arteries in the lungs narrow in diameter, increasing blood flow resistance to the lungs and damaging the heart over time.

What is erectile dysfunction and what causes it?

Erectile dysfunction, often called male impotence or ED, is a condition that occurs when a man has difficulty getting and/or keeping an erection long enough for sex. Men experiencing the condition may experience it only on certain occasions, or it may occur every time they try to have sex. Erectile dysfunction is caused by a limited blood flow to the penis, which prevents an erection from occurring. Although rarely talked about due to shame and stigma associated with the condition, erectile dysfunction is extremely common; approximately 30 million men in the U.S. suffer from ED.  
One of the reasons that erectile dysfunction is so common is that there are many factors and conditions that can cause it. Medical conditions that can contribute to ED include depression, diabetes, heart disease, high blood pressure, high cholesterol, obesity, prostate cancer treatment, and spinal cord injury. A man’s lifestyle and psychological factors, such as smoking, drinking, and stress, can also contribute to ED. Additionally, some medications used to treat high blood pressure, heart disease, and depression can also cause ED.
 
Depending on the cause of your erectile dysfunction, it may be possible to improve your circulation without the use of medication by changing your lifestyle. Strategies that may help include: 
Finding more ways to stay active
Managing your weight by eating whole foods and reducing portion sizes
Drinking less alcohol
Quitting smoking
Reducing stress in your daily life
 
While suffering from erectile dysfunction can be embarrassing and frustrating, you should know you’re not alone, and the condition is treatable. Talk to your healthcare professional about treatment options for ED. 

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How does tadalafil treat erectile dysfunction?

As previously discussed, erectile dysfunction is caused by a limited blood flow to the penis, which prevents an erection from occurring. Tadalafil increases blood flow to the penis, allowing men to get and keep an erection that is hard enough for sexual intercourse. The medication does not cause erections unless an individual is sexually stimulated, so men taking the medication do not have to worry about getting erections at inopportune times. 

What does tadalafil cost?

Even in its generic form, Cialis is not cheap. While costs have come down since the release of generic formulas of tadalafil, the cost to fill a prescription drug may leave some patients in shock. Today, the cost to fill a tadalafil prescription of 30 tablets at a dose of 5 mg is approximately 155 dollars, or 5 dollars per pill. While that might seem like a lot, you’ll save more than half when purchasing the generic form of Cialis rather than the brand name drug. A 30 day supply of Cialis would cost approximately 400 dollars at most pharmacies.  Now that the drug has been released in a generic form, tadalafil is covered by most Medicare and insurance plans. We recommend checking the cash price or purchasing the drug with a pharmacy discount card, as you may be able to save even more than when purchasing the drug through insurance.  

What is the difference between sildenafil and tadalafil?

While on the surface sildenafil (generic Viagra) and tadalafil (generic Cialis) might seem very similar, there are important differences between the two medications.
 
Use
Tadalafil can be used either on a daily basis or as needed. When used daily, tadalafil is kept at a consistent level in your bloodstream, allowing you to have sex spontaneously. When taken as needed, approximately 30 minutes before sex, Tadalafil will provide erectile dysfunction relief quickly and effectively. While it might seem like a no-brainer to simply take tadalafil every day, the cost of the medication can be prohibitive. However, the ability to take the medication on a daily basis is one of the main differences between tadalafil and sildenafil, which can only be taken on an as-needed basis and requires some additional pre-planning to give the medication time to work.
 
Dose
Dosages are another area of difference for tadalafil and sildenafil. Generic Cialis comes in 2.5 mg, 5 mg, 10 mg, and 20 mg strengths, while generic Viagra is prescribed in 20 mg, 40 mg, 60 mg, 80 mg, and 100 mg doses. The average prescribed dose for tadalafil is 10 mg, while the average prescribed dose for sildenafil is 50 mg.
 
Effectiveness
Both tadalafil and sildenafil are extremely effective when used to treat erectile dysfunction. The major difference between the two medications is that the effects of tadalafil can last for up to 36 hours, while the effects of sildenafil last about 4 hours. Again, while at first glance it may seem like tadalafil is the superior drug, patients should be aware that the medication lasts longer in their system, which is important when considering potential interactions between tadalafil and other drugs they may be taking.

What are the benefits of using tadalafil?

You already know that using tadalafil can provide you with relief from medical conditions like erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hyperplasia. Treatment of these conditions will be the same and equally effective whether you use the generic or brand name form of the drug. The biggest benefit of using tadalafil is, of course, the cost - you’ll save approximately one-third on the price of your medication when choosing the generic option over the brand name medication. Additionally, insurance companies are more likely to cover the generic form of the medication. Still, some patients are leery about using generic forms of brand name medications due to concerns about the quality and ingredients in the generic drug. At first glance, it can be confusing. If there is no difference in quality and ingredients, why would the costs vary so dramatically?
 
The fact is that generic medications undergo the same rigorous testing by the FDA as brand name medications do prior to being sold. The difference between generic and brand name forms of prescription medication have to do with the inactive ingredients (ingredients that do not affect treatment). Because pharmaceutical regulations require that the same active ingredients be used for both brand name medications and their generic equivalents, the only differences between the two medications are some of the inactive ingredients, which may affect cosmetic details like color, shape, and size of the medication.

How do I know which dose of tadalafil I should take?

Tadalafil for erectile dysfunction comes in tablets containing 2.5 mg, 5 mg, 10 mg, or 20 mg of the medication, so you have lots of different treatment options. The appropriate treatment dose of tadalafil for you will depend on several factors, including the condition being treated, your age, height, and weight, and the severity of your condition. Your doctor will prescribe you with the dosage level right for you, but the starting dose of tadalafil for erectile dysfunction is typically 10 mg. Depending on your needs, your doctor may prescribe you at a lower or higher starting dosage. Additionally, whether you take the medication as needed or on a daily basis will also affect your dosage. The lower strength forms of tadalafil (2.5 mg and 5 mg) are most commonly used when taken for daily use. Your doctor may start you at a dose higher or lower than this initially based on your needs. Unlike Viagra, the effects of Cialis can last up to 36 hours, so men have flexibility to adjust their dosages based on their lifestyle and needs.  When used for pulmonary arterial hypertension, tadalafil is sold in 20 mg tablets as the generic form of Adcirca. 

How do I use tadalafil to treat sexual dysfunction?

How you use tadalafil to treat sexual dysfunction will depend somewhat on your needs, lifestyle, and budget. When taken daily, tadalafil can be taken any time of day and with or without food, although no more than one tablet should be taken every 24 hours. When taken on an as needed basis, tadalafil should be taken about 30 minutes prior to sexual activity.  Since planning out exactly when sex will happen can be challenging, you should know that the effects of tadalfil last up to 36 hours, so you’ll still receive the desired effect even if you take it considerably more than 30 minutes in advance. 

Are there any side effects I should be aware of?

Like any medication, there are side effects associated with the use of Cialis and its generic forms. The side effects most commonly associated with tadalafil are:

  • Stuffy or runny nose
  • Headache
  • Upset stomach
  • Flushing (feeling of warmth)
  • Indigestion
  • Difficulty falling asleep or staying asleep
  • Back pain
  • Pain in the limbs
  • Muscle aches

 
Medical attention should be sought immediately if any of the following side effects occur during sexual activity:

  • Dizziness
  • Nausea
  • Numbness, tingling, or pain in the jaw, arms, chest, or neck

 
Other rarely reported, but serious, side effects requiring immediate medical attention include:

  • Priapism - erections lasting longer than four hours
  • Sudden vision loss in one or both eyes, which is a symptom of a serious eye problem called non-arteric anterior ischemic optic neuropathy (NAION)
  • Sudden hearing decrease, hearing loss, or ringing in the ears

Who should not take tadalafil?

While tadalafil is generally considered a safe medication, there are certain groups of people who should not take tadalafil and who may be prone to a higher risk of dangerous side effects. Individuals with any of the following conditions should not take tadalafil unless approved by their physician:

  • Heart rhythm problems, angina, or any kind of heart disease
  • High or low blood pressure
  • Congestive heart failure or stroke within the last six months, or myocardial infarction within the last three months
  • Sickle cell anemia, multiple myeloma, hemophilia, leukemia, or another blood disorder
  • Liver or kidney disease
  • Stomach ulcer
  • Retinitis pigmentosa
  • Structural deformity of the penis, such as Peyronie’s disease
  • Any health condition for which they have been advised not to have sexual intercourse

How do I know if tadalafil is right for me?

Tadalafil can only be prescribed by a doctor, so your first step is to talk to your healthcare provider about symptoms you are experiencing. Your doctor will evaluate your medical history, your list of current medications, and talk to you about your lifestyle prior to prescribing tadalafil.
 

 

Published March 9th, 2020 by Chris Riley
Fact Checked by Chris Riley

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