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Last updated: Mar 31, 2021
4 min read

Can you take Cialis in the morning, Viagra at night?

Cialis and Viagra are drugs used to treat erectile dysfunction (ED). In general, it’s not recommended to take Viagra within 36 hours of a dose of Cialis, but there might be certain situations in which your healthcare provider has given you a prescription for both.

felix gussone

Reviewed by Felix Gussone, MD

Written by Cale Li, MD

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Cialis (generic name tadalafil; see Important Safety Information) and Viagra (generic name sildenafil; see Important Safety Information) are drugs for erectile dysfunction. They both belong to the same family of drugs called PDE5 inhibitors. PDE5 inhibitors work by increasing blood flow to the penis during arousal leading to a harder erection (Smith-Harrison, 2016). 

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“In general, it’s not recommended to take both Cialis and Viagra within a 36 hour period, because that’s how long Cialis can stay in your system,” says Dr. Michael Reitano, an expert in sexual health and Physician in Residence at Roman. “They both work on the same mechanism […] there isn’t any support in the literature for going above the maximum dose.” 

You and your healthcare provider might find an individual schedule that works for your personal needs. Viagra and Cialis both belong to the same family of drugs and combining them could increase your risk of side effects. In general, if you’ve taken a dose of Viagra for ED, it’s not recommended to take Cialis within 24 hours after that. Or, if you’re taking Cialis, you shouldn’t take Viagra within the next 36 hours, Dr. Reitano says. 

Some common side effects of PDE5 inhibitors include (Smith-Harrison, 2016):

There might be some situations in which someone has both Cialis and Viagra in their medicine cabinet. “If you had a patient switching from one drug to the other drug, you would just give them a washout period,” says Dr. Reitano. “So there’s no reason why a person couldn’t be given two prescriptions over time and have two medications on hand, even if it’s just switching from one to the other.”

What are the main differences between Cialis and Viagra?

Cialis and Viagra are drugs called PDE5 inhibitors that work by increasing blood flow to the penis during arousal, leading to harder erections. PDE5 inhibitors don’t create erections on their own, but make it easier for you to get hard over the course of its action. 

One of the main differences between Cialis and Viagra is the duration of action. Cialis can cover you for up to 36 hours, allowing for spontaneity in your sex life. There are two ways to take Cialis: either as-needed, at least 30 to 60 minutes prior to sexual activity or once a day at the same time every day without regard for the timing of sexual activity (Smith-Harrison, 2016). 

What dosing schedule you prefer depends on your personal preferences, which you can discuss with your healthcare provider. If you don’t like taking medications every day, the as-needed Cialis may be more attractive. On the flip side, if you’d like more spontaneity without worrying about planning your sexual activity, the once-a-day way to take Cialis could be better for you. There’s only one way to take Viagra for erectile dysfunction: as needed around one hour prior to sexual activity. 

Which is better for you: Viagra or Cialis?

“It depends on your lifestyle, sexual needs, side effect profile, how they last in your system, and how well they work,” says Dr. Reitano. “Let’s say a person has side effects with one—with the sildenafil—and it causes nasal stuffiness. They might say, well I’m only going to have a single sexual experience, I’d rather have a drug that covers me for 8 hours, even though it causes me this stuffiness and discomfort because I’m not going to need the effects of the drug beyond that.”

“This same person may be going away for the weekend and they don’t know when they’ll be having sex. They want the effects for 36 hours […] and they might say ‘I’d like to take Cialis for this 36 hour period, even if it causes some nasal congestion.’”

One study comparing Cialis and Viagra showed that the two drugs were equally effective in treating erectile dysfunction. However, men and their partners preferred Cialis over Viagra, citing less time pressure, reduced sense of urgency and less planning before and during sexual encounters (Gong, 2017). In the end, it’s up to you and your healthcare provider to decide what works best for you.

What if Cialis or Viagra isn’t working for me?

If you’re still experiencing erectile dysfunction after having tried Cialis or Viagra, there are other options. 

Addressing underlying health conditions

Certain health conditions can impede your body’s ability to get an erection, even when taking drugs like Cialis. Common health conditions associated with erectile dysfunction include high blood pressure, heart disease, diabetes, depression, low testosterone, and enlarged prostate. Improving these underlying conditions may help improve your overall sexual health (Rew, 2016). 

Lifestyle changes

Cigarette smoking is associated with higher rates of erectile dysfunction (Kovac, 2015). Quitting smoking can help improve your sexual health. In addition, alcohol dependency was associated with more sexual dysfunction, including problems with desire, arousal, and erectile function (Pendharkar, 2016). 

Other treatments for ED

Beyond PDE5 inhibitors, there are other treatment options for erectile dysfunction (Rew, 2016):

  • Testosterone therapy for men with erectile dysfunction caused by low levels of testosterone, a condition called hypogonadism.
  • Injectable medications like alprostadil directly stimulate the penis to get hard.
  • Vacuum restriction devices placed over the penis can maintain erections up to 30 minutes.

References

  1. Food and Drug Administration (FDA). (2015). ADCIRCA (tadalafil) tablets for oral administration. FDA. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022332s007lbl.pdf 
  2. Gong, B., Ma, M., Xie, W., Yang, X., Huang, Y., Sun, T., Luo, Y., & Huang, J. (2017). Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. International Urology and Nephrology, 49(10), 1731–1740. doi: 10.1007/s11255-017-1644-5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603624/ 
  3. Kovac, J. R., Labbate, C., Ramasamy, R., Tang, D., & Lipshultz, L. I. (2015). Effects of cigarette smoking on erectile dysfunction. Andrologia, 47(10), 1087–1092. doi: 10.1111/and.12393. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25557907/ 
  4. Pendharkar, S., Mattoo, S. K., & Grover, S. (2016). Sexual dysfunctions in alcohol-dependent men: A study from north India. The Indian Journal of Medical Research, 144(3), 393–399. doi: 10.4103/0971-5916.198681. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5320845/ 
  5. Rew, K. T., & Heidelbaugh, J. J. (2016). Erectile Dysfunction. American Family Physician, 94(10), 820–827. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27929275/ 
  6. Smith-Harrison, L. I., Patel, A., & Smith, R. P. (2016). The devil is in the details: an analysis of the subtleties between phosphodiesterase inhibitors for erectile dysfunction. Translational Andrology and Urology, 5(2), 181–186. doi: 10.21037/tau.2016.03.01. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837309/