top of page

Sildenafil vs Tadalafil vs Avanafil: Which oral medications are best for treatment?

Oral medications are frequently used as the first-line treatment for erectile dysfunction. These drugs perform effectively and have few adverse effects for most men who have difficulties keeping an erection firm enough for intercourse. Sildenafil (Viagra), tadalafil, and avanafil are oral drugs that treat erectile dysfunction by increasing the effects of nitric oxide, a naturally occurring molecule in the body that relaxes penile muscles. This boosts blood flow, allowing you to obtain an erection in response to sexual stimulation.

Most men with erectile dysfunction are unable to openly discuss their situation, so they choose the easy route and go to the chemist for oral medication used to reverse erectile dysfunction, but without any medical consultation they are unsure as to which medication to take, Tadalafil, Sildenafil, or Avanafil. People suffering from erectile dysfunction should first and foremost seek consultation from an urologist or an andrologist as taking these medications without proper consultation can have harmful effects on the patients.

Different oral medications

Although they function in the same way, each oral drug has a somewhat different chemical composition. These slight variations influence how each prescription works, such as how quickly it takes action and wears off, as well as the potential negative effects. Your doctor will take these factors into account, as well as any other conditions you may have and any potential interactions with other medications you are taking.

Sildenafil (viagra)

Sildenafil was originally meant to be used in the treatment for pulmonary hypertension-a condition of high blood pressure that affects the arteries in the lungs and in the heart-but when patients were given this medication they noticed a side effect of improved erections. Thus, this medicine was eventually repurposed for erectile dysfunction.

Sildenafil made a significant impact as a medicine for treating Erectile dysfunction as there weren’t many options available prior to its repurposing and patients would simply suffer in silence and give up on their sexual life.

After its success as a medicine for ED, the use of sildenafil became common and increased drastically but this increased usage soon turned into abuse as it became the go to medicine for achieving an erection on command. Patients often abuse this medicine by going to the chemist and buying it over the counter without consulting a doctor, which can have drastic consequences and even cause death in cardiac patients or if they are currently on other medications.

Even today, sildenafil is considered the most potent medicine for achieving an erection and is available in 25mg, 50mg and 100mg doses.

Sildenafil is perfect for patients who only need to be sexually active occasionally. It works most effectively on an empty stomach and should be taken approximately 2 hours before engaging in sexual activity as it takes effect slowly and its effects remain for about 4 to 6 hours.

Sildenafil, besides being an effective medicine for ED, has some negative side effects too. For example, the user’s vision can turn blue which is why it’s also referred to as the blue pill, they can also experience mild headache and bodyache.


Tadalafil is safe for regular consumption and can also be used for penile rehabilitation. Married patients who engage in regular sexual activity can use this drug regularly or on alternative days to achieve an erection. Tadalafil is available in 2.5mg, 5mg, 10mg, and 20 mg doses. Tadalafil is usually given to patients who suffer from psychological erectile dysfunction or those who do not suffer from any organic problems. Thus, doctors usually start out by giving the lowest dosage. Its effects are very promising, at the beginning patients can take it every day and its consumption can eventually be reduced to every alternate day and so forth.

Tadalafil holds several advantages. For example, it starts to take effect within 2 hours of consumption, it is not necessary to consume it on an empty stomach, it does not interfere with cardiac conditions, it can be taken on the weekends as its effects last up to 2 days.

“Tadalafil is my drug of choice. Almost all the patients that come to me for consultation, expect a permanent cure to their condition and not a momentary solution. Tadalafil, when taken regularly, can at least cure any psychogenic dysfunction as well as offer relief in cases of organic erectile dysfunction. It can also be used safely by dialysis patients. It is also the best option for patients that suffer from chronic conditions as it can be safely consumed regularly.” Dr. Raman Tanwar, MCH Urology, senior Andrologist and secretary general of the Men’s Health Society of India told BFH.

Tadalafil also has some negative side effects that may include severe myalgia (a medical term for muscle pain) as the patient continues to take tadalafil the myalgia persists as well, doctors usually advise patients to stop taking it and continue it after 3 to 4 days. If the pan persists then doctors can prescribe a different medication.

Giving low dose tadalafil can restore the blood flow in the penis which is often referred to as rehabilitative therapy. Giving patients a small dosage of tadalafil over an extended period of time can condition the brain to forget ED issues and the patient, by increasing the intervals, can gradually be taken off tadalafil and be returned to a normal functioning state.


Avanafil is the latest drug to be launched in India. It is very similar to sildenafil and it quickly takes effect. However it holds certain advantages over sildenafil. For example, patients don’t need to consume it on an empty stomach, it takes effect faster, it metabolised quickly unlike tadalafil that stays in the body for days, so patients who take nitrates, or those who suffer from migraine or low blood pressure can consume it safely. Another advantage of avanafil is that it has less/reduced side effects like blue vision and headache etc.


When patients are not seeing any difference in condition when taking sildenafil, avanafil and tadalafil they can be given udenafil, but it is an expensive medicine and cannot be consumed on a regular basis.

When to take oral medications

Now that you have a grasp of different oral medications, when is it safe to take these medications? Even if you’re suffering from erectile dysfunction and it’s causing you distress and ruining your sex life, it is far from wise to self prescribe these medications and consume them at irregular intervals. By consuming the wrong medicine, you can experience distressing side effects such as, flushing, headache, indigestion, sensitivity to light, blurred vision, blue vision, stuffy/runny nose and back pain. More severe side effects include hearing and vision loss or an erection that does not go away. So the best course of action, when suffering from erectile dysfunction, is to consult a good doctor, more specifically, an urologist or an andrologist. They can offer you options that would effectively help your condition and keep you safe and healthy.

6 views0 comments
bottom of page