Effects Taking Viagra Cialis Together


Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction

Porst H, Gacci M, Büttner H, Henneges C, Boess F. Porst H, et al. Eur Urol. 2014 Feb;65(2):455-64. doi: 10.1016/j.eururo.2013.09.037. Epub 2013 Oct 2. Eur Urol. 2014. PMID: 24119319

Can You Take Cialis in the Morning and Viagra at Night?

By definition, erectile dysfunction (ED) is a continuing inability to get and maintain an erection firm enough for sexual intercourse.

Several medications are effective treatments for ED, including Cialis and Viagra. To minimize the chance of experiencing adverse effects, follow the advice of the drug manufacturers and your healthcare provider. Mixing Cialis and Viagra is not recommended.¹ Here’s why.

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What are Cialis and Viagra?

Cialis (tadalafil) and Viagra (sildenafil) are the two most common phosphodiesterase inhibitor (PDE5 inhibitor) medications in the world.²

Both drugs have been approved by the US Food and Drug Administration (US FDA) as safe and effective treatments for ED.³ ⁴

How do they work?

Neither Cialis or Viagra directly causes an erection, and these medications are not a cure for ED.⁵

Rather, they treat the symptoms of ED by increasing blood flow to the penis. You also need to be sexually aroused for Cialis and Viagra to work.⁶ ​​

Phosphodiesterase is an enzyme in the body that prevents erections from occurring. It breaks down a molecule called cyclic GMP which relaxes the muscles in the blood vessels and helps to increase blood flow to the penis, so an erection can happen.

PDE5 inhibitors — including Cialis and Viagra — block the phosphodiesterase enzyme from having this effect on cyclic GMP.

This process allows an erection to take place.

Can you take Cialis and Viagra at the same time?

Unless your doctor directs you to do so, it’s not recommended to take Cialis and Viagra on the same day. (Cialis stays in your body for approximately 36 hours).⁷

Cialis and Viagra are mainly taken on an as-needed basis when having difficulty achieving an erection.

Typical instruction is to take either Cialis or Viagra around 30 minutes before having sex.,⁸ ⁹

If you follow all the guidelines for taking either Viagra or Cialis, and you continue to experience ED, speak to a healthcare professional instead of taking the two drugs in the same day. A doctor can screen you for underlying health issues and present you with different treatment options and (possibly) medication adjustments.

What might happen if you take them at the same time?

In most instances, taking Viagra and Cialis together would have similar effects to taking a double dose of either medication, which could be dangerous and ineffective.

Similarly, it’s not safe to take Cialis in the morning and then take Viagra the same night because Cialis lasts up to 36 hours in the body.¹⁰

In other words, if you were to take Cialis in the morning, it would still be in your system when you take Viagra later that day.

Wait at least 36 hours before taking Viagra, another dose of Cialis, or any other PDE5 inhibitor.

Likewise, if you take Viagra at night, you shouldn’t take Cialis or any other PDE5 inhibitor the next morning.

Although Viagra is generally only effective for a few hours, it can still linger in your system, so wait at least 24 hours.

Although you should not take Cialis and Viagra simultaneously or within 36 hours, it may be okay to alternate outside this timeframe.

Still, it’s best to seek guidance from your prescribing doctor before you do.

What are the side effects of taking them together?

Taking Cialis and Viagra together doesn’t offer a combined beneficial effect on ED.

Although Cialis and Viagra aren’t known to interact dangerously (they are both the same type of medication), you will be increasing the overall risk of side effects.

You will end up with more than the recommended amount of PDE5 inhibitor in your system.

So, you might experience symptoms much like after taking too much Viagra or Cialis. These side effects may include (but are not necessarily limited to):

Low blood pressure

PDE5 inhibitors can reduce your blood pressure. However, if you take two inhibitors, your blood could drop to dangerously low levels. You might feel this as being dizzy, lightheaded, or nauseous.¹¹

Prolonged and potentially painful erection

Priapism is a prolonged erection that lasts more than four hours. Priapism can lead to permanent ED and damage to the penis, so it should be treated as a medical emergency.

How do you know if you’re taking too much?

You will likely experience the above side effects of dangerously low blood pressure or a prolonged painful erection if you take too much Cialis or Viagra.

Cialis and Viagra are designed to be taken as needed.

However, Cialis has a low-dose option, so your doctor may prescribe it as needed or taken daily. ¹²

It’s important to note that men over the age of 65 and men with impaired liver or kidney function are at higher risk of side effects. ¹³

This risk is related to having a slower average rate at which the medications clear from the body. If you happen to be in one of these demographics, a lower dose will usually be prescribed.

Can you overdose on these medications?

Overdose is rare, but it is possible to overdose on Cialis or Viagra, or have a fatal drop in blood pressure when too much is taken., ¹⁴ ¹⁵

If you take too much Cialis or Viagra, seek urgent medical attention and contact your local poison control helpline for support.

Can you drink alcohol when taking Cialis or Viagra?

Drinking alcohol in moderation is considered safe when using Cialis or Viagra. However, excessive alcohol use is dangerous.

Both drugs widen blood vessels and reduce blood pressure

Since alcohol also widens blood vessels and drops blood pressure, it can have dangerous interactions with how Viagra and Cialis are metabolized.¹⁶ In rare situations, this could be life-threatening.

Also, chronic alcohol use increases the risk of sexual dysfunction, so those with ED would be well-advised to avoid alcohol.¹⁷

What medications can’t be taken with Cialis or Viagra?

You should inform your doctor about all other medications you take, including supplements and recreational drugs.

Certain medications can have dangerous interactions with Cialis and Viagra. They can have serious effects like a sudden drop in blood pressure.

Cialis and Viagra should not be taken with:

  • Other PDE5 inhibitors Inhibitor drugs including Stendra (avanafil) and Levitra (vardenafil) should not be taken together.
  • Blood pressure medications Alpha-blockers are unsuitable, though some individuals may be able to take them with close monitoring.¹³
  • Vasodilators Nitrates that treat heart failure, such as nitroglycerin, should not be taken with Cialis and Viagra.
  • Recreational drugs Party drugs, especially stimulants, don’t mix with Cialis and Viagra. For example, cocaine decreases blood flow, while ED medication increases it. This can cause sudden fluctuations and can induce a stroke or heart attack. If you have a history of heart problems, the risks are even higher.¹⁸

Food and drugs that change Cialis and Viagra levels

Taking any of the following may cause your body to eliminate your medication slowly or process it differently than usual:

  • Antibiotics Antibiotics such as erythromycin elevate PDE5 inhibitors.¹⁹
  • Antifungals Ketoconazole can elevate PDE5 inhibitors.²⁰
  • Protease inhibitors HIV medication such as ritonavir may or may not be suitable.²¹ Ask your doctor.
  • CYP3A4 inducers Drugs like phenobarbital, rifampicin, phenytoin, St. John’s Wort, or glucocorticoids can decrease the effectiveness of Cialis and Viagra.²²
  • Grapefruit or grapefruit products Grapefruit and its juice can delay the metabolism and increase the amount of the drug in the blood.²³

Are there any side effects of taking Cialis or viagra?

Cialis and Viagra have similar side effects.

Most side effects are temporary and mild to moderate in severity.

  • Headache
  • Heartburn
  • Diarrhea
  • Flushing of the face (more common with Viagra)²
  • Difficulty sleeping or waking
  • Runny nose
  • Feeling numb or tingly in the limbs
  • Muscle aches and pain (more common with Cialis)²
  • Sensitivity to light

Cialis can also cause coughing and indigestion. These symptoms are less frequently reported when taking Viagra.⁸

One study found that sildenafil, the active ingredient in Viagra, had a higher rate of adverse effects than tadalafil, the active ingredient in Cialis.⁸

However, since Viagra lasts a shorter time in the body, the side effects may not be experienced for as long as they are with Cialis.

There are also some serious side effects of Viagra and Cialis, which you should seek medical attention⁸ for. These include :

  • Vision changes: blurred vision or a sudden loss of vision
  • Hearing changes: ringing in ears or sudden decrease or loss of hearing
  • Fainting, dizziness, or feeling lightheaded
  • Chest pain
  • Low blood pressure
  • Shortness of breath
  • A prolonged, painful erection that lasts more than four hours
  • A rash
  • Itching or burning during urination
  • Heart complications, like heart attacks, strokes, and irregular heartbeats
  • Hives, swelling, blistering, and/or peeling of the skin (more likely with Cialis)

When should you see a doctor?

See your doctor if you notice t an ongoing problem with achieving erections.

This is important so you can begin treatment, but also because ED can be caused by numerous underlying conditions you’re unaware of.

Viagra and Cialis are both prescription drugs, so you will need to see your doctor before being able to use them.

If Cialis or Viagra isn’t working the way you’d like it to, you should also speak with your doctor to see if your dose needs to be adjusted or discuss switching medications from Viagra to Cialis or vice versa.

Also, if you experience side effects, see your doctor. There are other medications and treatments in addition to PDE5 inhibitors, which you may be better suited to.

The lowdown

Cialis and Viagra are popular treatments for ED. Both have similar effectiveness and function in the body and are regarded as generally safe when taken as directed. You may be able to alternate between Cialis and Viagra. Still, you shouldn’t take them simultaneously, nor should you take Cialis in the morning and Viagra at night.

Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction

This study aimed to evaluate the efficacy and safety of long-term and low-dose tadalafil combined with sildenafil as needed at the early stage of treatment for erectile dysfunction (ED). We enrolled 180 patients with ED 1 : 1 to tadalafil 5 mg once daily or once-a-day tadalafil 5 mg combined with sildenafil 50 mg as needed. The efficacy measures included the 5-item version of the International Index of Erectile Function (IIEF-5) and the Sexual Encounter Profile (SEP). The safety was assessed by observing drug tolerability and adverse events. Total IIEF-5 scores of patients with severe ED in combined medication group were significantly higher than in tadalafil alone group. Question 2 scores of IIEF-5 of patients with moderate and severe ED in combined medication group were significantly higher than in tadalafil alone group. The significant improvement in question 3 scores of IIEF-5 existed only in patients with severe ED receiving combined medication. The percentage of ‘yes’ responses to SEP4, SEP5 and partner’s SEP3 were improved significantly in combined medication group. There was no difference between two groups in the incidence of adverse events. Our results suggest that combined medication can better improve erectile function, especially for patients with severe ED.

Keywords: Combination therapy; erectile dysfunction; safety; tadalafil.

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Why You Don’t Need to Take Cialis in the Morning and Viagra at Night

You shouldn’t take Cialis (tadalafil) and Viagra (sildenafil citrate) together to help with treating erectile dysfunction (ED).

It’s also typically recommended that you take one or the other shortly before sex, but not daily or on a regular schedule. These ED medications only work if you’re already aroused.

Taking both Cialis and Viagra can also increase your risk of side effects, such as low blood pressure.

And if you feel like you need to take a second ED medication because the first one isn’t helping, you may need to see your doctor so they can check for any underlying issues that may be causing your ED.

Let’s look into why taking both Cialis and Viagra won’t make a big difference in how easily you can get an erection, when you should seek treatment for ED, and what other home remedies for ED you can try.

Cialis and Viagra are both phosphodiesterase type 5 (PDE5) inhibitors. PDE5 is an important enzyme involved in erections that’s one of the biggest culprits behind ED.

  • When your penis nerves are stimulated, you get an erection. When this happens, muscles that surround two cylinder-shaped pieces of tissue in your penis, called the corpora cavernosa, relax and fill with blood.
  • When you have ED, nerves aren’t communicating between your brain and your penis to help make this process happen, so blood doesn’t flow properly into your penis.
  • Viagra and Cialis block PDE5 and help relax your blood vessel walls. This makes it easier for blood to flow into your penis tissues and give you an erection.

Since Cialis and Viagra are both PDE5 inhibitors and both are used to treat the symptoms of erectile dysfunction, it is not necessary or recommended to take both at the same time.

If you want to maximize the benefits of taking a PDE5 inhibitor, it’s better to evaluate which drug better suits your lifestyle rather than double up on medications. Doubling up increases your risk of severe side effects from exceeding the recommended dosage.

For example, Cialis has a longer 24-hour window of effectiveness than Viagra, but to see the results, you need to take it daily. You only need to take Viagra as needed, but it’s only effective for a few hours.

If someone is having sex infrequently or has trouble remembering to take their medications daily, Viagra may be the better option. They should see results after just one dose and won’t see a drop in effectiveness from missing daily doses.

However, someone having more frequent or spontaneous sex — where it would be difficult to take a pill early enough before a sexual encounter — may find Cialis is the better option.

Keeping in mind how Cialis and Viagra work, here’s why it’s not necessary to take them together:

  • Both Cialis and Viagra work on the same mechanism of arousal and erection. Taking both is basically the equivalent of increasing your overall dose of PDE5 inhibitor. Increasing your dose of any medication without approval from your doctor can be dangerous. Your body may not respond the same way to a higher dose of medication.
  • You need to be sexually aroused for PDE5 inhibitors to work. Cialis and Viagra don’t cause erections on their own. They simply help your natural erection processes work more easily. Taking them every day won’t help if you’re not aroused.
  • Cialis is designed to last much longer than Viagra. Viagra typically lasts about 4 hours after you take it. Cialis can last up to 36 hours after you take it. If you’re already taking Cialis, Viagra may not have any additional effects because Cialis is still functioning in your body.

The dosage of each medication makes it unnecessary to take them together, too.

Cialis is usually given in a low dose form of 2.5 milligrams (mg), which makes it safe to take every day on its own. The low dose also makes it less likely that you’ll experience side effects.

Viagra is given in much higher doses — the lowest available dose is 25 mg. It also needs to be taken 30 minutes or more before sex because the ingredients work much more quickly at such high concentrations.

Cialis and Viagra don’t have any dangerous interactions with each other because they’re the same type of medication.

But increasing your dose of a PDE5 inhibitor can increase your risk of side effects that are associated with these kinds of ED medications.

Here are some of the more common side effects of Viagra and Cialis:

  • stuffy or runny nose
  • headache
  • feeling dizzy
  • upset stomach
  • nausea
  • indigestion
  • blurry vision
  • rash
  • flushing
  • back pain
  • limb pain
  • muscle aches

See your doctor if you notice any of these side effects, especially if they last for a few hours after the medication has worn off or if they linger for more than a day afterward.

Cialis can cause your blood pressure to drop dangerously low when taken together with nitroglycerin (Nitrostat). Don’t use Cialis if you’re already taking nitroglycerin for blood pressure.

Seek emergency medical treatment if you notice any of the following side effects:

  • sudden chest pains during or after sex
  • an erection that lasts 4 hours or more (priapism)
  • trouble seeing or hearing
  • skin reactions like hives
  • face or eye swelling
  • unexplained seizures

If PDE5 inhibitors aren’t working for you, there are some other ED treatments your doctor might recommend:

  • therapy or counseling for anxiety, depression, stress, or other mental health conditions that can cause ED
  • other ED medications, such as avanafil (Stendra)
  • self-injected drug therapy
  • alprostadil urethral suppositories, which are inserted directly into your urethra
  • testosterone replacement therapy, if low T levels are causing ED
  • erectile dysfunction pumps, which can help induce an erection by sucking and trapping blood in the penis
  • insertion of an implant

Your doctor may also recommend one of the following experimental treatments:

Here are some other treatments you can try to help make your ED medication more effective or as alternatives to medication:

  • Limit alcohol. Drinking less alcohol can improve blood flow.
  • Quit smoking. Smoking can inhibit blood flow.
  • Maintain a healthy weight. Exercise and a healthy diet will keep your weight down and improve your blood flow.
  • Get a good night’s sleep. This will reduce stress damage to tissues that can make ED worse.

Don’t buy Cialis or Viagra without a prescription. Only your doctor can perform the examinations necessary to make sure these medications and their dosage are safe for you.

If you’re experiencing symptoms of ED on a regular basis over a period of several weeks, talk with your doctor to rule out the possibility of more severe underlying issues. Your doctor will be able to begin diagnosing your symptoms and help you find an effective treatment.

For people who are already taking Cialis or Viagra, consider seeing your doctor if you aren’t seeing the desired results from your medication or you are noticing a dip in its effectiveness. Your doctor will be able to discuss alternative treatment options or decide if you should change your dosage.

In addition, if you are experiencing severe or sudden side effects from either Cialis or Viagra, it’s important to reach out to your doctor.

As with most medications, some side effects are expected, but more severe side effects, like issues with your vision, hearing loss, and erections lasting over 4 hours should be reported to your doctor. These uncommon side effects may indicate that you have accidentally taken too much of the drug or it is having a negative reaction to another medication you are taking.

How long does it take for Viagra to work?

One of the biggest benefits of Viagra is how fast it starts working. On average, it can begin working in about 30 to 60 minutes, but it can take up to 2 hours to take effect in some people. Unlike Cialis, Viagra can work after taking just one pill and doesn’t require daily usage. It is worth noting that Viagra is only effective for a few hours and can become less reliable after 2 to 5 hours.

How long does Cialis last?

Cialis can work for an estimated 36 hours . However, Cialis does require a daily dose to be fully effective and relies on a certain level of the drug to have built up in your system. In other words, when a dose is being taken regularly every 24 hours, the effects of the drug can last as long as you are able to keep maintaining daily usage.

How does Cialis work?

Cialis works as a PDE5 inhibitor that works to block the PDE5 enzyme that restricts blood flow to the penis. Cialis is a low dose pill that requires you to take it daily so it can build up in your system and maintain its effectiveness. When used correctly, you should always be ready for sex and wouldn’t need to rely on taking a drug like Viagra a few hours in advance of having sex.

Don’t take Cialis and Viagra together. Not only will combining them not improve ED symptoms, but it can also be dangerous.

Talk with your doctor about any concerns you have about your ED and its causes. In some cases, incorporating both medication and lifestyle changes is the best way to help improve ED symptoms.

Last medically reviewed on June 15, 2022

Can You Take Cialis in The Morning and Viagra At Night?

If you’ve experienced erectile dysfunction (ED), you know it can cause embarrassing moments in your intimate life.

We put so much emphasis on virility as men that even a single incident of not being able to get it up can cause shame, depression or be a huge hit to our self-esteem.

ED is a common condition, and a lot of us may be tempted as a first instinct to go a bit overboard on treatments.

It seems to make sense if you don’t think it through. Viagra® (sildenafil) is a commonly prescribed treatment for short-term ED. You take it and get a few hours of confident reprieve.

Likewise, Cialis® (tadalafil) gives you a longer period of potency, as it’s a medication you take to get 36 hours of reliable erectile function.

So why not take both as a sort of insurance mechanism?

Believe it or not, that is, in fact, a terrible idea — and not just because it won’t actually work.

Taking two ED pills, even if they work slightly differently, can cause a multitude of problems, and we’re sorry to report that none of them will be a doubling in size of your member. The effects could be more dangerous — like a heart attack, or a stroke.

To understand more clearly why this is a bad idea for you and your penis, let’s walk through the background of how erections work and how ED happens.

How Erections Work

Erections are the result of two primary processes: increased blood flow to the penis’s blood vessels, and the trapping of that blood in the penis in two long champers called the corpora cavernosa.

When you become aroused, your brain sends chemical signals to your body to dilate the blood vessels in the penis, allowing blood to flow in. The blood becomes trapped in the corpora cavernosa, keeping you erect. That’s how it’s supposed to work, if you don’t have erectile dysfunction.

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ED: What’s Going Wrong

The National Institutes of Health (NIH) defines erectile dysfunction pretty clearly: “A condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse.”

There are many factors that can cause erectile dysfunction. They include:

poor diet, obesity, blood flow issues, stress, anxiety, illicit or prescribed drugs and their side effects, certain habits, hormone imbalances, and more.

It’s a fairly common condition, affecting an estimated 30 million to 50 million men nationwide. And because it’s so common, the treatment options available have been tested and used extensively over the years. Two of these FDA approved and widely used treatments are Cialis and Viagra.

Cialis and Viagra are Very Similar Treatments

We’ve written about these drugs more extensively in our guide comparing the two, but Cialis and Viagra have a lot in common.

Both Cialis and Viagra are phosphodiesterase type 5 (PDE5) inhibitors, which work by blocking the breakdown of certain substances in your body leading to prolonged dilation of your blood vessels and subsequent increase of blood flow to the soft tissue of your penis.

Because PDE5 inhibitors cause dilation of blood vessels, they can also be used to treat certain types of hypertension.

Because of these effects, it’s important to talk to your healthcare provider before using Cialis or Viagra if you have a heart condition, or if you use medication for high blood pressure.

The key difference is that Viagra is a shorter term medication, typically resulting in four to six hours of effects, while Cialis can work from a day to a day and a half.

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Doubling the Side Effect Risk

You’re not going to get twice as hard from taking a double dose of either Cialis or Viagra, and likewise you’re not going to get twice as hard from taking both in the same day. The reason? It doesn’t work like that.

Cialis and Viagra both work as PDE5 inhibitors, and though they may work slightly differently in that process, they’re working on the same mechanism, which is to create the ideal conditions for an erection, not to cause one out of the blue.

Just because you’re taking these medications, doesn’t mean you’re going to get an erection — stimulation of some kind is still needed to make that happen.

But unfortunately, the fact that both drugs won’t complement each other’s positive effects, doesn’t mean that tadalafil and sildenafil(generic Viagra) won’t complement each other’s side effects. And that’s what is likely to happen.

Both Viagra and Cialis carry warnings for side effects, and most of the side effects overlap.

In addition to things like headaches, rashes, and dizziness, they can both cause sudden drops in blood pressure, which may sound like it might be a great thing for people with high blood pressure, but in fact a large drop could have serious consequences, including death.

Here’s the catch: taking both medications in overlap will likely double the amount of chance for side effects, which could effectively double the rate and degree of drop in blood pressure, and that’s where this can go from a risky choice to a deadly one.

Another possible consequence of taking two ED drugs or doubling the dose of your ED drug is priapism — an erection that lasts for several hours.

This is a painful and potentially damaging emergency that has to be attended to immediately.

And more importantly, and this can’t be stated clearly enough, there is absolutely no benefit to taking both drugs — neither Cialis nor Viagra actually cause you to have more erections.

Got that? These drugs don’t cause erections. They cause the proper conditions for erections, but you still need to be stimulated or otherwise aroused for it to happen.

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The Bigger Picture

We’re guessing you hit this story out of a sense of curiosity — we were curious too, until we did the research.

But if you were here wondering if doubling up on the pills would be a solution to your problem, you may have bigger issues you’ll want to address.

If you’re taking one or both of these medications and still not achieving erections, the cause could be psychological.

Everything from depression and low self-esteem to a problematic porn habit could be causing your erectile issues, and those are problems that you’ll want to bring to your healthcare provider, therapist or other medical professional.

There are other treatments for ED as well, including diet and lifestyle changes.

All we’re saying is that more pills are definitely not the answer if one pill isn’t working, and if one pill isn’t working, it’s time to talk to someone about other treatment options.

Don’t despair: there are plenty of options available, and your solution might be as easy as trying a different pill, dropping some bad habits or picking up some good ones.

If you’re just learning about ED, we have resources available to help you determine if either tadalafil (Cialis) or sildenafil (Viagra) are right for you.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.