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In fact, Cialis represented 56 percent of new treatment initiations by urologists in April, compared to 21 percent for Levitra (vardenafil HCl)5 and 23 percent for Viagra.6 Based on data from IMS, another source of market information, in April, Cialis represented 30 percent of new ED treatment prescriptions written by urologists, compared to 16 percent for Levitra and 54 percent for Viagra.7 In April, nearly two thirds of all men who switched their oral ED treatment switched to Cialis.

• Cialis works by inhibiting PDE5 enzyme, enhancing blood flow.
• The drug's effects can last up to 36 hours, providing flexibility.
• Sexual stimulation is necessary for Cialis to work effectively.
• It is generally taken before anticipated sexual activity.
• Do not take multiple doses at once to avoid overdose.
• The recommended starting dose varies by individual health.
• Generic Cialis may be prescribed for daily use or on-demand.
• Consuming high-fat meals can delay Cialis absorption.
• Follow your doctor's instructions for safe use.

Following is information from ImpactRx™ on share of new prescriptions written in April by doctors changing their patients' ED treatment from product to another.

What Are the Key Risks and Uncertainties?

Cialis is marketed by Lilly ICOS LLC, a joint venture between Eli Lilly and Company (NYSE: LLY) and ICOS Corporation (Nasdaq: ICOS). Cialis is the only ED treatment shown to improve erectile function up to 36 hours in most men. Cialis can be taken without regard to food. According to market research firm ImpactRx™ (which tracks the habits of a panel of high prescribing physicians and may reflect emerging trends in doctors’ offices today)4, U.S. urologists initiated treatment with Cialis in April at a rate of more than two-to-one over each of the other oral ED treatments. In an independent clinical study, more men selected Cialis as their preferred treatment of choice after trying different oral ED medications, primarily because of how long the drug worked.8 This may explain why many men with ED who are on oral treatment are switching to Cialis.

The percentages of new prescriptions written by all doctors for oral ED treatments in April broke out as follows: Cialis, 19 percent; Levitra, 14 percent; and Viagra, 67 percent.9 "The early success of Cialis in the U.S.

As seen in

The longer duration of action is the biggest difference between Cialis and Viagra, according to Anthea Nwandu, MD, FACP, a board-certified internist and lifestyle medicine physician in Baltimore, Maryland. She explains: “For men who feel anxious about performance, or who want intimacy to feel more spontaneous, Cialis often leads to a more natural experience.” Viagra is a brand-name prescription medication that is FDA approved to treat ED. Off-label prescriptions for Viagra are not common, but it is occasionally used off-label for secondary Raynaud phenomenon, female sexual arousal disorder, and as an adjunct therapy for altitude-induced hypoxemia. Viagra’s active ingredient, sildenafil, is a PDE5 inhibitor that widens blood vessels in the penis to improve erectile function. Viagra is taken on demand, anywhere from 30 minutes to four hours before sexual activity.

Partner Perspectives

It works quickly but tapers off after four hours. Dr. Nwandu says this makes Viagra an excellent option for men who want an ED medication with a shorter duration that can be taken “only when needed.” Both Cialis and Viagra are approved to treat ED. But as mentioned above, Cialis is also approved to treat an enlarged prostate. Both medications also have a few off-label uses.

Pricing and Reimbursement

Both Viagra and Cialis are first-line treatments for ED. People taking these medications still require sexual stimulation, as the drugs do not trigger spontaneous erections. Cialis and Viagra are not treatment options for low libido or premature ejaculation. Which is better for you may depend on your lifestyle and preferences, as well as your individual tolerance to the medication. A systematic review and meta-analysis comparing Viagra and Cialis found that both drugs had similar rates of effectiveness and adverse events. is similar to the trend we saw when it first became available in other countries.

How Cialis and Viagra work in the body

However, individuals on Cialis experienced more improvements in sexual confidence compared to individuals on Viagra. “When patients tell me they feel more confident on Cialis compared to Viagra, it usually comes down to psychological freedom,” Dr. Nwandu says. “Viagra’s shorter effect can make men feel rushed. Of course, Viagra is better for spontaneity because it kicks in more quickly than Cialis.

Regulatory Approvals

Most men can feel the benefits less than 30 minutes after they take Viagra. By contrast, studies show that the effects of Cialis peak about two hours after taking it. Ultimately, the best medication for a patient should be determined only by a healthcare provider familiar with the person’s medical condition, history, and any medications they may already be taking that could interact with Cialis or Viagra, as well as the patient’s response to treatment. “If my patient asked me, ‘Doc, which one should I start with?” I’d say, ‘Let’s try Viagra first. It’s short-acting, so you’ll get a feel for how your body responds.

Contents of the leaflet

If you like the effect but want more flexibility, we can switch to Cialis later.’” – Anthea Nwandu, MD Both Cialis and Viagra are brand-name drugs that are available in generic form. “ED medications are very rarely covered by insurance, regardless of which one is prescribed,” says Blair Gingerich, Pharm.D., an ambulatory care pharmacist in northern Indiana. However, some plans may cover generic ED medications when an underlying health condition causes erectile dysfunction, or when the medication is taken for a different condition, such as BPH or an enlarged prostate. Without insurance, the retail costs for Cialis and Viagra can vary by pharmacy and location. The average retail price of Cialis is $437 for 30, 5 mg tablets, whereas the average Viagra cost is about $1,064 for 10, 100 mg tablets. Cialis has claimed market shares of 19 percent to 39 percent across Europe, and even higher in some other markets," said Leonard Blum, vice president of marketing, ICOS Corporation.

• Generic Cialis is the common name for tadalafil, used to treat erectile dysfunction.
• It is produced by multiple pharmaceutical companies worldwide.
• The drug works by increasing blood flow to the penis.
• Generic Cialis costs significantly less than the brand-name version.
• It typically comes in 2.5mg, 5mg, 10mg, and 20mg doses.
• Cialis has a long-lasting effect, up to 36 hours.
• It should be taken at least 30 minutes before sexual activity.
• Possible side effects include headache, flushing, and muscle pain.
• Consult a doctor before using Cialis, especially with other medications.

In the first quarter of 2004, Cialis achieved $108 million in global sales.

Who should avoid Cialis or Viagra?

The good news is that you can save on prescription drugs by using SingleCare coupons or your free SingleCare prescription discount card. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of Feb. 13, 2026. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available.

Lifestyle Factors

Cialis and Viagra are both PDE5 inhibitors, so they cause similar side effects. “The most common side effects have to do with the vasodilation properties associated with PDE5 inhibitors,” Dr. Gingerich says. “People taking these medications may experience flushing, headaches, or indigestion.” Common side effects of both Viagra and Cialis include: Serious side effects of Cialis and Viagra include: Consult your healthcare provider for a complete list of side effects. PDE5 inhibitors aren’t right for everyone.

Molecular Weight

That’s why it’s essential to disclose your full medical history and medications list (prescription and over-the-counter drugs and supplements) to your healthcare provider before starting Cialis or Viagra. Specifically, Cialis and Viagra may not be safe in some people with cardiovascular conditions since the medications affect circulation. Seek medical advice about using PDE5 inhibitors if you have high blood pressure or have had a heart attack or angina. Tadalafil and sildenafil cialis 2 5 mg should not be mixed with nitrates, alpha blockers, or hypertension drugs. Cialis and Viagra should also not be taken by people who are pregnant or breastfeeding. More than two million men around the world have been treated with Cialis since its first introduction globally last year.

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Tell your healthcare provider if you have low blood pressure or heart disease. Cialis and Viagra are both safe, effective ED medications. Choosing which is best, or whether an alternative might be better or safer, is a decision that should be made with a healthcare provider familiar with your health history, lifestyle, and other conditions you may have. The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Feb. 13, 2026.

Emerging Markets and Demographics

Visit our coupon pages for updated Cialis and Viagra prices near you. Highlights of prescribing information: CIALIS (tadalafil) tablets, for oral use, Food and Drug Administration (2018) Highlights of prescribing information VIAGRA® (sildenafil citrate) tablets, for oral use, Food and Drug Administration (2017) Onset and duration of action of sildenafil for the treatment of erectile dysfunction, British Journal of Clinical Pharmacology (2002) The role of tadalafil in treated hypertensive patients with erectile dysfunction, The Journal of Clinical Hypertension (2022) Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: A systematic review and meta-analysis, International Journal of Urology and Nephrology (2017) Tadalafil in the treatment of erectile dysfunction, Therapeutics and Clinical Risk Management (2008) Cialis – tadalafil tablet, film coated, DailyMed (2009) Viagra – sildenafil tablet, film coated, DailyMed (2017) Medically accurate: SingleCare’s Medical Review Board analyzes all of our content to confirm it’s in line with current medical advice. Evidence-based: Our content is sourced from reputable U.S.-based healthcare professionals and peer-reviewed research. Trustworthy: All of SingleCare’s content goes through a multi-phase review process by our writers, editors, and Medical Board in order to provide clear and credible information. This release was issued by Lilly ICOS LLC Cialis Leads Market in New Treatment Initiations and Switches for April After only six months, Cialis® (tadalafil)1, the latest oral erectile dysfunction (ED) treatment on the market in the U.S., is challenging Viagra® (sildenafil citrate)2for share of the ED market as Cialis leads in new treatment initiations by urologists3 and switches from other products for April. "For us, the number of Cialis prescriptions written by urologists is one of the most important indicators of future trends.

Urologists are the experts in treating ED.

We expected that urologists would be the quickest adopters of Cialis, and the data suggest that these specialists, like their peers overseas, are making Cialis their preferred treatment," said Blum.