Comparative Pharmacology
Head-to-head clinical analysis: CIALIS versus REVATIO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CIALIS versus REVATIO.
CIALIS vs REVATIO
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Phosphodiesterase-5 (PDE5) inhibitor; increases cGMP levels, causing smooth muscle relaxation and vasodilation in the corpus cavernosum, enhancing erectile function.
REVATIO (sildenafil) is a phosphodiesterase type 5 (PDE5) inhibitor. By inhibiting PDE5, it increases cyclic guanosine monophosphate (cGMP) levels in pulmonary vascular smooth muscle, leading to vasodilation and reduced pulmonary vascular resistance.
Tadalafil 10 mg or 20 mg orally as needed at least 30 minutes before sexual activity; maximum dosing frequency once daily. Alternative: 2.5 mg or 5 mg once daily for daily use.
20 mg orally three times daily, administered 4-6 hours apart.
None Documented
None Documented
The terminal elimination half-life of tadalafil is approximately 17.5 hours in healthy subjects, which supports once-daily dosing for erectile dysfunction and once-daily use for benign prostatic hyperplasia. This long half-life distinguishes it from other PDE5 inhibitors.
Terminal elimination half-life ~4 hours (range 3-5 hours) in steady state; similar in pulmonary arterial hypertension patients.
Following oral administration, tadalafil is predominantly eliminated by hepatic metabolism. The metabolites are excreted mainly in feces (approximately 61% of the dose) and to a lesser extent in urine (approximately 36% of the dose). No unchanged parent drug is detected in urine.
Primarily hepatic metabolism (CYP3A4) to N-desmethyl sildenafil (active). Renal excretion accounts for ~80% as metabolites; ~13% fecal.
Category C
Category C
PDE5 Inhibitor
PDE5 Inhibitor