Man under covers pouring blue pill out of pill bottle into hand

Do Combination Sildenafil/Tadalafil ED Medications Make Any Sense

There is no shortage of innovation in how Erectile Dysfunction (ED) medications are marketed. From online ED medication sellers to major e-commerce platforms, everyone is getting in on the ED med game. However, it’s important to understand what represents tried and true, gold standard treatment and what may be hyped to sell a more expensive product.

One such question revolves around a relatively new phenomenon – combining Tadalafil, the generic of Cialis, and sildenafil, the generic of Viagra, into a single-dose tablet, chewable, or sublingual tab. If you search online, many ED med sellers are now touting this as an effective alternative to single medication therapy.

Does Dual Combination Therapy Work?

The short answer is that both sildenafil and tadalafil are phosphodiesterase-5 (PDE-5) inhibitors and work similarly. To that end, it’s unlikely there will be any substantial difference between a single and dual medication therapy. From a urologist’s perspective, the dual medication option is a slick marketing tool to introduce a new medication option while creating a compoundable option that circumvents the limitations associated with marketing and selling generic drugs.

Are There Any Downsides to Combination Therapy?

While most patients will not have adverse effects with an appropriate combination of medical therapy, there can be potential concerns. The first revolves around excess dosing. For sildenafil, the max dose is 100 mg, while tadalafil’s max dose is 20 mg. It’s vital that, in combination, these two drugs do not cause patients to overdose. With different dosages and time of action, knowing precisely what proportion of each medication should be taken can be challenging. Some unscrupulous compounding pharmacies and online purveyors may not regulate how much of each drug they use.

A second practical consideration for most patients is that each drug has a somewhat different side effect profile. By taking a combination of drugs, patients are increasing their risk of experiencing a side effect – they are now subjected to the risk profile of two drugs rather than just one.

Combination drug therapy tends to be more expensive than standard generic tablets. Most patients will be better suited to try one drug for a couple of weeks and then switch to the other for another couple of weeks to see which has a better function and side effect profile. From then on, patients can enjoy the low cost of generic tablets while still getting the same benefit.

The Bottom Line

Marketing ED medications and various formulations and options is a billion-dollar business with plenty of misunderstandings that must be corrected.

Ultimately, patients should speak to a qualified men’s health urologist to understand more about the cause of their ED and their best treatment options. Newfangled ED medication options like combination therapy may be marketed as effective, but ultimately, they may be a waste of money. We encourage you to contact our office to learn more.