Comparison
Tadalafil vs. Viagra (Sildenafil)
Tadalafil or sildenafil – what is the difference?
The short answer
Two of the best-supported substances in the entire database, with the same mechanism of action and one practical difference: tadalafil works considerably longer, sildenafil faster and shorter. Both have been approved for more than two decades, both have extensive phase III programs and complete post-marketing surveillance – the inhibition of phosphodiesterase 5 is among the most precisely understood mechanisms in pharmacology. Tadalafil is also approved for benign prostatic enlargement. The only deduction concerns its fringe marketing as a general vascular longevity agent, for which there are no approval studies.
The numbers side by side
| Axis | Tadalafil | Viagra (Sildenafil) | Difference |
|---|---|---|---|
| Human evidenceHow much human data there is, and how good | 10 | 10 | tied |
| MechanismHow well the mechanism of action is understood | 9 | 9 | tied |
| Safety dataHow well safety has been studied – not how safe it is | 9 | 9 | tied |
| Hype gap10 means: the marketing stays level with the data | 7 | 7 | tied |
| Track record of useHow much documented use in humans exists – does not measure whether it works | 10 | 10 | tied |
| Rating | Well supported · Well supported | ||
“Track record of use” measures how long and how widely something has been used in humans – not whether it works. The BK-Score is a subjective assessment by Biohacking Kompakt based on published scoring rules. It is not a scientific rating, not the consensus of a professional society and not a medical recommendation.
Why these numbers
Tadalafil
One of the best-supported substances in the entire database: approved since 2003 for erectile dysfunction, and also for benign prostatic enlargement and pulmonary arterial hypertension, each on the basis of extensive phase III programs. PDE5 inhibition is quantitatively understood in humans. More than two decades of pharmacovigilance provide a clear warning profile – nitrate interaction, visual disturbances, priapism. The deduction concerns only its fringe marketing as a general vascular longevity agent, for which there are no approval studies.
Viagra (Sildenafil)
Approved since 1998, based on the pivotal trials around Goldstein et al. (NEJM 1998), which showed a significant improvement in erectile function compared with placebo, and later also for pulmonary arterial hypertension. PDE5 inhibition is among the best-characterized mechanisms in pharmacology. More than 25 years of post-marketing surveillance provide a complete risk profile, including the nitrate contraindication. Increasingly, a general circulation and anti-aging benefit is also being promoted – there are no approval data for this.
Frequently asked questions
Why does tadalafil work longer?
Because of its longer half-life – hence the nickname weekend pill. There is a separate approval for daily low-dose use.
What is the most important warning?
The combination with nitrates, because blood pressure can drop dangerously. This applies to both substances and is the reason they require a prescription. Visual disturbances and priapism are also documented.
Are they useful as longevity agents?
There are observational data and mechanistic arguments on vascular health, but no approval study for this purpose in healthy people. That is the difference between a plausible hypothesis and evidence.
See all 255 ratings in the ranking
Information only, not medical advice and not a usage or dosage recommendation. Prescription drugs and unapproved substances belong in the hands of a doctor.