Tadalafil is the name of the active ingredient used in many ED medications including Cialis. Cialis is only used to treat erectile dysfunction and benign prostatic hyperplasia while other brands of tadalafil may also be used to treat pulmonary arterial hypertension. Cialis is manufactured by Eli Lilly and Company and generic tadalafil – by other pharma companies. Cialis comes as yellow almond-shaped tablets with the strengths of 2.5 mg, 5 mg, 10 mg and 20 mg while its generics may come in other shapes, forms and strengths and include different active and inactive ingredients. Cialis is available worldwide and usually costs upwards of $10 per tablet. The availability of certain brands of generic tadalafil may be limited in some countries. It is much cheaper than Cialis, priced between $1 and $2 or even less.

Cialis and Tadalafil – What Is the Difference?

Tadalafil is a medication used in the treatment of male impotence, benign prostatic hyperplasia and pulmonary arterial hypertension. Cialis is a brand of tadalafil manufactured by Eli Lilly and Company and used to treat ED and BPH. Although Cialis is tadalafil-based, it wouldn’t be correct to say that Cialis and tadalafil are identical medications. The article below addresses the main differences between the two drugs.

Brands and Manufacturers

The basic difference between tadalafil and Cialis is as follows: the latter is one of many brands that tadalafil is available under. Other brands include Tadacip by Cipla Limited, Tadalis by Ajanta Pharma Limited, etc. Many pharmaceutical companies also manufacture and market their tadalafil-based medications without registering separate brand names for them – the examples are Teva tadalafil, Sandoz tadalafil, tadalafil Mylan and more. The versions of tadalafil intended for the treatment of different conditions may either be available under different brands (like Cialis for ED and Adcirca for PAH, for instance) or under the same brand but with different strengths (like tadalafil Mylan 2.5 mg for BPH, 5 mg for BPH and ED, 10 mg for ED and 20 mg for PAH and ED).

Conditions Treated

Tadalafil was initially approved for the treatment of erectile dysfunction in 2003. Later, the FDA approved it for use in patients with PAH in 2009, and in patients with BPH in 2011 . The manufacturer of Cialis, which was then the only legal version of tadalafil in the US, decided not to enter the PAH treatment market and sold the rights for tadalafil partially to United Therapeutics. The latter company is currently manufacturing tadalafil for patients with PAH as Adcirca.

According to the directions for use, Cialis is a medication intended solely for the treatment of ED and BPH while other brands of tadalafil can be used to treat these conditions as well as PAH. In fact, however, any version of tadalafil including Cialis and Adcirca has the same effect and can be used off-label to treat ED, BPH and PAH – but it is very important that the patient observes correct dosage and regimen for their condition. The recommended starting dosage for treating ED with tadalafil is one 10mg tablet taken 30-60 minutes before sex. For BPH+ED treatment the recommended dosage is 5mg of tadalafil once daily. For PAH treatment the recommended dosage is 40mg of tadalafil once daily. The dosage and regimen may need to be adjusted based on the patient’s individual tadalafil tolerability, the presence of some health conditions including renal function impairment, heart disorders, etc., so a visit to the doctor is strongly recommended prior to starting the treatment with tadalafil regardless of what the treated condition is.

Form and Design

Most tablet versions of tadalafil mock the design of brand-name Cialis to a certain degree – for example, tadalafil Stada and Tadacip tablets are also yellow and almond-shaped, Tadalis – yellow and oval, tadalafil Mylan – yellow and round. Still, not all tadalafil-based medications look the same and not all even come in tablet form. There are some alternative versions like orodispersible tadalafil films by CLPharm in South Korea and a fruit-flavored oral jelly version of tadalafil available under the brand-name Apcalis-SX and manufactured by Ajanta Pharma Limited. The orodispersible films and oral jellies are intended for those patients who have trouble swallowing pills as well as for those interested in consuming tadalafil discreetly as films and jellies can easily be taken without water.

Price

Cialis is more expensive than generic tadalafil – according to Pharmacy Checker, the former costs between $10 and $22 online while the generic of the same strength (20 mg) may cost less than $1 per tablet. Such striking difference results from several factors – generic manufacturers don’t spend money on the development of the new drug, rarely run large-scale marketing campaigns, are frequently based in countries where production costs are much lower, etc., so they have lower expenses to cover and can afford to sell their products for less. The low price doesn’t mean that the generics are somehow inferior to the brand-name medication though.

Available Strengths

Brand-name Cialis is available in 4 strengths – 2.5 mg pills are to be taken daily, 5 mg – daily or as needed, and 10 mg and 20 mg versions are intended solely for use as needed. These strengths are approved by the FDA and similar healthcare authorities in other countries and proven safe and effective. No alternative strengths of tadalafil are currently approved by the FDA. However, some manufacturers of tadalafil also produce drugs of higher/alternative strengths. Examples include Tadarise 40 mg by India-based Sunrise Remedies, Tadalista 40 mg and 60 mg by Fortune Healthcare. These may be used for treatment of pulmonary arterial hypertension, which requires that 40 mg of tadalafil is taken daily. If you’re taking tadalafil for ED management, increasing your dose to 40 mg or 60 mg is not recommended. Although the higher dose still is relatively safe, it doesn’t improve sexual performance compared to the regular 20 mg pills but increases your chances of suffering from side effects. If you have tried 20 mg tadalafil pills and they didn’t work for you, consider asking your doctor about switching you to another ED medicine.

Secondary Ingredients – Active and Inactive

All brands of tadalafil including Cialis, Adcirca, Tadacip, etc. have at least one common ingredient, which is tadalafil itself. However, the list of inactive ingredients, such as coloring agents, binding materials, preservatives, etc., will be different for each medication. For example, Cialis contains such excipients as croscarmellose sodium as superdesintegrant, hydroxypropyl cellulose, hypromellose, iron oxide and titanium dioxide as coloring agents, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, and triacetin. The list of ingredients in Teva tadalafil is very similar – but instead of hypromellose, microcrystalline cellulose, and triacetin it contains colloidal silicon dioxide, hydroxylpropyl methyl cellulose, polyethylene glycol, and povidone. Generic medication manufacturers are free to use whatever excipients they want as long as their version of the pill has exactly the same effect as the original.

There are also some generic tadalafil-based drugs that contain it in combination with dapoxetine – such as Tada Plus by Turkish pharmaceutical company Neutec, Tadapox by Indian RSM Enterprises and more. Dapoxetine, in this case, is a secondary active ingredient because it has a pronounced biological effect of its own. Dapoxetine – a medication used to treat premature ejaculation. Works by inhibiting the serotonin transporter and, consequently, ejaculatory reflex, which significantly increases the duration of intercourse in men. Dapoxetine does not interact with PDE-5 inhibitors and, therefore, can safely be used for treating patients suffering from erectile dysfunction and premature ejaculation. Most common side effects of dapoxetine include nausea, dizziness, the feeling of dryness in the mouth, headaches and stool disorders.

Availability in Different Countries

Another difference between Cialis and generic tadalafil is related to their availability in different locations. Cialis is available worldwide while the access to some generics remains limited in certain countries until they are approved by the respective government agencies regulating the local pharmaceutical markets. For example, Tadacip has not yet been approved by the FDA, so you can’t legally buy it from any US-based pharmacies at the moment. Until the expiry of the patent in September 2018, Cialis was the only legal form of tadalafil that could be used for ED treatment in the US.

As you can see, there are multiple differences between Cialis and other tadalafil-based medications although the way they work and their effect is the same. Putting it simply, ‘Cialis’ equals ‘tadalafil’ but not every tadalafil-based medication is Cialis. Tadalafil is manufactured by dozens of different pharmaceutical companies while Cialis is only produced by Eli Lilly and Company. Cialis is more expensive and supported by large-scale marketing campaigns and a massive base of loyal patients, but its market share is currently shrinking as more and more cheaper generic meds appear on pharmacy shelves.

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