Oral therapy for erectile dysfunction - a comparison of sildenafil and tadalafil Review article
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Published:
Oct 20, 2026
Keywords:
erectile dysfunction, treatment, sildenafil, tadalafil
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Abstract
This paper discusses the mechanism of action of phosphodiesterase type 5 inhibitors – drugs widely used in the oral treatment of erectile dysfunction. It highlights the fundamental differences in their mechanisms of action and therapeutic distinctions. The discussion focuses primarily on the two most commonly used active ingredients: sildenafil and tadalafil.
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How to Cite
Sapilak, B. J. (2026). Oral therapy for erectile dysfunction - a comparison of sildenafil and tadalafil. Medycyna Faktow (J EBM), 19(2(71), 231-236. https://doi.org/10.24292/01.MF.0226.13
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References
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7. Kloner RA. Cardiovascular profile of Tadalafil. Int J Imp Res. 2002; 14(3): 31.
8. Hellstrom WJ, Overstreet JW, Yu A et al. Tadalafil has no detrimental effect on human spermatogenesis or reproductive hormones. J Urol. 2003; 170(3): 887-91. http://doi.org/10.1097/01.ju.0000081053.97792.da.
9. Starowicz ZL. Inhibitory fosfodiesterazy typu 5 – podobieństwa i rożnice. Seksuologia Polska. 2003; 1(2): 79-82.
10. Ma J, Liu Z, Wu J et al. Role of application of tadalafil 5 mg once-daily (≥6 months) in men with erectile dysfunction from six randomized controlled trials. Transl Androl Urol. 2020; 9(3): 1405-14. http://doi.org/10.21037/tau-19-809.
11. Doggrell SA. Comparison of clinical trials with sildenafil, vardenafil, and tadalafil in erectile dysfunction. Expert Opin Pharmacother. 2005; 6(1): 75-84. http://doi.org/10.1517/14656566.6.1.75.
12. Gong B, Ma M, Xie W et al. Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. Int Urol Nephrol. 2017; 49(10): 1731-40. http://doi.org/10.1007/s11255-017-1644-5.
13. Cieślikowski WA. Tadalafil 5 mg dziennie w monoterapii BPH/LUTS oraz w terapii skojarzonej z finasterydem u mężczyzn z ED. Przegl Urol. 2014; 3(85): 30-34.
14. Junaid K, Subhojit S. Risk of multiple lower and upper urinary tract problems among male older adults with type-2 diabetes: a population-based study. Aging Male. 2023; 26: 1.
15. Salonia A, Capogrosso P, Boeri L et al. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2025 Update on Male Hypogonadism, Erectile Dysfunction, Premature Ejaculation, and Peyronie’s Disease. Eur Urol. 2025; 88(1): 76-102.
16. Wu H-C, Chang C-P, Shu K et al. Tadalafil improves erectile dysfunction in Taiwanese men with ED. 9th Biennial Meeting of the Asia Pacific SSIR, Cebu 2003, Abstract Book 40.
2. Lim P. Clinical efficacy and safety of Sildenafil citrate (Viagra) in a multi-racial population in Singapore: A retrospective study of 1520 patients. Int J Urol. 2002; 9: 308-15.
3. Rosen RC, Shabsigh R, Kuritzky L et al. The efficacy of tadalafil in improving sexual satisfaction and overall satisfaction in men with mild, moderate, and severe erectile dysfunction: a retrospective pooled analysis of data from randomized, placebo-controlled clinical trials. Curr Med Res Opin. 2005; 21(11): 1701-9. http://doi.org/10.1185/030079905X65538.
4. Rabijewski M. Awanafil w leczeniu zaburzeń wzwodu prącia. Przegl Urol. 2016; 4: 98.
5. Bryniarski L, Klocek M, Rzepecki M et al. Bezpieczeństwo stosowania inhibitorow 5-fosfodiesterazy w leczeniu zaburzeń erekcji u pacjentów z chorobami układu krążenia. Przegl Lek. 2009; 66 (4): 192-7.
6. Kloner RA, Stanek E, Crowe CL et al. Effect of phosphodiesterase type 5 inhibitors on major adverse cardiovascular events and overall mortality in a large nationwide cohort of men with erectile dysfunction and cardiovascular risk factors: A retrospective, observational study based on healthcare claims and national death index data. J Sex Med. 2023; 14; 20(1): 38-48. http://doi.org/10.1093/jsxmed/qdac005.
7. Kloner RA. Cardiovascular profile of Tadalafil. Int J Imp Res. 2002; 14(3): 31.
8. Hellstrom WJ, Overstreet JW, Yu A et al. Tadalafil has no detrimental effect on human spermatogenesis or reproductive hormones. J Urol. 2003; 170(3): 887-91. http://doi.org/10.1097/01.ju.0000081053.97792.da.
9. Starowicz ZL. Inhibitory fosfodiesterazy typu 5 – podobieństwa i rożnice. Seksuologia Polska. 2003; 1(2): 79-82.
10. Ma J, Liu Z, Wu J et al. Role of application of tadalafil 5 mg once-daily (≥6 months) in men with erectile dysfunction from six randomized controlled trials. Transl Androl Urol. 2020; 9(3): 1405-14. http://doi.org/10.21037/tau-19-809.
11. Doggrell SA. Comparison of clinical trials with sildenafil, vardenafil, and tadalafil in erectile dysfunction. Expert Opin Pharmacother. 2005; 6(1): 75-84. http://doi.org/10.1517/14656566.6.1.75.
12. Gong B, Ma M, Xie W et al. Direct comparison of tadalafil with sildenafil for the treatment of erectile dysfunction: a systematic review and meta-analysis. Int Urol Nephrol. 2017; 49(10): 1731-40. http://doi.org/10.1007/s11255-017-1644-5.
13. Cieślikowski WA. Tadalafil 5 mg dziennie w monoterapii BPH/LUTS oraz w terapii skojarzonej z finasterydem u mężczyzn z ED. Przegl Urol. 2014; 3(85): 30-34.
14. Junaid K, Subhojit S. Risk of multiple lower and upper urinary tract problems among male older adults with type-2 diabetes: a population-based study. Aging Male. 2023; 26: 1.
15. Salonia A, Capogrosso P, Boeri L et al. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2025 Update on Male Hypogonadism, Erectile Dysfunction, Premature Ejaculation, and Peyronie’s Disease. Eur Urol. 2025; 88(1): 76-102.
16. Wu H-C, Chang C-P, Shu K et al. Tadalafil improves erectile dysfunction in Taiwanese men with ED. 9th Biennial Meeting of the Asia Pacific SSIR, Cebu 2003, Abstract Book 40.