Sildalis is a dual-action erectile dysfunction product that combines sildenafil and tadalafil in a single tablet. It is promoted for rapid onset and extended support of erections when sexual stimulation is present. This page explains how it is used, important safety steps, how it compares to alternatives, rough price comparisons in USD, and key legal rules in the United States.
What is Sildalis?
Active ingredients: sildenafil + tadalafil.
Listed strength: 100 mg sildenafil + 20 mg tadalafil per tablet (100 mg + 20 mg).
Intended use: on-demand treatment of erectile dysfunction in adult men. It is not designed for daily continuous dosing.
Important note for the USA: Sildalis as a fixed-dose combination is not FDA-approved. While sildenafil-only and tadalafil-only products are FDA-approved by prescription, this particular combination product is not legally marketed by U.S.-licensed pharmacies. See Legal status in the USA.
How does it work?
Sildenafil and tadalafil are phosphodiesterase type 5 (PDE5) inhibitors. They help relax smooth muscle in penile blood vessels, improving blood flow during sexual stimulation. The dual-ingredient approach aims to pair sildenafil's quicker onset with tadalafil's longer half-life, potentially supporting an erection sooner and for a longer window. Sexual arousal is required for any effect.
Directions for use
Discuss a personalized plan with a licensed clinician before first use. General advice often includes:
- Swallow with a small glass of water; avoid excessive alcohol, which can reduce effect and increase dizziness.
- Take on an empty stomach or after a light meal; a fatty meal may delay onset.
- Plan dosing 20 to 30 minutes before sexual activity.
- Use only as needed, not more than once daily unless a clinician instructs otherwise.
- Sexual stimulation is required; the medicine does not cause an erection in the absence of arousal.
For additional risk-reduction steps, see Safety and who should not use it and Drug and food interactions.
Dosage and missed doses
Typical on-demand dose: 1 tablet containing sildenafil 100 mg + tadalafil 20 mg, taken at least 20 minutes prior to sexual activity.
Maximum frequency: Do not exceed 1 tablet in 24 hours.
Missed dose: Because Sildalis is taken as needed, there is nothing to make up if you skip a planned dose.
Onset and duration
Some users report initial effects in about 20 to 30 minutes. The potential window of responsiveness can extend up to roughly 36 hours due to tadalafil's long half-life. Individual response varies based on diet, alcohol intake, other medicines, and overall health.
Safety and who should not use it
You must consult a healthcare professional before first use to reduce risks and confirm it is appropriate for you. PDE5 inhibitors can lower blood pressure and interact with many medicines.
- Do not use if you have taken nitrates or nitric oxide donors recently for chest pain (for example, nitroglycerin, isosorbide) or if you take riociguat.
- Avoid if you are allergic to sildenafil or tadalafil.
- Do not use after a recent serious cardiovascular event (heart attack or stroke within the past 3 months) or if advised to avoid sexual activity for cardiac reasons.
- Use only with medical guidance if you have severe liver disease, significant kidney impairment, anemia or blood dyscrasias, severe glaucoma or optic neuropathy, or arrhythmias/cardiovascular disease.
- Not indicated for women or anyone under 18 years of age.
- Low baseline blood pressure or uncontrolled high blood pressure are reasons to speak with a clinician before use.
If you are unsure whether any of the above applies to you, consult a clinician. For interacting substances, see Drug and food interactions.
Drug and food interactions
- Other ED drugs or PDE5 inhibitors: do not combine with additional sildenafil, tadalafil, vardenafil, or avanafil.
- Alcohol: may worsen dizziness and reduce erectile response; limit or avoid.
- Potent CYP3A4 inhibitors or inducers: examples include ketoconazole, itraconazole, ritonavir, cobicistat, clarithromycin, rifampin; can markedly change drug levels.
- Alpha-blockers and antihypertensives: additive blood-pressure lowering may occur; spacing and dose adjustments may be needed under medical supervision.
- Nitrates or guanylate cyclase stimulators (riociguat): strictly contraindicated.
- Grapefruit or grapefruit juice: can increase drug exposure; avoid.
Possible side effects
Most users tolerate PDE5 inhibitors, but adverse effects can occur. Seek urgent help for chest pain, sudden vision or hearing loss, or an erection lasting more than 4 hours (priapism).
Reported effects include:
- Flushing, nasal stuffiness, or headache
- Dyspepsia or heartburn
- Lightheadedness or a drop in blood pressure
- Nausea, vomiting, or diarrhea
- Drowsiness, dizziness, or vertigo
- Visual changes such as blurriness or sensitivity to light
If you have significant liver disease, kidney failure, cardiovascular disease, glaucoma, blood disorders, or joint conduction problems, consult your clinician before use and consider additional evaluation. For broader precautions, revisit Safety and who should not use it.
Storage
- Store at room temperature in a dry, dark place.
- Keep out of reach of children and pets.
- Check the expiration date on the package before use.
Alternatives and similar medications
Because Sildalis is a combination of two FDA-approved ingredients, many patients in the USA use single-ingredient, prescription PDE5 inhibitors from licensed pharmacies. Discuss with your clinician which option suits your health and budget:
- Tadalafil (generic Cialis) - 5 mg daily for steady effect or 10-20 mg as needed; long half-life up to 36 hours.
- Avanafil (Stendra) - newer PDE5 inhibitor with fast onset; brand only in many pharmacies.
- Sildenafil (generic Viagra) - 25, 50, 100 mg on-demand; wide availability and low generic cost.
- Vardenafil (generic Levitra) - option for those who do not respond to others; orally disintegrating forms exist.
- Non-drug strategies - vacuum erection devices, pelvic floor therapy, counseling for psychogenic ED, lifestyle optimization.
- Clinician-managed combination strategy - separately prescribed sildenafil and tadalafil, but only with individualized medical supervision to avoid hypotension and adverse events.
Note: Do not self-combine PDE5 inhibitors without prescriber guidance.
Rough price comparison in the USA (USD)
Prices vary by pharmacy, insurance, dosage, and location. The ranges below are approximate cash prices per tablet as of recent market observations:
- Generic sildenafil 100 mg: about $0.50 to $5 per tablet from U.S. pharmacies.
- Generic tadalafil 20 mg: about $1 to $10 per tablet from U.S. pharmacies.
- Brand Viagra: often $70 to $90 per tablet.
- Brand Cialis: often $80 to $90 per tablet.
- Avanafil (Stendra): roughly $60 to $80 per tablet.
- Vardenafil (generic/brand Levitra): around $2 to $10 generic; $45 to $70 brand.
- Sildalis (100 mg sildenafil + 20 mg tadalafil): typically not sold by licensed U.S. pharmacies; unapproved online vendors may advertise about $2 to $6 per tablet, but products may be illegal, counterfeit, or unsafe. See Legal status in the USA.
Tip: Many U.S. pharmacies honor discount cards or coupons. Telehealth services can sometimes reduce out-of-pocket costs for generics.
Legal status and purchasing rules in the USA
- FDA approval: Sildalis as a fixed-dose combo is not FDA-approved. U.S.-licensed pharmacies generally cannot legally dispense it.
- Prescription requirement: FDA-approved PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) are prescription-only in the USA.
- Online pharmacies: Use only U.S.-licensed pharmacies that require a valid prescription and are licensed in your state. Look for NABP accreditation or LegitScript transparency.
- Importation: Personal importation of prescription drugs that are not FDA-approved may be refused or seized by Customs. Even under limited FDA enforcement discretion, importing unapproved ED products carries legal and safety risks.
- Telemedicine: Obtaining a prescription via telehealth is permitted when the clinician is licensed in your state and follows applicable standards of care.
- Insurance: Coverage for ED medicines varies; many plans require prior authorization or exclude brands but may cover generics.
- Driving and work safety: If you feel dizzy or lightheaded, avoid driving or hazardous tasks.
- Age limits: Intended for adult men; not for minors.
Sports and performance context
ED medicines are not approved for athletic performance. As of recent policies, PDE5 inhibitors are not prohibited by WADA, but rules can change and individual leagues or events may have additional requirements. If you compete, consult your team physician and review current anti-doping regulations. Using ED drugs for altitude or endurance benefits remains off-label and should be medically supervised.
Note: The original product mentions sport; however, the appropriate clinical use is for erectile dysfunction, not for athletic enhancement.
FAQ
How soon does Sildalis work? Many users report initial effects in 20 to 30 minutes. See Onset and duration.
Can I take more than one tablet in a day? No. Do not exceed 1 tablet in 24 hours unless a clinician specifically tells you otherwise. See Dosage and missed doses.
Is Sildalis available at my local U.S. pharmacy? Typically no. It is not FDA-approved. Consider FDA-approved single-ingredient options instead. See Alternatives and Legal status.
What if I am on blood pressure medicine? You may still be eligible, but there are interaction risks and dose adjustments may be needed. Review Drug and food interactions and speak with your clinician.
Key takeaways
- Sildalis contains sildenafil 100 mg plus tadalafil 20 mg in one pill and is intended for on-demand ED treatment.
- It is not FDA-approved in the USA; consider approved single-ingredient options via a licensed pharmacy.
- Never combine with nitrates or riociguat, and avoid multiple PDE5 inhibitors together without medical supervision.
- For cost savings in USD, generic sildenafil or tadalafil from U.S. pharmacies are often the most economical choices.
