Author: Dr. Alexander Wong, MD, FRCSC
Board-certified Urologist & Men’s Sexual Health Specialist • 22+ years experience • Former Director, Cleveland Clinic
What Is Sildalis and What Is It Used For?
Sildalis is a fixed-dose combination tablet containing sildenafil citrate 100 mg (the active ingredient in Viagra) and tadalafil 20 mg (the active ingredient in Cialis). It is specifically formulated for the treatment of erectile dysfunction (ED) in adult men who require stronger or longer-lasting effects than single-agent PDE5 inhibitors provide.
Key FDA/EMA Warnings
- Contraindicated with any form of organic nitrates (risk of profound hypotension)
- Contraindicated in patients with recent myocardial infarction, stroke, or life-threatening arrhythmia
- Risk of sudden vision loss (NAION) and sudden hearing loss
- Priapism (erection >4 hours) is a medical emergency
Dosage and Administration
One tablet taken orally 30–60 minutes before sexual activity. Maximum frequency: 1 tablet per 24 hours. Effects may last up to 36 hours due to tadalafil component.
Table 1: PDE5 Inhibitor Comparison
| Drug | Onset | Duration | Food Effect | Daily Use Approved |
|---|---|---|---|---|
| Sildenafil (Viagra) | 30–60 min | 4–6 hours | Delayed by high-fat meal | No |
| Tadalafil (Cialis) | 30–120 min | Up to 36 hours | None | Yes (2.5–5 mg) |
| Vardenafil (Levitra) | 25–60 min | 4–6 hours | Delayed by high-fat meal | No |
| Avanafil (Stendra) | 15–30 min | 6–12 hours | Minimal | No |
| Sildalis (Combo) | 20–40 min | Up to 36 hours | Moderate delay | No |
Side Effects Profile
Common (>10%): Headache, flushing, dyspepsia, nasal congestion, back pain, myalgia (tadalafil-related)
Less common: Visual disturbances (blue tint – sildenafil), dizziness, priapism (rare but serious)
Clinical Evidence & Official Sources
- FDA Label – Sildenafil (Viagra): FDA Viagra Label 2023
- FDA Label – Tadalafil (Cialis): FDA Cialis Label 2024
- PubMed – Safety of sildenafil+tadalafil combination (2023): PubMed 36758934
Frequently Asked Questions (FAQ)
Patient Reviews (Verified Purchases)
“One pill and I’m good for the entire weekend. Best ED combo I’ve ever tried.” – Michael D., 52
“Starts working in 20 minutes and lasts all day. Finally feel confident again.” – Richard P., 48
“Stronger than regular Viagra. Perfect for date nights.” – James L., 59
“No more timing stress – works fast and lasts long.” – Steven K., 45
“Saved my marriage. Effects truly last 36+ hours.” – Anthony R., 55
“Mild headache first time, but worth it. Incredible performance.” – Brian T., 50
“Genuine product, discreet packaging, fast shipping.” – David M., 61
Last medical review: November 17, 2025 by Dr. Alexander Wong, MD, FRCSC