Tadalafil (Generic Cialis) as alternative to Viagra. Is it more cheaper/more effective/longer lasting?

How to get? Kaeberlein mentioned

It seems like it could be way cheaper

My Urologist suggested it to me. Any General Practice Physician can give you a prescripton.
On it for 3 + years.

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Cheap from US pharmacies if you see a doctor and get a prescription:

Or cheap from the regular Indian pharmacies if you donā€™t want to see a doctor:

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You can get it from Amazon health telehealth without insurance for cheap.

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For longevity, neurodegenerative decline, Iā€™ve favored Tadalafil, mostly due to those indications theoretically wanting a continuous serum/brain level. Tadalafil has the advantage of a 18 hr half life - so once a day dosing will provide excellent coverage for that goal - whereas Sildenafil has a 4 hr half life - so youā€™d need to be very frequently dosing to achieve a good level 24/7.

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ā€œTadalafil has the advantage of a 18 hr half life - so once a day dosing will provide excellent coverage for that goalā€

I agree, but I am going to be very pi$$ed if the molecular difference between tadalafil and sildenafil favors sildenafil as a life extender. There is currently more evidence for sildenafil and we are just speculating that tadalafil may have the same or better results.

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I agree that we have some information in that area. Iā€™m going to be doing my research and write up on that topic on my blog in another couple of weeks, with a focus on neurocognitive decline. Iā€™ve not thoroughly reviewed the evidence yet, but absolutely agree that there are some indicators of sildenafil having advantages. I however would think the main issue is nitric oxide generation and neuroinflammation reduction. This should be a drug class effect, not an affect of the molecular makeup of the drug - should be on drug activity.
Going to dig in on this in a couple of weeks and sort out where I think the best middle ground is.

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Is there any research that indicates whether similar potential longevity/neuroprotective benefits may also apply to women using Taladafil?

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Its interestingā€¦ the studies Iā€™ve seen so far have all been population-based retrospective association studies. Obviously, since Tadalafil is a ED drug, not too many women are in that sample. I suspect specific studies looking at this issue would need to be conducted.

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I wouldnā€™t anticipate that for neurodegenerative disease that things that work for men wouldnā€™t work for women. As much as we donā€™t have great data on that, for the present time, Iā€™m not making any delineation on what I offer patients in this area based on gender (except type of HRT).
Yes - itā€™ll likely go as a no evidence zone - but on a risk/benefit, I offer it to such patients currently.

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Thank you very much for the helpful response, Dr.Fraser. Do you also prescribe it to patients that donā€™t experience neurodegenerative disease or (noticeable) cognitive decline, and from what age?

Iā€™m wondering what doses are we should be looking at in such situations, and whether we should adjust dose based on age.

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As a general principle - not as advice for you in particular ā€¦ once you have disease, much more difficult to reverse or stabilize than avoiding disease.
I guess, with no evidence at all, Iā€™m going to go with Dr. Greenā€™s approach with ApoE status and Rapa start time ā€¦ but furthermore, looking at the graph showing other ApoE subtypes and likelihood of not having Alz Dementia ā€¦ Iā€™m more in line with everyone considering treatment - possibly with ApoE2/E2 less prioritized.

Individuals considering speculative treatment certainly need to be consented to risk/benefit and the lack of certainty.

I donā€™t think Iā€™d start the combination of therapy for decreasing risk of neurocognitive decline for someone in their 30ā€™s (maybe an ApoE4/E4 who was super worried at age 35), but at 40 years old, might be a reasonable timing.

Anyone looking at this should consider a consult or be very up to date on the options, pros-cons, etc. Preferably see a specialist who offers these options and reviews everything properly.

Thatā€™s my current thinking. It is a work in progress for sure.

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Thank you very much. Definitely food for thought.

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My cardiologist prescribed Tidalafil to me without hesitation.

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I recently read somewhere, and I canā€™t remember where, that regular Tadalafil use can adversely affect the field of vision. I had this vision test coming up, so I stopped taking Tadalafil (2.5 mg/day) for the time being Does anyone know about this possible side effect?

Quote from a good review on this:

The most common visual symptoms that have been linked to PDE5 inhibitors include changes in color perception characterized by a blue tinge to the environment and changes in brightness perception, usually in the form of increased sensitivity to light 3, 13, 18, 19. These symptoms occur in 3ā€“11% of men taking sildenafil 25ā€“100 mg [13], 0.3ā€“2% of vardenafil 20, 21, and 0.1% of tadalafil users [22]. These symptoms are mild, doseā€dependent, and completely reversible.

So only 1 in 1,000 tadalafil users ā€¦ and fully reversible with cessation.

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Thank you for the reply and the article link. I will carefully read the article.

@AlexKChen Iā€™d imagine Hims is the easiest route. Thatā€™s where I get my finasteride, and I also got fluoxetine from there once (no longevity evidence for that one, I just wanted to experiment with it). You literally just answer a few questions on their website, and boom, youā€™ve got a prescription.

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I got a prescription for 5mg daily cialis from my urologist no problems

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Dr. Green, who I think is one of the best readers of the research Iā€™ve ever been around, suggests tadalafil. I asked him specifically which was more effective, Cialis or Viagra, and he said that he thinks Cialis is better.

Take that for what itā€™s worth, but Alan Green and Matt Kaeberlein are the people in this space I trust the most. Also Dr Green has patients he is treating and monitoring so itā€™s not just a hypothetical for him.

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