Drug Info
- Brand Name: Sildalis
- Active Ingredient: Sildenafil Citrate + Tadalafil
- Manufacturer: RSM Enterprises
Active substance Sildenafil + Tadalafil
Both components inhibit PDE5 in the corpus cavernosum smooth muscle. During sexual stimulation, nitric oxide is released and activates guanylate cyclase, increasing cyclic guanosine monophosphate (cGMP). Elevated cGMP relaxes smooth muscle and improves arterial inflow, enabling and maintaining an erection. By blocking PDE5, sildenafil and tadalafil slow cGMP breakdown and enhance this physiological response.
Pharmacokinetic complementarity explains the clinical profile: sildenafil is absorbed relatively quickly (typical onset around 30–60 minutes; high-fat meals may delay absorption), while tadalafil has a longer half-life, supporting responsiveness for an extended window after dosing. Because Sildalis contains two PDE5 inhibitors, dose discipline is important to reduce adverse effects (headache, flushing, dyspepsia, nasal congestion) and blood-pressure-related reactions. Alcohol may potentiate hypotension and dizziness; excessive intake should be avoided.
Sildalis is intended for adult men with ED. It is not indicated for women or individuals under 18 years. The medicine will not trigger an erection in the absence of sexual arousal. Clinical decisions about initiation, dose, and ongoing use should be individualized by the prescriber, taking into account comorbidities, concomitant medicines, and cardiovascular risk.
Indications for use
On-demand treatment of erectile dysfunction in adult men, as part of a clinician-directed plan that includes risk assessment and management of contributing factors
Treatment regimens and dosages
Use Sildalis exactly as prescribed. Typical on-demand guidance includes:
- Take one tablet (commonly 100 mg sildenafil + 20 mg tadalafil) about 30–60 minutes before planned sexual activity.
- Do not exceed one dose in 24 hours. Because tadalafil has a long half-life, some prescribers advise leaving a 36-hour interval before any additional PDE5 inhibitor exposure.
- Swallow the tablet with water. Heavy or high-fat meals can delay onset; a lighter meal may be preferable before dosing.
- Do not split, crush, or combine Sildalis with any other PDE5 inhibitor in the same dosing window.
Dose adjustments: If adverse effects (e.g., headache, flushing, dyspepsia) are prominent, the prescriber may recommend a longer interval between doses or an alternative single-agent PDE5 inhibitor at a lower strength. Patients with renal/hepatic impairment, those on interacting drugs, or older adults may require individualized plans.
Recommendations for use
Plan dosing around anticipated activity and allow time for onset. Avoid excessive alcohol, which can impair erection quality and increase the likelihood of dizziness or hypotension. Maintain consistent management of cardiovascular risk factors and chronic diseases, as better baseline health often improves ED outcomes. If you experience suboptimal response, document timing (dose vs. meal vs. activity), any alcohol intake, and adverse effects; share this information with your clinician to guide optimization.
Missed Dose
Sildalis is taken on demand, not on a fixed daily schedule. If a planned dose was not taken in time, do not double the dose. Take a single tablet before the next planned activity according to your clinician’s instructions.
Precautions
- Absolute contraindications: any form of nitrate or nitric oxide donor use (e.g., nitroglycerin, isosorbide dinitrate/mononitrate) and riociguat (soluble guanylate cyclase stimulator) due to risk of severe hypotension.
- Cardiovascular status: sexual activity carries cardiac demand. Patients with recent myocardial infarction or stroke, unstable angina, severe hypotension/uncontrolled hypertension, or advanced heart failure require specialist evaluation before ED therapy.
- Concomitant alpha-blockers: risk of symptomatic hypotension; if co-used, the alpha-blocker dose should be stable, and the lowest effective PDE5 inhibitor exposure considered.
- Anatomical deformation/bleeding disorders: caution in conditions predisposing to priapism (e.g., sickle cell disease, multiple myeloma, leukemia) or in significant penile anatomical abnormalities.
- Vision/hearing warnings: sudden vision loss (possible NAION) or sudden hearing decrease/ loss with or without tinnitus or dizziness—stop the medicine and seek urgent medical care.
- Not for women/children: Sildalis is not indicated for use in women or individuals <18 years.
Use during pregnancy
Not applicable; Sildalis is indicated for adult men only. If taken by a partner who can become pregnant, standard contraceptive considerations apply independently of Sildalis.
Possible side effects
Most adverse effects are mild to moderate and transient:
- Common: headache, facial flushing, nasal congestion, dyspepsia/acid reflux, dizziness.
- Less common: back pain and myalgia (more typical with tadalafil component), visual color tinge or increased light sensitivity (sildenafil component), palpitations.
- Rare/serious: priapism (erection >4 hours—requires urgent medical attention), severe hypotension, syncope, sudden vision or hearing loss, allergic reactions (rash, swelling, wheeze).
If adverse effects occur, note timing relative to food, alcohol, and dose; this helps clinicians adjust therapy safely.
Sildenafil + Tadalafil: interaction with other drugs
- Nitrates/NO donors & riociguat: contraindicated due to profound hypotension risk.
- Alpha-blockers (e.g., doxazosin, tamsulosin): additive blood-pressure lowering; use with caution under medical supervision.
- Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir, cobicistat): may increase PDE5 inhibitor exposure; medical guidance required.
- CYP3A4 inducers (e.g., rifampin, carbamazepine, phenytoin, St. John’s wort): may reduce efficacy.
- Alcohol and antihypertensives: additive hypotensive effects; moderation and monitoring advised.
- Grapefruit/grapefruit juice: may increase PDE5 inhibitor levels; avoidance is prudent.
Analogs & Generics
Same active ingredient (sildenafil + tadalafil — international examples)
- Sildalist 120 (Centurion Laboratories) — 100 mg sildenafil + 20 mg tadalafil
- Sildalis (RSM Enterprises) — sildenafil + tadalafil tablets (typical 100 mg + 20 mg)
- Tadalafil & Sildenafil tablets (Rewine Pharmaceutical) — combination presentations aligned with on-demand dosing
- Tadalafil & Sildenafil tablets (other Indian manufacturers) — equivalent combination strengths per local labeling
Drug analogs (different active ingredient, same purpose — ED therapy)
- Viagra (sildenafil)
- Cialis (tadalafil)
- Levitra (vardenafil)
- Stendra/Spedra (avanafil)
- Kamagra (sildenafil; international brand variants)
Storage
Store at 15–25°C in a dry place away from direct heat and sunlight. Keep tablets in the original packaging and out of the reach of children. Do not use after the expiry date printed on the pack.
Customer Experience – What to Expect
Many patients report a predictable response when Sildalis is taken on an empty or light stomach 30–60 minutes before activity, with a confidence window that remains for several hours due to the tadalafil component. Headache or facial flushing may occur early and usually lessen with adequate hydration, limiting alcohol, and allowing time between doses. If response is inconsistent, documenting meal size, alcohol intake, timing, and any other medicines (especially antihypertensives) helps the clinician adjust the plan—whether by modifying the interval between doses, changing the PDE5 inhibitor strategy, or addressing modifiable risk factors.
FAQ
How fast does Sildalis work?
Initial effects may appear within 30–60 minutes; high-fat meals can delay onset.
How long do the effects last?
Responsiveness can persist for several hours due to tadalafil’s longer half-life, but do not repeat the dose within 24 hours (some prescribers recommend a 36-hour window before any further PDE5 inhibitor exposure).
Can I drink alcohol with Sildalis?
Alcohol can worsen dizziness and reduce erectile quality. If used, keep intake low and avoid combining with other hypotensive agents.
What if I take alpha-blockers for the prostate?
Co-administration may lower blood pressure. Use only under medical supervision once your alpha-blocker dose is stable.
Is Sildalis suitable for daily use?
Sildalis is designed for on-demand dosing. If frequent dosing is needed, discuss alternatives (e.g., once-daily tadalafil) with your clinician.
What should I do if an erection lasts more than 4 hours?
Seek urgent medical attention. Priapism can cause permanent damage if not treated promptly.
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