Cialis v sidenfil

[Watts.E.Dunn]

I think one day dave that establishment you spend too much time at with have a Blue Plaque commerating you activities there for posterity!

[john122350]

  I seem to remember an artcile in Telegraph concerning Bill Gates Foundation trying to have generic drugs made cheaply then given to Third world and "Big Pharma" kicking up a Legal row ...

For my own part I really liked the Kamagra jellies and Ive not seen them in the dodgy shops like you used to be able to get in Soho . For One the taste is so much better than the sildenafil pill and it seemed to be stronger quicker and have the effect of me being ready again in 10 mins I was not able to pop again for hours but it gave the ability to enjoy parties and hour sessions better ... Mind you my age has probobaly added to the disapointing performances I now have with my little friend 

you can still find those jellies in some indian off license shops in london

[irwell]

Boots online doctor give you a medical screening, then a recomendation, before prescribing. Thay aren't your GP, but it's better than buying blind.

[Socialboy]

Kamagra/Viagra 100mg taken 30min before will give you an hour of fun and some more.

Calias 20mg starts slow so take 2 hours before but lasts for two days which is a pain.

Also, I find that taking these once a month dont matter a lot but taken weekly can start causing joint pains or even gout so please be careful taking it too frequently.

I looked online and they say there are no side effects but If you had any joint pains then please comment.

[Doc Holliday]

Also, I find that taking these once a month dont matter a lot but taken weekly can start causing joint pains or even gout so please be careful taking it too frequently.

I looked online and they say there are no side effects but If you had any joint pains then please comment.

"Sildenafil, commonly known by the brand name Viagra, is a phosphodiesterase type 5 (PDE5) inhibitor primarily prescribed for erectile dysfunction and pulmonary arterial hypertension. Whilst joint pain is not listed among the most common side effects of sildenafil, some patients do report musculoskeletal discomfort during treatment. Understanding whether there is a genuine link between sildenafil and joint pain requires careful examination of the available evidence.

According to the Medicines and Healthcare products Regulatory Agency (MHRA) and the European Medicines Agency (EMA), joint pain (arthralgia) is classified as an uncommon adverse effect of sildenafil. The Summary of Product Characteristics for sildenafil products indicates that musculoskeletal symptoms occur in fewer than 1 in 100 patients. These frequencies are based on clinical trial data and post-marketing surveillance reports.

It is important to recognise that correlation does not necessarily indicate causation. Many patients taking sildenafil are older adults who may have pre-existing musculoskeletal conditions such as osteoarthritis or other age-related joint problems. Additionally, the underlying conditions for which sildenafil is prescribed—particularly cardiovascular disease—may themselves be associated with joint symptoms. The dosing regimens also differ between erectile dysfunction (typically 25-100mg as needed) and pulmonary arterial hypertension (20mg three times daily), which may influence side effect profiles. Therefore, whilst some patients report joint pain during sildenafil treatment, there is no definitive evidence establishing a direct causal relationship between the medication and joint pain in the majority of cases.



Joint Pain and Musculoskeletal Symptoms: What the Evidence Shows
The relationship between sildenafil and musculoskeletal symptoms, including joint pain, remains somewhat unclear in the medical literature. Clinical trial data from pre-marketing studies indicate that musculoskeletal side effects such as myalgia (muscle pain), back pain, and arthralgia (joint pain) occur in fewer than 1% to 2% of patients taking sildenafil. According to the UK Summary of Product Characteristics, these symptoms are generally classified as uncommon adverse effects.

Post-marketing surveillance and spontaneous reporting systems have documented additional cases of patients experiencing joint or muscle discomfort whilst taking sildenafil. However, establishing causality is challenging for several reasons. Firstly, many patients prescribed sildenafil have multiple comorbidities and may be taking other medications that could contribute to musculoskeletal symptoms. Secondly, conditions such as diabetes, cardiovascular disease, and metabolic syndrome—which are common in the population using sildenafil—are themselves associated with increased rates of joint and muscle problems.

Some researchers have proposed potential mechanisms by which PDE5 inhibitors might theoretically affect musculoskeletal tissues. PDE5 is expressed in various tissues beyond vascular smooth muscle, including skeletal muscle. Alterations in cGMP signalling could potentially influence inflammatory pathways or muscle function, though this remains speculative. There is currently no robust clinical evidence demonstrating a direct pathophysiological link between sildenafil use and joint pain.

It is worth noting that back pain and myalgia are more commonly reported with tadalafil (Cialis), another PDE5 inhibitor, as documented in its Summary of Product Characteristics. By comparison, sildenafil appears to have a lower incidence of musculoskeletal side effects, though individual patient responses can vary considerably"

[GreyDave]

Goodness me ! I thought the joint pain i was getting was because of the thrusting of my hips in diffrent postions 

Funnily I only get it after a good session and it goes after an hour or so  I`LL be limiting my self to max two sessions a week now . (mind you my cash shortage is already doing this  )

[Analist]

Viagra (sildenafil) is the oldest and the least selective PDE5 inhibitor out there. All the newer drugs will be significantly better at avoiding side effects - Levitra (vardenafil), Cialis (tadalafil) and Stendra (avanafil). Avanafil is the most recent to be approved and the most expensive as generic versions are not yet available in the UK. The main advantage of Cialis is its slow degradation, hence the drug lasts longer. Not necessarily a good thing unless you're planning a sex binge for 24 hours.
I used to take Viagra but switched to the others some years back. The actual dose will vary person to person and if you find it's not working you can try a larger one. In the grand scheme of things, these are pretty safe drugs and the only major issue is that they lower blood pressure. So, not a good idea if you're already on medication that lowers it.
There should be no issues with taking two PDE5 inhibitors at the same time. But no benefit either as the effect should be the same as taking a larger dose of one drug.

[RandomGuy99]

There should be no issues with taking two PDE5 inhibitors at the same time. But no benefit either as the effect should be the same as taking a larger dose of one drug.

That's not true and the advice is that you should not mix them.

No — you should not take two different prescription erectile dysfunction (ED) drugs at the same time.

Key points:

Combining PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) can increase risk of severe side effects (prolonged low blood pressure, fainting, priapism, excessive drug exposure).

Never mix a PDE5 inhibitor with nitrates or nitric‑oxide donors — this can cause life‑threatening hypotension.

If one ED drug doesn’t work or causes side effects, talk to your prescriber about dose adjustment, switching agents, treating underlying causes, or alternative therapies (vacuum devices, injections, intraurethral pellets, hormones, psychotherapy).

If you experience chest pain, severe dizziness, fainting, or an erection lasting >4 hours (priapism), seek emergency care

I also think that taking longer acting ED medication such as Cialis in hot weather means you need to stay hydrated or you are more at risk of fainting.

[Analist]

That's not true and the advice is that you should not mix them.
Key points:

Combining PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) can increase risk of severe side effects (prolonged low blood pressure, fainting, priapism, excessive drug exposure).

And what does this tell you? It is the total dose that is important. Overdose and the risk of severe side effects will increase whether it's from two drugs combined or one drug alone. All the PDE5 ED drugs work the same way and on the same target. There is nothing inherently bad about taking two different PDE5 inhibitors but as I pointed out there's no added value either.

[Norwichwood]

I've heard of people mixing the two - as Viagra is faster acting but Cialis lasts longer - but I don't think it is recommended by Drs - and they are the best people to ask. That's the golden rule.

Regular taking your blood pressure to see if high or low is good practice. 

[scutty brown]

I also think that taking longer acting ED medication such as Cialis in hot weather means you need to stay hydrated or you are more at risk of fainting.

And don't take ED drugs and then go and sit in a sauna or hot bath - that produces a high risk of fainting due to low blood pressure

[RandomGuy99]

That's not true and the advice is that you should not mix them.
Key points:

Combining PDE5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) can increase risk of severe side effects (prolonged low blood pressure, fainting, priapism, excessive drug exposure).

And what does this tell you? It is the total dose that is important. Overdose and the risk of severe side effects will increase whether it's from two drugs combined or one drug alone. All the PDE5 ED drugs work the same way and on the same target. There is nothing inherently bad about taking two different PDE5 inhibitors but as I pointed out there's no added value either.

Patient information leaflet for Sildenafil External Link/Members Only

It says "You should not use this medicine with any other oral or local treatments for erectile dysfunction"

Different ED drugs such as Sildenafil and Cialis have different strengths and thus should be used in smaller doses, so it's definitely NOT the total dose that's important. 20mg of Cialis does a lot more than 20 mg of Sildenafil.

I suggest you follow the advice given in the Patient Information Leaflet (PIL) and provided by GPs.

[scutty brown]

And what does this tell you? It is the total dose that is important. Overdose and the risk of severe side effects will increase whether it's from two drugs combined or one drug alone. All the PDE5 ED drugs work the same way and on the same target. There is nothing inherently bad about taking two different PDE5 inhibitors but as I pointed out there's no added value either.

There's everything inherently wrong in mixing such drugs? Why? Because:
1) There's no way of knowing just what active dose you've taken
2) Drugs can interfere or enhance each other in non-linear ways. Taking two together can interfere with metabolic breakdown pathways resulting in higher than anticipated actual dosage. Or in higher than expected toxicity
A lot of research goes into drug dosage optimisation, don't even try to think you can get anywhere near doubleguessing the experts

[GreyDave]

A lot of research goes into drug dosage optimisation, don't even try to think you can get anywhere near doubleguessing the experts
[/quote]

And the research is done by testing and the reporting of effects experienced by the takers....

I`ve mixed a 20mg dose of Tadafil then a 50mg which made me feel auwful and I swore never to again then after reading that the Tadafill daily 5mg and a Sildeafil worked for guys I tried this on some day before and Punt days ....The effect was 2 fold a peeing was easier and I was hard quicker and stayed hard longer it delayed my cum ...Thus enabaling multi postions and more control.
This mix I do now as a treat to myself every now and again I mostly used Sildenafil 50mg the down side of it is I seem to go from soft to savoly slower and I harden up more while in the process of shagging I go in savoly hard and get full hardness for a short while before cumming mixing allows me to stay hard and control the cum ....Quite a few of the WGs ive experianced this two stage effect with have noticed and commented on " Oh your really hard now!" to which I usally reply like the big bad wolf " All the better to Fuck you with !"....mind you 4 1/2 inches is not going to cause too much of a problem for them

[Punting2022]

i used to use tadafil daily. 5mg .
Used to take 1 a day before a punt. One on the day.
Worked a treat no bad side effects.

Then as found that didnt work. I used 25mg viagra on a day of a punt. Worked ok,

But recently i am taking korean ginsing and found i dont need any sort of viagra or ed meds.
cummed 4 times with a SB on a afternoon meet recently.

[patelprat]

Dose for you is always going to be specific to you, so if what you take isn't working then ask a doc what to change. No point necessarily copying numbers that others do.

I prefer Cialis 20mg when needed, and it has a similar success rate to Viagra, but has other benefits (even in the gym it can help with "the pump" and muscle blood flow), isn't affected by food and lasts well into the next day. So if an SP unexpectedly cancels on me and I need to rebook for next day, I don't need another dose.

Side effects for me are mild headaches and sometimes body aches, and dry/red eyes sometimes. But all tolerable.

[Norwichwood]

i used to use tadafil daily. 5mg .
Used to take 1 a day before a punt. One on the day.
Worked a treat no bad side effects.

Then as found that didnt work. I used 25mg viagra on a day of a punt. Worked ok,

But recently i am taking korean ginsing and found i dont need any sort of viagra or ed meds.
cummed 4 times with a SB on a afternoon meet recently.

Hi Punting2022 - interesting! What brand and doseage of korean ginsing are you using please? Do you take a one off dose or everyday.

I sometimes take 1.5mg of Citrulline and arginine which seems to help a bit - but noting like tadafil daily. 5mg

[Doc Holliday]

i used to use tadafil daily. 5mg .
Used to take 1 a day before a punt. One on the day.

When you say 'a day' before do you mean just the day before? If so that would regime would be two 5mg doses taken on consecutive days, which is closer to on demand regime to coincide with your punt. Tadalafil daily is where you take a 5 mg dose every day, not just for two days.

[Punting2022]

Hi Punting2022 - interesting! What brand and doseage of korean ginsing are you using please? Do you take a one off dose or everyday.

I sometimes take 1.5mg of Citrulline and arginine which seems to help a bit - but noting like tadafil daily. 5mg

So i take one of these every morning
External Link/Members Only

and this is the ginising. 1 a day
External Link/Members Only

Since using these two i have found my energy is improved, dont need any form of ED tablets. I do take a 25mg of viagra sometimes just to make sure and as a confidence boost if unsure on the girl, Or if she really hot and i dont want to flap it. So use as a confidence booster and helper.
But most of the time i found these are good. I researched on Korean Ginsing and a few people had good results

[Punting2022]

When you say 'a day' before do you mean just the day before? If so that would regime would be two 5mg doses taken on consecutive days, which is closer to on demand regime to coincide with your punt. Tadalafil daily is where you take a 5 mg dose every day, not just for two days.

So when I used to plan a punt. I used to take 2.5mg Tadafil the night before. Then another 2.5 a few hours before. Made a mistake mentioning 5mg.
This used to work nicely. Then yes I didn't take daily after that.

Once i took a 10mg tadafil and although it worked to get it up, I found I couldn't cum with it. Eventually this method didn't work. So then I took 25mg of Viagra. This worked. Gave a bit of help and cumming was fine. I find anything stronger makes it harder to cum.
I then researched natural methods because i was fed up taking tablets to plan for sex or use them. Hence the Korean Ginsing.  Since using this im fine. Could also be more phycological now too. Maybe the mind relies on ED tablets etc sometimes. Body gets used to them etc.

Mate tried it too and said it makes a differnece.

[meptalon]

See your GP.

+1

[shyleo]

Did you have any side effects with the Ginseng and Testosterone stuff?

[Thriceweekly]

I read something really interesting recently about how PDE5 inhibitors decrease in effectiveness as you age (especially after 50) . And this is NOT because the body is becoming "tolerant" to the drug, but because the body's mechanisms for erectile function are naturally declining. The main issue seems to be the health of blood vessels. So it doesn't matter which pill you take or how much, it won't be as effective because your body just cannot use it as well anymore. So anything you can do to help maintain blood vessel health as you age is very important.


Healthy eating is paramount, and especially vegetables which help with the nitric oxide pathway (Google it if this is becoming too scientific). Think spinach, rocket (another name is arugula) and beetroot. I have been making a smoothie everyday for about the last year. I use fresh watermelon, pomegranate, beetroot, spinach or rocket, lemon and ginger, plus cayenne pepper and cinnamon powders. I have mentioned this elsewhere, but thought I'd repeat it here as it seems to fit in with the thread.

So the method I use is to drink a glass of this before bed. Every night if possible. The idea is to try build the body's reservoir of nitric oxide, which is lost very quickly, and again much quicker as we age. My aim here is to help my nocturnal erections, as this is what keeps your penis healthy. If I want to punt then I will drink another glass about an hour before. To say that the results are "helpful" is an understatement!

So, bottom line. Simply carry on taking a PDE5 inhibitor if you want, but if you are not getting to the root cause of your issues as your age then you will be fighting a losing battle in the end.

[Norwichwood]

Great post Thriceweekly.

To which I would add - baby aspirin enteric coated daily - I also take Citrulline and Arginine which the body can convert to nitric oxide - also nasal breathing in though nose increases nitric oxide - as well as exercise.
I also try to do intermittent fasting and a ketogenic Mediterranean diet to increase Autophagy

[Munter84]

I'll second that, great post, and I'll have to try that smoothie.

I'm not above popping a pill when the need arises but would love to be able to use more natural means.