Cialis Vs. Finasteride: Drug Comparison

Cialis^® (tadalafil) is used to treat erectile dysfunction (ED) and the symptoms of benign prostatic hyperplasia (BPH). It works by relaxing the muscles of blood vessels and increasing blood flow to particular areas of the body, notably the penis. Cialis is known for its long-lasting effects, allowing for more spontaneity, as it can remain effective for up to 36 hours. It is typically taken as needed, but a lower daily dose option is also available for continuous treatment. Common side effects of Cialis include headaches, indigestion, back pain, and muscle aches, which typically resolve within a few days. It is important to use Cialis with caution, especially for individuals with cardiovascular conditions, and to avoid combining it with nitrates or certain other medications due to the risk of serious interactions.

Finasteride is the active ingredient in the brand-name medication Proscar^®. The information below is about brand name Proscar. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Proscar (finasteride) is an oral medication used primarily to treat benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate. By inhibiting the enzyme 5α-reductase, Proscar reduces the levels of dihydrotestosterone (DHT), which is responsible for prostate growth. This helps alleviate symptoms of BPH such as difficulty in urinating, reduced urine flow, and the need to urinate frequently or urgently. Proscar is taken once daily and may also help reduce the need for surgery related to BPH. However, it can cause side effects such as decreased libido, erectile dysfunction, and breast tenderness​.

Phosphodiesterase-5 (PDE5) inhibitor

5α-reductase inhibitor

Cialis (tadalafil) is indicated to treat:

• Erectile dysfunction (ED)

• The signs and symptoms of benign prostatic hyperplasia (BPH)

• ED and the signs and symptoms of BPH (ED/BPH)

Proscar (finasteride) is indicated:

• For the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate to:

  • Improve symptoms

  • Reduce the risk of acute urinary retention

  • Reduce the risk of the need for surgery including transurethral resection of the prostate (TURP) and prostatectomy

Proscar (finasteride) administered in combination with the alpha-blocker doxazosin is indicated:

• To reduce the risk of symptomatic progression of BPH (a confirmed ≥4 point increase in American Urological Association [AUA] symptom score)

• Typically taken orally as needed prior to sexual activity, up to once daily (5 mg, 10 mg, and 20 mg doses) OR taken orally once daily (2.5 mg and 5 mg doses)

• Comes in 2.5 mg, 5 mg, 10 mg, and 20 mg tablets

• Typically taken orally once daily

• Comes in 5 mg tablets

Most common adverse reactions (≥2%) include:

• Headache

• Indigestion

• Back pain

• Muscle pain

• Nasal congestion

• Flushing

• Pain in limb

The drug-related adverse reactions, reported in ≥1% in patients treated with Proscar and greater than in patients treated with placebo over a 4-year study are:

• Erectile dysfunction

• Decreased libido

• Decreased volume of ejaculate

• Breast enlargement

• Breast tenderness and rash

• Administration of Cialis to patients using any form of organic nitrate is contraindicated

• History of known serious hypersensitivity reaction to Cialis or Adcirca

• Drug interactions: Nitrates, alpha blockers, antihypertensives, alcohol, CYP3A4 inhibitors (e.g., ketoconazole, ritonavir), CYP3A4 inducers (e.g., rifampin)

• Hypersensitivity to any components of this product

• Females who are or may potentially be pregnant

• Patients should not use Cialis if sex is inadvisable due to cardiovascular status

• Use of Cialis with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to low blood pressure

• Cialis is not recommended in combination with alpha blockers for the treatment of BPH, because efficacy of the combination has not been adequately studied and because of the risk of blood pressure lowering

• If taking potent inhibitors of CYP3A4, dose should be adjusted

• Patients should seek emergency treatment if an erection lasts >4 hours

• Patients should stop Cialis and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non arteritic ischemic optic neuropathy (NAION)

• Patients should stop Cialis and seek prompt medical attention in the event of sudden decrease or loss of hearing

• Prior to initiating treatment with Cialis for BPH, consideration should be given to other urological conditions that may cause similar symptoms

• Proscar reduces serum prostate specific antigen (PSA) levels by approximately 50%. However, any confirmed increase in PSA while on Proscar may signal the presence of prostate cancer and should be evaluated, even if those values are still within the normal range for men not taking a 5α-reductase inhibitor

• Proscar may increase the risk of high-grade prostate cancer

• Females should not handle crushed or broken Proscar tablets when they are pregnant or may potentially be pregnant due to potential risk to a male fetus

• Proscar is not indicated for use in pediatric patients or females

• Prior to initiating treatment with Proscar for BPH, consideration should be given to other urological conditions that may cause similar symptoms

*This information is from the label for brand name Cialis^®. See the Full Prescribing Information for more complete information. Tadalafil, the active ingredient in Cialis, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient tadalafil.

*This information is from the label for brand name Proscar^®. See the Full Prescribing Information for more complete information. Finasteride, the active ingredient in Proscar, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient finasteride.