Sildalis (Sildenafil Citrate 100 mg + Tadalafil 20 mg) — Patient Information (Australia)

Sildalis is an oral medicine that combines two well-known treatments for erectile dysfunction (ED): sildenafil citrate 100 mg and tadalafil 20 mg. It is designed to help men achieve and maintain an erection when sexually stimulated. This page explains what Sildalis is, how it works, how it’s typically used, important safety information, and practical tips for use—tailored for an Australian audience.

Important: This information is general and may not cover every individual situation. Always follow the instructions given by your healthcare professional and read the product label. If you have questions about suitability, interactions, or dosing, seek medical advice.

Basic product information

How it works (mechanism of action)

Sildalis contains two PDE5 inhibitors that increase blood flow to the penis during sexual stimulation:

• Sildenafil (a PDE5 inhibitor) helps relax smooth muscle in penile blood vessels by blocking the breakdown of cGMP. This supports erection by improving blood flow.
• Tadalafil (also a PDE5 inhibitor) works through a similar pathway—blocking cGMP breakdown—thereby supporting erection. Tadalafil tends to provide a longer duration of effect compared with sildenafil in many people.

Key point: PDE5 inhibitors don’t automatically cause an erection. Sexual stimulation is still needed for the body to activate the erection mechanism.

Pharmacokinetics (how the body processes it)

Pharmacokinetics describes absorption, distribution, metabolism, and elimination. Because Sildalis combines two medicines, its overall effect depends on how each component behaves in your body.

Sildenafil (100 mg component)

• Absorption: Absorbs from the gastrointestinal tract; onset is often within about 30–60 minutes for many users.
• Peak levels: Typically reached within roughly 1 hour after dosing.
• Duration: Effects usually last for several hours, often around 4–6 hours (individual variability is common).
• Metabolism: Mainly metabolised by liver enzymes (notably CYP3A4) into inactive metabolites.
• Elimination: Mostly excreted via the liver/bile and kidneys.

Tadalafil (20 mg component)

• Absorption: Absorbs after oral dosing; onset is often within 30–60 minutes for many people.
• Peak levels: Often reached about 2 hours after dosing.
• Duration: Commonly longer-lasting; effects may persist for up to 24–36 hours in many individuals.
• Metabolism: Mainly metabolised in the liver (notably via CYP3A4/related pathways).
• Elimination: Excreted primarily through metabolites, including via faeces and urine.

Practical implication: Combining sildenafil and tadalafil may influence both onset and duration, aiming to provide help over a wider time window than a single agent for some users.

Typical use and indications

Sildalis is primarily used to treat erectile dysfunction—the inability to achieve or maintain an erection sufficient for satisfactory sexual activity.

ED may be related to factors such as vascular health, diabetes, stress, relationship factors, smoking, obesity, or certain medications. PDE5 inhibitors like Sildalis improve erections by enhancing blood flow, but they do not address underlying causes by themselves.

Not suitable for:

• Women or use in children.
• People who should not take PDE5 inhibitors due to specific medical conditions or interactions (see Safety section below).

How and when to take Sildalis (timing)

Your prescriber’s instructions should be followed. Typical guidance for PDE5 inhibitors is outlined below.

Timing relative to sex

• Onset: Many users notice effects within about 30–60 minutes.
• Duration: Tadalafil is typically longer-acting, so effects may last considerably longer than sildenafil alone.

How often

For ED medicines, dosing frequency is important due to blood pressure effects and interaction risk. Do not exceed the recommended dose or take more frequently than advised by your healthcare professional.

Food interactions (what to eat and drink)

Food can influence the absorption and onset of PDE5 inhibitors.

• High-fat meals: Can delay the onset of sildenafil by slowing stomach emptying. If you take Sildalis after a heavy, fatty meal, you may need more time before it starts working.
• Faster onset: Taking it on a less heavy meal may help it work sooner for some people.

Hydration tip: Staying hydrated and avoiding very large meals close to dosing may help overall comfort.

Alcohol and medicine interactions

Alcohol

• Limit alcohol: Alcohol can worsen ED and can increase the chance of dizziness or low blood pressure when combined with PDE5 inhibitors.
• Avoid heavy drinking: Heavy alcohol intake may reduce effectiveness and increase side effects such as headache, flushing, and light-headedness.

Medicines and supplements to watch closely

Certain medicines can cause dangerous interactions with PDE5 inhibitors. Seek medical advice before combining Sildalis with anything listed below.

• Nitrates (e.g., glyceryl trinitrate tablets/spray; isosorbide dinitrate/mononitrate): Do not combine. This can lead to a potentially severe drop in blood pressure.
• Riociguat (for pulmonary hypertension): Do not combine.
• Alpha-blockers (for prostate/urinary symptoms or blood pressure): may increase dizziness or low blood pressure. Dose adjustment and timing may be required under medical supervision.
• Strong CYP3A4 inhibitors (e.g., some HIV protease inhibitors, certain antifungals such as ketoconazole/itraconazole, clarithromycin): may raise blood levels of sildenafil and tadalafil, increasing risk of side effects.
• Strong CYP3A4 inducers (e.g., rifampicin, some anticonvulsants like carbamazepine/phenytoin): may reduce effectiveness.
• Other ED medicines or other PDE5 inhibitors: do not stack doses unless specifically advised.
• Blood pressure medicines: may increase the chance of low blood pressure symptoms.
• “Popper” products (inhaled nitric oxide–type vasodilators): can be dangerous with PDE5 inhibitors.

If you use any regular medications, keep a list and review it with your healthcare professional or pharmacist.

Dosing guidance (general information)

Dosing depends on individual factors such as age, other medical conditions (especially heart/liver/kidney issues), and medication interactions. Because Sildalis contains relatively high strengths (sildenafil 100 mg and tadalafil 20 mg), it is especially important not to self-adjust.

Typical dose

• Most commonly: one tablet taken orally before sexual activity, according to guidance provided with your product or by your healthcare professional.

Missed dose

Because ED medicines are taken in anticipation of sexual activity, there is usually no concept of “missed dose.” Take it only when you plan to have sexual activity and only as directed.

Special considerations

• Older adults: may be more sensitive to blood pressure changes and side effects.
• Liver impairment: may increase medication levels; lower dosing or avoidance may be recommended.
• Kidney impairment: may require dose adjustment.
• Cardiovascular disease: ED is associated with heart and blood vessel risk; a medical review is important before using PDE5 inhibitors.

Do not take extra to “make it work.” If you don’t get the expected result, consult a professional rather than increasing frequency or combining with other ED drugs.

Safety profile and possible side effects

Sildalis is generally well tolerated for many people, but it can cause side effects—most commonly related to vasodilation (widening blood vessels) and headache.

Common side effects

• Headache
• Flushing (warmth/redness)
• Stuffy or runny nose
• Indigestion or nausea
• Dizziness
• Back pain or muscle aches (more associated with tadalafil in some users)

Less common but important side effects

• Visual changes (blurred vision, colour tinge)
• Shortness of breath or chest discomfort
• Prolonged erection (priapism)
• Sudden hearing changes or ringing in the ears
• Fainting or severe light-headedness

When to seek urgent help

• If you have an erection lasting more than 4 hours (priapism), seek urgent medical care.
• If you experience severe dizziness, fainting, or symptoms of a heart event (e.g., chest pain, severe shortness of breath), seek emergency help.
• If you develop sudden vision or hearing loss, seek urgent assessment.

Contraindications and “do not use” situations

You should not use Sildalis if any of the following apply:

• Use of nitrates (or “nitric oxide donors”) for chest pain.
• Use of riociguat.
• Unstable cardiovascular conditions where sexual activity is not advised.
• Known hypersensitivity to sildenafil or tadalafil or any ingredient.
• Severe liver impairment (needs clinician guidance).
• Certain rare conditions affecting blood flow or erections (discuss with a clinician).

Practical tips for best results

• Allow time: Take it with enough time before sex (commonly 30–60 minutes, depending on meal and individual response).
• Avoid heavy, fatty meals: For quicker onset, keep meals lighter beforehand.
• Keep stimulation in mind: You still need sexual arousal—PDE5 inhibitors support the process, they don’t replace it.
• Manage alcohol: Limit alcohol to reduce side effects and improve erection quality.
• Plan for safety: If you feel light-headed, sit or lie down immediately and avoid driving.
• Don’t “double up”: Do not combine with other ED medicines or additional PDE5 inhibitors.
• Track what works: If your response is inconsistent, note timing, meal size, alcohol intake, and other medications to discuss with your pharmacist or doctor.

Alternative options

ED treatment is not one-size-fits-all. Depending on your health needs, clinician preference, and risk profile, alternatives may include:

• Single-agent PDE5 inhibitors
  • Sildenafil alone (shorter acting)
  • Tadalafil alone (longer acting)
  • Vardenafil or Avanafil (available in some markets)
• Non-PDE5 options
  • Vacuum erection devices
  • Intraurethral or injectable treatments (under medical supervision)
  • Counselling/sex therapy for performance anxiety or relationship factors
• Address underlying causes
  • Diabetes management, weight loss, smoking cessation
  • Review of medicines that may contribute to ED (e.g., some blood pressure medicines)
  • Exercise and cardiovascular risk reduction

If you’re unsure which option fits your situation, a clinician can help you choose based on heart health, kidney/liver function, and current medications.

Market and legal context for Australia

In Australia, ED medicines containing PDE5 inhibitors are regulated and may fall under prescription-only or pharmacist-supplied categories depending on the exact product and strength. Some products may be marketed as generic forms or imported brands, and availability can vary.

What to check when ordering online in Australia:

• Australian compliance: Ensure the product is supplied from a reputable source that meets local regulatory requirements.
• Correct ingredients and strength: Confirm the label matches the stated medicines (sildenafil + tadalafil) and correct mg amounts.
• Storage and packaging: Check for intact packaging and expiry date.
• Clear safety information: Look for warnings about nitrates, riociguat, and other interactions.

If you have any doubt about whether a product is appropriate or legally supplied, contact a qualified healthcare professional or the pharmacy you are buying from for reassurance.

Recent guidance and updates (general overview)

Over recent years, public health guidance worldwide has continued to emphasise:

• Strong interaction warnings for nitrates and riociguat with PDE5 inhibitors.
• Caution with cardiovascular risk and assessment of whether sexual activity is safe for individuals with heart disease.
• Awareness of rare adverse events like priapism and sudden hearing/vision loss.
• Avoiding counterfeit medicines and buying from legitimate, regulated pharmacies.

Because rules and product availability can change, always check the latest information provided by Australian health authorities and your dispensing pharmacy.

Delivery and availability

Online pharmacies in Australia typically offer delivery options across states and territories. Availability may depend on stock, product registration status, and local regulatory requirements.

What you can expect

• Packaging: discreet, sealed packaging (where offered)
• Delivery times: vary by location and shipping method
• Tracking: many services provide tracking updates
• Customer support: reputable providers offer help for order changes, delivery questions, and product queries

Tip: If you need the medicine for a specific date, place the order early and check estimated delivery times before use.

FAQ — Frequently asked questions

1) What is Sildalis used for?

Sildalis is used to treat erectile dysfunction by helping increase blood flow to the penis during sexual stimulation.

2) How fast does Sildalis work?

Many people notice effects within 30–60 minutes. A heavy or fatty meal can delay onset, especially affecting sildenafil absorption.

3) How long does it last?

Because it contains sildenafil and tadalafil, effects may last longer than with sildenafil alone—often for several hours, and sometimes up to a day depending on the person. Individual response varies.

4) Can I take it every day?

Follow dosing instructions from your healthcare professional or product label. Do not take it more frequently than recommended.

5) Can I take Sildalis with alcohol?

It’s safest to limit alcohol. Alcohol can worsen erections and increase the likelihood of dizziness or low blood pressure with PDE5 inhibitors.

6) What medicines should I avoid?

Do not combine with nitrates or riociguat. Use caution and seek advice with alpha-blockers and with medicines that affect liver enzymes (such as certain antifungals, antibiotics, or HIV medicines). Always check your medication list.

7) Will it work if I don’t have sexual stimulation?

No. Sildalis supports erection in response to sexual arousal; it doesn’t automatically cause an erection.

8) What if I don’t get the expected effect?

ED can be influenced by stress, relationship factors, cardiovascular health, smoking, alcohol, and other medicines. If it doesn’t work, consult your healthcare professional rather than increasing dose or frequency.

9) What are the warning signs that I should seek urgent help?

Seek urgent care if you have an erection lasting more than 4 hours, severe chest pain, fainting, sudden vision/hearing loss, or severe breathlessness.

10) Is it safe to drive after taking Sildalis?

Some people experience dizziness or low blood pressure symptoms. If you feel unwell, avoid driving or operating machinery until you know how the medicine affects you.

Summary

Sildalis (sildenafil citrate 100 mg + tadalafil 20 mg) is a combined PDE5 inhibitor used for erectile dysfunction. It works by improving blood flow to support erections during sexual stimulation. Onset is commonly within 30–60 minutes, while tadalafil may help extend the period of effectiveness.

For safe use, pay close attention to interactions—especially nitrates and riociguat—and limit alcohol. If you have heart conditions, take multiple medicines, or are unsure about suitability, consult a healthcare professional. Choosing reputable, Australia-compliant supply helps ensure you receive a product that matches the label and safety information.

Disclaimer: This website content is for general information only and does not replace individual medical advice.