Sildalist

Sildalist is a tablet from India that puts two erectile dysfunction medicines into one: sildenafil 100 mg, the medicine in Viagra, and tadalafil 20 mg, the medicine in Cialis. The "120mg" on our listing is the two doses added together. We sell it in packs of 60, 120 and 180 tablets, from $0.83 a tablet in the largest pack.

Read this before ordering. No sildenafil and tadalafil combination is approved by the FDA, MHRA, TGA or Health Canada, and both US labels advise against taking these two medicines together. The Viagra label says the use of combinations with other PDE5 inhibitors "is not recommended", and the Cialis label tells doctors to "Inform patients not to take CIALIS with other PDE5 inhibitors". Each Sildalist tablet holds the label maximum of sildenafil and the label maximum of tadalafil for use as needed. We would not recommend Sildalist. For most men, one medicine at the right dose is the better choice: a sildenafil tablet such as Cenforce 100 or a tadalafil tablet such as Vidalista 20, chosen with a doctor. This page sets out what the labels say, what the evidence shows, who must not take it, and the price per tablet. Clinical figures come from the US Viagra and Cialis labels and the UK and EU product information, listed at the end.

Sildalist at a glance

Price per tablet

Prices below are as of October 2026; the pack selector shows the current price.

The 180 pack is the lowest per tablet before shipping too, so free shipping is not the only reason it is cheaper. Each pack is a large supply: the labels allow no more than one dose of either medicine a day, so even the 60 pack is 60 separate occasions. Check the expiry date on the strips when your order arrives and plan how many tablets you will realistically use before it.

What the Viagra and Cialis labels say about taking them together

Sildenafil and tadalafil block the same enzyme, PDE5. A tablet that contains both does not add a new way of working; it adds more of the same effect on two time scales. Both US labels have a section on exactly this:

• Viagra (US label, section 5.7): "The safety and efficacy of combinations of VIAGRA with other PDE5 Inhibitors, including REVATIO or other pulmonary arterial hypertension (PAH) treatments containing sildenafil, or other treatments for erectile dysfunction have not been studied. Such combinations may further lower blood pressure. Therefore, the use of such combinations is not recommended." The patient information adds that Viagra "should not be used" with other PDE5 inhibitors such as Adcirca, which is tadalafil.
• Cialis (US label, section 5.11): "The safety and efficacy of combinations of CIALIS and other PDE5 inhibitors or treatments for erectile dysfunction have not been studied. Inform patients not to take CIALIS with other PDE5 inhibitors, including ADCIRCA." The patient information also says: "Do not take sildenafil citrate (Revatio®) with CIALIS."
• UK and EU: the UK Viagra summary of product characteristics says the use of such combinations "is not recommended", and the UK and EU Cialis product information says patients "should be informed not to take CIALIS in such combinations".

The worry the Viagra label names is blood pressure. On their own, each lowers it a little: sildenafil by a mean maximum of 8.4/5.5 mmHg lying down in healthy volunteers, and tadalafil 20 mg by a mean maximum of 1.6/0.8 mmHg more than placebo. These come from different study designs and cannot be compared directly, and no label gives a figure for the two together. The risk matters most for men who also take alpha blockers or other blood pressure medicines, drink heavily, or have heart disease.

Compared with taking one licensed medicine

Sildenafil and tadalafil are each approved on their own in the US, UK, Australia and Canada. Here is what one tablet of each costs, next to Sildalist.

The brand and generic figures are what US pharmacies paid per tablet according to the Medicaid NADAC survey (rows effective 21 October 2026); the price at the counter is higher and depends on the pharmacy and your insurance. Viagra and Cialis were approved on clinical trial evidence, and US generics had to prove bioequivalence to them. Our arithmetic: at the same pack size, a Sildalist tablet from us costs the same as a Cenforce 100 tablet ($60 for 60, $105 for 120), so Sildalist is not a cheaper way to buy sildenafil, and the larger single-ingredient packs go lower ($0.71 and $0.72 a tablet in the 300 packs of Cenforce 100 and Vidalista 20, before shipping). US generic sildenafil and tadalafil cost pharmacies far less per tablet than any of our tablets. If you are in the US and have a prescription, compare cash prices for FDA-approved generic sildenafil or tadalafil first. Our generic Viagra guide and generic Cialis guide cover doses and costs.

What the evidence says

We found no published trial of sildenafil 100 mg and tadalafil 20 mg taken together, in one tablet or as two, and no trial of Sildalist itself. What we did find used lower doses or different schedules:

• Cui 2015: 180 men with erectile dysfunction were assigned 1:1 to tadalafil 5 mg once daily, or tadalafil 5 mg daily plus sildenafil 50 mg as needed. Erectile function scores were higher with the combination in men with severe erectile dysfunction, and the authors reported no difference in adverse events between groups. The doses are a quarter of the tadalafil and half of the sildenafil in a Sildalist tablet, and one study of 180 men cannot show that the combination is safe.
• Munk 2019 systematic review: in men who had not responded to a single tablet, the authors found that daily tadalafil alone and daily tadalafil combined with sildenafil as needed "showed similar" improvements in erectile function scores.
• Trials registered but without results: a small Israeli study of half doses of both against the maximum dose of one (NCT01364701, status unknown, no results posted), and two Egyptian trials, one of tadalafil 2.5 mg plus sildenafil 25 mg daily (NCT07177326, not yet recruiting) and one of daily tadalafil 5 mg plus sildenafil 100 mg as needed in non-responders (NCT07391579, recruiting). None of them tests sildenafil 100 mg with tadalafil 20 mg.

Many men who think a tablet "does not work" have not had a fair trial of it. In one study of men who said sildenafil had not worked for them, 24 of the 41 followed up had successful intercourse after thorough instruction and four doses of 100 mg. If one medicine at the right dose has not worked well enough, the better-studied next steps are a proper retry, a switch to the other medicine, or daily low-dose tadalafil: in two placebo-controlled trials pooled by Kim 2014, about 4 in 10 men who had only a partial response to the maximum as-needed dose reached a normal erectile function score after 12 weeks of daily tadalafil, against 12.1% on placebo. These are decisions to make with a doctor.

Where the doses sit, and which strength

The two sildenafil and tadalafil tablets we stock under this brand:

There is no lower strength of Sildalist, so it cannot follow the labels' advice to start most men on 50 mg of sildenafil or 10 mg of tadalafil. Single-ingredient tablets can: Cenforce 50 for sildenafil, and Vidalista 10 or daily Vidalista 5 for tadalafil. For tadalafil, the EMA review found the difference between 10 mg and 20 mg statistically significant but "rather marginal". Our tadalafil vs sildenafil comparison explains how the two differ.

If you and your doctor decide on Sildalist

• Use it only if a doctor who knows your heart health, blood pressure and medicines has agreed, knowing that both labels advise against combining PDE5 inhibitors.
• Do not take it as a first treatment. Each tablet is already the maximum label dose of both medicines.
• Never take it together with any other erectile dysfunction medicine, including separate sildenafil or tadalafil tablets, daily tadalafil, Revatio or Adcirca.
• If side effects are troublesome, stop and speak to your doctor.

How to take Sildalist

1. Swallow one tablet whole with water. Do not split or chew it; the Cialis label says "Do not split CIALIS tablets; entire dose should be taken."
2. Take no more than one tablet in 24 hours. Both labels set a maximum of one dose a day.
3. Timing comes from each medicine's own label: sildenafil about 1 hour before sex (anywhere from 30 minutes to 4 hours), and tadalafil at least 30 minutes before. The labels give no timing for the two together.
4. A high fat meal slows sildenafil: the label reports peak levels about 60 minutes later and 29% lower. Tadalafil can be taken with or without food.
5. Avoid heavy drinking. The Cialis label says substantial alcohol (for example 5 units or more) with tadalafil can increase the chance of dizziness, a faster heart rate, a drop in blood pressure on standing, and headache. In the Viagra label, sildenafil 50 mg did not add to the blood pressure effect of alcohol in healthy volunteers.
6. Neither medicine works without sexual stimulation. Tadalafil's half-life is 17.5 hours, and the label says it improved erectile function for up to 36 hours after a dose in studies of 10 mg and 20 mg; sildenafil's half-life is about 4 hours.

Groups for whom Sildalist is not suitable

For most of these groups one or both labels set a lower dose or a lower maximum than Sildalist contains; for the rest the labels warn of an interaction. Our view is that Sildalist is not suitable for them:

• Alpha blockers (for example doxazosin, tamsulosin or alfuzosin): the US Viagra label says be stable on the alpha blocker first, then start sildenafil at 25 mg; the US Cialis label says start at the lowest recommended dose. The UK and EU tadalafil label says the combination of tadalafil and doxazosin is not recommended.
• Ritonavir and other strong CYP3A4 inhibitors (ketoconazole, itraconazole, saquinavir and others): the US Viagra label sets a maximum of 25 mg of sildenafil in 48 hours with ritonavir and advises considering 25 mg with other strong CYP3A4 inhibitors or erythromycin. The US Cialis label sets a maximum of 10 mg of tadalafil once every 72 hours with strong CYP3A4 inhibitors. Clarithromycin and erythromycin are named in the Cialis patient information too.
• Kidney impairment: tadalafil exposure doubled in people with creatinine clearance of 30 to 80 mL/min. With 30 to 50 mL/min, the US Cialis label sets a maximum of 10 mg once every 48 hours, and below 30 mL/min or on dialysis a maximum of 5 mg once every 72 hours. The US Viagra label advises considering 25 mg of sildenafil below 30 mL/min. At 51 to 80 mL/min, ask your doctor first.
• Liver impairment: the US Cialis label says tadalafil should not exceed 10 mg in mild or moderate liver impairment, and the US Viagra label advises considering 25 mg of sildenafil. Severe liver impairment is a contraindication in the UK sildenafil label (see below).
• Age over 65: the US Viagra label advises considering 25 mg of sildenafil (the UK and EU label does not adjust the dose for age).
• Blood pressure medicines: both medicines can add to their blood pressure lowering effect.
• CYP3A4 inducers such as rifampin cut tadalafil exposure by 88%, so tadalafil may not work as expected.

Side effects

No trial has reported side effect rates for the two medicines taken together, so the best guide is what each does alone at the dose in Sildalist. The rates come from separate trial programmes and cannot simply be added together.

Sildenafil figures are from the Viagra label's fixed-dose studies (100 mg n=506, placebo n=607); tadalafil figures are from the Cialis label's eight main placebo-controlled studies of use as needed (20 mg n=635, placebo n=476). The Viagra label says some adverse reactions increased with dose, and that at doses above the recommended range they "generally were reported more frequently". Abnormal vision with sildenafil was mostly a temporary colour tinge, more sensitivity to light, or blurred vision.

Tadalafil back pain and muscle aches usually started 12 to 24 hours after a dose and settled within 48 hours. Changes in colour vision, which can impair the ability to tell blue from green, were reported in under 0.1% of tadalafil patients; the label says single doses of PDE5 inhibitors have caused a temporary, dose related change in blue/green colour discrimination.

When to get urgent help

• Fainting, chest pain, or severe dizziness during or after sex. If chest pain starts during sex, stop and get medical help right away.
• An erection lasting more than 4 hours, whether painful or not. Without prompt treatment it can permanently damage the penis and cause lasting erectile dysfunction.
• Sudden loss or reduction of vision in one or both eyes. Stop taking it and get medical help straight away.
• Sudden loss or reduction of hearing, sometimes with ringing in the ears or dizziness. Stop taking it and get prompt medical attention.
• Swelling of the lips, tongue or throat, difficulty breathing or swallowing, or a rash, hives or blistering skin.
• If you take more than one tablet in 24 hours, contact a doctor or emergency department straight away. In healthy volunteers given single sildenafil doses up to 800 mg, the Viagra label says adverse reactions were similar to those seen at lower doses, but incidence rates and severities were increased.

Tell emergency staff that you took both sildenafil and tadalafil, how much and when. The Viagra label says it is not known when nitrates can safely be given after sildenafil, even 24 hours later, and the Cialis label says at least 48 hours should pass after the last tadalafil dose before a nitrate is considered, even in a life-threatening situation, and only with close monitoring.

Who should not take Sildalist

Never take it if any of these apply:

• You use nitrates in any form, regularly or occasionally, including nitroglycerin sprays, tablets or patches and amyl or butyl nitrite "poppers" (contraindication in both US labels).
• You take a guanylate cyclase stimulator such as riociguat (both US labels).
• You already take sildenafil (Revatio) or tadalafil (Adcirca) for pulmonary arterial hypertension, or any other erectile dysfunction medicine (both US labels advise against combining PDE5 inhibitors).
• You are allergic to sildenafil, tadalafil or any ingredient of the tablet (both labels).
• You have been told that sexual activity is not safe for your heart, for example with unstable angina or severe heart failure (UK sildenafil label).
• You have severe liver impairment, blood pressure below 90/50, a recent stroke or heart attack, or an inherited retina disease such as retinitis pigmentosa. These are contraindications in the UK sildenafil label because they were not studied. The US Viagra label says there are no controlled data for a heart attack or stroke in the last 6 months, blood pressure below 90/50 or retinitis pigmentosa, and that any use should be with caution; the US Cialis label says tadalafil is not recommended in severe liver impairment or retinitis pigmentosa.
• You had a heart attack in the last 90 days or a stroke in the last 6 months, have unstable angina or angina during sex, heart failure (NYHA class 2 or worse) in the last 6 months, uncontrolled arrhythmias or uncontrolled high blood pressure. These are contraindications in the UK and EU tadalafil label; the US label says tadalafil is not recommended for these groups.
• You have lost vision in one eye from NAION (a sudden loss of blood flow to the optic nerve). This is a contraindication in the UK and EU labels for both medicines; the US labels say to use PDE5 inhibitors only with caution, when the expected benefits outweigh the risks.

Heart attack, sudden cardiac death and stroke have been reported in men taking tadalafil, mostly in men who already had heart risk factors, and many during or soon after sex. Observational studies described in the Viagra label suggest about a 2-fold increase in the risk of NAION around PDE5 inhibitor use. Talk to a doctor first if you have aortic stenosis or other heart disease, a deformed penis (angulation or Peyronie's disease), a condition that raises the risk of prolonged erections (sickle cell anaemia, multiple myeloma, leukaemia), a bleeding disorder or an active stomach ulcer. Sildalist does not protect against sexually transmitted infections.

Prescription and legal status

Sildenafil and tadalafil are prescription medicines in the US, Australia and Canada. In the UK they are prescription only apart from 50 mg sildenafil pharmacy packs such as Viagra Connect and Cialis Together 10 mg, which pharmacies can sell after a consultation. No sildenafil and tadalafil combination is approved by the FDA, MHRA, TGA or Health Canada: an openFDA search and a Health Canada drug database search on 21 October 2026 found no product containing both. In India, we found no sildenafil and tadalafil combination in the regulator's lists of approved fixed dose combinations, and a web search found no Sildalist listing on Tata 1mg, PharmEasy, Apollo or Truemeds, so this pack appears to be sold mainly for export. In the US, the FDA says personal importation of unapproved medicines is illegal in most circumstances. See a doctor before using it and check the rules where you live.

Buying genuine Sildalist

The MHRA warns: "Any medicine not authorised for sale in the UK can be unsafe or ineffective and there is no way of knowing what is in them or the negative health effects they can have." It adds that erectile dysfunction pills bought online may contain no active ingredient, the wrong dose, hidden drugs or toxic ingredients. That warning covers Sildalist, which is not authorised in the UK, and the MHRA advises UK buyers to "Only use UK-registered pharmacies, including online pharmacies displaying the official green cross logo". The carton in our product photo reads "Sildenafil Citrate & Tadalafil Tablets" and "10x6 Tablets", and its side panel lists sildenafil 100 mg and tadalafil 20 mg per film coated tablet. Check that each strip names both medicines and shows a batch number and an expiry date, read the "Mfd. by" line, and reject strips that are damaged, unsealed or unmarked. These checks cannot prove a product is genuine, because counterfeiters copy packaging. If a batch causes unusual symptoms, stop using it, seek medical advice, and report it to your medicines regulator (the MHRA Yellow Card scheme in the UK, FDA MedWatch in the US, the TGA in Australia or Health Canada) as well as to us.

Delivery

We ship Sildalist to the US, UK, Australia and Canada in plain packaging with tracking. Standard delivery takes 7 to 14 business days to most countries. Shipping costs a flat $25 on orders under $149 and is free from $149. See our shipping page and refund policy.

Related guides

• Sildalist: what the evidence says about combining Viagra and Cialis
• Tadalafil vs sildenafil: timing, food and side effects
• How to take sildenafil safely
• Daily tadalafil 5 mg for erectile dysfunction
• Tadalafil above 20 mg: what the evidence says
• Generic Viagra in the US: makers and costs

Sildenafil on its own: Cenforce 50 and Cenforce 100. Tadalafil on its own: Vidalista 10, Vidalista 20 and daily Vidalista 5.

Sources

• VIAGRA (sildenafil citrate) US prescribing information, Viatris Specialty LLC, sections 2, 4, 5.1, 5.3, 5.7, 5.8, 6.1 Table 1, 7, 10, 12.2, 12.3, 17 and Patient Information. DailyMed
• CIALIS (tadalafil) US prescribing information (Eli Lilly), effective June 2026, sections 2, 4, 5, 5.11, 6.1, 6.2, 7, 8.6, 8.7, 10, 12, 14 and Patient Information. DailyMed
• Viagra 25 mg film-coated tablets, UK summary of product characteristics, sections 4.2, 4.3 and 4.4, revised December 2025. emc
• Cialis 20 mg film-coated tablets, UK summary of product characteristics, sections 4.3, 4.4 and 4.5, revised 27 January 2026. emc
• European Medicines Agency. Cialis product information and scientific discussion (EPAR).
• Cui H et al. Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction. Andrologia 2015. PMID 24387078.
• Munk NE et al. Systematic review of oral combination therapy for erectile dysfunction when phosphodiesterase type 5 inhibitor monotherapy fails. Sex Med Rev 2019;7(3):430-441. PMID 30711478.
• Jiann BP et al. Rechallenge prior sildenafil nonresponders. Int J Impot Res 2004. PMID 14963473.
• Kim ED et al. A return to normal erectile function with tadalafil once daily after an incomplete response to as-needed PDE5 inhibitor therapy. J Sex Med 2014;11(3):820-30. PMID 23841532.
• ClinicalTrials.gov records NCT01364701, NCT07177326 and NCT07391579, accessed 21 October 2026.
• Central Drugs Standard Control Organisation, India. Lists of fixed dose combinations approved by DCG(I), 1961 to 2019, and the lists for January 2020 to March 2025 that we could obtain.
• Centers for Medicare and Medicaid Services. National Average Drug Acquisition Cost (NADAC), 2026 file, sildenafil 100 mg, Viagra 100 mg, tadalafil 20 mg and Cialis 20 mg rows effective 21 October 2026. data.medicaid.gov
• MHRA. 20 million illegal erectile dysfunction pills seized as MHRA warns against risky online buys, 13 February 2026. GOV.UK.
• US Food and Drug Administration. Personal Importation. FDA
• Sildalist listings (composition): IndiaMART listings from RSM Multilink LLP ("sildenafil citrate 100mg + tadalafil 20mg") and Modern Times Helpline Pharma ("100 & 20mg"), accessed October 2026; carton in our product photo.

This page is for information and is not medical advice. Sildenafil and tadalafil are prescription medicines; speak to a doctor before using either, and do not combine them without a doctor's advice.