Yes - this is probably relevant to many people here who are also looking into PDE5i.
As an aside - this is a collaborative website - so if you have specific questions, you can probably assume other people here have the same questions, so I encourage you to “do your own research” (as they say), using one of the AI systems, and post your results here. We’re all working together on this! And, please post your prompts as well as your responses (or portions of the responses that are most relevant). And post links to the full analysis too (via the “share” button in most AI systems).
Here is what I posted on Gemini as a prompt:
Comparison to PDE5i: How does chronic Citrulline compare to low-dose Tadalafil for endothelial maintenance? Also, can you graph the approximate blood level and half-life of both citrulline and tadalafil and sildenafil. Can you also graph the timing of the impact on blood pressure (percent reduction in blood pressure over time, after dosing) for each of these compounds.
Gemini Response:
This is a sophisticated pharmacological comparison. In the context of longevity, we are moving away from treating erectile dysfunction (ED) and toward endothelial preservation.
Here is the breakdown of how L-Citrulline compares to PDE5 inhibitors (specifically Tadalafil), followed by the pharmacokinetic visualizations you requested.
1. The Comparison: Citrulline vs. Low-Dose Tadalafil
Think of the Nitric Oxide (NO) pathway as a water hose.
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L-Citrulline is the Faucet (Supply Side): It provides the raw substrate to make the water (NO). It fixes “eNOS uncoupling,” ensuring the machinery produces NO rather than oxidative stress.
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Tadalafil is the Nozzle (Demand/Maintenance Side): It stops the water (cGMP) from leaking out. It inhibits the enzyme PDE5, which breaks down cGMP (the messenger molecule that tells arteries to relax).
| Feature |
L-Citrulline (Chronic) |
Tadalafil (Low-Dose, 2.5–5mg) |
The Verdict |
| Primary Mechanism |
Increases NO synthesis (upstream). |
Prevents NO signal degradation (downstream). |
Synergistic. |
| Endothelial Repair |
High. Reduces oxidative stress (ROS) and recouples eNOS. |
Moderate. improves FMD, but doesn’t fix the “fuel” shortage. |
Citrulline is better for repairing damaged machinery. |
| Half-Life |
Short (~1 hour), but physiological effects last ~6–8 hrs via Arginine. |
Long (T1/2 approx 17.5 hours). |
Tadalafil provides 24/7 coverage. |
| Blood Pressure |
Mild reduction (-6 mmHg systolic) via structural relaxation. |
Mild reduction (-5 to -7 mmHg) via constant vasodilation. |
Similar magnitude, different feel. |
| Cognitive/Brain |
Limited BBB crossing, but improves cerebral flow via perfusion. |
Crosses BBB. Emerging data suggests neuroprotection/glymphatic clearance. |
Tadalafil wins for brain aging. |
| Side Effects |
Rare (GI distress at high doses). |
Headache, back pain, reflux, flushing. |
Citrulline is much better tolerated. |
Summary: If you have high oxidative stress (Diabetes/Age >50), Citrulline is essential to “fix the engine.” Tadalafil is an amplifier; it works best if you already have decent NO production. Together, they are the “Gold Standard” vascular stack (monitor BP carefully).
2. Pharmacokinetics: Blood Levels & Half-Life
The following graph illustrates why Tadalafil is often preferred for “set it and forget it” background longevity support, while Sildenafil and Citrulline are “event-based” or require split dosing.
Visualizing the Curves (0 to 24 Hours)
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Sildenafil (Viagra): The “Spike.” Shoots up fast, crashes fast.
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L-Citrulline: The “Wave.” Fast absorption, converts to Arginine (the functional payload), which lingers for 4–6 hours.
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Tadalafil (Cialis): The “Plateau.” Slow rise, stays elevated all day.
Approximate Plasma Concentration (% of Peak) over Time
| Time Post-Dose |
Sildenafil (100mg) |
L-Citrulline (3-6g) |
Tadalafil (5-20mg) |
| 0.5 Hours |
40% (Rising fast) |
60% (Fast absorb) |
10% (Slow) |
| 1.0 Hours |
100% (Peak) |
100% (Peak) |
30% |
| 2.0 Hours |
70% |
85% (Arginine high) |
100% (Peak) |
| 4.0 Hours |
40% (T1/2 reached) |
50% |
90% |
| 8.0 Hours |
10% |
20% (Back to baseline) |
75% |
| 12.0 Hours |
<5% |
<5% |
65% |
| 24.0 Hours |
0% |
0% |
40% (Still active) |
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Key Takeaway: You need to dose Citrulline 2–3x daily to match the “area under the curve” (exposure) that a single Tadalafil dose provides.
3. Blood Pressure Impact: Timing & Magnitude
This graph visualizes the hemodynamic stability. Longevity enthusiasts generally prefer a steady curve (Tadalafil) or a physiological curve (Citrulline) over the “crash” associated with Sildenafil.
Percent Reduction in Mean Arterial Pressure (MAP) from Baseline
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Sildenafil: Induces a rapid, sharp drop in BP that correlates with its peak blood level. This can cause lightheadedness or “head rush.”
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Tadalafil: A smoother, shallower engagement. It doesn’t “drop” pressure so much as it “lowers the operating floor” consistently.
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Citrulline: The most gentle. It rarely causes acute hypotension. Its effect is cumulative over weeks, though a small acute drop occurs.
% Reduction in BP (MAP)
|
-15% | * Sildenafil (Sharp Drop)
| / \
-10% | / \
| / \
-5% | / \ * Tadalafil (Steady State)
| / \_________/________________________
|/ \ / ------------------------
-2% |/____________\_____/__________________________ * Citrulline (Mild/Transient)
|
0h 2h 4h 6h 8h 12h 24h
Data Points (Approximation for Systolic Drop):
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Sildenafil:
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Peak Drop: -8 to -10 mmHg at ~1 hour.
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Return to Baseline: ~6 hours.
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Risk: Acute hypotension if combined with nitrates.
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Tadalafil (Chronic 5mg):
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Peak Drop: -5 to -7 mmHg (sustained).
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Profile: Because of the 17.5h half-life, daily dosing creates a “stacking” effect. By Day 5, you achieve a steady state where BP is constantly suppressed by ~5-7 mmHg. It does not swing wildly.
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L-Citrulline:
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Acute Drop: -3 to -5 mmHg at ~2 hours (often barely noticeable).
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Chronic Effect: After 4 weeks, baseline BP drops by ~6-10 mmHg due to improved endothelial structure, not just acute dilation.
Actionable Synthesis for You
If your goal is longevity and endothelial maintenance without the “druggy” feeling of steep pressure drops:
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Foundation: L-Citrulline (3g, 2x/day). This fuels the tank and repairs the lining.
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Amplifier: Low-dose Tadalafil (2.5mg or 5mg daily). This keeps the lines open 24/7.
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Avoid: Sildenafil. Its “spike and crash” pharmacokinetics are less suited for chronic endothelial care and place more stress on homeostatic mechanisms.