Tadalafil

Tadalafil is a prescription medication used to treat erectile dysfunction (ED). It belongs to the same class of drugs as Viagra but is available as a generic medication (containing the same active ingredient but more affordable). It is the same active ingredient found in the well-known brand Cialis.

This medication is classified as a PDE-5 inhibitor, which works by improving blood flow to the penis, helping you achieve a strong erection when sexually stimulated, even if your body normally has difficulty doing so.

Tadalafil works similarly to Viagra and Cialis, with the active ingredient tadalafil, which belongs to a class of drugs called phosphodiesterase type 5 inhibitors (PDE-5 inhibitors). This substance helps relax the blood vessels in the penis, improving blood flow by inhibiting the enzyme that restricts blood circulation. This makes it easier to achieve an erection when sexually stimulated.

Like other erectile dysfunction medications, tadalafil does not work without sexual stimulation. You can enhance its effectiveness by engaging in foreplay or sexual arousal before intercourse.

How Long Does Tadalafil Last?

The effects of tadalafil can last up to 36 hours, earning it the nickname "the weekend pill." This means it helps you achieve an erection when sexually stimulated during this period but does not cause continuous erections for 36 hours.

For lower doses (2.5 mg or 5 mg), tadalafil is taken daily to maintain continuous effectiveness and readiness when needed.

However, tadalafil does not affect the time to orgasm. If you have premature ejaculation, you may need specific treatments for that condition, as erectile dysfunction and premature ejaculation can sometimes be related.

When Does Tadalafil Start Working?

Tadalafil begins to work within 30–60 minutes. It is recommended to take the medication with water about 30–60 minutes before sexual activity to allow it to take full effect.

If you have sexual activity more than twice a week, you may consider taking a low daily dose (2.5 mg or 5 mg) at the same time every day to maintain continuous effectiveness and readiness.

If you are unsure which dose is right for you, consult your doctor before using tadalafil.

How Effective Is Tadalafil?

Clinical studies confirm that tadalafil is an effective treatment for erectile dysfunction. The studies found that:

• 86% of patients with mild ED reported improvement
• 83% of patients with moderate ED reported improvement
• 72% of patients with severe ED reported improvement

In this study, 75% of sexual attempts were successful in the tadalafil group compared to 32% in the placebo group.

Other research found that 70% of daily tadalafil users were satisfied with the treatment, and 83.1% felt that daily medication was convenient for their lifestyle.

If you are using tadalafil in 10 mg or 20 mg doses, swallow one tablet whole with water about 30–60 minutes before sexual activity to allow the medication time to work. If taken too close to the activity, the medication may not reach full effectiveness.

For lower doses (2.5 mg or 5 mg), take it at the same time every day (daily dose). This allows the medication to work continuously, so you’re always ready when sexually stimulated, without needing to time the dose before intercourse. This is ideal for those who are sexually active regularly or prefer spontaneous intimacy.

For best results, avoid:

• Heavy or fatty meals before taking the medication, as they may slow down its absorption.
• Excessive alcohol consumption, as it may reduce effectiveness and increase the risk of side effects.

Remember, although tadalafil (like other Viagra alternatives) helps improve blood flow, it is not an "arousal enhancer"—sexual stimulation (such as foreplay) is still required for the medication to help achieve an erection.

How Often Should Tadalafil Be Taken?

There are two main ways to use it:

• Daily dose (2.5 mg / 5 mg): Taken at the same time each day. Suitable for those who have sex at least twice a week or prefer natural spontaneity and constant readiness.
• As-needed dose (10 mg / 20 mg): Taken 30–60 minutes before planned sexual activity.

Never exceed one tablet per day. Taking more than one dose daily will not improve effectiveness but increases the risk of serious side effects. If unsure about the appropriate dosage, always consult your doctor first.

Tadalafil comes in four main strengths, divided into two daily doses and two as-needed (on-demand) doses. If you have sex more than twice a week, a daily dose may be more suitable. If you have sex occasionally, the as-needed dose may be a better fit.

If you are unsure which dose is right for you, consult your doctor first. Always check with a doctor before changing your dosage.

Daily Dosages

• Tadalafil 2.5 mg: The lowest dose, suitable for those who found 5 mg effective but experienced mild side effects. This dose is slightly less effective than 5 mg but has a lower overall risk of side effects.
• Tadalafil 5 mg: The standard daily dose. Doctors typically recommend this as the first option if you have not used a daily dose before.

Before-sex / On-demand Dosages

• Tadalafil 10 mg: The standard as-needed dose. Doctors may recommend this if you have not used tadalafil before.
• Tadalafil 20 mg: A stronger as-needed dose. If 10 mg was not effective and you did not experience severe side effects, a doctor may consider increasing the dose to 20 mg. This dose is slightly more likely to be effective than 10 mg but carries a higher risk of side effects.

Important: Never take more than one tadalafil tablet per day. Exceeding the recommended dose will not increase your chances of success but will increase the risk of serious side effects. If you have questions about dosage or side effects, always consult your doctor.

(Note: Tadalafil is one option in the group of medications often collectively referred to as "Viagra," but each active ingredient, such as sildenafil or tadalafil, has different properties and durations of action. Choose the one that best fits your lifestyle and physical condition.)

Like all medications, taking tadalafil may cause side effects, but many people experience none or only mild symptoms. The risk of side effects increases with higher doses. If you have concerns about side effects when using tadalafil (or medications in the same class as Viagra), you should consult your doctor for peace of mind.

Common side effects (may occur in 1 in 10 people):

• Headache
• Back pain or muscle aches
• Arm and leg pain
• Facial flushing
• Nasal congestion
• Indigestion

Uncommon side effects (may occur in 1 in 100 people):

• Dizziness or stomach pain
• Nausea, vomiting, or acid reflux
• Blurred vision or eye pain
• Difficulty breathing
• Blood in urine
• Prolonged and painful erection
• Palpitations or rapid heartbeat
• Abnormal high or low blood pressure
• Nosebleeds or ringing in the ears
• Swelling of hands, feet, or ankles
• Fatigue

How Long Do Tadalafil Side Effects Last?

Side effects usually go away after you stop taking the medication. However, since tadalafil can remain in the body for up to 36 hours, side effects may last that long as well, gradually decreasing over time. If side effects interfere with daily life or do not improve, consult your doctor or pharmacist.

How to Manage Side Effects

If you experience mild symptoms such as headache, flushing, or nasal congestion, these usually resolve within a few days. You can manage them at home as follows:

• Flushing: Stay in a cool place, sip cold water, and avoid alcohol and caffeine.
• Headache: Drink plenty of water and consult a pharmacist about over-the-counter pain relievers.
• Nasal congestion: Consult a pharmacist for nasal spray to relieve symptoms.
• Nausea: Avoid spicy or fatty foods and eat smaller meals.

Precautions

If you experience muscle pain, consult a pharmacist. Seek immediate medical attention if you have any of the following severe symptoms:

• Sudden loss of vision or hearing
• Prolonged and painful erection, especially if lasting more than 2 hours

You should consult a doctor or pharmacist before starting tadalafil.

Risk for people with heart disease:

Sexual activity can put extra strain on the heart, so those with heart conditions should consult a doctor before engaging in sexual activity or using tadalafil.

For tadalafil 5 mg only:

Doctors may screen for prostate cancer before starting treatment because symptoms of an enlarged prostate and prostate cancer can be similar. Tadalafil is not a treatment for prostate cancer.

Inform your doctor if you have any of the following before using tadalafil:

• Sickle cell anemia
• Multiple myeloma
• Leukemia
• Penile abnormalities
• Severe liver disease
• Severe kidney disease

Effectiveness in people with a history of:

• Pelvic surgery
• Radical non-nerve-sparing prostatectomy
  
  It is not yet clear how effective tadalafil is in these groups.

If you experience any of the following while using tadalafil, stop taking it and seek medical advice immediately:

• Decreased vision, loss of vision, or visual disturbances
• Sudden hearing loss or decrease

Tadalafil is not suitable for:

• Women
• Children and adolescents under 18 years old

Drug Interactions with Tadalafil

Tadalafil may interact with certain medications. Inform your doctor if you are currently using or have recently used any of the following:

• Nitrates (e.g., poppers)
• Alpha blockers (used for high blood pressure or urinary symptoms related to enlarged prostate)
• Other blood pressure medications
• Riociguat
• 5-alpha-reductase inhibitors (used for enlarged prostate)
• Ketoconazole (antifungal)
• Protease inhibitors (used for AIDS or HIV)
• Phenobarbital, phenytoin, carbamazepine (anticonvulsants)
• Rifampicin, erythromycin, clarithromycin, itraconazole
• Other erectile dysfunction medications

Can tadalafil tablets be split in half?

No, you should swallow the tablet whole with water. If you have specific questions about how to take this medication, it is recommended to consult your doctor or pharmacist for safety.

How should tadalafil be stored?

Keep tadalafil in its original blister pack and box. Store it in a place below 30°C, away from sunlight and moisture. Importantly, do not use the medication after the expiration date printed on the box.

Is tadalafil as strong as Viagra?

Viagra’s active ingredient is sildenafil, and tadalafil contains the same active ingredient by name. Both start working within 30–60 minutes, but tadalafil lasts much longer (up to 36 hours) compared to Viagra (up to 4 hours).

Although the milligram amount of sildenafil may seem higher, it does not necessarily mean it is stronger. If you want a longer-lasting medication without worrying about timing before sex, tadalafil or the daily dose option may better suit your lifestyle.

Is tadalafil better than Cialis?

Tadalafil and Cialis contain the exact same active ingredient. Cialis is a brand name and is more expensive, while tadalafil is a generic version that is more affordable. Both are equally safe and effective when used under professional guidance.

Can I drink alcohol while taking tadalafil?

For the best effectiveness, it is recommended to avoid heavy alcohol consumption. Alcohol may make it harder to achieve an erection and increase the risk of side effects.

Does tadalafil affect fertility?

Two studies found that sperm count may slightly decrease in users of this medication, but this effect usually does not harm long-term fertility. On the contrary, by helping achieve and maintain erections longer, tadalafil can be beneficial, especially for couples planning to conceive. If you have concerns, you can always consult your doctor or pharmacist for more information.