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Tadalafil: Uses, Side Effects & More

Tadalafil is a medication you’ve probably never heard of — until you find yourself in the position to need it. To be fair, most people are more acquainted with its brand-name offering, Cialis®.

Believe it or not, millions of men the world over have turned to Cialis for help with numerous health conditions.

Maybe you’re looking up tadalafil facts or need guidance for managing erectile dysfunction (ED). We’ll cover all the basics here, but know the instructions and safety protocols for using it are going to be the same as with Cialis.

Below, we’ll summarize how this medication can be used, what it does and what schedule to follow to use it safely. (Hint: It changes situationally). We’ll also go over potential health risks and what could happen if tadalafil isn’t used correctly — or under the care of a healthcare professional.

What Is Tadalafil Used for?

Tadalafil belongs to a category of prescription medications known as phosphodiesterase type 5 (PDE5) inhibitors.

This particular version was approved in 2003 by the FDA (U.S. Food and Drug Administration). But the PDE5-inhibiting medications have been commercially available since 1998, following the introduction of sildenafil (the active ingredient in Viagra®).

PDE5 inhibitors block the PDE5 enzyme, which results in relaxed smooth muscle in the blood vessels. This makes for healthier blood flow in multiple circulatory scenarios, which we’ll look at in more detail.

Tadalafil can help with a type of high blood pressure (hypertension), benign prostatic hyperplasia (BPH) and erectile dysfunction.

Tadalafil for Erectile Dysfunction

Arguably, the most famous use case for tadalafil is for the management of ED.

Since PDE5 inhibitors help relax the smooth muscle cells in the arteries that supply the penis, they can encourage more blood to flow to the penis. This makes erections possible for guys who struggle to get or maintain an erection without treatment for erectile dysfunction.

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Tadalafil for Benign Prostatic Hyperplasia

BPH is a complicated term for an enlarged prostate — a condition common among aging men. Untreated benign prostatic hyperplasia symptoms could lead to bladder or kidney problems down the road. 

BPH may result in urination problems, including:

  • Feeling like your bladder is always full

  • Weak flow of urine

  • Straining while peeing

  • Difficulty emptying your bladder

  • Urgent urination

Research indicates that tadalafil can improve the quality of life and symptoms of BPH for men with erectile dysfunction.

Tadalafil for Pulmonary Arterial Hypertension

Tadalafil can be sold under several names, which is why we have to get into a quick digression about Adcirca® versus Cialis medications. While both use the same active ingredient (tadalafil), Adcirca’s dosage is much higher, as it’s formulated not for ED but for pulmonary arterial hypertension, which is a type of high blood pressure in the lungs.

How to Use Tadalafil

Tadalafil dosage and dosing frequency depend on how and why you’re using the medication.

For the treatment of erectile dysfunction, you can take a dose of tadalafil once daily or as needed. When the medication is in your system, it can help you achieve an erection after being exposed to some form of sexual stimulation (whether it’s foreplay with a partner, porn or tantalizing thoughts).

Tadalafil is effective for up to 36 hours and stays in the body longer than other ED medications. That’s why it’s often called the “weekend pill. For someone with a regular or frequent sex life, this can make things a lot easier. 

On the other hand, as-needed tadalafil can be much more affordable simply because you’re buying fewer pills. Even if your dosage is increased or decreased from the starting dose of 10 milligrams (mg), you’ll still pay less over time with as-needed use. 

When taken once daily, tadalafil is prescribed at a dose of 2.5 mg or 5 mg. 

For the treatment of BPH, daily tadalafil is taken in 5 mg dosages.

For pulmonary arterial hypertension, the dose of tadalafil is 40 mg daily. 

Regardless of what you’re treating, tadalafil should be taken around the same time each day — unless, of course, it’s being used as needed.

Tadalafil Side Effects

If your sexual activity or prostate health is in question, tadalafil could be an essential solution to the management of those problems.

But even though this medication is considered safe and effective, it’s crucial to know about the potential drug interactions, side effects and medical conditions tadalafil could interfere with.

With every prescription drug, there’s a risk of side effects. According to the FDA, common side effects of tadalafil include:

  • Headache

  • Upset stomach

  • Back pain

  • Nasal congestion (stuffy nose)

  • Limb pain (in the arms or legs)

  • Flushing

  • Muscle pain 

Serious side effects require medical attention. These include hearing loss, prolonged erection (priapism) and vision loss.

Allergic reactions are rare, but they can happen with any medication. Additionally, tadalafil sometimes reacts poorly when combined with alcohol, certain supplements, nitrites, nitrates (like nitroglycerin or amyl nitrate), alpha blockers and antihypertensives.

There’s a risk of tadalafil interactions with other meds, too. So definitely tell your provider about any medications you’re taking, especially:

  • Erythromycin

  • Ketoconazole

  • Vardenafil

  • Clarithromycin

  • Doxazosin

  • Itraconazole

  • Ritonavir

  • Rifampin

  • Riociguat

  • Tamsulosin 

  • Isosorbide mononitrate 

  • Isosorbide dinitrate

Your healthcare provider also needs to know if you’re being treated for or have conditions like:

  • Liver disease

  • Kidney disease

  • Sickle cell anemia

  • Leukemia

  • Bleeding disorders

  • Heart disease and heart problems like angina or pulmonary arterial hypertension

  • Peyronie’s disease

  • Ulcers

  • Retinitis pigmentosa (eye disease affecting the retina)

Oh, and drinking grapefruit juice or breastfeeding while on this medication can also be dangerous — so don’t do it.

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The Bottom Line on Tadalafil Uses

Whether you’re on your way to pick up a tadalafil prescription or doing some Google searches ahead of a very scary urology appointment, you can rest easy. The medication is safe, ED is common, and this treatment path is effective for many men. 

Here are the key takeaways from what we’ve discussed:

  • Tadalafil (as generic Cialis) is a PDE5 inhibitor approved by the FDA for the treatment of two conditions: erectile dysfunction and benign prostatic hyperplasia. Tadalafil (as generic Adcirca) is approved by the FDA for the treatment of pulmonary arterial hypertension.

  • It’s considered one of the safest erectile dysfunction medications on the market today.

  • Tadalafil can be prescribed at varying doses depending on your needs, your response to the medication and the side effects you experience.

  • There are other options. Medications like vardenafil (Levitra®), sildenafil (and brand-name Viagra) and avanafil (Stendra®) can also treat ED. These meds can even be taken in discreet forms, like our chewable hard mints.

For more on how long tadalafil lasts, the risks and rewards of daily Cialis, tadalafil dosage and its potential side effects, check out our guides.

Still have questions? Connect with a healthcare provider on our telehealth platform to see if this medication might be a good treatment option for you.

  1. Hatzimouratidis K. (2014). A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction. Therapeutic advances in urology, 6(4), 135–147. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054509/.
  2. Benign prostatic hyperplasia (BPH). Benign Prostatic Hyperplasia (BPH): Symptoms, Diagnosis & Treatment - Urology Care Foundation. (n.d.). https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph).
  3. HIGHLIGHTS OF PRESCRIBING INFORMATION: CIALIS (tadalafil) tablets, for oral use. (n.d.-a). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021368s030lbl.pdf.
  4. HIGHLIGHTS OF PRESCRIBING INFORMATION: VIAGRA® (sildenafil citrate) tablets, for oral use. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/20895s039s042lbl.pdf
  5. Dhaliwal A, Gupta M. PDE5 Inhibitors. Updated 2023 Apr 10. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/.
  6. Ng M, Baradhi KM. Benign Prostatic Hyperplasia. Updated 2022 Aug 8. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558920/.
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