Tadalafil
Also called Cialis; Adcirca (for pulmonary hypertension)
An FDA-approved PDE5 inhibitor for erectile dysfunction and enlarged-prostate symptoms. It lasts up to 36 hours, much longer than sildenafil.
Overview
What it is
A small-molecule prescription drug, not a peptide, sold as Cialis and as generic tablets. It is taken either as needed before sex or as a low dose every day.
How it works
Sexual arousal releases nitric oxide, which raises cGMP and relaxes the smooth muscle of the penis so blood can flow in. PDE5 breaks down cGMP. Tadalafil blocks PDE5, so the signal lasts longer. It does not cause an erection without arousal.
What the research shows
Approved by FDA in 2003 for erectile dysfunction after placebo-controlled trials in thousands of men, including men with diabetes. Daily dosing was later approved for erectile dysfunction and for urinary symptoms of benign prostatic hyperplasia (BPH). Its half-life is about 17.5 hours. Label dosing is 10 mg as needed (range 5 to 20 mg, no more than once a day) or 2.5 to 5 mg once daily.
Studied for
- Erectile dysfunctionFDA approved
- Urinary symptoms of BPHFDA approved, daily dosing
- Pulmonary arterial hypertensionFDA approved as Adcirca
Safety and regulatory status
Safety and side effects
Never combine with nitrates such as nitroglycerin, or with riociguat: blood pressure can drop dangerously. Use caution with alpha-blockers and alcohol. Common effects are headache, indigestion, back pain, muscle aches, flushing and stuffy nose. Seek emergency care for an erection lasting over 4 hours, or sudden loss of vision or hearing.
Regulatory status
FDA approved prescription medicine (Cialis, generics). Requires a prescription.
Common questions
How is tadalafil different from sildenafil (Viagra)?
They work the same way, but tadalafil lasts up to 36 hours versus about 4 hours for sildenafil, and food has little effect on it. It can also be taken at a low dose every day.
Is generic tadalafil the same as Cialis?
Yes. Generics contain the same active ingredient and must meet FDA standards for strength and how the body absorbs it.
Can I take it with blood pressure medicine?
Many people can, but nitrates are never safe with it, and alpha-blockers need dose care. Your provider checks every medicine you take.