What is Tadalafil?
Tadalafil is a prescription-only medication used to help men with erectile dysfunction (ED). The medicine contains the active ingredient tadalafil, which belongs to a class of medicines known as Phosphodiesterase type‑5 inhibitors (PDE-5 inhibitors).
Tadalafil was first approved to treat erectile dysfunction in 2003. It was first approved in the United States by the U.S. Food and Drug Administration (FDA) under the name Cialis, and was developed by Eli Lilly and Company. At the same time, tadalafil was also approved in Europe by the European Medicines Agency (EMA) and national authorities like the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK.
When the patent for Cialis expired, other pharmaceutical companies were permitted to manufacture generic medicines with tadalafil. Tadalafil contains the same active ingredient at the same strength as Cialis and therefore provides the same therapeutic effect at a lower cost.
Tadalafil is intended for adult men who experience erectile dysfunction (ED) — the persistent inability to get an erection or maintain erections sufficient for satisfactory sexual activity. By relaxing the smooth muscles in the blood vessels, Tadalafil improves blood flow to the penis, which supports the natural erection process.
It is also approved to treat benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate that can cause urinary symptoms, and in higher-dose formulations for pulmonary arterial hypertension.
Key Facts About Tadalafil
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Dosages |
10 mg and 20 mg |
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Recommended starting dose |
10 mg |
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Maximum dose |
20 mg |
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Dose timing |
30-60 minutes before sexual activity |
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Effect duration |
4-6 hours |
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Condition |
Requires sexual stimulation |
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Minimum interval between doses |
24 hours |
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Taking with food |
With or without food. Avoid grapefruit |
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Tadalafil and alcohol |
Only small amounts recommended (1–2 drinks) |
How does Tadalafil work?
Tadalafil belongs to the group of PDE-5 inhibitors, just like Sildenafil, Vardenafil and Avanafil.
Tadalafil inhibits the enzyme PDE-5, so that the messenger substance cGMP remains active in the penis for longer – this keeps the blood vessels dilated, increasing blood flow in the penis, which allows for a stronger and longer-lasting erection during sexual arousal.
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Onset of action |
Duration of effect |
|---|---|
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After 30 to 60 minutes |
Up to 36 hours |
The exceptionally long duration is what distinguishes tadalafil from other ED treatments. However, tadalafil tablets, like all ED medicines, can only help treat erectile dysfunction when a man is sexually aroused.
Tadalafil Dosages
Tadalafil is available in four strengths — 2.5 mg, 5 mg, 10 mg, and 20 mg — each corresponding to a specific use and dosing regimen.
Tadalafil 10mg is the standard starting dose for on-demand use. If this proves insufficiently effective, the dose can be increased to 20 mg. For men who experience side effects at 10 mg, a reduction to 5 mg on-demand is also an option, though at this level, it is approaching the lower end of therapeutic efficacy for most men.
Tadalafil 2.5mg and 5mg doses are intended for daily continuous use. The 2.5 mg dose is typically the starting point for the daily regimen, with the option to increase to 5 mg if the response is inadequate. At these doses, tadalafil maintains a steady concentration in the bloodstream, removing the need to time the tablet around sexual activity.
Tadalafil 5 mg daily dose is also the standard dose used for benign prostatic hyperplasia, either alone or in combination with erectile dysfunction treatment.
Regardless of regimen, only one dose should be taken within any 24-hour period.
How to buy Tadalafil in the UK?
Tadalafil is a prescription only medication. This applies to both Cialis and all generic Tadalafil products. To buy tadalafil, consult a doctor who will determine whether the treatment is appropriate and safe.
This also applies if you want to purchase Tadalafil online in the UK. Reputable healthcare platforms where you can order Tadalafil online always require a medical consultation before prescribing it.
Ordering tadalafil online from non-verified websites increases the risk of counterfeit medicines, which may be ineffective or dangerous.
Steps to buy Tadalafil online safely
When ordering tadalafil online, it is important to choose a reliable and regulated provider. Medicines for erectile dysfunction should only be supplied following a medical assessment to ensure they are suitable for your health condition and compatible with any other medications you may be taking.
Before placing an order for tadalafil tablets, check that the platform works with licensed doctors and registered pharmacies, requires a health questionnaire or consultation, and clearly provides information about the medicine, dosage and possible side effects. Trusted providers also use secure payment systems and discreet delivery, while avoiding unrealistic claims or unusually low prices that may indicate counterfeit products.
Here are the steps to follow when you buy tadalafil online:
1. Choose the product and dosage
Select the tadalafil product and dosage that best suits your needs from the available options.
2. Complete the medical questionnaire
Fill in an online health questionnaire. This allows a licensed doctor to assess whether tadalafil is suitable for you.
3. Online doctor review and prescription
A qualified healthcare professional reviews your information. If appropriate, an e-prescription is issued for the medication. Alternatively, you can redeem a paper prescription for tadalafil tablets issued by your GP by sending it to the pharmacy for verification and dispensing.
4. Secure order and payment
Confirm your order and complete the payment through the secure checkout system.
5. Pharmacy dispensing and delivery
A partner pharmacy prepares and dispatches the medication to your address in discreet packaging.
6. Receive your medication
Your tadalafil order is delivered directly to your home, allowing you to start using the medication as prescribed.
Prescription Requirements
You can only get Tadalafil with a prescription from a doctor in the UK. You can get it from your GP, a private doctor, or an online healthcare platform.
One exception is Cialis Connect (tadalafil 5 mg), which, along with Viagra Connect, is available from pharmacies without a GP prescription, but only if a pharmacist has checked you out. You'll still need a prescription from a doctor for higher doses of tadalafil (10 mg and 20 mg).
Patients should be careful of websites offering tadalafil without checking with their doctor first, as this is against the law in the UK, and there is a risk of getting fake or low-quality medicine.
How to take Tadalafil tablets correctly?
- Take tadalafil pills with a glass of water 30–60 minutes before sexual activity
- Take no more than one dose in 24 hours
- Do not exceed the maximum dose of tadalafil in 24 hours – 20 mg
- Sexual stimulation is required for the medicine to work
- Avoid drinking grapefruit juice when taking tadalafil
Common mistakes when using Tadalfil for erectile dysfunction treatment
The most common mistake is giving up after one disappointing experience. A first attempt can easily be undermined by anxiety, alcohol, lack of stimulation, or poor timing around food. Most guidelines suggest trying tadalafil on at least four to six occasions before concluding it is not working.
Taking the wrong dose is another frequent issue. Men who see limited results on 10 mg may simply need the 20 mg dose. While others take more than prescribed, assuming it will work faster or better, it will not, and side effects of tadalafil become more likely.
Grapefruit and grapefruit juice should be avoided while taking tadalafil, as they inhibit the CYP3A4 enzyme responsible for breaking down the medication, which can cause tadalafil levels in the bloodstream to rise unpredictably and increase the risk of side effects.
It is also worth remembering that tadalafil does make you get an erection automatically. Sexual stimulation is always required; the medication enhances the body's natural response rather than replacing it.
Finally, not disclosing all current medications to a prescriber — particularly recreational drugs such as poppers — is a serious and avoidable mistake.
Who is Tadalafil suitable for?
Tadalafil is suitable for adult men diagnosed with erectile dysfunction who are looking for an effective, well-tolerated oral treatment.
It is also a good fit for men who have tried sildenafil but found the timing requirements around food and the shorter duration of action restrictive. Because of its flexible dosing options, it tends to suit a wide range of lifestyles — from men who are sexually active occasionally and prefer an on-demand tablet, to those who are more regularly active and would benefit from the simplicity of a daily low dose.
Men who experience performance anxiety may also find the daily regimen beneficial, as it removes the psychological association between taking a tablet and initiating sex.
It is particularly well-suited to men who have both erectile dysfunction and benign prostatic hyperplasia, as the 5 mg daily dose addresses both conditions simultaneously.
Who can not take Tadalafil?
Most healthy adult men can take tadalafil safely, provided it is taken under medical guidance and as indicated. However, it is not suitable for everyone.
Men with severe cardiovascular conditions, particularly those for whom sexual activity itself is inadvisable, such as those with unstable angina or poorly controlled heart failure or uncontrolled high blood pressure, should not take tadalafil. It is also contraindicated in men taking nitrates in any form, as the combination can cause a dangerous and potentially life-threatening drop in blood pressure. The same applies to riociguat, used for pulmonary hypertension.
Men with severely impaired liver or kidney function require careful assessment before use, and those with a history of priapism, certain rare eye conditions such as non-arteritic anterior ischaemic optic neuropathy (NAION), or hereditary degenerative retinal disorders should discuss the risks with their doctor beforehand.
Tadalafil is not indicated for use in women or in men under 18. Older men can generally take it safely, though they may be more sensitive to its blood-pressure-lowering effects and are more likely to be on medications that could interact with it. A doctor's assessment is therefore especially important in this group.
Side effects of Tadalafil - what to expect?
Tadalafil is generally well tolerated, but because it works by relaxing blood vessels and affecting blood flow throughout the body — not exclusively in erectile tissue — its effects are not always confined to where they are wanted. This systemic vasodilation is the root cause of most side effects reported with tadalafil, and understanding this helps explain why symptoms such as headaches or flushing occur at all.
The majority of men who do experience side effects when taking tadalafil describe them as mild and short-lived, typically appearing within the first few hours after taking a dose and settling without any treatment. That said, the picture varies from person to person: dose, individual physiology, and whether tadalafil is taken occasionally or as a daily low-dose regimen all influence how the medication is experienced. Some men experience no side effects whatsoever, while in rare cases, more serious reactions can arise that warrant stopping the medication and seeking medical advice.
Common Side Effects
Common tadalafil side effects may occur in between 1 in 10 and 1 in 100 patients. These effects are usually mild and tend to improve as the body adjusts to the medicine.
Typical side effects include headache, back pain, muscle pain, pain in the arms or legs, facial flushing, nasal congestion, and digestive discomfort such as indigestion or acid reflux.
Serious side effects – when to seek help
Although serious side effects with tadalafil are uncommon, they do occur in a small number of men and require immediate medical attention when they do. Knowing what to watch for — and acting promptly — can prevent lasting harm.
Priapism is a prolonged painful erection lasting more than four hours that is unrelated to sexual stimulation and does not subside. Despite its appearance, this is not a sign of the medication working well — it is a medical emergency. Priapism is rare with tadalafil but occurs because the drug's vasodilatory effects can, in susceptible individuals, trap blood in the erectile tissue. Without prompt treatment, permanent damage to penile tissue and long-term erectile dysfunction can result.
Sudden loss of vision or hearing is a rare but serious reaction that has been reported with PDE5 inhibitors as a class. Visual disturbances may indicate non-arteritic anterior ischaemic optic neuropathy (NAION), a condition involving reduced blood flow to the optic nerve. Sudden hearing loss or tinnitus has also been reported, though a direct causal link remains under investigation. If you have either of these symptoms, you should stop taking tadalafil right away and consult a doctor immediately.
Chest pain during or after sexual activity should never be dismissed as exertion-related. It may signal a cardiac event, and the additional cardiovascular demand of sexual activity combined with tadalafil's blood-pressure-lowering effect can be a contributing factor in men with underlying heart disease. Men experiencing chest pain should stop all activity, avoid taking nitrates — as this combination can cause a severe blood pressure drop — and call emergency services.
Allergic reactions, including swelling of the face, lips, tongue or throat, skin rash, or difficulty breathing, are rare but can indicate a serious hypersensitivity response. Any signs of anaphylaxis require immediate emergency treatment.
Severe dizziness or fainting may indicate a significant drop in systemic blood pressure, known as hypotension. This is more likely in men who are also taking alpha-blockers, antihypertensives, or who have consumed alcohol, as these can compound tadalafil's vasodilatory effect. If this occurs, lying down and seeking medical help promptly is advisable.
The lower the dosage of Tadalafil, the lower the risk of side effects and the shorter their duration.
For detailed safety information, refer to the official package leaflet.
Taking Tadalafil pills with other medicines
Tadalafil may interact with some other medicines.
You must not take tadalafil with nitrates.
Special care should be taken with the following medicines:
- Alpha blockers
- Other medicines for treating high blood pressure
- Riociguat
- 5-alpha reductase inhibitors
- Ketoconazole and protease inhibitors
- Phenobarbital, phenytoin and carbamazepine
- Rifampicin, erythromycin, clarithromycin or itraconazole
- Other medicines used to treat erectile dysfunction
Experiences with Tadalafil
Tadalafil impresses many users with its long duration of action and good tolerability.
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Although some men report negative experiences with Tadalafil due to side effects, they say that the effect on erections is worth it.
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Tadalafil vs other erectile dysfunction treatments
Tadalafil is one of several effective ED treatments. While all PDE5 inhibitors share the same basic mechanism of action, they are not interchangeable in practice. Differences in how quickly they take effect, how long they last, how food and alcohol influence their absorption, and how they fit into daily life mean that the right choice varies from one man to the next.
Sildenafil vs Tadalafil
Sildenafil (or branded Viagra) and tadalafil are both PDE5 inhibitors and remain the two most widely used treatments for erectile dysfunction, but they suit different lifestyles and preferences. Sildenafil acts relatively quickly — within 30 to 60 minutes — but requires some planning around meals, as fatty food can delay its absorption and blunt its effect. Its window of action is around four to six hours, making it better suited to occasions where timing can be anticipated.
Tadalafil, by contrast, offers considerably more flexibility. The active ingredient tadalafil is known for its extended duration of action. Its effects can last up to 36 hours, removing much of the pressure around timing, and it is largely unaffected by food. For men who find the on-demand approach to sildenafil disruptive or anxiety-inducing, tadalafil's longer duration often feels more natural.
In terms of side effects, both are broadly similar, though sildenafil is more commonly associated with visual disturbances — a bluish tint or increased light sensitivity — due to its mild inhibition of PDE6 in the retina, an effect tadalafil does not share. Tadalafil, on the other hand, is more frequently associated with muscle aches and back pain, thought to be related to PDE11 inhibition.
Comparison with Vardenafil & Avanafil as Tadalafil alternatives
Vardenafil (Levitra) and avanafil (Spedra) are two other options that are not talked about as much, but are just as important. They work in a similar way to sildenafil and tadalafil, but are better for some men.
Vardenafil is structurally similar to sildenafil and shares a comparable duration of action of around four to six hours. Vardenafil typically starts working within 25–60 minutes after taking the tablet. Tadalafil may begin to work within a similar timeframe, but in some men it can take slightly longer. Vardenafil is also available in an orodispersible tablet formulation (Levitra orodispersible), which dissolves on the tongue and may be absorbed somewhat faster — a practical option for men who have difficulty swallowing tablets or prefer a discreet format.
Avanafil (Spedra) stands apart from the other PDE5 inhibitors primarily through its speed of onset. It is the fastest-acting oral tablet in its class, with some men responding within 15 minutes, and most within 30. This is due to its high selectivity for PDE5 over other phosphodiesterase enzymes, which allows it to act more efficiently with fewer off-target effects. As a result, avanafil tends to have a cleaner side effect profile overall, with lower rates of flushing and visual disturbances compared to tadalafil and sildenafil. The principal drawback is cost — avanafil remains available only as a branded product, Spedra, in most markets, including the UK, making it considerably more expensive than it might be with a generic version.
Tadalafil daily vs on-demand as ED treatments
Tadalafil is the only ED medication available in two dosing formats, and choosing between them largely comes down to how frequently a man is sexually active and how much timing matters to him.
On-demand Tadalafil 10mg or 20mg is taken an hour or so before sexual activity. Thanks to its long half-life, it remains effective for up to 36 hours, meaning there is no pressure to be precise about timing, unlike sildenafil or vardenafil. It is a practical choice for men who are sexually active occasionally and prefer to take medication only when needed.
Daily tadalafil (2.5 mg or 5 mg), also its branded version Cialis Daily, is taken every day regardless of planned sexual activity, maintaining a constant level of the drug in the bloodstream. This removes the need to take a tablet in anticipation of sex altogether, which many men find reduces performance anxiety and feels more natural. It is particularly well-suited to men who are sexually active several times a week, those who also have benign prostatic hyperplasia, or those who simply prefer to separate medication from the moment entirely.
The main trade-off with daily dosing is cost, as tablets are taken on days when they may not be needed. For men who are sexually active infrequently, on-demand dosing is the more economical option. Both approaches are equally effective; the right choice is simply the one that fits best with how a man lives.
Is Tadalafil useful for premature ejaculation?
Tadalafil is not approved for premature ejaculation (PE) and should not be presented as a treatment for it. However, in men who experience both PE and erectile dysfunction, improved erectile confidence and reduced performance anxiety from tadalafil may indirectly help with ejaculatory control — this is a psychological benefit rather than a direct pharmacological effect.
Where both conditions are present, some evidence supports combining tadalafil with dapoxetine — the only licensed medication for PE — for better outcomes than either drug alone.
For men with PE but no erectile dysfunction, dapoxetine, certain SSRIs used off-label, or topical anaesthetic agents are the appropriate evidence-based options. A doctor is best placed to assess which approach suits the individual.
How to store tadalafil?
Tadalafil should be stored at room temperature, below 25°C, in its original packaging and kept away from moisture and direct sunlight. It should be kept out of reach of children and never stored in a bathroom cabinet, where heat and humidity can degrade the medication.
Patient information leaflet
Package leaflet of Tadalafil 10mg for download.
Package leaflet of Tadalafil 20mg for download.
