Tadalafil: uses, dosages, side effects, and more.
Remote Pharmacy Research Team
May 19, 2025
Tadalafil is a prescription medication used to treat erectile dysfunction (ED) and symptoms of benign prostatic hyperplasia (BPH). It belongs to a class of drugs called PDE5 inhibitors and works by improving blood flow in specific parts of the body.
Known for its long duration of action and flexible dosing options, tadalafil is one of the most common choices for men seeking medical support for sexual performance or urinary symptoms. It’s available in both brand and generic forms and can be taken either daily or as needed, depending on the treatment goal.
In this guide, we explain how tadalafil works, when it’s used, how to take it safely, and what side effects to watch for — so you can make informed decisions with your healthcare provider.
Tadalafil is a prescription medication used to treat erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and in some cases, pulmonary arterial hypertension (PAH). It is part of a class of drugs known as PDE5 inhibitors, which work by relaxing blood vessels and improving blood flow in the body.
Tadalafil is best known by the brand name Cialis, but it is also available in generic form. It is commonly prescribed to men who need medical help achieving or maintaining an erection or who experience urinary symptoms related to prostate enlargement.
What sets tadalafil apart from other ED medications is its long half-life, which allows the drug to remain active in the body for up to 36 hours. It can be taken either on-demand before sexual activity or as a daily low-dose treatment for continuous support.
Tadalafil works by blocking the PDE5 enzyme, which affects blood flow regulation in the body. In men with ED, this action increases blood flow to the penis during sexual stimulation, helping to create and maintain a firm erection.
In men with BPH, tadalafil relaxes smooth muscle tissue in the prostate and bladder, improving urine flow and reducing symptoms such as frequent or difficult urination. The medication helps relieve pressure and improves bladder emptying.
Because tadalafil stays in the bloodstream longer than most ED medications, it offers a wider treatment window and can support more spontaneous sexual activity. Its effects depend on sexual arousal and do not cause automatic erections.
The drug does not affect libido, hormone levels, or fertility. Its primary effect is to support natural function by enhancing the body’s ability to respond to stimulation.
Tadalafil is approved for three medical conditions. Each use is supported by clinical studies and has specific dosing guidelines. Though most known for treating erectile dysfunction, its effects on smooth muscle relaxation make it useful in other areas as well.
Tadalafil is widely prescribed to treat erectile dysfunction. It improves blood flow to the penis during sexual stimulation, helping men achieve and maintain an erection. What makes tadalafil different from other ED medications is its extended duration of action — up to 36 hours, allowing for more flexibility and less timing pressure.
It can be taken either as needed or daily, depending on the patient’s preference and lifestyle. For on-demand use, it's usually taken at 10 or 20 mg, at least 30 minutes before sexual activity. For daily use, lower doses such as 2.5 mg or 5 mg are used to maintain a steady level in the bloodstream.
Tadalafil is also approved to treat urinary symptoms caused by benign prostatic hyperplasia. BPH is a common condition where the prostate becomes enlarged, leading to frequent urination, difficulty starting, or a weak urine stream.
Tadalafil helps by relaxing smooth muscle in the prostate and bladder, improving urine flow and reducing discomfort. The standard dosage for BPH is 5 mg once daily. It is often chosen for men who have both BPH and ED, allowing one medication to treat both conditions.
In some cases, tadalafil is used to treat pulmonary arterial hypertension — a rare condition where high blood pressure affects the arteries in the lungs. In this context, tadalafil helps relax the pulmonary vessels, lowering pressure and improving exercise ability.
The dose for PAH is usually 40 mg once daily, and this use is typically managed under specialist supervision. It is marketed under a different brand name when used for this purpose, and patients are carefully monitored during treatment due to the complexity of the conditions.
Tadalafil dosing depends on the condition being treated, individual response to the medication, and the presence of other health factors. It's important to follow medical advice and avoid self-adjusting the dose, especially when using the drug long-term or in combination with other treatments.
For erectile dysfunction, tadalafil offers two dosing options:
As-needed use: The recommended starting dose is 10 mg, taken at least 30 minutes before sexual activity. Depending on how the patient responds, this may be adjusted to 20 mg or reduced to 5 mg. The maximum frequency is once per day.
Daily use: A lower dose of 2.5 mg or 5 mg once daily, taken at the same time each day, is used to allow for continuous readiness without the need to plan around sexual activity.
As-needed dosing is preferred by men who engage in sexual activity less frequently. Daily use is better for those who prefer flexibility or have ED more regularly.
For benign prostatic hyperplasia, the standard dose is 5 mg once daily, taken at the same time each day. It should be taken consistently, with or without food.
This dosing regimen is intended to reduce urinary symptoms like frequent urination, urgency, or weak stream, and results are typically seen after a few weeks of consistent use.
For men dealing with both ED and BPH, 5 mg once daily is also the standard dose. This dual approach simplifies treatment by addressing both conditions with a single tablet.
Daily dosing supports spontaneous sexual activity while also reducing urinary discomfort caused by prostate enlargement.
For pulmonary arterial hypertension, tadalafil is used at a higher dose: 40 mg once daily, taken with or without food. This use is typically managed under specialist care, and it is not interchangeable with ED or BPH doses.
Patients using tadalafil for PAH are monitored closely due to potential interactions with other medications and the need for precise blood pressure control.
Tadalafil must be used with caution in patients with kidney or liver impairment.
For mild to moderate kidney impairment, the starting dose is usually reduced, and daily dosing may not be recommended depending on function levels.
In severe kidney disease, the medication is typically avoided or used only under strict supervision.
In patients with liver impairment, dosing may also be reduced or avoided, especially if liver function is significantly affected.
Before starting tadalafil, it’s essential to disclose any history of kidney or liver problems so that the provider can adjust the treatment accordingly.
Tadalafil is generally well tolerated, especially when taken at the correct dose. Still, like all medications, it can cause side effects. Some are mild and temporary, while others are more serious and require medical attention.
The most frequently reported side effects of tadalafil include:
These effects usually appear within the first few hours after taking the medication and tend to fade on their own. Back pain and muscle aches may occur 12 to 24 hours after use and usually resolve within 48 hours. Taking the medication with water and avoiding alcohol can reduce discomfort in some cases.
Most men experience no side effects or only mild symptoms, especially when the dosage is appropriate and taken as directed.
Although uncommon, tadalafil may cause serious side effects that require immediate medical evaluation. These include:
These reactions are rare but can be serious. If any of these symptoms occur, treatment should be stopped immediately and a healthcare provider contacted.
Tadalafil should not be combined with nitrates, alpha-blockers, or medications for pulmonary hypertension without proper supervision, as these combinations can cause dangerous drops in blood pressure.
Tadalafil can interact with other medications and medical conditions. These interactions may increase the risk of side effects or reduce the drug’s effectiveness.
One of the most important warnings is for patients who use nitrate medications. Combining tadalafil with nitrates can cause a dangerous drop in blood pressure. The same risk applies to certain alpha-blockers used to treat high blood pressure or prostate issues.
Tadalafil may also interact with:
Patients with heart disease, liver or kidney problems, or vision disorders should discuss their full medical history with a provider before starting tadalafil. Regular use of alcohol may also increase side effects such as dizziness or low blood pressure.
To get the best results with tadalafil while minimizing risks, it’s important to follow a few key practices.
Take the medication exactly as prescribed. Do not exceed the recommended dose or mix with other ED medications. If using the daily version, take it at the same time each day for consistent effect.
Avoid heavy meals and alcohol when using the medication, especially for on-demand doses. These can delay absorption or increase side effects.
Always inform your healthcare provider about all medications, supplements, or herbal products you use. Even over-the-counter drugs can affect how tadalafil works.
Report any unusual side effects, especially if they interfere with vision, hearing, or blood pressure. Early monitoring allows for safe adjustments.
While tadalafil works well for many men, it may not be suitable for everyone. Several other prescription medications are available to treat erectile dysfunction, each with different timing, duration, and side effect profiles.
These include:
For men who don’t respond well to oral medications, other treatments like penile injections, vacuum erection devices, or hormonal therapy may be explored with a specialist.
Choosing the right option depends on the patient’s medical history, goals, and response to treatment. A licensed provider at Remote Pharmacy can help evaluate the best path forward.
If you're ready to explore tadalafil as a safe and effective option for treating erectile dysfunction or urinary symptoms, Remote Pharmacy makes the process simple, private, and convenient.
You’ll begin with a quick online consultation, reviewed by a licensed healthcare provider. If approved, your prescription is processed and shipped directly to your door, no in-person visits or long waits.
Start today and take control of your health with confidence and convenience. Your path to better performance begins here.