Tadalafil

Generic Tadalafil: A Complete Buyer's Guide

Tadalafil is the active ingredient in the brand-name medicine Cialis. Generic tadalafil contains the same active ingredient in the same strengths. It is made by pharmaceutical companies once the original patent has expired, which is why it usually costs a fraction of the branded price. Its long duration of action sets it apart from other erectile dysfunction (ED) medicines. That gives men more freedom around timing and less pressure to plan intimacy around a tablet.

How Tadalafil Works

An erection depends on healthy blood flow into the penis. When a man is sexually aroused, the body produces a chemical messenger called cGMP, which relaxes the blood vessels and allows the erectile tissue to fill with blood. An enzyme called phosphodiesterase type 5 (PDE5) breaks cGMP down again, ending the erection.

Tadalafil is a PDE5 inhibitor. By slowing this enzyme, it lets cGMP build up during arousal, making it easier to get and keep an erection firm enough for sex. It does not cause an erection by itself or increase sexual desire. Arousal and stimulation are still needed. Once sexual activity ends, the erection subsides normally.

Tadalafil stays in the body much longer than similar medicines. Its half-life is roughly 17.5 hours, so a single dose can support erections for up to 36 hours.

What Tadalafil Is Used For

• Erectile dysfunction: either taken as needed before sexual activity, or as a low dose once daily.
• Benign prostatic hyperplasia (BPH): a 5 mg daily dose relaxes smooth muscle in the prostate and bladder neck, easing symptoms such as a weak stream, frequent urination and getting up at night to pass urine. It can treat ED and BPH together.
• Pulmonary arterial hypertension (PAH): prescribed by specialists at a different dose, under brand names such as Adcirca, to improve exercise capacity.

Tadalafil Strengths and Formats

All formats contain the same active ingredient. The difference is mainly convenience and how the medicine is taken.

How to Take Tadalafil

As-needed use

• The usual starting dose is 10 mg, taken before sexual activity. A doctor may lower it to 5 mg or raise it to 20 mg depending on how well it works and how well it is tolerated.
• Many men notice an effect within 30 minutes to 2 hours. The window of effect then lasts up to 36 hours.
• Do not take more than one dose in 24 hours. The recommended maximum for ED is 20 mg per day. Higher strengths offer little extra benefit and increase the risk of side effects.

Once-daily use

• For ED, the usual daily dose is 2.5 mg, which may be increased to 5 mg. For BPH, or ED with BPH, it is 5 mg daily.
• Take it at around the same time every day, whether or not you plan sexual activity.
• If you miss a dose, take it when you remember the same day. Never take two doses on one day to catch up.

Food and alcohol

Unlike some other ED medicines, tadalafil can be taken with or without food. Meals do not meaningfully change how well it works. Heavy drinking, however, can make dizziness, a fast heartbeat and low blood pressure more likely, and alcohol itself can make erections harder to achieve. Keep alcohol to a moderate level.

Possible Side Effects

Most side effects are mild and tend to settle as the body gets used to the medicine. The most frequently reported include:

• Headache
• Indigestion or acid reflux
• Back pain and aching muscles, typically 12–24 hours after a dose
• Flushed face
• Blocked or runny nose
• Pain in the arms or legs
• Dizziness

Stop taking tadalafil and get medical help immediately if you experience:

• An erection lasting longer than 4 hours, or a painful erection (priapism)
• Sudden loss or dimming of vision in one or both eyes
• Sudden decrease or loss of hearing, or ringing in the ears
• Chest pain, fainting or an irregular heartbeat, especially during or after sex
• Swelling of the face, lips or throat, rash or difficulty breathing

Safety: When Tadalafil Is Not Suitable

Never combine tadalafil with

• Nitrates for angina, such as nitroglycerin (glyceryl trinitrate) (GTN) spray or tablets, isosorbide mononitrate or dinitrate. The same applies to recreational "poppers" (amyl nitrite). This combination can cause a life-threatening fall in blood pressure. Because tadalafil lasts so long, at least 48 hours should pass after a dose before a nitrate is given.
• Riociguat, used for some forms of pulmonary hypertension
• Other PDE5 inhibitors, including sildenafil, vardenafil or avanafil

Tell your doctor if you take

• Alpha-blockers (such as tamsulosin, doxazosin or alfuzosin) or other blood pressure medicines
• Certain antifungals (ketoconazole, itraconazole), antibiotics (clarithromycin, erythromycin) or HIV medicines (such as ritonavir). These raise tadalafil levels, so a lower or less frequent dose is usually needed.
• Rifampicin or some anti-seizure medicines, which can make tadalafil less effective

Grapefruit juice can also raise tadalafil levels and is best avoided.

Medical conditions that need a doctor's review first

• Heart disease, a heart attack or stroke in the last 6 months, or heart failure
• Very low blood pressure, or high blood pressure that isn't controlled
• Kidney or liver problems, which may need a lower maximum dose
• Previous sudden vision loss (NAION) or the inherited eye condition retinitis pigmentosa
• Conditions that raise the risk of priapism, such as sickle cell disease, leukaemia or multiple myeloma, or a deformed penis (e.g. Peyronie's disease)

Tadalafil or Sildenafil?

Both medicines work in the same way and are similarly effective. The key difference is timing. Sildenafil works for around 4–6 hours and can be slowed by a heavy meal. Tadalafil lasts up to 36 hours, isn't affected by food, and can be taken daily. For a detailed side-by-side comparison, read our guide: Sildenafil vs Tadalafil: Key Differences, Dosage and Which One to Choose, or browse our sildenafil range.

Storage

Keep tadalafil in its original packaging at room temperature (below 25–30°C), away from moisture, heat and direct sunlight, and out of the reach of children. Don't use tablets after the expiry date.

Frequently Asked Questions

Is generic tadalafil as effective as Cialis?

Generic tadalafil contains the same active ingredient as Cialis and is designed to work the same way. The inactive ingredients, shape and color may differ.

How long does tadalafil last?

A single as-needed dose can support erections for up to 36 hours. With daily dosing, the level of tadalafil in the body stays fairly constant, so there's no need to time a tablet.

Is a higher strength like 40 mg or 60 mg better?

Not usually. For ED, the recommended maximum is 20 mg in 24 hours. Going above this mainly increases side effects such as headache, back pain and dizziness. If 20 mg isn't working, speak to a doctor rather than increasing the dose yourself.

Can I take tadalafil every day?

Yes, but only as the low-dose daily regimen (2.5–5 mg). Taking 10–20 mg every day is not the same thing and is not recommended unless a doctor advises it.

Why isn't tadalafil working for me?

Common reasons include not allowing enough time after the first dose, lack of sexual stimulation, heavy drinking, anxiety, or an underlying condition such as diabetes, low testosterone or vascular disease. Many men need to try it on several occasions before judging the result. Speak to a doctor if it still isn't effective.

The information on this page is for general education and does not replace advice from a doctor or pharmacist. Tadalafil is a prescription medicine. Always confirm it is safe for you before use, particularly if you have a heart condition or take other medicines.