Tadalafil is a prescription-only medication used to treat erectile dysfunction (ED) and is the generic, more affordable version of Cialis. As a PDE-5 inhibitor, it works by enhancing blood flow to the penis, making it easier to achieve an erection when aroused, especially if you experience difficulties getting one normally.

Tadalafil works similarly to Viagra and Cialis by containing the active ingredient tadalafil, a phosphodiesterase type 5 (PDE-5) inhibitor. PDE-5 inhibitors help relax the blood vessels in the penis, improving blood flow and making it easier to get an erection when aroused. It does this by blocking an enzyme that limits blood flow to the penis.

Like other erectile dysfunction treatments, tadalafil will not work without arousal. Engaging in foreplay can help enhance its effectiveness.

How long does tadalafil last?

Tadalafil’s effects can last up to 36 hours, earning it the nickname ‘Weekend Pill’. During this time, it can help you get an erection when sexually aroused. It does not mean an erection will last 36 hours, but rather it enhances your ability to get and maintain an erection when aroused during this period.

For daily use, lower doses (2.5mg or 5mg) are available. These are designed to be taken daily, ensuring the medication is always active, so you're ready for sex whenever you're aroused.

However, tadalafil doesn’t affect how long it takes you to orgasm. If premature ejaculation is a concern, it may be helpful to explore techniques or treatments specifically for this issue, as it can sometimes be linked to erectile dysfunction.

How long does tadalafil take to work?

Tadalafil typically takes 30 to 60 minutes to start working. You should take one tablet with water 30 to 60 minutes before sexual activity to give the medication time to be effective.

For frequent sex (more than twice a week), a lower daily dose (2.5mg or 5mg) might be more convenient. By taking a lower dose daily, the effects are always active, so you’re ready for sex when aroused.

How effective is tadalafil?

Clinical studies show tadalafil is highly effective for treating erectile dysfunction (ED):

• 86% of patients with mild ED reported improvement.
• 83% of patients with moderate ED reported improvement.
• 72% of patients with severe ED reported improvement.

Additionally, 75% of intercourse attempts were successful in patients treated with tadalafil, compared to only 32% with a placebo.

Other studies have found that 70% of daily tadalafil users were satisfied with the treatment, with 83.1% appreciating the convenience of a daily dose.

To use tadalafil 10mg or 20mg, swallow one tablet whole with a glass of water at least 30 to 60 minutes before sex. This allows the medication time to take effect.

For lower doses (2.5mg or 5mg), take one tablet daily at the same time each day. This ensures the medication is always active, making it easier to have spontaneous sex without needing to plan ahead. This is ideal if you have sex twice a week or more.

Tips for best results:

• Avoid heavy or fatty meals before taking tadalafil, as they can slow down its absorption.
• Limit alcohol as it can reduce tadalafil’s effectiveness and increase the risk of side effects.
• Ensure arousal: Tadalafil will only work if you’re sexually aroused. Make sure to engage in foreplay for the best results.

How often to take tadalafil:

• Daily doses (2.5mg and 5mg) are taken at the same time each day if you have sex twice a week or more.
• On-demand doses (10mg and 20mg) should be taken 30 to 60 minutes before sex.

Do not take more than one tablet per day. Taking multiple doses in a day will not improve the chances of getting an erection and may lead to serious side effects.

There are 4 doses of tadalafil. 2 daily doses and 2 doses that you take before sex (on demand). Daily doses can be a better choice if you have sex on more than 2 different days a week. Otherwise, on demand doses might be more suitable.

If you are unsure about what dose is right for you, speak with a doctor. You must also check with a doctor before switching the dose of any medication.

Daily dosages:

1. Tadalafil 2.5mg

The lowest dosage of tadalafil is 2.5mg. You can try this dose if you’ve already tried 5mg and it worked well but gives you some mild side effects. This dose is slightly less effective than 5mg, but has a lower chance of side effects overall.

2. Tadalafil 5mg

The standard daily dose is 5mg. Your doctor may recommend this dosage first if you have not tried a daily dosage of tadalafil before.

Before sex dosages:

1. Tadalafil 10mg

Tadalafil 10mg is the standard on demand dose. Your doctor may recommend this dose if you haven’t tried tadalafil before.

2. Tadalafil 20mg

Tadalafil 20mg is the higher-strength on demand dose. You may be recommended this dose if 10mg does not work for you and you don’t get any serious side effects. Although this dose is slightly more likely to work than 10mg, it has a higher risk of side effects.

Can I buy tadalafil online?

You can request tadalafil from online doctor services like Superdrug Online Doctor by simply following the instructions below:

1. Fill out a short medical questionnaire about your health.
2. Request and pay for treatment.
3. One of our online doctors will review your questionnaire and will approve you for treatment if it is suitable.
4. Your order will be delivered to your address or you can collect it at your local Superdrug Pharmacy.
5. If your order is not approved, your payment will be refunded and you will be notified by one of our doctors in your account.

With Superdrug Online Doctor there are no face-to-face appointments, only discreet online consultations and deliveries.

Can I buy tadalafil over the counter?

No, tadalafil is only available by prescription. Tadalafil is a generic (unbranded and cheaper) version of Cialis, which is also only available by prescription.

The over-the-counter alternative to Cialis and tadalafil is Cialis Together. Similar to tadalafil 10 and 20 mg doses, Cialis Together should be taken at least 30 to 60 minutes before sex and lasts up to 36 hours.

Can I get tadalafil on the NHS?

Yes, you can get tadalafil on the NHS by speaking with your regular GP and they may prescribe it if you meet the requirements. Alternatively, you can order tadalafil online from online doctor services like Superdrug Online Doctor by filling in a quick medical questionnaire.

Like with all medications, there are side effects that can be caused by taking tadalafil, but many people have no side effects or only minor ones. The risk of side effects increases with higher doses of tadalafil. If you have any concerns about side effects when taking tadalafil, speak with a doctor.

Common side effects (may affect 1 in 10 people):

• headache
• back pain
• muscle aches
• pain in arms and legs
• facial flushing
• nasal congestion
• indigestion

Uncommon side effects (may affect up to 1 in 100 people):

• dizziness
• stomach ache
• nausea
• vomiting
• reflux
• blurred vision
• eye pain
• difficulty breathing
• blood in urine
• prolonged erection
• pounding heartbeat sensation
• fast heart rate
• high blood pressure
• low blood pressure
• nose bleeds
• ringing in ears
• swelling of the hands, feet, or ankles
• tiredness

For rare and serious side effects please refer to the patient information leaflet that comes with your medication.

How long do tadalafil side effects last?

Tadalafil side effects usually go away when you stop taking the tablets. Speak with a doctor or pharmacist if a side effect is affecting your daily life or does not go away. Since tadalafil can last up to 36 hours, side effects may last this long, although they might ease off as time goes on.

What to do if you get tadalafil side effects

If you are experiencing common, mild side effects of tadalafil such as a headache, facial flushing (going red in the face) or nasal congestion, these symptoms should pass within a few days or less.

To manage and ease your symptoms at home, we recommend for:

• facial flushing: keep the room cool, or sip cold water, avoid alcohol and caffeinated drinks
• headaches: ask your pharmacist to recommend a painkiller, and drink plenty of fluids
• nasal congestion: ask your pharmacist to recommend a nasal spray
• feeling sick: avoid spicy or fatty foods, eat smaller portions

If you are experiencing muscle aches you should speak with your pharmacist. Speak with a doctor if a side effect is affecting your daily life or does not go away.

If you are experiencing serious side effects like:

• a sudden loss of vision or sudden problems with hearing
• a prolonged or painful erection (especially if it lasts for more than 2 hours)

Stop taking tadalafil and go to A&E straight away.

Call 999 if you have:

• a seizure or fit
• chest pain (if you get chest pain during or after sex and you usually use nitrates, do not take them to treat your chest pain)
• a serious allergic reaction (symptoms include fainting, drowsiness, your skin, tongue, or lips turning blue, grey or pale, your throat feels tight, you’re struggling to breathe, or have a rash that’s swollen, raised, and itchy)

Stop taking tadalafil if you get any of these symptoms.

If you have any concerns about particular side effects, speak with a doctor.

You must speak with a doctor or pharmacist before taking tadalafil tablets.

Be aware that sexual activity carries a possible risk to patients with heart disease because sexual activity puts an extra strain on your heart. If you have a heart problem you should speak to your doctor.

Tadalafil 5mg only

Your doctor may check you for prostate cancer before starting treatment with tadalafil because benign prostatic hyperplasia and prostate cancer may have the same symptoms. Tadalafil tablets do not treat prostate cancer.

Before taking tadalafil, tell your doctor if you have any of the following:

• sickle cell anaemia
• multiple myeloma
• leukaemia
• any deformation of your penis
• a serious liver problem
• a severe kidney problem

It is unknown if tadalafil is effective in patients who have had:

• pelvic surgery
• removal of all or part of the prostate gland in which nerves of the prostate are cut (radical non nerve-sparing prostatectomy)

If you experience a decrease or loss of vision, or if your vision is distorted or dimmed while you are taking tadalafil, stop taking the tablets and speak with your doctor immediately.

Decreased or sudden hearing loss has been noted in some patients taking tadalafil. Although it is not known if this is directly related to taking tadalafil, if you experience decreased or sudden hearing loss, stop taking tadalafil tablets and speak with your doctor immediately.

Tadalafil is not suitable for use by:

• women
• children and adolescents under the age of 18

Interactions with other medicines

Tadalafil may react with other medications, to be safe, be sure to let your doctor know if you are taking, have recently taken, or are planning to take any other medication.

Tell your doctor if you are already taking:

• nitrates (poppers)
• an alpha blocker (used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia)
• other medications to treat high blood pressure
• riociguat
• a 5-alpha-reductase inhibitor (used to treat benign prostatic hyperplasia)
• medicines such as ketoconazole tablets (to treat fungal infections)
• protease inhibitors (for treatments of AIDS or HIV)
• phenobarbital, phenytoin and carbamazepine (anticonvulsant medicines)
• rifampicin, erythromycin, clarithromycin or itraconazole
• other erectile dysfunction treatments

Can I split tadalafil tablets?

No, you must swallow the tablet whole. If you have any particular questions about how to take this medication, speak to your doctor.

How should tadalafil be stored?

You should store tadalafil in its original blister pack, in its carton. Keep the medication in an area below 30°C and away from sunlight and moisture. Do not use it after the expiry date.

Is tadalafil as strong as Viagra?

Viagra contains the active ingredient sildenafil, whereas tadalafil contains tadalafil. While both start working within 30 to 60 minutes, tadalafil is effective for longer (up to 36 hours) compared to Viagra (up to 4 hours). Sildenafil has higher dosage numbers, but this doesn’t mean it is a stronger medication overall. For a longer-lasting medication that you can take without planning when to take your medication before sex, you may want to choose tadalafil or tadalafil daily.

Is tadalafil better than Cialis?

Tadalafil and Cialis have the same active ingredient. Cialis is a branded and more expensive version of the generic tadalafil. We do not recommend one over the other. Both are safe so long as a doctor approves of either treatment for you.

Can I drink alcohol while taking tadalafil?

To get the most benefit from tadalafil, do not drink lots of alcohol as it may make it more difficult for you to get an erection. Your patient information leaflet that comes with your medication will provide more specific guidance on alcohol use with tadalafil.

Will tadalafil affect my fertility?

Two studies have shown decreases in sperm count in patients treated with tadalafil. These effects are unlikely to lead to a lack of fertility long-term and the benefits of being able to get and keep an erection for sex, especially if you’re trying for a baby, is likely to outweigh these risks. If you have any concerns about fertility when taking tadalafil, speak with a doctor or pharmacist.

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• Electronic Medicines Compendium (Vardenafil 20 mg). Available at: EMC - Vardenafil 20 mg [Accessed 8th July 2024]
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