Tadalafil

What is tadalafil and what is it used for?

Tadalafil is a medication used to treat[1]: 

• Erectile dysfunction (ED) 

• Benign prostatic hyperplasia (BPH) – an enlarged prostate 

• Pulmonary arterial hypertension (PAH) – high blood pressure in the lungs 

It’s available under brand names like Cialis (for ED and BPH) and Adcirca (for PAH), and can be bought in a pharmacy or prescribed to you by your doctor or pharmacist. 

How does tadalafil work?

Tadalafil belongs to a class of drugs called phosphodiesterase type 5 (PDE5) inhibitors. It works by[1]: 

• Relaxing blood vessels 

• Increasing blood flow to specific areas such as the penis or lungs 

• Helping the bladder and prostate muscles relax (for BPH) 

These effects help improve erectile function, ease urination, and reduce pulmonary pressure.

Who can take tadalafil?

Tadalafil is suitable for most men over 18 for erectile dysfunction and most adults over 18 for pulmonary hypertension, but you should not take it if you[1]: 

• Use nitrate medicines (e.g., for chest pain) 

• Have serious heart or liver problems 

• Have recently had a stroke or heart attack 

• Have low blood pressure 

• Have lost your vision due to reduced blood flow to the eye 

• Have sickle cell anaemia, leukaemia, multiple myeloma, or Peyronie’s disease 

• Have certain eye conditions like retinitis pigmentosa 

• Are allergic to tadalafil 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].

What is the typical dosage of tadalafil?

Tadalafil comes as 2.5mg, 5mg, 10mg, and 20mg tablets. Your dosage depends on the condition being treated[1]: 

• Erectile Dysfunction (ED): 

• 10mg before sexual activity (may increase to 20mg if needed), but you should never take more than one a day or, 

• 2.5mg to 5mg taken once daily 

• Benign Prostatic Hyperplasia (BPH): 

• 5mg once daily 

• Pulmonary Arterial Hypertension (PAH): 

• 40mg once daily (usually as two 20mg tablets) 

Your doctor will recommend the best dose for you. 

How do you take tadalafil?

You can take tadalafil with or without food, and you should swallow whole with water. For ED, take at least 30 minutes before sexual activity. Do not take more than one dose per day[1]. 

Can you stop taking tadalafil?

If you are taking tadalafil for ED it is safe to stop taking at any time. However, if you are prescribed tadalafil for another reason do not stop taking unless told so by your prescriber as the condition it is managing may worsen[1]. 

What if you take too much tadalafil?

Signs of overdose may include[1]: 

• Dizziness 

• Fainting 

• Prolonged or painful erection 

• Stuffy nose 

• Headache 

• Indigestion 

Seek emergency medical help immediately if this happens.

What if you forget a dose of tadalafil?

If you forget to take tadalafil[1]: 

• Daily use: Take as soon as you remember unless it’s close to your next dose 

• As-needed use: Skip the missed dose and take it before your next planned activity 

• Do not double up doses 

Medicines you can and can’t take with tadalafil

Avoid combining tadalafil with[1][2]: 

• Nitrates (e.g., glyceryl trinitrate) 

• Riociguat for pulmonary hypertension 

• Alpha-blockers (unless advised) 

• Other ED medications (e.g., sildenafil) 

• Certain antibiotics and antifungals 

• HIV medications 

• Blood pressure medicines (consult your GP) 

Although not a medicine, you should also avoid drinking grapefruit juice when taking tadalafil, as it can affect how it works. 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of tadalafil?

The most common side effects include[1]: 

• Headache 

• Indigestion 

• Back pain 

• Muscle aches 

• Flushing 

• Nasal congestion 

The rarer, but more serious side effects may include[1]: 

• Chest pain 

• Sudden vision or hearing loss 

• Erection lasting more than 4 hours (priapism) 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include: 

• Difficulty breathing 

• Tightness in throat and chest 

• Swelling of the tongue or throat 

• Feeling faint or dizzy 

• Blue/grey skin or lips 

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about tadalafil

Can I drink alcohol with tadalafil? 
Yes, but limit alcohol as it can increase side effects like dizziness or low blood pressure[1]. 

How long does tadalafil last? 
Effects can last up to 36 hours for ED. 

Is tadalafil available on the NHS? 
Yes, for conditions like ED, BPH, and PAH. Your GP will assess your eligibility[1]. 

Can women take tadalafil? 
It is approved for PAH in women, but not for sexual dysfunction[1]. 

Can I take tadalafil every day? 
Yes, for BPH or regular ED treatment, under medical supervision[1]. 

For the official NHS guide for tadalafil, visit their website.