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Tadalafil Dosage Guide

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Geoffrey C. Whittaker

Published 04/20/2021

Updated 04/18/2024

Getting a prescription for tadalafil (the active ingredient in brand names Adcirca and Cialis®) can be a more complicated experience than many men expect. While Cialis and its generic tadalafil are effective erectile dysfunction (ED) treatments, many men get overwhelmed by the dosages and ways to take the medication.

Like sildenafil (the active ingredient in Viagra), avanafil (sold as Stendra®) and other ED medications, tadalafil is available in several dosages, but unlike the others, it can also be prescribed for daily use. 

While the maximum dose of tadalafil for erectile dysfunction may give you intense erections, it’s important to choose the right dosage for your individual needs to experience minimal side effects and avoid permanent or serious injury.

Here’s what to know if you want the best results possible.

Since tadalafil is the longest-lasting medication for erectile dysfunction, you have to treat it differently than many other medications on the market. The key reason: A single dose of tadalafil may provide relief from ED for up to 36 hours — about one and a half days.

If we wade into the science for a moment, that means the half-life of tadalafil is approximately 17.5 hours.

That’s a really long time — and it’s only an average. In elderly men, for instance, tadalafil has a slightly longer half-life of roughly 21.6 hours.

As a long-lasting ED medication, tadalafil is only recommended for use one time per day. When used at a typical as-needed dosage, tadalafil remains effective for up to 36 hours.

For optimal results, it’s recommended to take tadalafil at least 30 minutes before you and your partner plan to have sex. But if you have sex every four hours (high-five to that), you won’t want to use tadalafil every time — this could be very dangerous.

Tadalafil Dose Uses

Contrary to popular belief, tadalafil and other PDE5 inhibitors won’t make you get random erections. Instead, proper use of tadalafil just increases blood flow to your penis, meaning you’ll only get an erection when you receive sexual stimulation or feel sexually aroused.

Tadalafil works by inhibiting the effects of cGMP-specific phosphodiesterase type 5 (or PDE5) — an enzyme found in the smooth muscle cells of blood vessels.
PDE5 plays a major role in regulating the flow of blood to certain parts of your body, including the erectile tissues of your penis. By inhibiting the effects of PDE5, tadalafil makes it easier for blood to flow to your penis and produce an erection.

Our guide to PDE5 inhibitors has more information about how tadalafil, sildenafil and other medications for erectile dysfunction work.

There are a number of common use cases for this medication, including:

Let’s look at the actual dosages in more detail.

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The prescription drug is a PDE5 inhibitor, meaning it blocks phosphodiesterase type 5 enzymes that reduce blood flow to the penile tissues. So tadalafil essentially treats erectile dysfunction by increasing blood flow to your penis, making it easier for you to get an erection when you feel sexually aroused.

Tadalafil is available in several dosages, from a minimum dosage of 2.5mg (milligrams) all the way up to a 20mg per tablet, the maximum dose of tadalafil in 24 hours.

Tadalafil 10mg: Typical Starting Dose  

10mg is the typical starting dosage of as-needed tadalafil. The medication is typically prescribed at this dosage for use as needed before sex for men with mild to moderate ED. And if you begin your ED treatment journey with tadalafil, you’ll almost certainly be prescribed a 10mg dose to start.

Research shows that most men with ED who use tadalafil at this dosage are able to have sex successfully. Still, it’s possible that this dosage won’t meet your individual needs. In this case, your healthcare provider may prescribe a higher dose. 

For all as-needed dosages, you’ll typically want to take tadalafil at least 30 minutes to two hours before you plan to get intimate.

Mild ED Dose: 5mg Tadalafil

If your erectile dysfunction is fairly mild, or if you develop side effects from using tadalafil at a higher dosage, your healthcare provider may prescribe tadalafil at a dosage of 5mg.

This is the lowest as-needed tadalafil dosage currently available. Although it’s slightly less effective than the 10mg and 20mg dosages at treating ED, it’s also less likely to cause certain side effects — which, for men with heart conditions and those vulnerable to dizziness, can be a necessary precaution for safe and effective use.

Tadalafil 20mg: Max Dose 

If you don’t notice any improvements from a 10mg dosage, or don’t experience a big enough improvement to have satisfactory sex, your healthcare provider may prescribe a stronger 20mg dosage of tadalafil.

The maximum dosage of tadalafil is 20mg, used as needed for sexual intercourse for men with more severe ED. If you’re prescribed tadalafil at this dosage, it’s likely because smaller doses weren’t giving you the results you were hoping for.

Since tadalafil 20mg dosage is a higher dose, it’s important to follow your healthcare provider’s instructions and take your medication no more than once per day.

At this dosage, tadalafil is more effective at improving erectile function and helping men with ED have sex successfully. Research shows that a dosage of 20mg is particularly effective for men with severe erectile dysfunction.

Clinical trials show that side effects from tadalafil are slightly more common at this dosage than at a lower dosage of 10mg, though the difference in tolerability is relatively small.

For Daily Tadalafil Dosing: 2.5mg and 5mg Tadalafil 

While tadalafil is available as-needed, it’s also available for once-daily use in much smaller dosages for always-on preparedness for sexual activity. Daily dose tadalafil is available at a dosage of 2.5mg or 5mg tablets. 

There might be several reasons to go with daily dosages instead of the dosages where you take the medication as needed. Using tadalafil daily offers several advantages, as we’ve explained in our full guide to daily-use Cialis

However, keep in mind that daily use might change the side effect outcomes for some people. Side effects such as indigestion and flushing may become more frequent with daily use.

When used daily, tadalafil should be taken at approximately the same time each day to maintain a stable concentration in the body. 

Choose your chew

Tadalafil Dosage Side Effects

It’s important to know that side effects can increase based on dosage, frequency of use and whether you’re on any other medications.

We’ve covered the numerous (and mostly tolerable) tadalafil side effects in our comprehensive guide, but serious side effects at all dosages can include:

  • Hearing loss

  • Loss of vision

  • Priapism (prolonged erections without stimulation)

Once you and your healthcare provider work out the correct dosage for you, tadalafil should effectively improve your erections and enhance your sexual performance.

But there are also some potentially dangerous mistakes you’ll want to avoid when taking tadalafil — let’s look at those in the big picture of how to take the medication correctly.

Tadalafil Drug Interactions

Drug interactions can be serious business. If you’re taking certain medications, you might need a lower dose of tadalafil, so tell your healthcare provider if you use:

  • Alpha blockers

  • Nitrates, nitroglycerin and nitric oxide supplements

  • Ketoconazole, itraconazole or other antifungal medications

  • Tamsulosin

  • Erythromycin

  • Doxazosin

You should also tell your healthcare provider if you have renal or kidney disease, angina, Peyronie’s disease, an enlarged prostate or pulmonary hypertension (high blood pressure).

You’ll want to avoid consuming grapefruit juice while taking tadalafil; the juice can lead to some of the same interactions as those of prescription drugs.

Not following best practices around tadalafil can reduce the medication’s effectiveness, increase your risk of common side effects and generally make your tadalafil-taking experience less optimal. You don’t want to do any of those things intentionally.

Instead, follow this guide. To get the best results from tadalafil, try to:

  • Take tadalafil at least 30 minutes before having sex. Tadalafil usually reaches its peak blood concentration between 30 minutes and six hours. If you’re prescribed tadalafil for use as needed, you’ll get the best results by taking it at least 30 minutes before you and your partner plan to have sex. If you don’t notice any improvement, try taking tadalafil about two hours before you have sex.

  • Limit your alcohol consumption. Taking tadalafil (Cialis) with alcohol may increase your risk of developing side effects, including reduced blood pressure. Alcohol can also affect your sexual performance and ability to maintain an erection during sex. It’s okay to drink a small amount of alcohol while using tadalafil, but it’s best to avoid heavy drinking while using this medication.

  • Combine tadalafil with a healthy lifestyle. Your cardiovascular health plays a key role in your erectile function and sexual performance, meaning medications such as tadalafil work best if you live a healthy lifestyle.

  • Avoid drug interactions. Medications and foods may cause problems with ED medication and intensify the effects of tadalafil. Beyond potential drug interactions, this also means that you shouldn’t double up on a missed dose.

Obviously, there are many things you can do to take tadalafil incorrectly, and the worst of them is, arguably, taking too much of the medication.

For example, taking 40mg of tadalafil (two 20mg tablets) is not recommended when being used for ED. This dosage of tadalafil is higher than the typical recommended dose for ED and could increase your risk of developing side effects, including potentially harmful side effects. 

Do not double your dose without professional supervision. 

And if you don’t experience improvements from tadalafil at a dosage of 10mg or 20mg, talk to your healthcare provider. They’ll be able to guide you through other steps so you can have a happy and healthy sex life.

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If you’re one of the tens of millions of men in the United States affected by ED, medications like tadalafil can improve your erections and make it easier to have satisfying sex.

But you have to take it properly and safely to get the results you want. The following cheat sheet will help you get what you need safely — and get your sex game back in action:

  • Tadalafil is one of four FDA-approved oral medications for ED, along with sildenafil (Viagra), vardenafil (Levitra) and avanafil (Stendra).

  • Tadalafil is a widely used medication, mostly prescribed to treat erectile dysfunction and sometimes to treat the symptoms of benign prostatic hyperplasia (BPH) as well as pulmonary arterial hypertension (under the brand name Adcirca).

  • Compared to other ED medications, tadalafil is very long-lasting. On average, a typical 10mg dose of tadalafil can improve erectile function for up to 36 hours.

  • Tadalafil is available in several dosages. As a treatment for ED, it’s typically prescribed at a dosage of 10mg for use as needed, which may be adjusted to 20mg or 5mg based on your response to the medication.

  • For once-daily use, tadalafil is prescribed at a lower dosage of either 2.5mg or 5mg per day.

  • As with other ED medications, there’s no “best” dosage of tadalafil for all. Your healthcare provider will work with you to choose the best dosage based on your desired health outcomes, including treatment for benign prostatic hyperplasia.

  • You should be taking tadalafil or any ED medication only as directed with medical advice, which means no double-dosing without the approval of a healthcare professional.

  • If medication isn’t helping, there’s more you can do. Our guide to naturally protecting your erections shares actionable, science-based tactics you can use to improve your sexual health and get better results from tadalafil.

Need more guidance? Want medication? We can help.

We also offer tadalafil chewables to take daily or as needed to help with stronger, longer-lasting erections.

We offer tadalafil and other FDA-approved ED medications online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.

You can learn more about the treatment of erectile dysfunction and improving your sexual performance in our guide to the most common erectile dysfunction treatments and drugs.

4 Sources

  1. HIGHLIGHTS OF PRESCRIBING INFORMATION: ADCIRCA (tadalafil) tablets for oral administration . (n.d.-b). https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/022332s007lbl.pdf.
  2. Marumo, K., Imaoka, T., Fujimoto, K., Watts, S., Stothard, D., & McGill, J. (2007). A comparison of the efficacy and tolerability of tadalafil 10 mg and 20 mg in Japanese patients with severe erectile dysfunction. The journal of sexual medicine, 4(3), 745–752. https://pubmed.ncbi.nlm.nih.gov/17087800/.
  3. Dhaliwal A, Gupta M. PDE5 Inhibitors. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/.
  4. HIGHLIGHTS OF PRESCRIBING INFORMATION: CIALIS (tadalafil) tablets, for oral use . accessdata.fda.gov. (n.d.). https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf.
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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