Tadalafil (Cialis®) is a medication used to treat ED, an enlarged prostate, or both. It’s known for its long-lasting effects and can be taken daily or as needed.
Tadalafil is the active ingredient in the brand-name medication Cialis® and is used to treat erectile dysfunction (ED) and the symptoms of benign prostatic hyperplasia (BPH). Tadalafil works the same way as Cialis and has the same benefits and risks, according to the FDA.
Tadalafil works by relaxing the blood vessels and increasing blood flow to particular areas of the body, notably the penis. The drug is known for its long-lasting effects, allowing for more sexual spontaneity, as it can remain effective for up to 36 hours. It is typically taken as needed, but a lower-dose daily prescription is also available for continuous treatment.
Common side effects of tadalafil include headaches, indigestion, back pain, and muscle aches, which typically resolve within a few days. It is important to use Cialis with caution, especially for those with cardiovascular conditions, and to avoid combining it with nitrates or certain other medications due to the risk of serious interactions.
Cialis (tadalafil) is indicated to treat:
Erectile dysfunction (ED)
The signs and symptoms of benign prostatic hyperplasia (BPH)
ED and the signs and symptoms of BPH (ED/BPH)
The drug category for tadalafil is phosphodiesterase-5 (PDE5) inhibitor.
Most common adverse reactions (≥2%) include:
Headache
Indigestion
Back pain
Muscle pain
Nasal congestion
Flushing
Pain in limb
Administration of Cialis to patients using any form of organic nitrate is contraindicated
History of known serious hypersensitivity reaction to Cialis or Adcirca
Drug interactions: Nitrates, alpha blockers, antihypertensives, alcohol, CYP3A4 inhibitors (e.g., ketoconazole, ritonavir), CYP3A4 inducers (e.g., rifampin)
Patients should not use Cialis if sex is inadvisable due to cardiovascular status
Use of Cialis with alpha blockers, antihypertensives or substantial amounts of alcohol (≥5 units) may lead to low blood pressure
Cialis is not recommended in combination with alpha blockers for the treatment of BPH, because efficacy of the combination has not been adequately studied and because of the risk of blood pressure lowering
If taking potent inhibitors of CYP3A4, dose should be adjusted
Patients should seek emergency treatment if an erection lasts >4 hours
Patients should stop Cialis and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non arteritic ischemic optic neuropathy (NAION)
Patients should stop Cialis and seek prompt medical attention in the event of sudden decrease or loss of hearing
Prior to initiating treatment with Cialis for BPH, consideration should be given to other urological conditions that may cause similar symptoms
Boxed Warning is not available for this drug.
The cost of tadalafil may vary depending on factors such as your insurance plan, the dosage, quantity, and where you buy it.
Without insurance, the average price of the medication is between $1 and $25 per tablet. Coupons and discount cards may be available to bring down the price, and insurance may cover all or some of the cost of the drug.
Tadalafil through Hims’ online platform for treating erectile dysfunction (ED) starts at around $40 per month. Hims also offers access to chewable Hard Mints that can contain tadalafil and/or sildenafil, starting at $1.63 per use. These mints are compounded medications prescribed by licensed medical providers and made in licensed, FDA-regulated pharmacies but they have not been approved by the FDA.
There are other medications prescribed to treat ED and BPH. Some of these drugs may be better suited to you than others. If you’re interested in finding an alternative to tadalafil, talk with your provider to learn more about other medications that may work well for you.
Other oral medications that can treat ED include:
Viagra® (sildenafil)
Stendra® (avanafil)
Vardenafil
Chewable ED meds available through Hims that contain one or more of the active ingredients in Cialis and Viagra
Penile injection medications for ED include:
Caverject® or Edex® (alprostadil)
Papaverine
Phentolamine
Combination medications such as Bimix, Trimix, and Quadmix
As an alternative or addition to ED medications, your healthcare provider may suggest therapy for mental health issues that may be contributing to ED and/or lifestyle changes to support sexual health, like following a healthy diet, exercising, and cutting back on alcohol.
Other treatments for ED include a topical gel, a penis pump with or without a constriction ring, penile implant surgery, and testosterone therapy (if low testosterone is a contributor).
Other treatments for benign prostatic hyperplasia (BPH) include:
5-alpha reductase inhibitors:
Avodart® (dutasteride)
Proscar® (finasteride)
Alpha-blockers:
Uroxatral® (alfuzosin)
Cardura® (doxazosin)
Rapaflo® (silodosin)
Flomax® (tamsulosin)
Terazosin
Combination therapies
Surgery
Tadalafil for ED typically starts working within about 30 minutes to two hours of taking the medication, with sexual stimulation.
Tadalafil can be taken daily or as needed. Daily tadalafil is prescribed at a low dose (either 2.5 or 5 mg) and taken once per day. When used on an as-needed basis for ED, tadalafil is typically taken about two hours before you plan to have sex and prescribed at a higher dose (5 mg, 10 mg, or 20 mg).
Tadalafil is effective for up to 36 hours after you take it, making it longer-lasting than other medications for ED.
Tadalafil is the active ingredient in Cialis. Research has shown they are equally effective at treating ED, last the same amount of time, and have the same side effects risk. The main difference between the two is that Cialis is a brand name, which typically means it’s more expensive than generic tadalafil.
You can get a prescription for tadalafil after being evaluated by your primary care doctor or a specialist who can determine if the medicine is right for you based on factors like your symptoms and medical history.
Hims offers access to daily and as-needed tadalafil if you’re deemed eligible for treatment by a healthcare provider. Hims connects you with a provider who will assess your symptoms and health history. If you’re approved for treatment, you’ll receive your prescription in discreet packaging within a few days.
CIALIS (tadalafil) tablets, for oral use. (2011). https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021368s20s21lbl.pdf
*This information is from the label for brand name Cialis®. See the Full Prescribing Information for more complete information. Tadalafil, the active ingredient in Cialis, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient tadalafil.
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.
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