Tadalafil (Generic Cialis)

Treatment for erectile dysfunction with tadalafil

Tadalafil is a prescription-only medicine for the treatment of erectile dysfunction (ED), defined as the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual activity.

Tadalafil is a  phosphodiesterase type-5 (PDE-5) inhibitor that increases blood flow to the penis during sexual stimulation, helping  some men achieve and maintain an erection. It does not cause an erection without sexual stimulation.

Tablets are available in different strengths, with the appropriate dose determined by a pharmacist following an individual assessment.

Access tadalafil via online consultation

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A UK-registered pharmacist will review your information and, if tadalafil is clinically appropriate, a prescription can be issued following assessment.

Important information

DoktorABC UK is a digital health platform that connects patients with independent, UK-registered pharmacists. DoktorABC UK does not itself provide medical care, issue prescriptions or dispense medicines. All clinical decisions are made by the prescribing pharmacist following an individual medical assessment.

What is tadalafil?

Tadalafil treats erectile dysfunction in adult men by relaxing blood vessels and improving blood flow during sexual stimulation. It supports the natural erectile response, and does not cause an erection without sexual arousal. 

Tadalafil is a longer-acting PDE-5 inhibitor. Its effects may last for up to around 36 hours in some individuals, though this varies..

What is the active substance in tadalafil?

The active substance is tadalafil, a PDE-5 inhibitor that enhances the natural erectile response to sexual stimulation by regulating blood flow to the penis.

Who may be considered for treatment with tadalafil?

Tadalafil may be considered for adult men aged 18 and over with erectile dysfunction, following an individual medical assessment.

A pharmacist will consider cardiovascular health and fitness for sexual activity, current medicines (including nitrate medicines), and relevant medical history including liver/kidney function and eye conditions.

What dosages are available?

Tadalafil is commonly available in 2.5 mg, 5 mg, 10 mg, and 20 mg. 

Dosing depends on whether tadalafil is prescribed as needed or as a lower daily dose. Your pharmacist will advise which option may be most suitable.

Can I change doses myself?

No. Any dose adjustments should be made only in consultation with your prescribing pharmacist.

How is tadalafil taken?

Follow the instructions provided by your pharmacist and the patient information leaflet. Take tadalafil before sexual activity as directed, swallow the tablet whole with water, with or without food. Do not  exceed the prescribed dose. Tadalafil only works with sexual stimulation. 

A heavy meal may delay the onset of effect in some individuals. Heavy alcohol intake may reduce the ability to achieve an erection and may increase the risk of side effects.

What can affect the effect of tadalafil?

Several factors may impact response,  including excessive alcohol consumption, underlying health conditions such as diabetes, cardiovascular disease, certain medicines that interact with tadalafil, and incorrect timing or dose. Your pharmacist can advise on optimising treatment.

When should tadalafil not be used?

Do not take tadalafil if you:

• Are allergic to tadalafil or any of its ingredients.
• Take nitrate medicines for chest pain (angina).
• Use nitric oxide donors (such as amyl nitrite, "poppers").
• Take riociguat.
• Have certain serious heart conditions where sexual activity is not advised.
• Have had a recent heart attack or stroke.
• Have severe liver disease.
• Have very low blood pressure.
• Have certain rare inherited eye conditions or a history of sudden vision loss (e.g., NAION).

Always inform your pharmacist of your full medical history and current medicines before treatment.

Warnings and precautions

Speak to a pharmacist before using tadalafil if you have:

• Heart problems or have been advised to avoid sexual activity.
• Kidney or liver impairment.
• Blood disorders such as sickle cell anaemia, leukaemia or multiple myeloma.
• Anatomical deformation of the penis or Peyronie's disease.
•  A stomach ulcer or a bleeding disorder.
• Noticed changes in vision or hearing.

Do not use tadalafil with other treatments for erectile dysfunction or other PDE-5 inhibitors unless specifically advised by a pharmacist.

Interactions with other medicines, food and drink

Some medicines may interact with tadalafil. Tell your pharmacist if you take:

• Medicines for high blood pressure
• Alpha blockers
• Certain antifungals or antibiotics
• Medicines for HIV
• Other medicines used for erectile dysfunction

Grapefruit juice may affect how tadalafil works in some individuals.

What side effects can occur?

Like all medicines, tadalafil can cause side effects, although not everyone experiences them.

Common side effects may include:

• Headache
• Flushing
• Indigestion
• Nasal congestion
• Back pain or muscle aches
• Dizziness

Serious side effects (seek urgent medical help):

• Chest pain
• Sudden loss of vision or hearing
• Prolonged or painful erection lasting more than 4 hours (priapism)
• Severe allergic reactions (e.g., swelling of face/lips/throat, breathing difficulty)

Reporting side effects (UK)

Suspected adverse reactions can be reported via the MHRA Yellow Card scheme or by searching for MHRA Yellow Card in the Google Play or Apple App Store.

Driving and operating machinery

Tadalafil may cause dizziness or visual disturbances. Do not drive or operate machinery if affected.

Storage information

• Keep out of the sight and reach of children
• Do not use after the expiry date shown on the packaging
• Store as directed in the patient information leaflet
• Dispose of unused medicines safely; ask a pharmacist if unsure

Tadalafil active substance and excipients

Active substance:

Tadalafil, available in 2.5 mg, 5 mg, 10 mg, or 20 mg tablets.

Other ingredients:

Excipients vary by manufacturer and strength. Full ingredient information and marketing authorisation holder details can be found in the UK patient information leaflet for the specific tadalafil product dispensed.

Patient information leaflet

The UK patient information leaflet for tadalafil is available via the electronic Medicines Compendium (eMC).

Frequently asked questions