Tadalafil: What it is and who it helps

Tadalafil, commonly known by the brand name Cialis, treats erectile dysfunction (ED) and symptoms of benign prostatic hyperplasia (BPH). A separate formulation (Adcirca) is used for pulmonary arterial hypertension. It relaxes blood vessels by blocking an enzyme called PDE5. That increases blood flow where it’s needed, which helps with erections or lowers pressure in the lungs.

This drug isn’t a hormone and doesn’t cause sexual arousal by itself. You still need sexual stimulation for it to work. Lots of men find tadalafil useful because it can last much longer than other ED pills—sometimes up to 36 hours—so it feels more natural for spontaneous activity.

How to take tadalafil

Tadalafil comes in two common ways: an as-needed dose and a daily low dose. As-needed dosing is usually 5–20 mg taken at least 30 minutes before sex. The low-dose option is 2.5–5 mg once a day, which keeps steady levels in your body and allows more flexibility. For BPH, doctors often use daily dosing to help urinary symptoms.

Take it with or without food. Heavy, fatty meals may slow how quickly it starts working, but they don’t stop it. Don’t crush or split extended-release versions. If your doctor prescribes it for pulmonary hypertension, follow the exact dose they give—those doses and schedules differ from ED or BPH use.

Side effects, risks, and what to avoid

Common side effects include headache, flushing, indigestion, back pain, muscle aches, and nasal congestion. Back and muscle pain can show up 12–24 hours after taking it and usually go away within a day or two. Serious side effects are rare but include sudden vision loss, hearing loss, or an erection lasting longer than four hours (priapism). Seek medical help for those immediately.

Never take tadalafil with nitrate medicines (like nitroglycerin) or recreational drugs called "poppers." Combining them can cause a dangerous drop in blood pressure. Be careful with alpha-blockers used for blood pressure or prostate issues—start low and go slow under medical supervision. Strong CYP3A4 inhibitors (ketoconazole, ritonavir) can raise tadalafil levels and may require a dose change.

Alcohol doesn’t stop tadalafil, but heavy drinking plus tadalafil can increase dizziness or lower blood pressure. If you have heart disease, severe liver or kidney problems, active bleeding, or recent stroke or heart attack, talk with your doctor before using it. Women and children generally should not use tadalafil; pregnant or breastfeeding women should consult a clinician if exposed.

Want to try tadalafil? Get a proper check-up first. A short medical review helps rule out risky drug interactions and finds the right dose for you. Keep track of side effects and any new meds your doctor prescribes. With the right precautions, tadalafil can be a convenient and effective option for many people dealing with ED or BPH.