Disclaimer: This information is educational and not a substitute for a doctor’s consultation. Always speak with a qualified healthcare professional for personal medical advice, diagnosis, or treatment decisions.
Tadalafil: What It Is and What to Do
Tadalafil is a prescription medication most commonly used to treat erectile dysfunction (ED), symptoms of benign prostatic hyperplasia (BPH), and sometimes pulmonary arterial hypertension (PAH). If you’ve heard of the brand name Cialis®, that is one of the well-known versions of this drug.
This complete guide explains what tadalafil is, how it works, when it’s used, possible risks, and what to do if you think you may need it.
Quick summary in 30 seconds
- Tadalafil belongs to a group of medicines called PDE5 inhibitors and helps improve blood flow.
- It is mainly used for erectile dysfunction, enlarged prostate symptoms, and certain lung blood pressure conditions.
- It requires a prescription and medical evaluation to ensure it’s safe for you.
- Seek urgent care for chest pain, vision loss, or an erection lasting more than 4 hours.
What is Tadalafil (definition in simple terms)
Tadalafil is a medication that relaxes blood vessels and improves blood flow in specific parts of the body. It works by blocking an enzyme called phosphodiesterase type 5 (PDE5). By doing so, it increases the effect of nitric oxide, a natural chemical the body produces to relax muscles in blood vessel walls.
In simple terms:
- For erectile dysfunction, it helps increase blood flow to the penis during sexual stimulation.
- For benign prostatic hyperplasia (BPH), it may help relax muscles in the prostate and bladder, easing urinary symptoms.
- For pulmonary arterial hypertension, it can help relax blood vessels in the lungs, lowering blood pressure in that area.
If you want to understand related men’s health issues, see our overview of erectile dysfunction basics.
Causes and risk factors
Tadalafil itself does not “cause” a disease; it treats conditions. The underlying reasons someone might need tadalafil depend on the diagnosis.
Erectile dysfunction (ED)
Common causes and risk factors include:
- Diabetes
- High blood pressure
- High cholesterol
- Heart disease
- Obesity
- Smoking
- Depression and anxiety
- Certain medications
Benign prostatic hyperplasia (BPH)
- Age (risk increases after 50)
- Family history
- Hormonal changes
Pulmonary arterial hypertension (PAH)
- Autoimmune diseases
- Congenital heart disease
- Chronic lung disease
- Unknown (idiopathic) causes
Addressing these underlying conditions—such as improving cardiovascular health—can reduce the need for medications in some cases. Learn more in our guide to heart-healthy lifestyle changes.
Symptoms and how to distinguish from similar conditions
Tadalafil treats symptoms rather than causing them. Recognizing the difference between ED, BPH, and other issues is important.
Erectile dysfunction
Typical symptoms:
- Difficulty achieving an erection
- Difficulty maintaining an erection
- Reduced rigidity during intercourse
Distinguish from:
- Low libido: reduced sexual desire (often hormonal or psychological).
- Premature ejaculation: ejaculation that occurs sooner than desired, not related to erection quality.
Benign prostatic hyperplasia
- Frequent urination
- Weak urine stream
- Difficulty starting urination
- Waking at night to urinate
Distinguish from: Urinary tract infections (often painful urination, fever) or prostate cancer (may have similar symptoms but requires specific testing).
Pulmonary arterial hypertension
- Shortness of breath
- Fatigue
- Chest pain
- Fainting episodes
Because symptoms can overlap with heart or lung disease, medical evaluation is essential.
Symptom guide table
| Symptom | What it may mean | What to do |
|---|---|---|
| Difficulty maintaining erection | Possible erectile dysfunction | Consult a doctor for evaluation of cardiovascular and metabolic risk factors |
| Frequent nighttime urination | Possible BPH | Schedule prostate evaluation |
| Chest pain during sexual activity | Possible heart disease | Seek urgent medical assessment |
| Erection lasting over 4 hours | Priapism (medical emergency) | Go to emergency care immediately |
Diagnosis (how it is usually confirmed, what tests/examinations are common)
Before prescribing tadalafil, a healthcare provider typically evaluates the underlying condition.
For erectile dysfunction
- Medical and sexual history
- Physical examination
- Blood tests (glucose, cholesterol, testosterone)
- Blood pressure measurement
For BPH
- Digital rectal exam (DRE)
- Prostate-specific antigen (PSA) test (when appropriate)
- Urine tests
For pulmonary arterial hypertension
- Echocardiogram
- Right heart catheterization (confirmatory test)
- Lung imaging and function tests
These evaluations help determine whether tadalafil is suitable and safe, especially for people with heart conditions.
Treatment and approaches (overview of options without prescribing treatment to the reader)
Treatment depends on the diagnosed condition and individual health status.
Tadalafil for erectile dysfunction
Tadalafil can be prescribed for use as needed or as a once-daily therapy, depending on clinical judgment. It works only with sexual stimulation and does not increase sexual desire.
Other ED treatments may include:
- Lifestyle changes (weight loss, exercise, smoking cessation)
- Psychological counseling
- Other PDE5 inhibitors
- Vacuum devices or injections (in selected cases)
Tadalafil for BPH
It may be used alone or alongside other medications that relax prostate muscles. Decisions depend on symptom severity and prostate size.
Tadalafil for pulmonary hypertension
In PAH, tadalafil is part of a broader treatment plan managed by specialists.
Important: Tadalafil should not be used with nitrates (commonly prescribed for chest pain) due to the risk of severe blood pressure drops. Always follow the instructions and your doctor.
For more about medication safety, visit our guide to safe medication use.
Possible complications and when to see a doctor urgently (red flags)
Most people tolerate tadalafil well, but side effects can occur.
Common side effects
- Headache
- Flushing
- Indigestion
- Back pain
- Nasal congestion
Serious but rare reactions
- Sudden vision loss
- Sudden hearing loss
- Priapism (erection lasting more than 4 hours)
- Severe drop in blood pressure
Seek urgent medical help if you experience:
- Chest pain or pressure
- Fainting
- Severe dizziness
- Signs of an allergic reaction (swelling, difficulty breathing)
If you have heart disease, always discuss sexual activity safety with your doctor. See also our cardiovascular risk overview.
Prevention and lifestyle
While tadalafil treats symptoms, long-term improvement often involves lifestyle measures:
- Regular physical activity
- Balanced diet (e.g., Mediterranean-style)
- Weight management
- Smoking cessation
- Limiting alcohol intake
- Managing stress and mental health
Improving vascular health supports better erectile function and reduces overall cardiovascular risk.
FAQ
1. How long does tadalafil last?
Its effects may last up to 36 hours in the context of erectile dysfunction, which is why it is sometimes called the “weekend pill.” Individual response varies.
2. Is tadalafil the same as sildenafil?
Both are PDE5 inhibitors, but they differ in duration of action and dosing schedules.
3. Can women take tadalafil?
It is not routinely approved for female sexual dysfunction. In some cases, it may be used for pulmonary hypertension under specialist care.
4. Can I take tadalafil with alcohol?
Alcohol may increase the risk of side effects like dizziness or low blood pressure. Discuss safe use with your doctor.
5. Is tadalafil safe for people with heart disease?
It depends on the type and stability of heart disease. It must not be combined with nitrates. Medical clearance is essential.
6. Does tadalafil cure erectile dysfunction?
No. It helps manage symptoms but does not cure underlying causes.
7. Do I need a prescription?
Yes. In most countries, tadalafil is prescription-only due to safety considerations.
8. What if it doesn’t work?
Follow up with your healthcare provider. Dose adjustments or alternative treatments may be considered by a professional.
Sources
- U.S. Food and Drug Administration (FDA): https://www.fda.gov
- MedlinePlus (U.S. National Library of Medicine): https://medlineplus.gov
- American Urological Association: https://www.auanet.org
- European Medicines Agency (EMA): https://www.ema.europa.eu
- National Heart, Lung, and Blood Institute (NHLBI): https://www.nhlbi.nih.gov