The Weekend Pill

Tadalafil is a generic prescription drug that is used to treat several conditions, namely erectile dysfunction (impotence), as well as enlarged prostate (benign prostatic hyperplasia or BPH) and high blood pressure in the lungs (pulmonary arterial hypertension). Tadalafil (like its brand-name counterparts, Cialis® and Adcirca®) belongs to a group of medicines called phosphodiesterase type 5 (PDE5) inhibitors. These medicines prevent the enzyme PDE5 from working too quickly. The penis is one of the body parts where this enzyme works.

When Tadalafil (or the brand version Cialis®) is taken as needed for ED, it can start working within 30-45 minutes but reaches peak effect in most men 2 hours after it’s taken. Like other ED drugs that are taken as needed for ED, it must be taken in advance of when you plan to be sexually active to give it time to start working.

Tadalafil can also be taken at a lower prescribed dose at the same time every day. When taken in this way over time, you may find an increased ability to achieve an erection anytime you experience sexual stimulation. After beginning a daily regimen of Tadalafil, you may be able to have successful intercourse in as early as 4 to 5 days.

One dose of Tadalafil taken as needed for sexual activity can remain effective for up to 36 hours, however peak concentration of Tadalafil in the bloodstream usually occurs between 30 minutes and 6 hours with a median time of 2 hours. Since Tadalafil’s effectiveness lasts for a long time, it can be taken well in advance to allow for more spontaneous sexual activity over the course of a day or night.

Tadalafil tablets available through hims contain the active ingredient tadalafil and the following inactive ingredients: croscarmellose sodium, hydroxypropyl cellulose, hypromellose, iron oxide, lactose monohydrate, magnesium stearate, microcrystalline cellulose, sodium lauryl sulfate, talc, titanium dioxide, and triacetin.

Tadalafil is offered in several different strengths.

Tadalafil dosing depends on whether or not it is taken daily or as-needed. Once-a-day Tadalafil builds up in your system to 1.6-times the daily dose, and so the 5 mg daily treatment offered through hims is similar to taking 8 mg of Tadalafil before sex. Tadalafil taken as needed for sexual activity is usually used at higher doses because it does not have time to build up in your system. Typical starting doses of as-needed Tadalafil are 10 or 20 mg, depending on your specific health conditions and age.

Tadalafil is the affordable, generic version of brand-name Cialis®. Cialis was originally created and is produced by the pharmaceutical company Eli Lilly, and generic tadalafil became available in 2018 after the patent protection ended. Both brand-name Cialis and tadalafil have been shown to be safe and provide the same treatment effects for erectile dysfunction, but tadalafil is available for a fraction of the price of Cialis.

Common side effects of tadalafil include headaches, indigestion, heartburn, back pain, muscle aches, facial flushing, nasal congestion, cold symptoms, dizziness, vision changes and blood pressure changes. If any of these side effects bother you or don't go away, contact your healthcare provider. Serious side effects are rare, but may include a dangerous drop in blood pressure, sudden vision loss, hearing loss and priapism (an erection lasting four hours or longer). If you experience any of these serious side effects, get medical help immediately.

Tadalafil is generally safe for most men with ED. However, men who have other health conditions should alert their doctor prior to starting any erectile dysfunction medication.

Some medical conditions and symptoms that may predispose to adverse effects from tadalafil include heart problems like heart failure or a previous heart attack, angina or chest pain, irregular heartbeats, high or low blood pressure, retinitis pigmentosa (a rare genetic eye disease), pulmonary hypertension, stroke, liver problems, kidney problems, severe vision loss, stomach ulcers, bleeding problems, deformed penis shape or Peyronie’s disease, experience with erections lasting more than 4 hours, or blood cell disorders like sickle cell anemia, multiple myeloma or leukemia.

Tadalafil can be taken with other medications, unless there is a known interaction between the two drugs. Common drug interactions with Tadalafil include nitrates, alpha-blockers, guanylate cyclase stimulators, HIV protease inhibitors, some antifungals and some antibiotics. Some examples of these drugs include nitroglycerin, amyl nitrate, doxazosin, erythromycin, ketoconazole, rifampin, riociguat, ritonavir, tamsulosin, itraconazole and poppers.

Tadalafil should not be taken at the same time as other ED medications, including sildenafil (Viagra®), avanafil (Stendra®) and vardenafil (Levitra®). Seek medical advice if you are taking any other medications prior to starting Tadalafil.