What to know about tadalafil

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Tadalafil is a medication prescribed to treat erectile dysfunction (ED). The drug increases blood flow to the penis during sexual stimulation.
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An estimated 1 in 10 men experiences sexual difficulty. This could be in the form of ED, premature ejaculation, or a loss of sex drive.
1 in 10
premature ejaculation
This article explores ED, tadalafil, alternative remedies, and when to see a doctor.
Sexual health and erectile dysfunction
ED relates to the difficulty a person may have achieving or maintaining an erection. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) states that approximately 30 million men in the United States may have this health condition.
30 million men
The NIDDK goes on to say that ED is more common in:
older adults
people with specific psychological, emotional, or physical health conditions
people who take particular medications
people who smoke
people with a higher BMI
BMI
Additionally, a recent study found that ED was common in a cohort of sexually active men aged between 18–31 years in the US. The study found that relationship status and mental health were the most significant contributing factors.
recent study
Brand-name vs. generic drugs
When a pharmaceutical company develops a new drug, it must obtain a New Drug Approval (NDA) from the Food and Drug Administration (FDA). Once granted, there is an exclusivity period in which no other company may produce the same drug using the same active ingredients. Periods of exclusivity can last from 180 days to 7 years.
New Drug Approval (NDA)
180 days to 7 years
After this time, other manufacturers are free to make generic versions of a drug under an Abbreviated New Drug Application (ANDA). It is “abbreviated” because generic drug developers do not have to submit the preclinical and clinical testing data supplied by the original pharmaceutical company. This also accounts for the difference in brand-name and generic drug costs.
Abbreviated New Drug Application (ANDA)
Tadalafil is the generic name for the brand-name drug Cialis. At the time of publishing, the average cash price of 30, 10-milligram (mg) Cialis tablets is approximately $2,524.92, whereas tadalafil is around $1,603.20, making it far more cost effective. Some online companies, such as GoodRx, also offer discount coupons that dramatically lower prices. For example, the same dose and quantity of tadalafil tablets using a GoodRx coupon at Food Lion Pharmacy costs $17.00.
Cialis
$2,524.92
$1,603.20
$17.00
How tadalafil works
Tadalafil is part of the class of phosphodiesterase (PDE5) inhibitors that treat people with high blood pressure in the lungs’ arteries, also known as pulmonary hypertension, ED, and an enlarged prostate known as benign prostatic hyperplasia.
phosphodiesterase (PDE5) inhibitors
pulmonary hypertension
benign prostatic hyperplasia
PDE5 inhibitors work by increasing blood flow to the penis. They block a specific enzyme in the blood vessels. This means these blood vessels can relax, resulting in an increased blood flow to a specific area.
Find out more about PDE5 inhibitors here.
Find out more about PDE5 inhibitors here.
The effects of tadalafil can last for 36 hours. This is significantly longer than the similar drug, sildenafil (brand name Viagra), which lasts approximately 4 hours. A person may consider this an advantage or a disadvantage.
Viagra
Where to buy tadalafil
Tadalafil is available in most pharmacies across the U.S., provided a person has a prescription from their doctor. The FDA recommends that people not obtain ED treatments without a prescription, as these products may contain undisclosed ingredients.
FDA
Romans and Hims offer free online consultations, but a person must pay for the prescription if the doctor deems them a good fit for tadalafil. Insurance does not typically cover the cost of medications from these companies.
Romans
Hims
Lemonaid requests payment for a consultation, but a person can submit a query free of charge. Insurance does not cover consultations from Lemonaid but may cover some prescription medications. A person should check their available benefits with their plan provider.
Lemonaid
Side effects and warnings
Due to the possibilities of side effects and allergic reactions, a person should always consult with their doctor before taking tadalafil.
Some individuals may experience few or no side effects when taking tadalafil, but some of the most common side effects may include:
headache
headache
indigestion or heartburn
indigestion
sickness
diarrhea
stomach, leg, arm, or back pain
back pain
cough
red or flushed face
stuffy nose
Less commonly, a person may experience severe side effects, including:
chest pain
prolonged or painful erections
sudden vision or hearing loss
hearing loss
skin reactions such as rashes
seizures
In these cases, individuals should stop taking the medication and seek immediate medical attention.
In extremely rare cases, a person may experience a severe allergic reaction, known as anaphylaxis. They should seek immediate and urgent medical attention in this situation.
Find out more about anaphylaxis here.
Find out more about anaphylaxis here.
A doctor may not recommend tadalafil for everyone. For example, if they a person has serious heart or liver conditions, have low or high blood pressure, or have recently had a stroke or heart attack, a doctor may consider alternative options.
stroke
heart attack
Frequently asked questions
Below, we look at some common questions surrounding tadalafil.
In some cases, yes, though this is usually to treat medical conditions other than ED. A person can take the medication daily or when needed, but they should first discuss dosage and frequency with their doctor.
If taken only when needed, a person should aim to take tadalafil at least 30 minutes before sexual intercourse.
The effects of tadalafil may last for 24–36 hours.
No. Individuals should take only one tablet in a 24-hour period.
Yes, a person must have a prescription for tadalafil. If they do not wish to visit their regular doctor, individuals can obtain a prescription online following a virtual consultation from an online pharmacy such as Hims or Lemonaid.
Hims
Lemonaid
No. A person must experience sexual arousal for this medication to help them achieve an erection.
Alternative options
A person may prefer to consider alternative remedies for ED. Some examples include:
L-arginine: This is an amino acid found in the body that helps open up blood vessels. Some people take this as a supplement to help with ED.
L-arginine
Ginseng: This is a herbal supplement that promotes the relaxation of smooth muscles, which may help with an erection. But a 2018 systematic review and meta-analysis concluded experts should conduct further research into its efficacy.
Ginseng
2018 systematic review and meta-analysis
Dehydroepiandrosterone (DHEA): This is a natural hormone that decreases as a person ages. A person can purchase supplements of DHEA that may aid ED.
Dehydroepiandrosterone (DHEA)
It is important to note that the FDA does not regulate the use of supplements, so it is essential a person chooses a well-reputed brand.
Lifestyle choices can also affect ED. Some things a person may consider when looking to help with ED include:
regular exercise
healthy diet
stress management
stress
decreasing smoking
decreasing alcohol consumption
Find out more about natural and home remedies for ED here.
Find out more about natural and home remedies for ED here.
When to see a doctor
A person should consult with their doctor if they experience ED regularly. In some cases, it may be due to an underlying health condition, such as diabetes.
diabetes
Individuals should also seek immediate medical attention if they experience severe side effects, such as prolonged or painful erections, chest pain, vision or hearing loss, skin reactions, or seizures.
Summary
Tadalafil can help people with ED by increasing the blood flow to the penis when sexually aroused.
A person can only obtain tadalafil with a valid prescription that they can receive following a consultation with their regular doctor or from an online pharmacy.
Alternative options are available for those who would like to try something other than medication to manage their ED.