Tadalafil

Tadalafil is used to treat erection problems. Find out how to take it safely and the possible side effects. Tadalafil is also called Cialis.

Type of medicine Also called
  • It belongs to a group of medicines called phosphodiesterase type-5 (PDE5) inhibitors. They help to make a penis erect.
  • Read more about PDE5 inhibitors.
  • Cialis®

What is tadalafil?

Tadalafil is used for men with erection problems (erectile dysfunction). It works by increasing blood flow to the penis, to help achieve an erection. It will only work if you are sexually excited. Read more about erectile dysfunction. 

Dose

  • In Aotearoa New Zealand tadalafil is available as tablets (5 mg, 10 mg and 20 mg).
  • Tadalafil can be taken either on-demand (before sex) or every day. Your doctor can advise if everyday treatment is best for you.
  • Always take your tadalafil exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much tadalafil to take, how often to take it and any special instructions.

How to take tadalafil

  • For the ‘on-demand’ dose, 10 mg or 20 mg should be taken at least 30 minutes before you plan to have sex (it may still work 36 hours later). Do not take more than one dose in 24 hours.
  • The everyday dose is 5 mg or 2.5 mg once a day. The once-daily dosing is for people who have sex more than twice weekly. It will cause an erection whenever sexually stimulated. Tadalafil must be taken everyday and for up to 1 week for a full effect.
  • Swallow the tablet whole with a full glass of water. Do not take with grapefruit or orange juice.
  • You can take it with or without food.
  • Alcohol: Avoid excessive alcohol as it can lessen the sexual response.
  • Effectiveness: PDE5 inhibitors do not work for everyone – about a third of men don't see an improvement. Many men need to try the medication a few (6–8) times before it works. If you don't have any improvement, do not increase your dose. Instead talk to your doctor as there may be other treatment options.

How do I get tadalafil?

Tadalafil is available on prescription from your doctor. It is not funded in Aotearoa New Zealand. None of the PDE5 inhibitor medications are funded in New Zealand for general erectile dysfunction. You cannot buy tadalafil from a Pharmacy.

Precautions before taking tadalafil

  • Have you ever had a stroke?
  • Do you have any heart or blood pressure problems?
  • Do you have an eye problem called optic neuropathy?
  • Do you have leukaemia (cancer of the blood cells) or multiple myeloma (a cancer of the bone marrow)?
  • Do you have sickle cell disease?
  • Do you have any disease or deformity of your penis?
  • Do you have kidney or liver problems?
  • Are you taking any other medicines including alpha blocker medicine (such as doxazosin, terazosin, prazosin)?
  • Are you taking any over-the-counter and complementary medicines, eg, vitamins, minerals, herbal or naturopathic medicines?

If you have answered yes to any of these questions, it’s important that you tell your doctor or pharmacist before you take tadalafil. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Serious medication interaction with nitrates

Nitrates and tadalafil should NOT be taken together, as both medicines together can cause a dangerous drop in blood pressure and collapse. Nitrates come in a variety of forms. Examples of nitrates are:

What are the side effects of tadalafil?

Like all medicines, tadalafil can cause side effects, but not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Blocked nose
  • A sensation of redness and warmth or burning of the face (called facial flushing)
  • These will pass quite quickly.
  • Headache, muscle aches and pains
  • Dizziness
  • Tell your doctor if they bother you.
  • If dizzy, do not drive or operate heavy machinery.
  • Indigestion 
  • Tell your doctor if they bother you.
  • An erection that lasts longer than 4 hours
  • Painful erection
  • Chest pain 
  • Rash or swelling of the face
  • Sudden problems with your eyesight such as loss of vision, in one or both eyes
  • Sudden loss of hearing  
 
  • Tell your doctor immediately or ring Healthline 0800 611 116.
For more information on side effects, see the Medsafe consumer information leaflets Cialis.

Did you know that you can report a medicine side effect to the Centre for Adverse Reactions Monitoring (CARM)? Report a side effect to a product. 

Learn more

References

Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, MPharm PGDipClinPharm, Auckland Last reviewed: 26 Jan 2022