Tadalafil (Cialis) is a common medication for erectile dysfunction (ED). Generally, you can expect its effects within 30 minutes of taking it, lasting up to 36 hours.
Medically reviewed by Jennie Olopaade, PharmD, RPH
If you experience erectile dysfunction (ED), you are not alone. Many men experience this condition for many different reasons.
ED is when you consistently cannot get or maintain an erection. This condition can make sexual activities difficult. Living with the condition has links with issues like anxiety, poor self-esteem, and limited intimacy.
Medications like tadalafil, marketed as Cialis in the United States, can help you get and maintain an erection.
Sex and gender exist on spectrums. This article uses the term “men,” when discussing people assigned male at birth to reflect language that appears in source materials. While gender is solely about how you identify yourself, independent of your physical body, you may need to consider how your personal circumstances will affect diagnosis, symptoms, and treatment. Learn more about the difference between sex and gender here.
How does tadalafil (Cialis) work?
Photography by Westend61/Getty Images
Recent research suggests that up to 18.4% of men in the United States live with ED, and this number may be as high as 70% in men ages 70 years and older. One of the medications a healthcare professional may prescribe for ED is tadalafil (Cialis).
The Food and Drug Administration (FDA) approves tadalafil (Cialis) to treat ED and benign prostatic hyperplasia (BPH). BPH occurs when the prostate gland gets enlarged. It can cause symptoms like frequent urination and a feeling of incomplete emptying of the bladder.
Tadalafil (Cialis) blocks an enzyme called phosphodiesterase type 5 (PDE5). This enzyme increases levels of a signaling molecule called cyclic GMP that affects the prostate and bladder muscles, relieving BPH symptoms.
For ED, the medication alone is not enough to cause an erection. You still need sexual stimulation to get the desired effect. Once sexually stimulated, tadalafil (Cialis) relaxes the smooth muscles in the penis for improved blood flow and a firmer erection.
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The tadalafil (Cialis) package insert explains that it typically starts working in 30–60 minutes. The exact time can differ depending on how your body processes the medication. It could be due to your metabolism, diet, or medication dosage.
The effect can last up to 36 hours, with these long lasting benefits allowing some spontaneity in intimate moments.
Should you use tadalafil (Cialis) daily or as you need it?
If you take tadalafil (Cialis) for ED and wish to extend the duration beyond 36 hours, you may be able to take the pill once per day.
You may take a lower dose of either 2.5 milligrams (mg) or 5 mg daily to enable sexual activity at any time between doses. You will still need sexual stimulation to get an erection. If you take the medication as you need, you may take a higher dose of 10 mg or 20 mg before you have sex.
Taking tadalafil (Cialis) once per day can also be suitable if you take it for ongoing BPH symptom management.
Whether you take tadalafil (Cialis) for ED, BPH, or both, you should not take more than one daily dose.
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Before taking tadalafil (Cialis), you should tell the prescribing healthcare professional about any other drugs you take.
You should also avoid drinking too much alcohol when taking ED medications like tadalafil (Cialis). The label states that a general rule is not to exceed five units of alcohol. One unit of alcohol is the approximate equivalent of one 125 milliliters (mL) of wine, 250 mL of beer, or 40 mL of vodka.
Although rare, tadalafil (Cialis) may cause chest pain and stroke after taking it or after engaging in sexual activity. The label states that this could be more likely in people with existing heart disease.
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If tadalafil (Cialis) is not right for you, you can consider other ED treatments. They may differ in the time they take to work, how long the effects last, and their potential side effects. A 2024 article lists some examples:
Sildenafil (Viagra):Sildenafil (Viagra) is another type of PDE5 inhibitor that you take by mouth. Many men who do not get the desired effect with one type of PDE5 inhibitor may benefit from trying a different type. Unlike tadalafil (Cialis), taking sildenafil (Viagra) with food can reduce its effectiveness.
Testosterone: If PDE5 inhibitors don’t work for you or if you have low libido, testosterone supplements may be effective and may work well in combination with PDE5 inhibitors. It is rarely the first-line treatment for ED.
A healthcare professional can recommend the most suitable option for you.
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Natural ways to improve ED
There may be some natural ways to help manage ED, with options including:
quitting smoking (if you smoke)
quitting recreational or illegal drugs (if you take them)
avoiding drinking alcohol (if you drink)
increasing physical activity
seeking treatment for other health conditions, like diabetes and high cholesterol
trying a Mediterranean diet or following the guidance of a registered dietitian
considering psychological therapies to help with your mental health
You can work with a healthcare professional to identify which natural ED treatments to try and how to get started safely and sustainably.
When to speak with a healthcare professional
If you have persistent or recurrent ED, you can benefit from consulting a doctor or healthcare professional.
They can check for potential underlying causes, like heart conditions, diabetes, or hormonal imbalances.
They can also explain the different treatment options and suggest the most suitable option for your circumstances.
Summary
Tadalafil (Cialis) helps men manage ED, offering a fast-acting solution with an extended duration. The medication also treats BPH.
You can take tadalafil (Cialis) occasionally as you need it or take a lower dose every day to gain ongoing effects.
A doctor or healthcare professional can talk through the benefits of tadalafil (Cialis), along with its side effects. They can also offer any appropriate alternatives, allowing you to make an informed decision about your sexual health and well-being.
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