Important Safety Information for Tadalafil

What Tadalafil is Used For

Tadalafil is a medication commonly prescribed for:

  • Erectile Dysfunction (ED): Helps men achieve and maintain an erection sufficient for sexual activity.
  • Benign Prostatic Hyperplasia (BPH): Reduces symptoms such as difficulty urinating, frequent urination, and weak urine flow.
  • Pulmonary Arterial Hypertension (PAH): Helps improve exercise capacity in people with high blood pressure in the lungs (note: different dosing).

Who Should Not Take It

You should not use tadalafil if you are:

  • Use medications that release nitric oxide such as nitrates or nitrites, as combining them may cause a dangerous drop in blood pressure. Nitrates must not be taken within 48 hours after the last dose of tadalafil.
  • Take guanylate cyclase (GC) stimulators such as riociguat.
  • Have a known allergy or hypersensitivity to tadalafil or any of its ingredients.

How to Take Tadalafil

Tadalafil may be taken 30 minutes to 2 hours before sexual activity, depending on your prescription. It may be taken with or without food.

  • For ED (as needed): Usually taken as needed prior to sexual activity (30 minutes to 2 hours before). Do not exceed once daily.
  • For daily use (ED or BPH): May be prescribed as a lower daily dose.

Swallow tablets whole with water. Avoid grapefruit and grapefruit juice, as they can increase side effects. Avoid combining with other erectile dysfunction medications or PDE5 inhibitors.

Talk to a doctor before use

Before using tadalafil, inform your healthcare provider about all medications you are currently taking, including prescription drugs, over-the-counter medicines, supplements, and herbal products. Tadalafil can interact with certain medications and may lead to serious side effects.

Extra caution is needed if you are taking:

  • Nitrates
  • Alpha-blockers
  • Blood pressure medications
  • Certain CYP3A4 inhibitors such as ritonavir, ketoconazole, or itraconazole
  • Consume large amounts of alcohol, as this may increase the risk of dizziness, low blood pressure, or fainting.

You should also share your full medical history, particularly if you have or have had:

  • Cardiovascular conditions such as heart attack, stroke, chest pain, or abnormal blood pressure
  • Eye disorders including sudden vision loss or retinitis pigmentosa
  • Bleeding disorders or stomach ulcers
  • Liver or kidney disease
  • A history or risk of priapism (prolonged erection)

Dose adjustments may be required:

If you are taking potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir), tadalafil levels may increase.

  • As-needed use: Do not exceed 10 mg every 72 hours
  • Daily use: Do not exceed 2.5 mg once daily

Serious Side Effects to Watch For

If you experience a medical emergency, seek immediate medical attention.

  • Cardiovascular risk: Sexual activity places stress on the heart. Do not use if sexual activity is not advised
  • Prolonged erection (priapism): Seek care if >4 hours
  • Vision problems: Sudden loss of vision may indicate NAION
  • Sudden hearing loss: May include ringing in the ears
  • Low blood pressure: Especially when combined with nitrates, alpha-blockers, antihypertensives, or alcohol
  • Nitrate interaction: Do not take nitrates within 48 hours after your last dose of tadalafil
  • Use with other ED medications: Do not combine PDE5 inhibitors
  • Bleeding risk: Rare bleeding events reported
  • STIs: Does not protect against sexually transmitted infections

 Common side effects

Some users may experience mild side effects while taking tadalafil, including:

  • Headache
  • Flushing
  • Upset stomach or indigestion
  • Back pain or muscle aches (typically 12–24 hours after dose)
  • Nasal congestion
  • Dizziness

Most side effects go away on their own within a few hours to a day. Contact your provider if they persist or worsen.

Related information

This page is provided for informational purposes only. Always consult a licensed healthcare provider before starting any treatment.