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Erectile dysfunction (impotence) is the inability to get and keep an erection firm enough for sex.

  • Brand Name: Cialis (U.S.)
  • Chemical Name: tadalafil (tah-DAL-a-fil)
  • Usage in MS: Erectile Dysfunction
  • Generic Available: No


Tadalafil belongs to a group of medicines that delay the action of enzymes called phosphodiesterases that can interfere with erectile function. Tadalafil is used to treat men with erectile dysfunction (also called sexual impotence) because it helps to maintain an erection that has been created by stimulation. Tadalafil will not cause an erection without stimulation of the penis.

Type of medicine A phosphodiesterase type-5 inhibitor
Used for Erectile dysfunction in adult men; enlarged prostate gland
Also called Cialis®
Available as Tablets

Erectile dysfunction (sometimes called impotence) means that you cannot get or maintain a proper erection. There are several causes, the most common being due to a narrowing of the arteries that take blood to the penis.

Tadalafil works by preventing the action of a chemical in your body, called phosphodiesterase type 5. This helps to relax (widen) blood vessels and improves the flow of blood to the penis following sexual stimulation. This helps to maintain an erection.

Tadalafil is available on prescription, but it is only prescribed on the NHS for men with erectile dysfunction resulting from certain medical conditions. If you are given a private (non-NHS) prescription, you will be asked to pay for the tablets.

Tadalafil is also prescribed for men with prostate gland enlargement. The prostate gland commonly becomes larger in older men. The condition is also called benign prostatic hyperplasia (BPH). The prostate is situated close to the bladder, so its enlargement can cause problems with passing urine. Common symptoms that are experienced are having to wait before your urine starts to flow, taking longer at the toilet, dribbling urine, and a feeling that your bladder is not quite empty. Tadalafil works by improving the blood flow to the prostate and bladder, and also by relaxing the muscles in these areas. These actions help urine to follow more easily.

Another brand of tadalafil tablets called Adcirca® is used to treat a completely different condition called pulmonary arterial hypertension – see the separate medicine leaflet called Tadalafil for pulmonary hypertension if you have been prescribed this brand of tadalafil tablets.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking tadalafil it is important that your doctor knows:

      • If you have any disease, injury or deformity of your penis.
      • If you have a heart condition, or blood vessel disease.
      • If you have had an eye condition causing loss of vision.
      • If you have low blood pressure or angina.
      • If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
      • If you have had a stroke or a heart attack.
      • If you have sickle cell disease.
      • If you have ever had bone marrow cancer or leukaemia.
      • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines, and recreational drugs.
      • If you have ever had an allergic reaction to a medicine.
  • Before you take tadalafil, read the manufacturer’s printed information leaflet from inside your pack. It will give you more information about the tablets and will provide you with a full list of the side-effects which you could experience from taking them.
  • Take tadalafil exactly as your doctor tells you to. There are several strengths of tablet.
    • If you are taking tadalafil 10 mg or 20 mg tablets for erectile dysfunction: these tablets should only be taken before sexual activity – they are NOT for continuous daily use. You should take one tablet at least half an hour before you plan to have sex (it may still be effective up to 36 hours after taking the tablet). Do not take more than one dose in 24 hours.
    • If you are taking tadalafil 2.5 mg or 5 mg tablets for erectile dysfunction: take one tablet a day. Take the tablet at the same time of day each day.
    • If you are taking tadalafil 5 mg because of an enlarged prostate gland: take one tablet daily. Take the tablet at the same time of day each day.
  • You can take tadalafil either with or without food. Swallow the tablet with a drink of water.
  • Each time you collect a prescription, check to make sure it contains the strength of tablet you are expecting.
      • It is recommended that you do not drink grapefruit juice with tadalafil. This is because there is a chemical in grapefruit juice which can increase the amount of tadalafil in your bloodstream. This could make side-effects more likely.
      • Keep your regular appointments with your doctor so your progress can be monitored.

Additional information for men taking tadalafil for erectile dysfunction

      • You and your partner will still need to engage in foreplay, just as you would if you were not taking a medicine for erectile dysfunction. Tadalafil will not cause an erection unless you are sexually aroused.
      • Do not drink large amounts of alcohol before you plan to take tadalafil. Drinking too much alcohol can reduce your ability to get an erection and this may prevent you from getting the maximum benefit from the tablets.
      • If you do not get an erection after taking tadalafil, or if it does not last long enough for you to have sex, discuss this with your doctor – do not take more tablets than you have been told to. Alternatively, if you feel the tablets are too strong for you, you should discuss this with your doctor too.
      • You should not take tadalafil if you are using any other products or taking any other medicines to treat erectile dysfunction.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with tadalafil. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer’s printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer’s information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common tadalafil side-effects (these affect less than 1 in 10 people) What can I do if I experience this?
Headache, muscle aches and pains Ask your pharmacist to recommend a suitable painkiller. If the aches continue, let your doctor know
Indigestion, flushing, feeling sick (nausea), blocked nose These should soon pass
Feeling dizzy, problems with vision Do not drive and do not use tools or machines until your reactions/vision have returned to normal

Important: if you get an erection which lasts for longer than four hours, or if you get chest pains or a sudden loss of vision or hearing, contact a doctor for medical attention straightaway.

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.