Key takeaways
Tadalafil is a prescription oral medication that treats erectile dysfunction (ED), benign prostatic hyperplasia (BPH), or pulmonary arterial hypertension (PAH).
Daily tadalafil doses range from 2.5 mg to 40 mg. When taken as-needed for ED, doses range from 5 mg to 20 mg.
Different tadalafil dosages may be prescribed, depending on the condition it’s treating and your personal medical situation.
Here's what we'll cover
Here's what we'll cover
Key takeaways
Tadalafil is a prescription oral medication that treats erectile dysfunction (ED), benign prostatic hyperplasia (BPH), or pulmonary arterial hypertension (PAH).
Daily tadalafil doses range from 2.5 mg to 40 mg. When taken as-needed for ED, doses range from 5 mg to 20 mg.
Different tadalafil dosages may be prescribed, depending on the condition it’s treating and your personal medical situation.
Tadalafil, the active ingredient in the brand-name medications Cialis and Adcirca, is prescribed to treat several conditions, including erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and pulmonary arterial hypertension (PAH).
The tadalafil dosage your healthcare provider recommends can vary based on the condition being treated, your overall health, and any medications you’re currently taking.
In this tadalafil dosage guide, we’ll break down everything you need to know about how to take tadalafil—whether daily or as-needed—including the maximum dose of tadalafil for erectile dysfunction and how much you can safely take in 24 hours.
Cialis Important Safety Information: Read more about serious warnings and safety info.
Tadalafil dosage: strengths, forms, etc.
Tadalafil oral tablet is taken daily or as-needed, depending on what you’re taking it for. Available only by prescription, tadalafil comes in dosage strengths ranging from 2.5 milligrams (mg) to 40 mg, but the recommended dosages differ for ED, BPH, and PAH. Your prescribed tadalafil dosage may vary further based on your personal medical situation or other medications you’re currently taking. Tadalafil is also the active ingredient in Tadliq, a brand-name medication for PAH that comes in an oral liquid suspension.
Here’s an overview of the dosages of tadalafil oral tablets for different conditions:
| Available dosages | Recommended starting dosage | Maximum dosage |
|---|---|---|---|
Erectile dysfunction (ED) | Daily use: 2.5 mg, 5 mg As-needed use: 5 mg, 10 mg, 20 mg | Daily use: 2.5 mg, As-needed use: 10 mg | Daily use: 5 mg As-needed use: 20 mg |
Benign prostatic hyperplasia (BPH) | 5 mg daily | 5 mg daily | 5 mg daily |
Pulmonary arterial hypertension (PAH) | 20 mg daily | 40 mg (two 20-mg tablets) daily | 40 mg daily |
The drug is an oral phosphodiesterase type 5 (PDE5) inhibitor, which means it works by blocking an enzyme called PDE5. This enzyme is located in the smooth muscles of the penis, the prostate, and the blood cells surrounding the heart and lungs. PDE5’s job is to break down a molecule called cyclic guanosine monophosphate (cGMP) that increases blood flow. By blocking PDE5, drugs like tadalafil enable blood to keep flowing, which helps men with ED get an erection. For those with PAH, the increased blood flow reduces pressure on the lungs and heart, and for those with BPH, it relieves pressure in the prostate and bladder.
For those taking tadalafil to treat ED, it’s important to note that tadalafil does not make you horny; it simply helps you get an erection once you’re already feeling aroused.
Tadalafil dosage for erectile dysfunction
When taken for erectile dysfunction (ED), tadalafil can be taken daily or on an as-needed basis, which makes it unique among PDE-5 inhibitors. Other PDE5 inhibitors, including Viagra (sildenafil), Stendra (avanafil), and vardenafil are all taken on-demand, usually about one hour before you plan on having sex.
Tadalafil can also be taken this way, but some men prefer the convenience of taking it daily, which gives them more spontaneity around sex. The lower doses of daily tadalafil may also reduce the incidence of side effects in some men. A healthcare professional can help you determine whether as-needed or once-daily tadalafil is the right option for you.
Here’s an overview of the typical tadalafil dosages for ED:
Tadalafil for ED | Strength | When to take it |
|---|---|---|
Once-daily tadalafil | 2.5 mg, 5 mg | Daily, around the same time each day |
As-needed tadalafil | 5 mg, 10 mg, 20 mg | At least 30 minutes before sex |
When taken daily, you should aim to take tadalafil around the same time each day. The recommended starting dose is 2.5 mg. If the 2.5-mg dose is not working well enough for you and you can handle the side effects, your healthcare provider may increase your dose to 5 mg. When taken daily, the maximum dose of tadalafil for erectile dysfunction is 5 mg.
When taken as-needed, tadalafil may start working as soon as 30 minutes after you take it, with effects lasting for up to 36 hours. You can have sex as often as you like within that period, and you do not need to take more tadalafil. The recommended starting dose is 10 mg, but your healthcare provider may increase your dose to 20 mg, or decrease it to 5 mg, depending on your response to the medication and tolerance for side effects. When taken as-needed, the maximum dose of tadalafil for erectile dysfunction is 20 mg. You shouldn’t take tadalafil more than once per day.
Viagra Important Safety Information: Read more about serious warnings and safety info.
Tadalafil dosage for benign prostatic hyperplasia (BPH)
When treating benign prostatic hyperplasia (BPH), tadalafil should be taken once a day, around the same time each day, with or without meals. The recommended dosage of tadalafil for BPH is 5 mg daily.
If you’re taking tadalafil to treat both ED and BPH, the recommended dosage is 5 mg taken once a day, around the same time each day, with or without meals.
Tadalafil dosage for pulmonary arterial hypertension (PAH)
When treating pulmonary arterial hypertension (PAH), tadalafil should be taken once a day, with or without food. The recommended dosage of tadalafil for PAH is 40 mg daily. For BPH, the medication comes in 20-mg tablets, so you’ll take both tablets at once. The doses should not be divided over the course of a day.
How to take your tadalafil dose for best results
To get the best results from tadalafil, you should follow your healthcare provider’s medical advice and review the prescribing information that comes with the medication. In addition to taking tadalafil as prescribed, the drug makers recommend the following:
Limit your alcohol intake. Taking your tadalafil dose with five or more drinks of alcohol may lead to hypotension (low blood pressure) and increase your risk of experiencing dizziness, headache, or a fast heart rate.
When taking tadalafil daily for ED, BPH, or PAH, take it at around the same time each day. You can take it with or without food.
When taking tadalafil as-needed for ED, plan to take it at least 2 hours before you plan on having sex. Tadalafil may kick in as soon as 30 minutes after you take it, but it usually takes around 2 hours.
Never take more tadalafil than prescribed, and never take more than one dose in a 24-hour period.
Tadalafil dosage: side effects, risks, and drug interactions
While there are standard starting dosages for tadalafil, your healthcare provider may adjust your dosage depending on your tolerance for side effects, other health conditions you have, and other medications you’re taking.
Side effects
The most common side effects of tadalafil include:
Headache
Indigestion
Back pain
Muscle pain
Nasal congestion
Flushing
Limb pain
More serious side effects may include:
Hypotension (low blood pressure)
Priapism (an erection lasting four or more hours)
Loss of vision in one or both eyes
Hearing loss
Some side effects—including headache and indigestion—may be more common at higher doses of tadalafil, such as the 20-mg on-demand dose. If you experience intolerable side effects at the 20-mg dosage of tadalafil for ED, your healthcare provider may decrease your dosage to 10 mg. For most people taking tadalafil daily for ED, the side effects go away on their own with time.
Risks and drug interactions
Long-term studies show that when taken as prescribed, tadalafil is safe and well-tolerated in most men. But, the drug can carry an increased risk for men with certain health conditions or who take certain medications. Depending on the situation, you may not be able to take tadalafil at all, whereas in others, your healthcare provider may adjust your dosage so that tadalafil can be safe for you to take.
Tadalafil is contraindicated in (should not be taken by) or not recommended for people who:
Have a known allergy to tadalafil, Cialis, or Adcirca
Have been advised not to have sex due to their cardiovascular status
Are taking organic nitrates, such as nitroglycerin, or guanylate cyclase (GC) stimulators such as riociguat, or other PDE5 inhibitors like Viagra
With some health conditions and medications, tadalafil can be safe to take as long as dosage adjustments are made by your prescriber. For example:
If you are taking a CYP3A4 inhibitor, such as ketoconazole or ritonavir, the maximum dose of tadalafil that’s safe for you to take is 2.5 mg daily. The 10-mg dose is recommended for as-needed dosing, with at least 72 hours in between doses.
If you have liver problems or mild kidney failure, your healthcare provider may reduce your tadalafil dosage or recommend a different ED treatment.
If you have moderate or severe kidney failure, or you’re on hemodialysis, you should not take daily tadalafil. The 5-mg dose is recommended for as-needed dosing, with at least 72 hours in between doses.
Other health conditions that may require dosage adjustments include:
Conditions that increase your risk of priapism
Non-arteritic anterior ischemic optic neuropathy (NAION)
Certain urological conditions
Combining tadalafil with grapefruit juice or alcohol raises the risk of side effects, so it’s best to limit or avoid these beverages while taking tadalafil. And, tadalafil may interact with other drugs, including:
Nitrates
Some antifungal medications, including ketoconazole or itraconazole
Some antibacterial medications, including erythromycin or rifampin
HIV protease inhibitors like ritonavir or saquinavir
Medications that treat high blood pressure (anti-hypertensives)
Phenobarbital
Phenytoin
Carbamazepine
Some prostate medications and alpha-blockers, including doxazosin
Before starting tadalafil, tell your healthcare provider about all of the medications you’re currently taking so they can determine if tadalafil will be safe for you, make dosage adjustments if applicable, or recommend another ED treatment altogether.
What to do if you miss a dose of tadalafil
If you miss a dose of tadalafil or Cialis for BPH or ED, take your dose as soon as you remember, but don’t take more than one dose per day. If you miss a dose of tadalafil or Adcirca for PAH, take it as soon as you remember, unless it is close to your next dose. In that case, skip the missed dose and take your next dose at the regular time.
What to do if you take too much tadalafil
Tadalafil doses should never be taken more than once per day, no matter what you’re taking it for. Taking more than your prescribed dosage of tadalafil can make you more likely to experience side effects, including serious side effects like priapism, a sometimes painful erection lasting four or more hours that requires emergency medical attention.
If you take too much tadalafil, monitor your symptoms and contact your healthcare provider or Poison Control at 1-800-222-1222. You can also go to an emergency room.
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Bottom line
Tadalafil is the active ingredient in, and the generic form, of the brand-name medications Cialis and Adcirca. It’s an oral prescription medication indicated for the treatment of erectile dysfunction (ED), benign prostatic hyperplasia (BPH), or pulmonary arterial hypertension (PAH). Tadalafil comes in a range of dosage strengths, and the one your healthcare provider prescribes can depend on what you’re taking it for, other health conditions you have, and other medications you’re currently taking.
Tadalafil is a PDE-5 inhibitor that works by increasing blood flow and relaxing the muscles in different areas of the body, including the penis, lungs, heart, prostate, and bladder.
Tadalafil doses range from 2.5 mg to 40 mg. The tadalafil dosage for BPH is 5 mg daily. For PAH, the tadalafil dosage is 40 mg daily. For ED, tadalafil can be taken daily or on-demand. The daily doses include 2.5 mg and 5 mg, while the on-demand doses include 5 mg, 10 mg, and 20 mg.
You can take your tadalafil dose with or without food. It should not be combined with grapefruit juice or substantial amounts of alcohol.
Taking more tadalafil than prescribed can increase your risk of side effects, including serious side effects like priapism and low blood pressure. Never take more than one dose of tadalafil at a time.
Frequently asked questions (FAQs)
What is the maximum dose of tadalafil in 24 hours?
The maximum dose of tadalafil in 24 hours is 5 mg daily or 20 mg as-needed for erectile dysfunction (ED), 5 mg for benign prostatic hyperplasia (BPH), and 40 mg for pulmonary arterial hypertension (PAH). If you are taking tadalafil daily to treat ED, the maximum dose is 5 mg in 24 hours. If you are taking it as-needed for ED, the maximum dose is 20 mg in 24 hours.
When is 60 mg of tadalafil prescribed?
There is no FDA-approved 60-mg dose of tadalafil for any condition. The FDA has approved the following maximum daily doses of tadalafil: 5 mg for erectile dysfunction (ED), 5 mg for benign prostatic hyperplasia (BPH), and 40 mg for pulmonary arterial hypertension (PAH). If you are taking tadalafil as-needed for ED, the maximum dose is 20 mg, taken at least 30 minutes before sexual activity.
DISCLAIMER
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
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