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tadalafil

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Brand names: Cialis

PDE5 Inhibitor Rx

Tadalafil (Cialis) is a medicine that helps men with erectile dysfunction (ED) or enlarged prostate (BPH). It belongs to a class of drugs called PDE5 inhibitors.

Drug Pricing (NADAC)

Brand Price

$54.23/unit

Generic Price

$0.10/unit

Generic Savings

100%

Generic Available

Yes (31 manufacturers)

Pricing data from NADAC (CMS), effective December 25, 2024. Compare all drug costs →

What it does

This medicine can help men who have trouble getting or keeping an erection (ED).

Common side effects

Headache, Upset stomach, Back pain

Key warnings

If you have chest pain, tell your doctor.

How It Works

Tadalafil works by relaxing the muscles in the penis and prostate. This increases blood flow to these areas. For BPH, it relaxes muscles in the prostate and bladder, which can improve urinary symptoms.

How to Take It

You should not split the tablets; swallow them whole. For ED, you can take a 10 mg dose as needed before sex. Your doctor may change the dose to 5 mg or 20 mg based on how it works for you. Do not take more than one dose a day. For BPH, take 5 mg daily at the same time each day. You can take this medicine with or without food.

Pregnancy & Breastfeeding

This medicine is not for use in women. It is not known if this medicine will harm an unborn baby. It is also not known if this medicine passes into breast milk.

Missed Dose

If you take this medicine daily and miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.

Storage

Store this medicine at room temperature, away from heat and moisture.

Side Effects (from patient reports)

Based on 67,414 FDA adverse event reports.

Shortness of breath
11,663
Headache
10,690
Diarrhea
7,800
Feeling sick to your stomach
6,498
Death
5,896
Tiredness
5,836
The medicine is not working
5,432
Feeling lightheaded
5,177
Pneumonia
4,224
Cough
4,198

FDA Adverse Event Report Analysis

Detailed analysis of 96,629 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.

Total Reports

96,629

Death-Related Reports

10,913

Hospitalization Reports

36,455

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 48,958 (53%)
Male 43,694 (47%)

Age Distribution

0–17 2,493
18–44 10,011
45–64 25,717
65–74 15,808
75+ 10,533

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DYSPNOEA 11,663
2 HEADACHE 10,690
3 DIARRHOEA 7,799
4 NAUSEA 6,498
5 DEATH 5,899
6 FATIGUE 5,836
7 DRUG INEFFECTIVE 5,432
8 DIZZINESS 5,177
9 PNEUMONIA 4,225
10 COUGH 4,199
11 MALAISE 3,723
12 VOMITING 3,434
13 ASTHENIA 3,306
14 PAIN IN EXTREMITY 3,297
15 PAIN 3,291

Reactions in Death Reports

DEATH 5,856
DYSPNOEA 1,277
PULMONARY ARTERIAL HYPERTENSION 1,043
DIARRHOEA 630
PNEUMONIA 622
PULMONARY HYPERTENSION 554
HEADACHE 547
CARDIAC FAILURE 516
RIGHT VENTRICULAR FAILURE 470
NAUSEA 458

Reactions in Hospitalization Reports

DYSPNOEA 6,932
PNEUMONIA 3,625
HEADACHE 3,525
DIARRHOEA 3,413
NAUSEA 2,867
FLUID RETENTION 2,396
FATIGUE 2,191
PULMONARY ARTERIAL HYPERTENSION 1,970
DIZZINESS 1,968
VOMITING 1,919

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

If you have chest pain, tell your doctor. If you need nitrates for a heart problem, wait 48 hours after taking tadalafil before taking nitrates. If you get an erection that lasts more than 4 hours, get medical help right away. If you have sudden vision loss in one or both eyes, stop taking this medicine and get medical help right away. If you have a sudden decrease or loss of hearing, stop taking this medicine and get medical help right away.

Known Drug Interactions

7 DRUG INTERACTIONS 7.1 Phosphodiesterase Inhibitors BiDil is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), PDE5 inhibitors such as avanafil, sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates.

Mechanism: These medicines both lower blood pressure in a similar way, and using them at the same time can cause a severe and unsafe drop in blood pressure.

What to do: You should not use these drugs together as it is strictly advised against.

Phosphodiesterase inhibitors: Sildenafil Tadalafil Vardenafil Use With Caution Sildenafil, Tadalafil, Vardenafil: Each of these phosphodiesterase inhibitors is primarily metabolized by CYP3A, and CYP3A will be inhibited by concomitant administration of clarithromycin. Co-administration of clarithromycin with sildenafil, tadalafil, or vardenafil will result in increased exposure of these phosphodiesterase inhibitors.

Mechanism: Clarithromycin stops the body from breaking down tadalafil properly. This leads to higher levels of tadalafil in your blood, which can increase the risk of side effects.

What to do: Use this combination with caution. Your doctor may need to change your dose of tadalafil.

Pulmonary hypertension agents (PDE5 inhibitors) tadalafil (Adcirca ® ) ↑ tadalafil Avoid concomitant use of tadalafil with PAXLOVID for pulmonary hypertension. sildenafil, tadalafil, vardenafil ↑ sildenafil ↑ tadalafil ↑ vardenafil Dosage adjustment is recommended for use of sildenafil, tadalafil or vardenafil with PAXLOVID when used for erectile dysfunction.

Mechanism: This combination prevents the body from clearing tadalafil, leading to much higher levels of the drug in your system.

What to do: Avoid this combination if you take tadalafil for lung pressure, or talk to your doctor about a lower dose if using it for erectile dysfunction.

Clinical pharmacology studies were conducted to assess the effect of tadalafil on the potentiation of the blood-pressure-lowering effects of selected antihypertensive medications (amlodipine, angiotensin II receptor blockers, bendrofluazide, enalapril, and metoprolol).

Mechanism: Both drugs lower blood pressure, so taking them together can cause an additive effect that drops blood pressure further.

What to do: Monitor your blood pressure closely and watch for signs of dizziness or lightheadedness.

Clinical pharmacology studies were conducted to assess the effect of tadalafil on the potentiation of the blood-pressure-lowering effects of selected antihypertensive medications (amlodipine, angiotensin II receptor blockers, bendrofluazide, enalapril, and metoprolol).

Mechanism: These drugs both work to lower blood pressure, which can lead to a combined effect that lowers pressure more than intended.

What to do: Your doctor may need to monitor your blood pressure or adjust your doses if you feel faint.

Check all your medications →

Common Questions

Can I take this medicine with food?
Yes, you can take this medicine with or without food.
How long does this medicine last?
For ED, a single dose can improve erectile function for up to 36 hours.
Can I drink alcohol while taking this medicine?
Drinking a lot of alcohol while taking this medicine can increase your risk of side effects, such as dizziness and low blood pressure.
What should I do if I get a headache?
Headache is a common side effect. You can try taking an over-the-counter pain reliever.
Can I take this with other medications?
Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Is it safe to take Tadalafil every day?
Yes, Tadalafil can be taken every day at a low dose (2.5mg or 5mg) to treat ED or BPH.
Can Tadalafil cure ED or BPH?
No, Tadalafil does not cure ED or BPH, but it can help manage the symptoms.
How quickly does Tadalafil work?
When taken as needed for ED, Tadalafil can start working within 30 minutes.
Can women take Tadalafil?
No, Tadalafil is not approved for use in women.
Can I buy Tadalafil over the counter?
No, Tadalafil requires a prescription from a doctor.
What are the common side effects of tadalafil?
The most commonly reported side effects of tadalafil include Headache, Upset stomach, Back pain, Muscle aches, Nasal congestion. Based on 67,414 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does tadalafil interact with other medications?
Yes, tadalafil has 25 known drug interactions. Notable interactions include hydralazine/isosorbide dinitrate, clarithromycin, nirmatrelvir/ritonavir. Always inform your doctor about all medications you are taking.
What drug class is tadalafil?
tadalafil belongs to the PDE5 Inhibitor drug class. It requires a prescription (Rx). This medicine can help men who have trouble getting or keeping an erection (ED).
Is there a generic version of tadalafil?
Yes, generic tadalafil is available from 31 manufacturers. The generic costs $0.10 per unit compared to $54.23 for the brand version, saving approximately 100%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is tadalafil safe during pregnancy?
This medicine is not for use in women. It is not known if this medicine will harm an unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has tadalafil been recalled?
There are 2 recalls associated with tadalafil products. cGMP Deviations for the manufacturing Firm (Accord Healthcare) after their inspection. Check the recalls section below for full details and affected products.

Active Recalls

Class II March 23, 2023

cGMP Deviations for the manufacturing Firm (Accord Healthcare) after their inspection.

Preferred Pharmaceuticals, Inc.

Class II March 16, 2023

CGMP Deviations

Northwind Pharmaceuticals LLC

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What the FDA Data Shows for tadalafil

The FDA label for tadalafil (sold under brand names such as Cialis) classifies it as a prescription-only medication in the PDE5 Inhibitor class. This medicine can help men who have trouble getting or keeping an erection (ED). Official labeling lists 7 commonly reported side effects, including Headache, Upset stomach, Back pain.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 67,414 voluntary reports. The database also lists 25 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.10 versus $54.23 for the brand — a 100% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 2 recall records on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: October 16, 2024

All federal data sources used on this page