Overview
Active ingredient: Tadalafil
Brand example(s): Tadalista (international generic brand), Cialis (US brand), multiple US generics
Main conditions discussed: Erectile dysfunction (ED); note on sports context in Uses
Available strengths referenced: 10 mg, 20 mg, 40 mg. In US practice for ED, 10 mg and 20 mg are common as needed; 2.5 mg and 5 mg are common for daily use. The 40 mg strength is typically associated with pulmonary arterial hypertension regimens and should not be used for ED unless specifically prescribed.
How Tadalista works
Tadalista contains tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor. When a man is sexually stimulated, nitric oxide promotes cyclic GMP in penile tissue. PDE5 breaks down cGMP; tadalafil slows that breakdown so more blood can flow into the penis, helping to achieve and maintain an erection. It does not increase sexual desire and only works with sexual stimulation.
Onset is typically within 30 to 60 minutes, and effects may persist up to about 36 hours. See Dosage and timing for practical tips.
Uses and who it is for
Tadalista is intended for adult men with erectile dysfunction. It is not approved for use in women or in children.
Sports note: PDE5 inhibitors are not currently prohibited by WADA, but athletes should confirm the latest rules with governing bodies and a team physician. Do not use tadalafil to enhance performance without medical guidance.
Dosage and timing
Use only as directed by a licensed clinician. Common patterns include:
- As-needed dosing: usually 10 mg taken about 30 minutes before sexual activity; some may require 20 mg. Do not exceed one dose per day.
- Daily dosing for ED: 2.5 mg to 5 mg once daily, taken at the same time each day, independent of sexual activity.
- Food: may be taken with or without food. A very high-fat meal can delay onset.
The 40 mg strength is generally not used for ED. Using higher-than-prescribed doses increases the risk of adverse effects without improving benefit.
Safety precautions
Before starting, share your full medical history with your clinician, especially if you have:
- Sickle cell disease, leukemia, multiple myeloma, or penile anatomical abnormalities (higher risk of prolonged erection)
- Recent stroke or heart attack, unstable angina, heart failure, or were told to avoid sexual activity
- Severe liver or kidney disease
- Retinal disorders or prior vision/hearing loss events
Limit alcohol; heavy drinking can lower blood pressure and worsen side effects. Do not combine with other ED therapies unless your prescriber specifically instructs you to do so. For medicines that cannot be taken together, see Do not use if and Drug and food interactions.
Do not use if
Tadalista must not be used together with nitrate medicines due to the risk of a severe, dangerous drop in blood pressure. Examples include:
- Isosorbide mononitrate or isosorbide dinitrate
- Nitroglycerin in any form (tablets, sprays, ointments, patches, pastes)
- Recreational nitrites such as amyl nitrite or amyl nitrate ("poppers")
If you use nitrates for chest pain, discuss non-PDE5 options with your clinician.
Possible side effects
Most people tolerate tadalafil well, but side effects can occur:
- Headache, facial flushing, indigestion or heartburn
- Back or muscle pain (myalgia), nasal congestion or runny nose
- Blurred vision or color tinge (trouble distinguishing blue/green)
- Diarrhea or urinary tract infection
Less common events reported include chest discomfort, sensitivity to light, skin rash, fainting from low blood pressure, rapid heartbeat, migraines, dry mouth, gingivitis, colitis, liver enzyme changes, or blood clots.
Seek urgent care if you experience any of the following: an erection lasting more than 4 hours (priapism), sudden loss of vision or hearing, severe chest pain, or signs of an allergic reaction. Dose reduction may alleviate milder effects; do not change your dose without medical advice.
Drug and food interactions
In addition to the absolute nitrate contraindication in Do not use if, use caution with:
- Alpha-blockers or other blood pressure medicines (additive blood pressure lowering)
- Strong CYP3A4 inhibitors (for example, ketoconazole, ritonavir, clarithromycin, itraconazole) which can raise tadalafil levels; dose adjustments may be required
- CYP3A4 inducers (for example, rifampin, carbamazepine, phenytoin) which can reduce effectiveness
- Grapefruit or grapefruit juice (may increase blood levels)
- Excess alcohol (increases risk of dizziness, low blood pressure)
Tell every prescriber and pharmacist you use tadalafil so they can screen for interactions.
Missed dose
As-needed use: there is no scheduled dose; do not double up.
Daily use: if a dose is missed, take it when remembered unless it is close to the next dose. Do not take more than one dose per day.
Overdose
If you suspect an overdose or experience severe symptoms (for example, fainting, severe chest pain, priapism), seek emergency medical attention immediately or call 911 in the USA.
Storage
- Store at room temperature in a dry place (generally 20 to 25 C / 68 to 77 F).
- Keep in a tightly closed container, away from moisture and direct heat.
- Keep out of reach of children and pets.
- Do not use past the expiration date.
Similar and alternative medications
Other FDA-approved ED treatments in the USA include:
- Vardenafil (brand Levitra, Staxyn ODT; generics available) - onset and duration similar to sildenafil; some individuals prefer its side effect profile.
- Avanafil (brand Stendra) - often faster onset in some users; shorter duration than tadalafil.
- Sildenafil (brand Viagra; widely available as generics) - effective for many; typical duration 4 to 6 hours.
- Tadalafil US generics and brand Cialis - same active ingredient as Tadalista; long duration up to about 36 hours; also used in daily low doses.
Non-oral options for selected patients include vacuum erection devices, intraurethral alprostadil, and intracavernosal injections (for example, alprostadil or tri-mix). Choice depends on medical history, convenience, and tolerance.
Ask your prescriber which option fits your health status, concomitant medications, and personal preferences.
Typical prices in the USA (rough guide)
Prices vary widely by pharmacy, dose, quantity, discounts, and insurance. The figures below are ballpark retail cash prices per tablet in USD as of recent market checks:
- Tadalafil generic 10 mg or 20 mg: about $1 to $4 each with common discount programs; higher without discounts.
- Brand Cialis 10 mg or 20 mg: often $15 to $70 per tablet depending on pharmacy and quantity.
- Sildenafil generic 50 mg or 100 mg: roughly $0.50 to $2 per tablet with discounts.
- Vardenafil generic 10 mg or 20 mg: around $3 to $10 per tablet.
- Avanafil (Stendra) 50 mg to 200 mg: commonly $8 to $20 per tablet.
Note: Tadalista as a brand manufactured for markets outside the USA may not be stocked by US pharmacies. In the USA, pharmacies dispense FDA-approved tadalafil generics or Cialis. Importing foreign versions is generally restricted (see Legal status).
Legal status and purchase rules in the USA
- Prescription-only: Tadalafil for ED is an FDA-approved prescription medicine. A valid US prescription from a licensed clinician is required.
- Online purchase: Use state-licensed pharmacies. Look for the NABP .pharmacy domain or the NABP-accredited Safe Pharmacy list. Avoid unverified sites that offer prescription drugs without a prescription.
- Importation: Personal importation of prescription drugs from abroad is generally illegal. The FDA may exercise enforcement discretion in very limited situations, but ED drugs typically do not qualify. Customs may seize shipments.
- Telehealth: US telemedicine services can legally prescribe after an appropriate evaluation per state law. Tadalafil is not a controlled substance, but prescribing must follow state and federal regulations.
- Age and use: Intended for adult men. Use only as directed; sharing prescription medicine is unlawful.
- Doping rules: While PDE5 inhibitors are generally not prohibited by WADA, athletes should verify current regulations with their sport authorities.
Quick answers
How long does it last? Many men experience improved erectile response for up to 36 hours after a dose.
Can I drink alcohol? Small amounts may be acceptable, but heavy drinking can increase the risk of dizziness or low blood pressure and reduce erectile performance.
Can I take it with other ED pills? Do not combine with other PDE5 inhibitors unless a clinician specifically directs you to do so.
What if I take nitrates? Do not use tadalafil or any PDE5 inhibitor. See Do not use if.