What is the recommended daily dose of Tadalafil (Cialis) for Benign Prostatic Hyperplasia (BPH)?

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From the Guidelines

The recommended daily dose of tadalafil for benign prostatic hyperplasia (BPH) is 5 mg taken once daily. This medication should be taken with or without food, and it's essential to swallow the tablet whole without crushing or splitting it. The 5 mg daily dose is specifically approved for BPH treatment, whether used alone or in combination with treatment for erectile dysfunction. Unlike as-needed dosing for erectile dysfunction, the BPH treatment requires consistent daily administration to maintain therapeutic blood levels. Tadalafil works for BPH by relaxing smooth muscle in the prostate and bladder, which helps improve urinary symptoms like weak stream, hesitancy, incomplete emptying, and frequent urination. Most patients experience symptom improvement within 1-2 weeks, though full effects may take up to 4 weeks. Common side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion. Tadalafil should not be taken with nitrate medications or if you have certain heart conditions, and alcohol consumption should be limited while using this medication. According to the American Urological Association (AUA) guideline 1, low-dose daily tadalafil is a recommended treatment option for BPH. Additionally, the AUA guideline 1 suggests that combination therapy with alpha blockers and 5-ARI or other agents may be offered to patients with specific conditions, but the combination of low-dose daily 5mg tadalafil with alpha blockers is not recommended due to the lack of advantages in symptom improvement over either agent alone.

Some key points to consider when prescribing tadalafil for BPH include:

  • The medication should be taken consistently every day to maintain therapeutic effects
  • Patients should be monitored for common side effects and potential interactions with other medications
  • Tadalafil is not recommended for use with nitrate medications or in patients with certain heart conditions
  • The AUA guideline provides recommendations for combination therapy, but the daily dose of 5mg tadalafil is the recommended dose for BPH treatment.

It's essential to follow the AUA guideline recommendations and consider the individual patient's condition and medical history when prescribing tadalafil for BPH. The guideline recommendations are based on the latest evidence and expert opinion, and the recommended daily dose of 5mg tadalafil is supported by the highest quality evidence 1.

From the FDA Drug Label

2.3 Tadalafil Tablets for Once Daily Use for Benign Prostatic Hyperplasia The recommended dose of tadalafil tablets for once daily use is 5 mg, taken at approximately the same time every day.

The recommended daily dose of tadalafil for BPH is 5 mg, taken at approximately the same time every day 2.

From the Research

Recommended Tadalafil Daily Dose for BPH

The recommended tadalafil daily dose for Benign Prostatic Hyperplasia (BPH) is:

  • 5 mg once daily, as indicated by multiple studies 3, 4, 5, 6, 7

Efficacy of Tadalafil for BPH

The efficacy of tadalafil for BPH has been demonstrated in several studies, with significant improvements in:

  • Total International Prostate Symptom Score (IPSS) 3, 4, 6, 7
  • IPSS voiding subscore 3
  • IPSS storage subscore 3
  • IPSS quality of life 3, 7
  • BPH Impact Index (BII) 3, 6

Safety of Tadalafil for BPH

The safety of tadalafil for BPH has been evaluated in several studies, with:

  • No significant difference in serious adverse events between tadalafil and placebo 3
  • Adverse events occurring at a higher incidence in the tadalafil group than in the placebo group, but generally being mild to moderate in intensity 3, 4, 6, 7

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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