From the Guidelines
Tadalafil is typically prescribed at doses of 2.5 to 20 mg depending on the condition being treated, with a recommended starting dose of 10 mg for erectile dysfunction (ED) taken prior to anticipated sexual activity, and major contraindications include concurrent use of nitrates and recent stroke or heart attack. The dosage and timing of Tadalafil (Cialis) can vary depending on the condition being treated.
- For erectile dysfunction (ED), the recommended starting dose is 10 mg taken prior to anticipated sexual activity, with a maximum frequency of once daily.
- For daily use in ED, 2.5 to 5 mg is prescribed.
- For pulmonary arterial hypertension, 40 mg once daily is common. Tadalafil can be taken with or without food and works within 30 minutes, with effects lasting up to 36 hours, earning it the nickname "weekend pill" 1. Major contraindications include:
- Concurrent use of nitrates (like nitroglycerin) which can cause dangerous drops in blood pressure
- Recent stroke or heart attack (within 90 days)
- Unstable angina
- Severe liver or kidney disease
- Uncontrolled hypertension or hypotension
- Retinitis pigmentosa Caution is needed with alpha-blockers, certain antifungals, and HIV protease inhibitors which may increase tadalafil levels 1. Tadalafil works by inhibiting phosphodiesterase type 5 (PDE5), increasing blood flow to specific tissues by relaxing smooth muscles in blood vessel walls, but requires sexual stimulation to be effective for ED. The evidence from the studies 1 suggests that tadalafil is effective in improving erectile function and is generally well-tolerated. However, it is essential to consider the potential contraindications and precautions when prescribing tadalafil to ensure safe and effective use.
From the FDA Drug Label
Do not split Tadalafil tablets; entire dose should be taken. The recommended starting dose of tadalafil tablets for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity. The dose may be increased to 20 mg or decreased to 5 mg, based on individual efficacy and tolerability. The maximum recommended dosing frequency is once per day in most patients The recommended starting dose of tadalafil tablets for once daily use is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. The tadalafil tablets dose for once daily use may be increased to 5 mg, based on individual efficacy and tolerability. Concomitant use of nitrates in any form is contraindicated
The recommended dosage of Tadalafil (Cialis) is:
- 10 mg, taken prior to anticipated sexual activity, for use as needed
- 2.5 mg, taken at approximately the same time every day, for once daily use The recommended timing is:
- Prior to anticipated sexual activity, for use as needed
- At approximately the same time every day, for once daily use The contraindications are:
- Concomitant use of nitrates in any form 2
From the Research
Recommended Dosage and Timing of Tadalafil (Cialis)
- The recommended dosage of Tadalafil (Cialis) is 5mg or 10mg taken once daily, as shown in a multicenter, randomized, double-blind, placebo-controlled trial 3.
- Tadalafil 2.5mg or 5mg once daily is also effective for the treatment of erectile dysfunction (ED), with findings from an integrated analysis of trials showing increased International Index of Erectile Function (IIEF) erectile function (EF) domain scores and mean successful intercourse attempts (SEP3) 4.
- On-time dosing of Tadalafil at 10mg/20mg twice a week for 8 weeks has been shown to be efficacious and well tolerated in the treatment of ED, with improved IIEF-5 scores and ED Inventory of Treatment Satisfaction (EDITS) scores compared to on-demand dosing 5.
Contraindications of Tadalafil (Cialis)
- There are no specific contraindications mentioned in the provided studies, but it is known that Tadalafil is contraindicated in patients taking nitrates, as it can cause a significant decrease in blood pressure 6.
- Patients with certain medical conditions, such as pulmonary arterial hypertension, may require special consideration when taking Tadalafil, as it can have effects on pulmonary vascular resistance 7.
- Common adverse events associated with Tadalafil include dyspepsia, headache, back pain, upper abdominal pain, and myalgia, which occurred in at least 5% of patients in clinical trials 3, 4.