Tadalafil
Also known as Cialis
What it is
Tadalafil is a phosphodiesterase type 5 inhibitor. Its long half-life distinguishes it from other PDE5 inhibitors and allows either on-demand or low-dose daily use.
How it is used
Taken orally, either as an on-demand dose before activity or as a lower daily dose. Which suits you is a clinical decision based on frequency of use, other medications and tolerance.
What a provider evaluates first
- Cardiovascular history and exercise tolerance
- Nitrate use — an absolute contraindication
- Alpha-blocker use and blood pressure
- Whether erectile dysfunction may signal underlying vascular or endocrine disease
Considerations and monitoring
- Must never be combined with nitrates
- Headache, flushing, nasal congestion and back pain are commonly reported
- Erectile dysfunction can be an early marker of cardiovascular disease and warrants evaluation rather than treatment alone
Questions about tadalafil
Tadalafil or sildenafil — what is the difference?
Both are PDE5 inhibitors. Tadalafil has a much longer half-life, which allows either on-demand use or a lower daily dose; sildenafil is shorter-acting and taken on demand roughly an hour beforehand, with onset delayed by a heavy meal. Side-effect profiles differ slightly. Neither may be combined with nitrates under any circumstances. Which suits you is a clinical decision based on frequency of use, other medications and tolerance.
Can erectile dysfunction be a sign of something else?
Yes, and this is the reason evaluation matters. Erectile dysfunction is frequently an early marker of vascular disease, and can also reflect diabetes, low testosterone, medication side effects, sleep apnoea or psychological factors. Treating the symptom without assessing the cause can mean missing something more consequential. A provider will review cardiovascular risk factors and relevant laboratory work as part of the evaluation.
Part of Sexual Health.