Active substances and medicines

What is Tadalafil?

Tadalafil under the name of Cialis is a drug that has a beneficial effect on male erection.

Tadalafil increases blood flow to the pelvic organs including the penis. That is why it is used to treat  mild to moderate erectile dysfunction in men as well as the symptoms of benign prostatic hypertrophy. For these purposes, a drug with  the brand name Cialis is used. Another brand of Tadalafil is Adcirca which is used to treat pulmonary arterial hypertension.

Tadalafil Citrate was approved by the U.S Food and Drug Administration (FDA) responsible for control and supervision of foods, dietary supplements, prescription and over-the-counter pharmaceutical drugs in 2003.

How does Tadalafil Citrate work?

This is cGMP-specific phosphodiesterase type 5 (PDE-5) substance. What does it mean? PDE-5 is an enzyme that participates in relaxing the vessels. An inhibitor is a substance that prevents it.

PDE-5 is found in large concentration in the lungs, penis and retinal tissue as well as in vascular smooth muscle cells in our body.

When blood flows to the penis as a result of sexual arousal, the vessels widen and cavernous bodies are filled with blood inducing erection.

When the vessels tend to relaxation, erection is weak and short. Inhibiting mechanisms of action of PDE-5, Cialis (Tadalafil Citrate) provides stronger and longer erection.

Interaction of Cialis with other drugs. Contraindications and side effects of Tadalafil

Before taking Cialis, consult your doctor and notify him or her about other drugs you are taking and about your current conditions. Taking Cialis with certain other medicines can cause serious consequences.

Tell your doctor about the following symptoms and conditions to make sure this medicine is safe for you.

  • Allergy to any substances same or similar to Tadalafil.
  • Cardiovascular diseases.
  • Liver or kidney disease.
  • Heart attack within 3 months and less.
  • Hereditary eye diseases.
  • Discomfort in the chest during sexual activity.
  • Health problems that make sexual activity unsafe.

Do not take Tadalafil if you are already taking nitrate drugs as it can cause a sudden and serious drop in blood pressure. Poppers can cause unwanted effects when taking with Cialis.

Do not take Cialis with similar medications such as Viagra (Sildenafil), Levitra (Vardenafil), Stendra (Avanafil) and Adcirca (Tadalafil).

Grapefruit or grapefruit juice may interact with Tadalafil and lead to unwanted side effects. Avoid the use of grapefruit products.

Side effects

Tadalafil was approved by the U.S Food and Drug Administration (FDA) responsible for control and supervision of foods, dietary supplements, prescription and over-the-counter pharmaceutical drugs in 2003. This means that this substance is effective and safe.

In many cases, side effects do not do any lasting harm and go away over time when the body adapts to the medication.

However, immediately call your doctor if side effects are persistent and affect your day-to-day life.

The most common side effects of Cialis are headache and digestive disorders. Stuffy nose, cough, flushing, backache, pain in the arms and legs are less common.

Side effects that require an immediate call to a doctor

  • Rash, itchy skin, skin edema, flaky skin, skin and mucosal redness, blistering.
  • Facial, mouth and throat swelling; difficulty with breathing and swallowing.
  • Loss of balance; difficulty with thinking and speaking.
  • Irregular heart rhythm, tightness and pain in the chest.
  • Severe headache.
  • Light-headed feeling, like you might pass out.
  • Vision or hearing loss, ringing in the ears.
  • Swelling in your hands and feet.
  • Shortness of breath for no apparent reason.
  • Hematoma and bleeding.
  • Painful erection that lasts for more than 4 hours.

If you have any of these, seek medical help.

Tadalafil dosage and use

Tadalafil is a prescription drug, strictly follow your doctor recommendations and do not increase or decrease the dose. Do not take Tadalafil longer than it was prescribed.

Do not break or split a Cialis tablet. Swallow it whole.

The recommended dose of Cialis for most of the patients to take as needed before a sexual activity is 10 mg. The dose may be increased to 20 mg or reduced to 5 mg depending on individual efficacy and tolerability.

The dose for a regular daily use is 2.5 mg – 5 mg based on individual tolerability.

Take Cialis at least half an hour before sexual activity. This drug has shown to improve erectile dysfunction up to 36 hours following dosing.

It is not recommended to take Tadalafil more than once a day and it is better to take it in approximately the same time. Cialis can be taken with or without food.

A reduced dose of Cialis is recommended to the patients with mild to moderate liver disease. In severe cases, avoid using Tadalafil.

The same is true for the patients with kidney disease: the dose is reduced for mild to moderate liver disease mild to moderate kidney disease and the drug should be avoided for severe cases.

Remember that Tadalafil induces erection only in the presence of sexual stimulation. The medication itself does not induce erection.

The recommended dose of Tadalafil for benign prostatic hypertrophy is 5 mg daily.

Cialis generics – other medications with Tadalafil

Generic drugs are copies of brand-name drugs that have exactly the same active substance.

When a company is developing a new medication, its active substance is thoroughly tested and studied. Only when the result of the studies is positive – which is not always the case – the company obtains a patent. While the patent remains in force, only the drug developer can manufacture and sell medications with this active substance. It allows the company to recover its expenses that worth millions.

When the term of the patent expires, other companies are entitled to manufacture drugs with this active substance. These drugs become generics.

The drug developer of Tadalafil is the company Eli Lilly. Its exclusive right to manufacture Tadalafil (Cialis) expires in spring 2020 but the term may be extended.

Otherwise, Cialis generics or other drugs with Tadalafil may enter the market.

Note that legal generics are also tested and studied and only when the results are positive generics are approved and can be introduced to the market.

Currently, there are no FDA approved generics with Tadalafil. However, there are many illegal generics manufactured in third countries, especially in India. The Indians do not care much about exclusive rights and patents and soon after the original drug appears on the market, they manufacture generics and sell them at much lower price. It attracts the customers both in third countries and in Europe, Canada, and the USA. Efficacy and safety of such drugs are questionable.

Illegal generics are so popular because they are easily available. One may buy them in illegal online stores and online pharmacies.

The original Tadalafil under the name of Cialis is a controlled substance which means that you need  a prescription to buy it legally. Online pharmacies require a copy of your prescription.


Cialis (Tadalafil) is a popular medication to treat erectile dysfunction in men. It is second only to Viagra (Sildenafil). Cialis is effective and its side effects  do not do any lasting or serious harm. Its main advantage is a prolonged duration of action up to 36 hours. Millions of men around the world gained their self-confidence and got their sex life back on track.