Tadalafil, known commonly as brand name Cialis, is a medication used to treat erectile dysfunction (ED), pulmonary arterial hypertension, and benign prostatic hyperplasia. Is it taken orally in tablet form, with an onset time of about 30 minutes; its duration lasts about 36 hours, with some users reporting benefits for up to a week. It has been shown to improve erections in up to 81% of men who try it.
Because of the prevalence of erectile dysfunction in older men, Tadalafil is more commonly used by adult men over the age of 40.
Is it often sold as a yellow pill in dosages of 2.5mg, 5mg, 10mg, and 20mg. It should not be taken more than once per 24 hours, and 20mg should not be taken every day, as the medication remains in the system for at least 24 hours. It works best when taken at least 30 minutes before sexual activity.
How is working?
Tadalafil improves penile erection during sexual stimulation with increased blood flow to a man’s penis. The medication’s mode of action is by relaxing the penile arteries and the smooth muscle. Nitric oxide is released from nerve terminals and endothelial cells, and PDE5 inhibited, thereby improving blood flow.
Sexual stimulation is required for the penis to release nitric oxide, so Tadalafil effects aren’t seen without sexual arousal.
The most common side effects are dizziness, hypotension, muscle pain, nausea, skin flushing, and headache; side effects are rare but usually involve a prolonged erection lasting beyond four hours which can damage the penis (priapism), or problems of with vision and hearing loss. (A 2007 announcement by the FDA demanded that all PDE5 inhibitors, including Tadalafil, include a more prominent warning of sudden and temporary hearing loss as a possible side effect.)
Because Tadalafil can cause a sudden drop in blood pressure, it’s not recommended for people taking nitrovasodilators (like nitroglycerin). It is not recommended for anyone with a heart condition, and overdose can result in heart attack and death.
Although one of the most common medications in the United States (with over 1.5 million users), a doctor’s prescription is required, and Cialis is rarely covered in full by insurance companies in the US, or is covered for only a few pills per month. It is commonly bought in one of its generic forms over the internet; many of these are manufactured in India and Israel. The FDA warns of counterfeit versions of the drug being ineffective or dangerous. Development of the drug began in the early 1990s, but it was not approved by the FDA until 2003.
A commonly-cited advantage of Tadalafil over other popular ED drugs, Viagra and Levitra, is its especially long half-life: Cialis is advertised as lasting for up to 36 hours, whereas Viagra works for about 4.