tah-DAL-ah-fil
A long-acting ED medication that can last up to 36 hours — also used daily at low doses for ongoing support.
Also known as: Cialis
FDA approved for: Erectile dysfunction · Benign prostatic hyperplasia (BPH) · Pulmonary arterial hypertension
Last reviewed: April 2026
Like sildenafil, tadalafil blocks the PDE5 enzyme to improve blood flow during arousal. The key difference is duration — tadalafil lasts up to 36 hours, earning it the nickname 'the weekend pill.' At daily low doses (2.5–5mg), it provides around-the-clock readiness.
As-needed: take 30 minutes to 2 hours before activity. Daily: take at same time each day.
Frequency
As needed or daily
Pain Level
○○○ None
Self-Administered
Yes — at home
Typical Range
2.5mg daily or 10mg – 20mg as needed
30 min – 2 hours
Effects begin (faster on empty stomach).
2–12 hours
Peak effectiveness.
Up to 36 hours
Effects can persist — the 'weekend' duration.
Overall: Mild
Headache
Most common side effect, usually mild.
Back pain
Unique to tadalafil, resolves in 24–48 hours.
Muscle aches
Typically in legs, temporary.
Indigestion
Acid reflux or upset stomach.
• Currently taking nitrates
• Severe liver disease
• Recent stroke or heart attack
• Hypotension
• Nitrates — NEVER combine, life-threatening hypotension
• Alpha-blockers — start with lower tadalafil dose
• Ritonavir — increases tadalafil levels significantly
Pregnancy: Not indicated for women. If prescribed off-label, not for use in pregnancy.
Longer-acting than sildenafil. Daily dosing provides continuous support without timing pressures.
Sildenafil
The original erectile dysfunction medication — relaxes blood vessels to improve blood flow when aroused.
PT-141 (Bremelanotide)
A peptide that increases sexual desire by acting on the brain — works differently from ED medications that only improve blood flow.
This peptide is available through our protocols.
FDA-approved for at least one indication. Your provider will determine if this is appropriate for you.