Description
Tadalafil (20 mg/ml)
Tadalafil may be advantageous to the following people in clinical settings:
- Men with erectile dysfunction (ED)
- Men with benign prostatic hyperplasia (BPH)
- Patients with pulmonary arterial hypertension
- Men seeking improved exercise capacity
- Individuals with combined ED and BPH symptoms
Tadalafil, which is a phosphodiesterase type 5 (PDE5) inhibitor, treats erectile dysfunction and benign prostatic hyperplasia. Doctors also prescribe it to treat pulmonary arterial hypertension because it helps widen blood vessels and supports better blood flow.
Tadalafil is FDA-approved and may be prescribed under its brand names, Cialis or Adcirca.
Mechanism of Action
Tadalafil works through several mechanisms:
- Inhibition of PDE5 enzyme: Tadalafil selectively inhibits phosphodiesterase type 5 (PDE5), which is responsible for the degradation of cyclic guanosine monophosphate (cGMP). By preventing cGMP breakdown, tadalafil allows for increased levels of cGMP in smooth muscle cells, leading to smooth muscle relaxation and vasodilation.¹
- Enhancement of nitric oxide signalling: The increased cGMP levels amplify the effects of nitric oxide (NO) released during sexual stimulation, resulting in improved blood flow to the corpus cavernosum of the penis and facilitating erection.²
- Smooth muscle relaxation in the prostate and bladder: Tadalafil’s PDE5 inhibition also affects smooth muscle in the prostate and bladder neck. The bladder neck connects the bladder to the urethra, so relaxing these key muscles is a key mechanism for reducing urinary symptoms typically associated with an enlarged prostate.³
- Pulmonary vasodilation: In pulmonary arteries, PDE5 inhibition leads to vasodilation and reduced pulmonary arterial pressure, which is beneficial in treating pulmonary arterial hypertension.⁴
Therapeutic Potential
These mechanisms enable tadalafil to address multiple conditions related to smooth muscle function and blood flow:
- Erectile dysfunction: Tadalafil is highly effective for ED treatment. A meta-analysis of 22 randomised controlled trials involving 5,478 patients demonstrated that tadalafil significantly improved erectile function scores compared to a placebo, with efficacy rates ranging from 60-81% depending on dosage.⁵
- Benign prostatic hyperplasia: Tadalafil alleviates lower urinary tract symptoms associated with BPH by relaxing smooth muscle in the prostate and bladder. Clinical trials have shown significant improvements in International Prostate Symptom Scores (IPSS), with one study reporting an average reduction of 3.9 points after 12 weeks of 5 mg daily dosing.⁶
- Combined ED and BPH: For men experiencing both conditions, tadalafil provides dual benefits. A randomised trial of 606 men found that daily tadalafil improved both erectile function and BPH symptoms simultaneously, with 71% of patients reporting improved erectile function.⁷
- Pulmonary arterial hypertension: Tadalafil is approved for PAH treatment at higher doses (40 mg daily). A pivotal trial showed that tadalafil improved exercise capacity by an average of 33 meters in a six-minute walk test compared to placebo, along with improvements in PAH symptoms and haemodynamics.⁸
- Exercise performance: Some research suggests tadalafil may enhance exercise capacity in healthy individuals through improved blood flow and oxygen delivery, though results are mixed and more research is needed.₉
Safety
Tadalafil is generally well-tolerated, but certain side effects and contraindications should be noted:
Common side effects include:
- Headache (11-15% of users)
- Dyspepsia (10-12%)
- Back pain (6-12%)
- Myalgia (3-6%)
- Nasal congestion (3-4%)
- Flushing (2-3%)¹³
Serious considerations:
- Contraindicated in patients taking nitrates or nitric oxide donors due to risk of severe hypotension.10
- May cause sudden vision loss in rare cases (non-arteritic anterior ischaemic optic neuropathy)11
- Can result in priapism (prolonged erection), requiring immediate medical attention.10
- Should be used cautiously in patients with cardiovascular disease.12
- May interact with alpha-blockers, causing symptomatic hypotension.13,14
How It Compares to Other PDE5 Inhibitors
Tadalafil differs from sildenafil (Viagra) and vardenafil in several key ways:
- Duration of action: Tadalafil’s 17.5-hour half-life provides up to 36 hours of therapeutic effect, compared to 4-5 hours for sildenafil and vardenafil. This extended duration allows for greater spontaneity and the option for daily low-dose administration.15
- Food interactions: Unlike sildenafil, tadalafil absorption is minimally affected by food intake, providing more flexibility in administration timing.16
- Selectivity: While all PDE5 inhibitors are selective for PDE5, tadalafil also has some activity against PDE11, though the clinical significance of this is unclear.17
- BPH indication: Tadalafil is the only PDE5 inhibitor approved for the treatment of BPH, either alone or in combination with ED.18
- Onset of action: Sildenafil may have a slightly faster onset (30-60 minutes) compared to tadalafil (2 hours), though individual responses vary.19
Data Sheet
- CAS Number: 171596-29-5
- Molecular Formula: C₂₂H₁₉N₃O₄
- ChemSpider ID: 99301
- PubChem CID: 110635
- DrugBank ID: DB00820
- UNII: 742SXX0ICT
Conclusion
Tadalafil works as a strong and long-lasting PDE5 inhibitor. It helps in treating erectile dysfunction, benign prostatic hyperplasia, and pulmonary arterial hypertension. It is already FDA-approved and available via prescription. Its longer half-life sets it apart from other PDE5 inhibitors by providing relief for up to 36 hours, allowing it to be used either when needed or in small daily doses.
We sell for research purposes only, and we encourage all individuals to consult with their doctor to determine if tadalafil is suitable for their specific circumstances. The information provided here does not constitute medical advice.
References
- Role of Nutraceuticals in Treating Erectile Dysfunction via Inhibition of Phosphodiesterase-5 Enzyme: A Mini Review – PubMed
- Chronic inhibition of phosphodiesterase 5 with tadalafil affords cardioprotection in a mouse model of metabolic syndrome: role of nitric oxide – PubMed
- In vitro effects of PDE5 inhibitors sildenafil, vardenafil and tadalafil on isolated human ureteral smooth muscle: a basic research approach – PubMed
- Tadalafil therapy for pulmonary arterial hypertension – PubMed
- Efficacy and safety of daily tadalafil in men with erectile dysfunction previously unresponsive to on-demand tadalafil – PubMed
- Tadalafil for the treatment of benign prostatic hyperplasia – PubMed
- Tadalafil – a therapeutic option in the management of BPH-LUTS – PubMed
- Tadalafil therapy for pulmonary arterial hypertension – PubMed
- The impact of PDE5 inhibitors on cardiovascular outcomes – PMC
- The efficacy and safety of PDE5 inhibitors – PubMed
- Vision disorders and phosphodiesterase type 5 inhibitors: a review of the evidence to date – PubMed
- Cardiovascular effects of tadalafil in patients on common antihypertensive therapies – PubMed
- Phosphodiesterase type 5 inhibitors for erectile dysfunction – PubMed
- Non-Arteritic Anterior Ischemic Optic Neuropathy Associated With the Use of Phosphodiesterase Type 5 Inhibitors: A Literature Review – PMC
- Patient preference and satisfaction in erectile dysfunction therapy: a comparison of the three phosphodiesterase-5 inhibitors sildenafil, vardenafil and tadalafil – PMC
- Efficacy and safety of tadalafil taken as needed for the treatment of erectile dysfunction in men: results of an integrated analysis – PMC
- Potency, selectivity, and consequences of nonselectivity of PDE inhibition – PubMed
- An open-label, multicentre, randomized, crossover study comparing sildenafil citrate and tadalafil for treating erectile dysfunction in men naïve to phosphodiesterase 5 inhibitor therapy – PubMed
- Tadalafil and vardenafil vs sildenafil: a review of patient-preference studies – PubMed
Kelvin –
Works excellent for erection. Has increased length. My urologist put me on daily Cialis, and my ejaculations have greatly improved, and my frequency of urination at night also has improved. Double jackpot
C. Miller –
Finally Something That Works for Both Conditions
katherinne Mendez –
Just one day after starting 5 mg Tadalafil, my BPH symptoms improved significantly. I was considering surgery before this. After several days, I experienced some low back and thigh pain, but that was resolved by Tylenol and ibuprofen and gradually diminished after a couple of weeks. The relief is worth it
Steph Gindorff –
I’m 54 and have experienced increasing ED problems over the past 2 years. I was also diagnosed with BPH. I started taking daily 5 mg Tadalafil, and the results are superb
Alexander F. Moreau –
It Just Felt Natural
Shawqi Almarzouq –
It’s working very well by reducing symptoms of frequent urination urge during the night, better flow of urine, and a stronger erection. I’m very pleased.
Danny Russo –
Great product, lasts for 3 days. I take 20mg and it’s effective for the entire weekend. It’s given me spontaneity and confidence back.
Jorge –
Better sleep has improved my energy and mood
Michael –
My wife was the first to notice. She said I seemed more confident, more engaged, more present. Tadalafil didn’t just improve my erections—it improved our connection
Michael –
My doctor recommended tadalafil for my ED and BPH. I was skeptical at first, but I’m so glad I listened. The results have been excellent. I just wish I had started sooner
Cesar Reales –
My Endurance Improved
Osmany Pupo –
It’s Made Me More Confident in the Bedroom
Laura Sorensen –
The improvement in my sex life has improved my overall wellbeing. I’m happier, more relaxed, and more engaged
Osmany Pupo –
Tadalafil has helped quiet that anxiety. I’m more present and able to focus on pleasure rather than worry.
Stephen Zukowski –
I’ve been on it for six months with excellent results
carlos antonio –
I used to dread intimacy because I felt like I was failing. Now, I look forward to it. My confidence is back. It’s been transformative
Patrick –
I hadn’t had morning erections in years. Since starting tadalafil, I wake up with strong morning erections every morning. It’s a sign that everything is working as it should.
Deanna Bell –
I’ve noticed better blood flow throughout my body, not just in my penis. My hands and feet are warmer. It’s a systemic effect that’s improved my overall health
Nick Garcia –
It’s Improved My Relationship
palleh farcarthy –
No side effects except when combined with alcohol I sometimes get a stuffy nose. Erections are very strong, sex is very pleasurable again, and I’ve seen a reduction in frequency of urination
Michael Edwards –
Reliable improvement in blood flow and function
William Chambers –
It’s been a positive change.
P. Gates –
My Sleep Improved
Adrian Gallardo –
Tadalafil helped me reclaim my confidence and my sense of self. I feel like me again.
Joshua Taylor –
I’m in my 50s and my libido had declined. Tadalafil has brought it back. I actually want to initiate intimacy again
Melvin –
My exercise capacity has improved. I can walk further without getting short of breath. It’s been a valuable treatment.
John Cosgrove –
The results are excellent—my erections are strong and my BPH symptoms improved. But I experienced the back and leg pain that some users report. It was significant for the first two weeks. It gradually diminished, but it was uncomfortable. A Tylenol helped. Still, the benefits outweigh the side effects.
Franklin Moss –
Took Time to Work for BPH
Paresh Shrestha –
Good for Mood, Less So for Arousal
randy darsan –
Effective
Daniel R. –
It improved our intimacy, but we still need to work on communication and connection. It’s a tool, not a replacement for a healthy relationship
Jessica villa –
Effective, But I Had to Adjust My Expectations
Gordon Scott –
I noticed a mood boost
stephanie mastando –
It Improved My Overall Wellbeing