thoughtscape NP Psychiatry · Patient education
Tadalafil
Cialis / Adcirca — different treatment plans
One medicine, different schedules. Know which plan you are following before taking the first tablet.
Draft for review · Clinical content has not been revalidated for this website.
PDE5 supports blood-flow signaling with sexual stimulation. It does not directly increase sexual desire.
What it is used for
Cialis treats erection difficulties, urinary symptoms from an enlarged prostate, or both.
Adcirca treats PAH, a lung blood-pressure condition. Its dose is different. Do not combine these products or borrow someone else's plan.
How it works
Helps blood vessels relax so an erection can develop with sexual stimulation. It does not create desire or cure every sexual problem.
Can also ease prostate-related urinary symptoms. PAH treatment helps blood flow through the lungs and needs specialist follow-up.
What to expect over time
AS-NEEDED ED DOSE
Take at least 30 minutes before sex, as prescribed. Benefit may last up to 36 hours; a continuous erection is not the goal.
DAILY ED OR BPH PLAN
Take at about the same time daily. Do not add an extra tablet before sex. Food does not meaningfully change absorption.
CHECK YOUR RESPONSE
Discuss benefit and side effects over follow-up. If urinary symptoms worsen, do not simply increase the dose.
Taking your medication
Follow either your daily or as-needed ED plan, never both. Do not take more than once daily; some people need longer intervals.
Swallow tablets whole, with or without food. Kidney/liver problems and interacting medicines can change the dose or make it unsuitable.
For PAH, take your prescribed daily amount together, not in divided doses. Do not add another erection medicine or stop PAH therapy yourself.
When to get help
Chest pain during sex: stop and call 911. Do not take nitroglycerin. Tell responders exactly when you last took tadalafil.
Erection lasting 4 hours: get emergency care even without pain. Sudden vision or hearing loss also needs immediate care; take no further doses.
Severe reaction: get urgent help for blistering/peeling skin. Call 911 for breathing trouble, facial/throat swelling, or collapse.
Early side effects
Headache, indigestion, flushing, stuffy nose, or dizziness can occur. Tell your prescriber if symptoms interfere with life. Do not drive when dizzy or your vision is affected.
Other effects to discuss
Back or muscle aches may begin 12–24 hours after a dose and often ease within two days. Report severe or persistent pain. Do not assume a new serious symptom is just the medicine.
What to keep track of
Track your dose schedule, benefit, urinary changes, and side effects. Check blood pressure as advised. PAH needs separate specialist monitoring, even when you feel well.
Before you start
Discuss heart disease, chest pain, stroke, low/uncontrolled blood pressure, kidney/liver disease, retinal disease, past vision loss, bleeding/ulcers, blood disorders, or prolonged erections. Ask whether sex is safe for your heart. Trouble peeing needs assessment; it is not always an enlarged prostate. For PAH, discuss pregnancy or breastfeeding with the specialist before changing treatment.
Medicines & interactions
Nitrates, poppers, and riociguat
Do not combine them with tadalafil. Nitrate tablets, sprays, patches, and ointments all count. Even after stopping, the interaction can persist. Emergency nitrate decisions require medical supervision; waiting two days is not permission to take one yourself.
Blood-pressure and other prescriptions
Prazosin, tamsulosin, and other alpha blockers can increase fainting risk. Some antibiotics, antifungals, HIV, and seizure medicines change tadalafil levels. Let the pharmacist check every new medicine and any treatment being stopped.
Alcohol, grapefruit, and supplements
Heavy alcohol use increases low-blood-pressure risk and can worsen erections. Avoid grapefruit juice and discuss supplements, including St. John's wort. Do not add sildenafil, another tadalafil product, or a sexual-enhancement supplement.
Everyday tips
Use a daily reminder only if you have a daily prescription. Keep as-needed directions separate.
Allow sexual stimulation and time. More tablets will not reliably solve a difficult encounter.
Discuss sexual side effects without abruptly stopping an antidepressant or other medicine.
Use contraception and STI protection when needed. Tadalafil provides neither.
Your questions, answered
What if I miss a daily dose?
Take it when remembered unless nearly time for the next; then skip it. Never double up or take more than one daily dose.
Does 36 hours mean an erection all that time?
No. It is a window in which the medicine may help with stimulation. An erection lasting four hours is an emergency.
What if it does not work?
Review timing, stimulation, your schedule, and other health factors with your clinician. Do not add an extra dose or another ED medicine.
Can I stop taking it?
ED/BPH treatment generally does not need tapering, but symptoms may return. PAH is different: speak to your specialist before stopping.
Storage & safety
Keep tablets in the original closed container at room temperature, away from heat, moisture, children and pets. Never share. For an extra dose, call Poison Control at 1-800-222-1222; call 911 for severe symptoms.
About this information
For general information only; not a substitute for individualized medical advice. This sheet does not cover every risk or interaction. Ask your prescriber or pharmacist before changing how you take this medication.
Sources
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.