Tadalafil

Tadalafil belongs to the phosphodiesterase type 5 (PDE5) inhibitor group. By blocking this enzyme in the penis, it lets blood vessels relax and fill more easily once a man is sexually aroused. It does not create desire on its own and does nothing without stimulation. The UK SmPC lists erectile dysfunction in adult men as its main use, and the lower 5 mg strength is also licensed for the urinary symptoms of an enlarged prostate (benign prostatic hyperplasia). A separate 20 mg product carries a licence for pulmonary arterial hypertension, a condition handled by dedicated hospital centres rather than in routine practice.

This listing offers 10 mg, 20 mg, 40 mg, 60 mg and 80 mg tablets. The 10–60 mg options come in packs of 10, 20, 30, 60, 90, 120, 180, 270 and 360 tablets, while the 80 mg strength is available in packs of 10 up to 120. Bear in mind that UK-licensed tablets for erection problems are made in 2.5, 5, 10 and 20 mg only. The 40, 60 and 80 mg versions are not UK-licensed strengths, and none of them holds a UK marketing authorisation.

For occasional use, the SmPC suggests 10 mg taken at least 30 minutes before sex, with or without food. If that proves too weak, 20 mg may be tried, and no more than one dose should be taken in 24 hours. Because the effect can last up to 36 hours, many men find there is less need to plan around a single evening. Some men prefer a continuous approach instead: 5 mg once daily at roughly the same time, which can be lowered to 2.5 mg. The 10 and 20 mg tablets are not meant for everyday continuous use. People with severe kidney impairment should not exceed 10 mg on demand. Any dose above 20 mg sits outside UK guidance for erectile dysfunction, and the right amount for you is decided by your prescriber.

Tadalafil is a prescription-only medicine (POM) in the UK. The only exception is one 10 mg product that the MHRA reclassified in 2023 as a pharmacy (P) medicine: it may be sold after a pharmacist's assessment, in packs of no more than eight tablets, to adult men with erectile dysfunction. All other strengths and brands stay on prescription. The pulmonary hypertension product is sold under the brand name Adcirca, and generic tablets from several manufacturers are widely used across the NHS.

Do not take tadalafil if you use any nitrate, such as glyceryl trinitrate spray or isosorbide mononitrate, or recreational "poppers", because the combination can cause a dangerous fall in blood pressure. The same applies to riociguat. It is also unsuitable after a heart attack within the past 90 days, a stroke within six months, with unstable angina, uncontrolled high or low blood pressure, or loss of vision from non-arteritic ischaemic optic neuropathy. Alpha-blockers like doxazosin may add to its blood-pressure-lowering effect, and strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) raise its levels, while rifampicin lowers them. Grapefruit juice and heavy drinking should be kept to a minimum.

The most frequent complaints are headache, indigestion, back or muscle ache, flushing and a blocked nose. These usually ease within a few hours. Rarely, men report sudden loss of sight or hearing; stop the tablets and seek urgent help if that happens. An erection lasting more than four hours (priapism) needs immediate treatment at A&E to protect the tissue. Chest pain during sexual activity is another reason to stop and get medical attention straight away.

Erection difficulties can be an early sign of diabetes, raised cholesterol or heart disease, so it is worth having a GP check before relying on any treatment. Keep the tablets in their original packaging and out of children's reach. Tadalafil is intended for men only and is not suitable for anyone under 18. Your doctor or prescriber is the right person to decide whether this medicine, and which strength, suits your health.