Tadalafil Dosage Guide
Reviewed by Kristin Hall, FNP
Written by Geoffrey Whittaker
Erectile dysfunction (ED) can really put a damper on your sexual activity. But luckily, the problem can be addressed pretty efficiently with lifestyle changes, therapy and/or medication.
That said, getting a prescription for something like tadalafil can be a bit more complicated than you initially assume — especially when it comes to the question of dosage.
Tadalafil (the active ingredient in brand names Adcirca and Cialis®) is one of the best-known erection pills on the market today.
The prescription drug is a PDE5 inhibitor, meaning it blocks phosphodiesterase type 5 enzymes that prevent blood flow to the penile tissue. So tadalafil essentially treats erectile dysfunction by increasing blood flow to your penis, making it easier for you to get an erection when you feel sexually aroused.
Like sildenafil (the active ingredient in Viagra), avanafil (generic for Stendra®) and other ED medications, tadalafil is available in several dosages — and they’re not all just for problems with getting hard.
It’s important to choose the right dosage for your needs. That way, you can treat ED with minimal side effects or complications.
We know you have questions, and we have answers. Below, we’ll explain how this medication is dosed, what conditions it can treat and how to take it safely and effectively.
After all, you want the best results from the medication (and your penis) possible.
Here’s how to do it.
Tadalafil is available in several dosages, from a minimum dosage of 2.5mg (milligrams) all the way up to a maximum dose of 20mg per tablet.
For optimal results, take tadalafil at least 30 minutes before you and your partner plan to have sex. But if you have sex every four hours (high-five to that), you won’t want to use tadalafil every time — this could be very dangerous.
Since tadalafil is the longest-lasting medication for erectile dysfunction, you have to treat it differently than many other medications on the market. The key reason: A single dose of tadalafil may provide relief from ED for up to 36 hours — which is about one and a half days.
If we wade into the science for a moment, that means the half-life of tadalafil is approximately 17.5 hours, so a 20mg dose would take around four days to exit your system entirely.
That’s a really long time — and it’s only an average. In elderly men, for instance, tadalafil has a slightly longer half-life of roughly 21.6 hours and may take four to five days to completely exit the body.
As a long-lasting ED medication, tadalafil is only recommended for use one time per day. When used at a typical as-needed dosage, tadalafil remains effective for up to 36 hours.
Tadalafil Dose Uses
There are some misunderstandings we should clear up before you go begging a healthcare provider to hand over the pills — one of them is the proper use of tadalafil.
Here’s the most critical thing to understand: Contrary to popular belief, tadalafil and other PDE5 inhibitors won’t make you randomly get erections. Instead, they just increase blood flow to your penis, meaning you’ll only get an erection when you receive sexual stimulation or feel sexually aroused.
Tadalafil works by inhibiting the effects of cGMP-specific phosphodiesterase type 5 (or PDE5) — an enzyme found in the smooth muscle cells of blood vessels. PDE5 plays a major role in regulating the flow of blood to certain parts of your body, including the erectile tissue of your penis. By inhibiting the effects of PDE5, tadalafil makes it easier for blood to flow to your penis and produce an erection.
Our guide to PDE5 inhibitors has more information about how tadalafil, sildenafil and other medications for erectile dysfunction work.
Oh, and tadalafil can be used to treat other conditions as well. As a matter of fact, there are a number of common use cases for this medication, including:
Daily tadalafil for ED
On-demand tadalafil for ED
Tadalafil for pulmonary arterial hypertension (PAH)
Let’s look at the actual dosages in more detail.
Typical Starting Dose: 10mg Tadalafil
10mg is a typical starting dosage of tadalafil. The medication is typically prescribed at this dosage for use as needed before sex for men with mild to moderate ED. And if you begin your ED treatment journey with tadalafil, you’ll almost certainly be prescribed a 10mg dose to start.
If you have mild to moderate ED, or if you’re just starting with tadalafil, your healthcare provider may prescribe the medication at this dosage and see how you react.
Research shows that most men with ED who use tadalafil at this dosage are able to have sex successfully, though it may not be exactly what meets your individual needs. In that case, you may need a higher dose.
For all as-needed dosages, you’ll typically want to take tadalafil 30 minutes to an hour before you plan to get intimate.
Mild ED Dose: 5mg Tadalafil
If your erectile dysfunction is fairly mild, or if you develop side effects from using tadalafil at a higher dosage, your healthcare provider may prescribe tadalafil at a dosage of 5mg.
This is the lowest as-needed tadalafil dosage currently available. Although it’s slightly less effective than the 10mg and 20mg dosages at treating and preventing ED, it’s also less likely to cause certain side effects — which, for men with heart conditions and those vulnerable to dizziness, can be a necessary precaution for safe and effective use.
Max Dose: 20mg Tadalafil
If you don’t notice any improvements from a 10mg dosage, or don’t experience a big enough improvement to have satisfactory sex, your healthcare provider may prescribe a stronger 20mg dosage of tadalafil.
The maximum dosage of tadalafil is 20mg, used as needed for sexual intercourse for men with more severe ED. If you’re prescribed tadalafil at this dosage, it’s likely because smaller doses weren’t giving you the results you were hoping for.
Since 20mg is a higher dose, It’s important to follow your healthcare provider’s instructions and take your medication no more than once per day.
At this dosage, tadalafil is more effective at improving erectile function and helping men with ED have sex successfully. Research shows that a dosage of 20mg is particularly effective for men with severe erectile dysfunction.
Clinical trials show that side effects from tadalafil are slightly more common at this dosage than at a lower dosage of 10mg, though the difference in tolerability is relatively small.
Daily Dose: 2.5mg and 5mg Tadalafil
While tadalafil is available as-needed, it’s also available for once-daily use in much smaller dosages. Daily tadalafil is available at a dosage of 2.5mg or 5mg.
There might be several reasons to go with daily dosages rather than taking the medication as needed. Using tadalafil daily offers several advantages, as we’ve explained in our full guide to daily-use Cialis.
However, keep in mind that daily use might change the side effect outcomes for some people. Side effects such as indigestion and flushing may become more frequent with daily use.
When used daily, tadalafil should be taken at approximately the same time each day to maintain a stable concentration in the body.
Tadalafil Dosage Side Effects
We’ve covered the numerous (and mostly tolerable) tadalafil side effects in our comprehensive guide. Still, it’s important for us to point out that side effects can increase based on dosage, frequency of use and whether you’re on any other medications.
Serious side effects at all dosages can include:
Loss of vision
Dangerously low blood pressure
Priapism (prolonged erections without stimulation)
There are also some dangerous errors you’ll want to avoid when taking tadalafil — let’s look at those in the big picture of how to take the medication correctly.
ED treatments, delivered
No matter the treatment plan, the best place to start is somewhere.
How to Take Tadalafil Dose for Best Results
Once you and your healthcare provider work out the correct dosage for you, tadalafil should effectively improve your erections and enhance your sexual performance.
However, there are ways to reduce the medication’s effectiveness, increase your risk of common side effects and generally make your tadalafil-taking experience less optimal.
To get the best results from tadalafil, try to:
Take tadalafil at least 30 minutes before having sex. Tadalafil usually reaches its peak blood concentration between 30 minutes and six hours. If you’re prescribed tadalafil for use as needed, you’ll get the best results by taking it at least 30 minutes before you and your partner plan to have sex. If you don’t notice any improvement, try taking tadalafil about one hour before you have sex.
Limit your alcohol consumption. Taking tadalafil (Cialis) with alcohol may increase your risk of developing side effects, including reduced blood pressure. Alcohol can also affect your sexual performance and ability to maintain an erection during sex. It’s okay to drink a small amount of alcohol while using tadalafil, but it’s best to avoid heavy drinking while using this medication.
Combine tadalafil with a healthy lifestyle. Your cardiovascular health plays a key role in your erectile function and sexual performance, meaning medications such as tadalafil work best if you live a healthy lifestyle.
Avoid drug interactions. Medications and foods may cause problems with ED medication and intensify the effects of tadalafil. Beyond potential drug interactions, this also means that you shouldn’t double up on a missed dose.
Drug interactions can be serious business due to contraindications. Taking certain medications could mean you’ll need a lower dose of tadalafil, so tell your healthcare provider if you use:
Nitrates, nitroglycerin and nitric oxide supplements
Ketoconazole, itraconazole or other antifungal medications
You should also tell your healthcare provider if you have renal or kidney disease, angina, Peyronie’s disease, an enlarged prostate or pulmonary hypertension (high blood pressure).
Also, avoid grapefruit juice, which can have the same effects as prescription drugs, despite being much more delicious.
Obviously, there are many things you can do to take tadalafil incorrectly, and the worst of them is arguably taking too much of the medication.
Taking 40mg of tadalafil (two 20mg tablets) is not recommended. This dosage of tadalafil is far higher than the typical recommended dose and could increase your risk of developing side effects, including potentially harmful side effects.
Some men may feel compelled to double up if the medication doesn’t give them what they want. This is a mistake — do not double your dose without professional supervision.
And if you don’t experience improvements from tadalafil at a dosage of 10mg or 20mg, talk to your healthcare provider.
Tadalafil Dosages for ED: Final Thoughts
If you’re one of the tens of millions of men in the United States affected by ED, medications like tadalafil can improve your erections and make it easier to have satisfying sex.
But you have to take it properly and safely to get the results you want. The following cheat sheet will help you get what you need safely — and get your sex game back in action:
Tadalafil is one of four medications for ED, along with sildenafil (Viagra), vardenafil (Levitra) and avanafil (Stendra).
Tadalafil is a widely used medication, mostly prescribed to treat erectile dysfunction and sometimes to treat benign prostatic hyperplasia (BPH).
Compared to other ED medications, tadalafil is very long-lasting. On average, a typical 10mg dose of tadalafil can improve erectile function for up to 36 hours.
Tadalafil is available in several dosages. As a treatment for ED, it’s typically prescribed at a dosage of 10mg for use as needed, which may be adjusted to 20mg or 5mg based on your response to the medication.
For once-daily use, tadalafil is prescribed at a lower dosage of either 2.5mg or 5mg per day.
As with other ED medications, there’s no “best” dosage of tadalafil for everyone. Your healthcare provider will work with you to choose the best dosage based on your desired health outcomes, including treatment for benign prostatic hyperplasia (in the form of Adcirca).
You should be taking tadalafil or any ED medication only as directed with medical advice, which means no double-dosing without the approval of a healthcare professional.
If medication isn’t helping, there’s more you can do. Our guide to naturally protecting your erections shares actionable, science-based tactics you can use to improve your sexual health and get better results from tadalafil.
Need more guidance? Want medication? We can help.
We also offer tadalafil chewables to take daily or as needed to help with stronger, longer-lasting erections.
We offer tadalafil and other FDA-approved ED medications online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.
You can also learn more about the treatment of erectile dysfunction and improving your sexual performance in our guide to the most common erectile dysfunction treatments and drugs.