C₂₂H₁₉N₃O₄ · PubChem CID 110635 · Drag to rotate

Performance

Tadalafil 20mg

PDE5 Inhibitor · Extended Duration · Schedule H

The weekend protocol. 36-hour window means no timing pressure. Also available in daily low-dose (5mg) for continuous coverage. Doctor-supervised, discreetly delivered.

₹1,199

/month

Includes: Doctor consultation · Prescription · Medication · Delivery

100% refund if not medically appropriate

Have questions? Talk to us first

What happens after you purchase

You pay

Secure checkout via Razorpay

Doctor calls you

Free consultation within 2hrs

Prescription issued

If medically appropriate

Delivered

Delivered within 48hrs

Duration

Up to 36 hrs

Onset

~30 min

Options

On-demand or daily

Pack

4 tablets (20mg)

Pharmacology

How tadalafil works

Tadalafil is distinguished by its extended duration of action compared to sildenafil. Its long half-life creates a sustained window of effectiveness, reducing timing anxiety and allowing for a more natural approach to sexual activity.

Extended Half-Life

17.5-hour half-life vs sildenafil's 4 hours, creating a 36-hour efficacy window. Perfect for spontaneity without planning.

Smooth Muscle Relaxation

Enhanced blood flow response to natural sexual stimulation through sustained smooth muscle relaxation in penile tissue.

Dual Indication

FDA-approved for benign prostatic hyperplasia (BPH) at 5mg daily. Treats ED and urinary symptoms simultaneously.

Pharmacokinetics

How your body processes it

Tadalafil's bioavailability is not formally stated (due to IV insolubility) but oral absorption is extensive. The key pharmacokinetic feature is the long half-life (17.5 hours) — much longer than sildenafil (3–5h). This creates a unique "weekend pill" profile where one dose covers an extended window. Tmax ranges 0.5–6 hours (highly variable). Active metabolite methylcatechol contributes minimally to effects.

Bioavailability	Unknown (IV insolubility prevents formal determination), but oral absorption extensive
T_max (time to peak)	0.5–6 hours (highly variable)
Elimination half-life	17.5 hours (much longer than sildenafil!)
Duration of action	36 hours at effective concentrations (therapeutic window extends far beyond half-life)
Volume of distribution	~1.25 L/kg
Protein binding	~94% — highly protein-bound
Metabolism	Hepatic: CYP3A4 (primary). Slower metabolism than sildenafil due to longer half-life.
Active metabolite	Methylcatechol (minimal activity, ~0.1% of parent potency)
Excretion	Fecal ~61%, renal ~36%. Minimal unchanged parent excreted.
Food effect	NO food effect — absorption is independent of meals. Can take anytime.

Source: FDA-approved prescribing information (Cialis), Porst et al 2006 (PMID: 16422906)

Dosing

Optimal protocol

Tadalafil offers two distinct dosing strategies: (1) Daily low-dose (5mg once daily) for continuous coverage, no timing required; or (2) As-needed higher-dose (10–20mg) before sexual activity with 36h efficacy window. Daily dosing is increasingly preferred as it removes timing anxiety and may improve overall endothelial function.

Daily Dosing (Preferred)

5mg once daily, any time of day. No timing around sexual activity needed. Provides continuous PDE5 inhibition and steady-state endothelial effect. Takes 3–5 days to reach steady state. Most users report improved spontaneity and consistent efficacy. Removes performance anxiety tied to dosing timing.

PREFERRED

As-Needed Dosing

10–20mg taken 30 minutes before sexual activity. Efficacy window extends 36 hours post-dose (vs 4 hours for sildenafil). One dose Friday evening covers weekend. Start with 10mg. If ineffective, increase to 20mg for next use. Max once daily frequency.

ALTERNATIVE

Food Independence

MAJOR advantage over sildenafil: Food does NOT affect tadalafil absorption. Take anytime, with any meal, on empty stomach—no difference. This reduces timing complexity and allows more flexibility in daily use.

KEY ADVANTAGE

Steady-State Monitoring

Daily 5mg dosing reaches therapeutic steady state in 3–5 days. Initial dosing may show variable efficacy—by day 5–7, effects plateau. For as-needed dosing, effects are more predictable dose-to-dose. Blood pressure monitoring recommended at baseline.

FOR DAILY DOSING

Evidence

Published research

Tadalafil is extensively studied with dual FDA indications (ED and benign prostatic hyperplasia). Long half-life and daily dosing strategy add unique evidence base compared to on-demand PDE5 inhibitors. Emerging research suggests cardiovascular protective effects.

2006 European Urology PMID: 16422906

Tadalafil 5mg daily noninferior to on-demand 20mg dosing

Porst et al. showed that daily 5mg tadalafil was noninferior to on-demand 20mg in efficacy for ED. Daily dosing offered improved spontaneity and reduced performance anxiety. No tolerance development over 12 months.

RANDOMIZED CONTROLLED TRIAL

2006 Journal of Sexual Medicine PMID: 16942416

Pharmacokinetics and food interaction of tadalafil

Forgue et al. confirmed that food has no effect on tadalafil absorption or pharmacokinetics. This contrasts with sildenafil and represents a major practical advantage for users in daily dosing.

PHARMACOKINETIC STUDY

2003 American Journal of Cardiology PMID: 12517460

Cardiovascular safety of tadalafil in patients with coronary artery disease

Kloner et al. demonstrated that tadalafil is hemodynamically safe in patients with existing CAD. Extended safety monitoring suggests potential cardioprotective effects from chronic PDE5 inhibition via endothelial function improvement.

CARDIOVASCULAR SAFETY

2020 Current Sexual Health Reports PMID: 32213255

Daily tadalafil and endothelial function: emerging cardiovascular benefits

Emerging evidence suggests that chronic daily tadalafil may improve endothelial function and vascular health beyond ED treatment. Potential implications for cardiovascular health optimization in aging populations.

EMERGING EVIDENCE — CARDIOVASCULAR

Safety

Side effects & safety

Tadalafil's side effect profile is similar to sildenafil at therapeutic doses, with one notable addition: back pain and myalgia (unique to tadalafil at ~6% incidence). This is attributed to PDE11 cross-reactivity in skeletal muscle. Most effects are mild and dose-dependent.

Headache

15%

Dyspepsia / Indigestion

Back Pain / Myalgia

Muscle Aches

Nasal Congestion

Flushing

Serious Adverse Events (Rare)

Back pain/myalgia unique to tadalafil — occurs in ~5–6% vs. negligible rate with sildenafil. Mechanism likely PDE11 inhibition in skeletal muscle. Usually mild and reversible. Priapism (prolonged erection >4 hours) — extremely rare, medical emergency. NAION (vision loss) — incidence ~0.001%, higher in men with cardiovascular risk factors. Sudden hearing loss possible but very rare. Contraindicated with organic nitrates. Caution with alpha-blockers.

Interactions

Drug interactions

Tadalafil is metabolized by CYP3A4 like sildenafil. Long half-life means CYP3A4 interactions have extended consequences — inhibitors accumulate tadalafil over days. Nitrates are absolute contraindication. Alpha-blockers require caution, especially with daily dosing.

Organic Nitrates (nitroglycerin, isosorbide)

ABSOLUTE CONTRAINDICATION. Tadalafil potentiates nitrate-induced hypotension. Severe, life-threatening BP drop. DO NOT COMBINE. The long half-life (17.5h) means tadalafil persists—wait 48 hours after last tadalafil before taking nitrates.

Mechanism: Synergistic vasodilation

CYP3A4 Inhibitors (Ketoconazole, Ritonavir)

Strong CYP3A4 inhibitors significantly increase tadalafil levels. Long half-life means levels accumulate—risk is higher than with sildenafil. Ketoconazole increases AUC substantially. REDUCE tadalafil dose or AVOID. If necessary for daily dosing, reduce to 2.5mg or lower frequency (every 48h).

Mechanism: CYP3A4 inhibition with half-life accumulation

Alpha-Blockers (especially with daily dosing)

Both cause vasodilation. Combined use increases hypotension risk. For as-needed tadalafil, risk is lower. For daily 5mg dosing, additive effect is continuous. If combining daily tadalafil with alpha-blocker, monitor BP closely. Start alpha-blocker first, then add tadalafil at lowest dose. Doxazosin + daily tadalafil requires caution.

Mechanism: Additive vasodilation, extended with daily dosing

Rifampin

CYP3A4 inducer—DECREASES tadalafil by 88%. If TB treatment is needed, tadalafil may become ineffective. Dosing adjustment may be necessary or discontinue tadalafil during TB therapy. Coordinate with physician.

Mechanism: CYP3A4 induction → severe reduction

Alcohol

Alcohol potentiates tadalafil's hypotensive effect. Combined use may cause dizziness or syncope. Limit to moderate drinking. Daily tadalafil users should be especially cautious with alcohol due to continuous drug presence.

Mechanism: Additive vasodilation

FAQ

Common questions

Tadalafil vs sildenafil?

Tadalafil has a much longer duration (36 hours vs 4 hours), reducing timing pressure. Both are PDE5 inhibitors, but tadalafil's extended window makes it ideal for those wanting spontaneity. Some prefer tadalafil; others prefer sildenafil's shorter half-life. Your doctor can help choose the best option.

Can I take it daily?

Yes. Low-dose daily tadalafil (5mg) is FDA-approved for both ED and BPH. Many prefer this approach as it removes timing considerations entirely and may improve overall pelvic blood flow. Your doctor will discuss which approach suits you best.

What are the side effects?

Common side effects include headache, indigestion, and back pain. These are typically mild. Muscle aches occur more frequently with tadalafil than sildenafil. Serious side effects are rare. Your doctor will review all risks during consultation.

Food interactions?

Tadalafil can be taken with or without food, though absorption may be slower with high-fat meals. Unlike some other medications, alcohol has minimal interaction with tadalafil, though moderation is advised. Your doctor will provide detailed guidance.

How does the protocol work?

Book a consultation with an arq physician who will evaluate your health history and discuss whether on-demand or daily dosing suits you better. If appropriate, you'll receive a prescription for either 20mg tablets (4/month for on-demand use) or 5mg daily tablets, delivered discreetly within 48 hours.