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| monitoring = Blood pressure with concurrent antihypertensives or alpha-blockers.
| monitoring = Blood pressure with concurrent antihypertensives or alpha-blockers.
| counseling = Contraindicated with any nitrate. Less visual side effect than sildenafil/vardenafil (higher PDE5 vs PDE6 selectivity). Daily dosing provides continuous coverage useful for spontaneity and BPH symptoms.
| counseling = Contraindicated with any nitrate. Less visual side effect than sildenafil/vardenafil (higher PDE5 vs PDE6 selectivity). Daily dosing provides continuous coverage, useful for spontaneity and BPH symptoms.
| anecdotes =
| anecdotes =
| seealso = [[Avanafil]], [[Sildenafil]], [[Vardenafil]]
| seealso = [[Avanafil]], [[Sildenafil]], [[Vardenafil]]

Latest revision as of 03:16, 19 May 2026

PDE5 Inhibitor
Tadalafil
Cialis, Adcirca
Tadalafil's distinguishing feature is its long half-life (~17.5 h) and usable duration up to 36 h, hence "the weekend pill." It is the only PDE5 inhibitor FDA-approved for daily use, both for ED and for BPH. 5 mg daily often provides better continuous coverage than 20 mg PRN.

Experience

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Problems

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Titration strategies

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Effects

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Pharmacokinetics

Absorption

Oral; not affected by food (vs sildenafil).

Distribution

Plasma protein binding ~94%.

Metabolism

Hepatic via CYP3A4.

Elimination

Fecal and renal as metabolites.

Interactions

No interactions reported yet.

Monitoring

Blood pressure with concurrent antihypertensives or alpha-blockers.

Patient counseling

Contraindicated with any nitrate. Less visual side effect than sildenafil/vardenafil (higher PDE5 vs PDE6 selectivity). Daily dosing provides continuous coverage, useful for spontaneity and BPH symptoms.

Relevant anecdote

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Relevant Literature

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See also

Avanafil, Sildenafil, Vardenafil

References

Pharmacy
Starting dose
10 mg PRN; 2.5–5 mg daily for continuous coverage / BPH
Preparations
2.5, 5, 10, 20 mg tabs
US FDA Max
20 mg/d (ED, PRN); 5 mg/d (daily / BPH); 40 mg/d (PAH)
Common uses
Classification(s)
Classes
PDE5 Inhibitor
Pharmacology
Routes
Oral
Onset
30 min
Duration
Up to 36 h ("the weekend pill")
Half-life
~17.5 h
Bioavailability
Reasonable (not formally established as a percentage)
Pregnancy
Category B
Legal status
Rx-only in US
Purported mechanism
Selective inhibitor of PDE5 with a substantially longer half-life than other PDE5 inhibitors, allowing once-daily continuous dosing.