What Are The Side Effects of Tadalafil?

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 16 Feb 2022

Tadalafil is an erectile dysfunction (ED) medication that is safe and effective. Tadalafil works by increasing blood flow to your penis to help you get or maintain an erection. This means you might have some side effects when taking tadalafil, especially if it’s your first time.

Pack of 8 20mg tadalafil film-coated tablets that could cause tadalafil side effects

The side effects of tadalafil do not affect everyone. Some side effects are less common than others. In general, tadalafil’s side effects tend to be mild and will ease with time. The most common side effects include headaches and indigestion, or heartburn.

If the side effects of tadalafil persist for more than a few hours or if you cannot tolerate the effects, speak to your doctor. They may suggest switching to another ED medication.

What side effects can tadalafil give me?

Tadalafil can give you side effects that are connected to your blood vessels. This is because it works to increase blood flow to the blood vessels in your penis. Tadalafil is part of a group of medicines called phosphodiesterase type-5 (PDE5) inhibitors.

When you are sexually stimulated, the nerves in your penis will release a certain chemical. This chemical allows blood to flow into your penis and cause an erection. Tadalafil works by making sure this chemical stays in the blood for longer. This leads to an erection that lasts long enough for you to have sex.

Although tadalafil works specifically on the nerves in your penis, it can affect blood vessels all over your body. This may lead to side effects that are common or rare. See below to find out more.

Most common side effects

The most common side effects of tadalafil include:

  • headache
  • back pain
  • muscle aches
  • flushing of the face
  • nasal congestion
  • indigestion

Less common side effects

Some less common side effects of tadalafil include:

  • dizziness
  • feeling sick or being sick
  • acid reflux
  • prolonged erection
  • a fast heart rate where you can feel your heartbeat
  • blood pressure changes
  • nosebleeds
  • swelling of the hands or body
  • tiredness

Both common and uncommon side effects of tadalafil should disappear within a few hours once the medicine has been cleared from your body.

Rare side effects

Rare side effects happen to very few people. If 2000 people took tadalafil, only 1 or 2 people would experience these rare side effects. This means it’s very unlikely that you’ll get a rare side effect.

Some rare side effects of tadalafil are:

  • fainting
  • seizures
  • swelling of the eyelids
  • hearing problems
  • skin rashes
  • penile bleeding
  • blood in semen
  • increased sweating

Some side effects are serious and require medical care. Though they’re less common, you should stop taking tadalafil and contact 999 right away if you have:

  • an allergic reaction (including rashes)
  • chest pain
  • ­priapism (a prolonged erection that occurs without sexual stimulation)
  • loss of vision

If you have chest pain when taking tadalafil do not take any medications containing nitrates. This includes glyceryl trinitrate (GTN) spray or isosorbide mononitrate tablets. Nitrates can cause a sharp drop in blood pressure if you take them with PDE5 inhibitors like tadalafil.

For a full list of side effects, you can read the patient information leaflet that comes in your pack of tadalafil.

Does tadalafil have any long term side effects?

Tadalafil is not likely to have long term side effects. But after long term use, it may become less effective. This may be because of:

  • changes to your health
  • if you develop a health condition
  • if you have had to change the dose of your medications

If tadalafil becomes less effective you can safely switch to another medication. Speak to a healthcare professional who can recommend a different medication for you.

Am I likely to get side effects from tadalafil?

You will not necessarily get side effects when you take tadalafil. Some side effects are more common than others which means you might be more likely to have them. While these side effects may not be pleasant, they usually clear up after a couple of hours.

If you take any medications that cause a similar effect to the side effects of tadalafil, it might make it more likely that you’ll have them. For example, if you take blood pressure medication, like doxazosin, you might feel dizzy after taking tadalafil. This is because PDE5 inhibitors can lower your blood pressure as well.

Remember that tadalafil stays in your body for around 36 hours (or a day and a half). Due to this, you might feel side effects for a little longer than you might expect. This is because it takes time for your body to eventually clear the medication. Other ED medications will stay in your body for a shorter period of time, like Levitra or Viagra.

While most ED medications work in a similar way, your body may tolerate each one differently. For example, if you get side effects from tadalafil, you may not experience any with sildenafil.

Tips for avoiding side effects when taking tadalafil

You can avoid getting side effects from tadalafil by taking it as directed by your doctor. What you eat and drink can affect how tadalafil works in your body too. Remember that not everyone gets side effects and they are normally short lived.

1. Only take tadalafil as directed by your doctor

Take tadalafil as directed by your doctor, as it is available in different strengths.

To take tadalafil, make sure that you:

  • take 1 tadalafil tablet 30 minutes before you want to have sex
  • swallow the pill whole with water
  • avoid drinking too much alcohol when taking tadalafil

You’ll need to be sexually stimulated for tadalafil to work.

Tadalafil is available as a 10mg or 20mg tablet. The amount you take will depend on what your doctor decides is suitable for you. That will be based on your current health and any other medications you take. If you get persistent side effects on your current dose of tadalafil, speak to your doctor. They may suggest reducing the dose to a lower strength tablet.

You should take tadalafil before you plan on having sex and only a maximum of once per day. You should not use tadalafil 10mg or 20mg tablets daily as this can cause serious side effects.

If you prefer a tablet that you can take every day, you can request Cialis Daily from ZAVA. Cialis is the brand name for tadalafil and Cialis Daily is available as 2.5mg or 5mg tablets. You take Cialis Daily once a day and it might be suitable for you if you want to avoid side effects or have sex more often. The Side Effects of Cialis and Tadalafil will be identical.

2. Inform your doctor of all medications and medical conditions

You should also let your doctor or pharmacist know if you are taking any medications or have any pre existing health conditions. They can check if tadalafil is suitable for you or if it interacts with any of your current medications.

Tell your doctor if you have:

  • heart problems
  • blood pressure conditions
  • eye disease
  • sickle cell anaemia
  • cancers including multiple myeloma and leukaemia
  • deformation of your penis
  • ­liver problems
  • kidney problems

Tell your doctor or pharmacist if you are taking:

  • bosentan
  • nitrates
  • alpha blockers such as doxazosin
  • treatment for high blood pressure
  • riociguat
  • antifungal medication such as itraconazole
  • treatments for HIV such as ritonavir
  • epilepsy medications such as carbamazepine or phenytoin
  • antibiotics such as rifampicin, erythromycin or clarithromycin
  • other treatments for erectile dysfunction

If you take any of these medications, your doctor may suggest alternative ED treatment, or may ask you to have regular checkups while you’re using tadalafil.

3. Avoid grapefruit and grapefruit juice

You should avoid grapefruit and grapefruit juice when taking tadalafil. Grapefruit and grapefruit juice affect the breakdown of tadalafil, as well as other medicines you might be taking.

4. Avoid high fat content foods and heavy meals

High fat foods and heavy meals may mean that less tadalafil is absorbed by your body. This may decrease the effectiveness of tadalafil. So it’s a good idea to avoid high fat foods and heavy meals around 4 hours before taking tadalafil.

5. Don’t drink alcoholic beverages

Alcohol can affect your blood pressure and how your nerves work. This can make it difficult for you to get an erection. Try to limit your intake of alcohol to avoid side effects like dizziness, and to give yourself the best possible chance of keeping your erection. Avoid drinking alcohol within a few hours of taking tadalafil.

Is there an alternative erectile dysfunction treatment that has no side effects?

There are alternative erectile dysfunction (ED) treatments that are either different medicines or non-medicated. You may find that one medication works better and has fewer side effects than another. Some alternatives to tadalafil include:

  • sildenafil, a generic version of Viagra
  • Levitra, which contains the active ingredient vardenafil
  • Viagra Connect, an ED medication that is available over the counter

If you're unsure which ED treatment is suitable for you, you can also request a trial pack from ZAVA.

If you cannot use medicines, you can try these non medicated options:

  • vacuum pump - this device uses suction to achieve an erection
  • psychological therapy for yourself or with your partner - this may help to overcome any emotional or psychological barriers

To find out which ED medication is right for you, ZAVA can help. Fill out an online questionnaire today and you could get an ED medication delivered to your door within 24 hours. Our doctors can also offer advice to make sure your treatment is as safe and effective as possible.

Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion
Accreditations: BSc, MBBS, MRCGP (2008)

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 16 Feb 2022

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