What Are The Side Effects of Tadalafil?

Tadalafil is the generic version of the erectile dysfunction (ED) medication Cialis. The tablets come in four strengths (2.5mg, 5mg, 10mg and 20mg) and can either be taken daily, or when you plan to have sex (‘on demand’). It is a popular ED medication because it is effective and lasts up to 36 hours – so you don’t have to remember to take it just before having sex.

In general, tadalafil side effects tend to be mild and will ease with time. The most common side effects include:

• headaches
• flushing
• indigestion
• heartburn
• muscle aches

If the side effects 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.

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.

For example, getting a headache is by far the most common tadalafil side effect (in a study with almost 500 men, 16% got headaches). Scientists believe that tadalafil may make blood vessels in the brain expand a little, which is likely to be the cause of these headaches.

Tadalafil side effects are the same as Cialis side effects, since they contain the same active ingredient.

What is the most common side effect of tadalafil?

Numerous trials and studies have consistently identified headache as the most common tadalafil side effect. Around one in 10 men will experience a headache when taking tadalafil.

Common side effects of tadalafil

Common side effects of tadalafil include:

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

Less common tadalafil side effects

Some less common side effects of tadalafil include:

• dizziness
• feeling sick or being sick
• acid reflux
• 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 clear up within a few hours once the medicine has been cleared from your body.

Rare side effects of tadalafil

Rare tadalafil side effects happen to very few people. If 1,000 people took tadalafil, only 1 person 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 include:

• fainting
• Seizures
• an painful erection which lasts longer than 4 hours (priapism)
• 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
• seizures

Tadalafil interactions with other drugs

It is important to tell your doctor if you are taking any other medications when you take tadalafil, as it can interact with these other drugs.

In particular, you should not take any medications (or recreational drugs) containing nitrates. This includes glyceryl trinitrate (GTN) spray or isosorbide mononitrate tablets, as well as ‘poppers’. 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.

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
• development of another health condition
• changes to the dose of your medications

If tadalafil becomes less effective you can switch to a different erectile dysfunction medication. Speak to a healthcare professional who can recommend a different medication for you and they should be able to advise a safe way to do so.

Tadalafil was originally approved for usage in the UK in 2003 (under the brand name Cialis), and the medicine has been extensively studied and used by tens of thousands of men for long periods of time.

One study into tadalafil’s long term side effects looked at the experiences of 493 men using the medication for 24 months. It found no obvious negative long term side effects. A different research paper compared tadalafil daily (Cialis Daily) side effects and tadalafil on-demand (Tadalafil) side effects. It found that men who took the medication every day had a slightly lower incidence of emergency treatment than on-demand users.

Tadalafil’s side effects long term were no different to on-demand side effects.

How long do tadalafil side effects last?

Tadalafil stays in your body for around 36 hours (or a day and a half). Although most people’s side effects last just a few hours, you might feel tadalafil side effects for up to two days. This is because it takes time for your body to eventually clear the medication.

Other ED medications, like Levitra or Viagra, will stay in your body for a shorter period of time and so the side effects last less time too. If you find tadalafil side effects bothersome, using another ED medication can be a good option.

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.

Most people either get none or mild side effects when they 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.

You can reduce your chances of 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 2.5 mg, 5mg, 10mg or 20mg tablet. The amount you take will depend on what your doctor decides is suitable for you. The dosage you are prescribed 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
• a maximum of once per day

You should not use tadalafil 10mg or 20mg tablets daily as this can cause serious side effects.

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. Side effects of Cialis and Tadalafil are the same .

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. This could mean you end up with too much tadalafil in your bloodstream, making side effects more likely.

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 four hours before taking tadalafil.

5. Avoid drinking alcohol

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.

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, or you may find a treatment where you might not experience any side effects. 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 medications, 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 our online questionnaire today and our doctors will review your information and advise you on the best treatment for your situation – you could get an ED medication delivered discreetly to your door within 24 hours. Our doctors can also offer advice to make sure your treatment is as safe and effective as possible.