Tadalafil for Treating Pulmonary Arterial Hypertension

This means you can have sex at any time, rather than needing to take a pill from time to time as needed like other ED brands. The starting dose for daily-use Cialis is 2.5 milligrams (mg).

• Tadalafil improves sexual function by increasing blood flow during arousal.
• It is contraindicated in patients with severe heart disease without medical advice.
• The drug may cause side effects that usually resolve within a few hours.
• Men over 65 should discuss potential risks of tadalafil with their doctor.
• Patients should report any allergic reactions, including rash or swelling.
• Tadalafil can be used in combination with some other ED medications, if approved.
• Regular exercise and healthy lifestyle may enhance tadalafil's effectiveness.
• Discontinue use and seek medical help if chest pain occurs during use.
• Inform your doctor of all medications to avoid dangerous interactions.

If that doesn't work, you can increase your daily dose up to 5 mg. But is this the right approach for you—or are you better off with traditional ED drugs like Viagra, Levitra, or even the nondaily version of Cialis?

What should I know about storage and disposal of this medication?

This means you can have sex at any time, rather than needing to take a pill from time to time as needed like other ED brands. The starting dose for daily-use Cialis is 2.5 milligrams (mg). If that doesn't work, you can increase your daily dose up to 5 mg. But is this the right approach for you—or are you better off with traditional ED drugs like Viagra, Levitra, or even the nondaily version of Cialis? If you are contemplating Cialis for daily use, consider these questions and then discuss it with your doctor: If it's two or more times a week, a daily pill might be a reasonable choice, since the drug continually circulates in your bloodstream.

How it works

A daily pill clears the path for sex at any time—if the drug works for you. (Remember, just like other ED drugs, it may not work for everyone). On the other hand, the 36-hour window offered by the nondaily version of Cialis might offer enough spontaneity. Have side effects of your current ED pill been bothering you? Taking a daily low-dose pill may reduce side effects, though it may reduce effectiveness as well. If you are contemplating Cialis for daily use, consider these questions and then discuss it with your doctor: If it's two or more times a week, a daily pill might be a reasonable choice, since the drug continually circulates in your bloodstream. A daily pill clears the path for sex at any time—if the drug works for you. (Remember, just like other ED drugs, it may not work for everyone). On the other hand, the 36-hour window offered by the nondaily version of Cialis might offer enough spontaneity. Have side effects of your current ED pill been bothering you? Taking a daily low-dose pill may reduce side effects, though it may reduce effectiveness as well. In studies, the most common daily pill side effects were headache, muscle pain, indigestion, and back pain. Men sublingual tadalafil taking Cialis for daily use can experience a worrisome drop in blood pressure if they drink too much. Ask your doctor if any medications or supplements you take might interact with a daily erectile dysfunction pill, including blood pressure drugs, antifungal drugs, and HIV drugs. Also, men taking nitrate medications are advised not to take any ED drugs. While the manufacturer suggests that a 30-day supply of daily Cialis should cost about the same as eight pills of 36-hour Cialis a month, there's no way to enforce this. Check your insurance policy and local pharmacies for price information. – By Matthew Solan Executive Editor, Harvard Men's Health Watch As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

Please note the date of tadalafil daily last review or update on all articles.

How should this medicine be used?

What should I do for a missed dose of tadalafil?

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Get the latest in health news delivered to your inbox! All content on this page has been medically reviewed by: Hassan Thwaini, Clinical Pharmacist and Copywriter, Master of Pharmacy (MPharm) on 30 March, 2026. Tadalafil is a clinically-proven erectile dysfunction treatment that gives you the freedom to enjoy sex when you want it. It lasts for 36 hours - so there’s less need for planning before sex.

What other information should I know?

Find the clinically proven ED treatment that suits you best. No names, no logos, no delivery fee.

4.6* from over 33,000 people like you. BSc (Hons) MBBS MRCGP AFHEA MA (Hons) AFMCP Answer a few simple questions to get the treatment you need. Indicated for treatment of erectile dysfunction (ED) Cialis (or generic equivalent) or Chewtadzy only PRN use: 10 mg PO initially before sexual activity, with or without food; may be increased to 20 mg or reduced to 5 mg on basis of efficacy and tolerability; in most patients, maximum dosing frequency is once daily Once-daily use (Cialis): 2.5 mg/day PO in single daily dose, without regard to timing of sexual activity, with or without food; may be increased to 5 mg/day on basis of efficacy and tolerability Indicated for treatment of signs and symptoms of benign prostatic hyperplasia (BPH); daily use also indicated for treatment of patients with both BPH and erectile dysfunction Cialis (or generic equivalent) or Chewtadzy only BPH with ED: 5 mg PO once daily, taken at approximately same time each day without regard to timing of sexual activity Coadministration with finasteride for BPH: Tadalafil 5 mg plus finasteride 5 mg PO once daily for ≤26 weeks; incremental benefit of tadalafil decreases from 4 weeks until 26 weeks, and the benefit beyond 26 weeks is unknown Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, Tadliq, or generic equivalent only 40 mg PO once daily; dividing dose for more frequent dosing is not recommended Patients also taking ritonavir: 20 mg PO once daily initially for ≥1 week; may be increased to 40 mg/day on basis of tolerability Cialis, Chewtadzy (PRN use)Mild (CrCl >50 mL/min): No dosage adjustment neededModerate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hrSevere (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Mild (CrCl >50 mL/min): No dosage adjustment needed Moderate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hr Severe (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Cialis (once daily use)ED (CrCl >50 mL/min): No dosage adjustment neededBPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual responseED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended ED (CrCl >50 mL/min): No dosage adjustment needed BPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual response ED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended Chewtadzy (once daily use)BPH, ED/BPHCrCl >50 mL/min: No dosage adjustment neededCrCl ≤50 mL/min or hemodialysis: Not recommended CrCl >50 mL/min: No dosage adjustment needed CrCl ≤50 mL/min or hemodialysis: Not recommended Adcirca, Alyq, TadliqMild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerabilitySevere (CrCl <30 mL/min and on hemodialysis): Avoid use Mild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerability Severe (CrCl <30 mL/min and on hemodialysis): Avoid use Cialis, Chewtadzy (PRN use)Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once dailySevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once daily Severe (Child-Pugh class C): Not recommended Cialis, Chewtadzy (once daily use)Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advisedSevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advised Severe (Child-Pugh class C): Not recommended Adcirca, Alyq, TadliqMild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once dailySevere (Child-Pugh class C): Avoid use Mild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once daily Severe (Child-Pugh class C): Avoid use ED PRN use: Not to exceed 10 mg/72 hr ED or ED/BPH once-daily use: Not to exceed 2.5 mg/day Adcirca, Alyq, TadliqOn ritonavir for at least 1 week: Start tadalafil at 20 mg PO qDay; may increase to 40 qDay based on individual tolerabilityAvoid tadalafil during ritonavir initiationStop tadalafil at least 24 hr before to starting ritonavirAfter at least 1 week following ritonavir initiation, resume tadalafil 20 mg PO qDay; may increase to 40 qDay based on individual tolerability On ritonavir for at least 1 week: Start tadalafil at 20 mg PO qDay; may increase to 40 qDay based on individual tolerability Stop tadalafil at least 24 hr before to starting ritonavir After at least 1 week following ritonavir initiation, resume tadalafil 20 mg PO qDay; may increase to 40 qDay based on individual tolerability Chewtadzy: Not indicated for once daily use for ED because dosing is not possible (recommended dosage for this indication cannot be achieved with lowest available strength) Orphan designation for Duchenne muscular dystrophy (DMD) Eli Lilly and Company; Lilly Corporate Center; Indianapolis, IN 46285 Indicated for treatment of erectile dysfunction (ED) Cialis or generic equivalent only: No dosage adjustment is warranted solely on basis of age; however, greater sensitivity to medications in some older individuals should be considered Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, or generic equivalent only: Lower dose or reduced dosing frequency may be required in elderly because of decreased renal or hepatic clearance Allow 48h after last tadalafil dose before nitrate administration. Allow 48h after last tadalafil dose before nitrate administration.

Select a medication above to begin.

Alcohol interaction warning

nitroglycerin rectaltadalafil increases effects of nitroglycerin rectal by additive vasodilation.

Which Makes You Harder?

Use of nitroglycerin within a few days of PDE5 inhibitors is contraindicated. PDE5 inhibitors have been shown to potentiate the hypotensive effects of organic nitrates. tadalafil increases tadalafil 20mg price effects of nitroglycerin rectal by additive vasodilation. Either increases effects of the other by additive vasodilation. Coadministration of PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, vardenafil) and guanylate cyclase stimulators (eg, riociguat) is contraindicated due to risk of additive hypotension; do not administer 24 hr before or within 48hr of each other.

Erectile Dysfunction

Either increases effects of the other by pharmacodynamic synergism. Coadministration of vericiguat with PDE-5 inhibitors may result in additive hypotensive effects. apalutamideapalutamide will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Use of nitroglycerin within a few days of PDE5 inhibitors is contraindicated. PDE5 inhibitors have been shown to potentiate the hypotensive effects of organic nitrates. tadalafil increases tadalafil 20mg price effects of nitroglycerin rectal by additive vasodilation. Either increases effects of the other by additive vasodilation. Coadministration of PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, vardenafil) and guanylate cyclase stimulators (eg, riociguat) is contraindicated due to risk of additive hypotension; do not administer 24 hr before or within 48hr of each other.

Pregnancy & Lactation

In studies, the most common daily pill side effects were headache, muscle pain, indigestion, and back pain. Men sublingual tadalafil taking Cialis for daily use can experience a worrisome drop in blood pressure if they drink too much. Ask your doctor if any medications or supplements you take might interact with a daily erectile dysfunction pill, including blood pressure drugs, antifungal drugs, and HIV drugs. Also, men taking nitrate medications are advised not to take any ED drugs. While the manufacturer suggests that a 30-day supply of daily Cialis should cost about the same as eight pills of 36-hour Cialis a month, there's no way to enforce this.

If you take more than the recommended amount of tadalafil

Check your insurance policy and local pharmacies for price information. – By Matthew Solan Executive Editor, Harvard Men's Health Watch As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of tadalafil daily last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Get the latest in health news delivered to your inbox! Either increases effects of the other by pharmacodynamic synergism. Coadministration of vericiguat with PDE-5 inhibitors may result in additive hypotensive effects.

• Tadalafil is not suitable for individuals taking certain antifungal or antibiotic medications.
• It may interact with blood thinning drugs, increasing bleeding risk.
• The common dosage and timing depend on individual health and condition severity.
• Tadalafil's shelf life is typically 2-3 years when stored properly.
• The medication is a prescription-only product in most countries.
• Patients should avoid using expired medication to prevent reduced efficacy or risks.
• Some health insurance plans may cover tadalafil depending on the diagnosis.
• Always check with a healthcare provider before combining tadalafil with other treatments.
• Tadalafil can help restore sexual confidence and improve intimacy quality.

apalutamideapalutamide will decrease the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism.

• Tadalafil is not recommended for use by women or children.
• The pill should be stored in a dry place away from direct sunlight.
• It may take some time to find the most suitable dose for an individual.
• Regular follow-up with a healthcare provider is helpful for safe use.
• Patients should report persistent side effects or allergic reactions immediately.
• Tadalafil can sometimes cause sudden vision loss, requiring urgent medical attention.
• Avoid activities that require alertness if feeling dizzy or headache occurs.
• Tadalafil is generally well-tolerated, but individual responses vary.
• Patients with recent history of stroke or heart attack should consult a doctor before use.

Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible.

How should I take tadalafil?

All content on this page has been medically reviewed by: Hassan Thwaini, Clinical Pharmacist and Copywriter, Master of Pharmacy (MPharm) on 30 March, 2026. Tadalafil is a clinically-proven erectile dysfunction treatment that gives you the freedom to enjoy sex when you want it. It lasts for 36 hours - so there’s less need for planning before sex. Find the clinically proven ED treatment that suits you best. No names, no logos, no delivery fee.

Communicate and stay relaxed

4.6* from over 33,000 people like you. BSc (Hons) MBBS MRCGP AFHEA MA (Hons) AFMCP Answer a few simple questions to get the treatment you need. Indicated for treatment of erectile dysfunction (ED) Cialis (or generic equivalent) or Chewtadzy only PRN use: 10 mg PO initially before sexual activity, with or without food; may be increased to 20 mg or reduced to 5 mg on basis of efficacy and tolerability; in most patients, maximum dosing frequency is once daily Once-daily use (Cialis): 2.5 mg/day PO in single daily dose, without regard to timing of sexual activity, with or without food; may be increased to 5 mg/day on basis of efficacy and tolerability Indicated for treatment of signs and symptoms of benign prostatic hyperplasia (BPH); daily use also indicated for treatment of patients with both BPH and erectile dysfunction Cialis (or generic equivalent) or Chewtadzy only BPH with ED: 5 mg PO once daily, taken at approximately same time each day without regard to timing of sexual activity Coadministration with finasteride for BPH: Tadalafil 5 mg plus finasteride 5 mg PO once daily for ≤26 weeks; incremental benefit of tadalafil decreases from 4 weeks until 26 weeks, and the benefit beyond 26 weeks is unknown Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, Tadliq, or generic equivalent only 40 mg PO once daily; dividing dose for more frequent dosing is not recommended Patients also taking ritonavir: 20 mg PO once daily initially for ≥1 week; may be increased to 40 mg/day on basis of tolerability Cialis, Chewtadzy (PRN use)Mild (CrCl >50 mL/min): No dosage adjustment neededModerate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hrSevere (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Mild (CrCl >50 mL/min): No dosage adjustment needed Moderate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hr Severe (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Cialis (once daily use)ED (CrCl >50 mL/min): No dosage adjustment neededBPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual responseED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended ED (CrCl >50 mL/min): No dosage adjustment needed BPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual response ED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended Chewtadzy (once daily use)BPH, ED/BPHCrCl >50 mL/min: No dosage adjustment neededCrCl ≤50 mL/min or hemodialysis: Not recommended CrCl >50 mL/min: No dosage adjustment needed CrCl ≤50 mL/min or hemodialysis: Not recommended Adcirca, Alyq, TadliqMild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerabilitySevere (CrCl <30 mL/min and on hemodialysis): Avoid use Mild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerability Severe (CrCl <30 mL/min and on hemodialysis): Avoid use Cialis, Chewtadzy (PRN use)Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once dailySevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once daily Severe (Child-Pugh class C): Not recommended Cialis, Chewtadzy (once daily use)Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advisedSevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advised Severe (Child-Pugh class C): Not recommended Adcirca, Alyq, TadliqMild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once dailySevere (Child-Pugh class C): Avoid use Mild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once daily Severe (Child-Pugh class C): Avoid use ED PRN use: Not to exceed 10 mg/72 hr ED or ED/BPH once-daily use: Not to exceed 2.5 mg/day Adcirca, Alyq, TadliqOn ritonavir for at least 1 week: Start tadalafil at 20 mg PO qDay; may increase to 40 qDay based on individual tolerabilityAvoid tadalafil during ritonavir initiationStop tadalafil at least 24 hr before to starting ritonavirAfter at least 1 week following ritonavir initiation, resume tadalafil 20 mg PO qDay; may increase to 40 qDay based on individual tolerability On ritonavir for at least 1 week: Start tadalafil at 20 mg PO qDay; may increase to 40 qDay based on individual tolerability Stop tadalafil at least 24 hr before to starting ritonavir After at least 1 week following ritonavir initiation, resume tadalafil 20 mg PO qDay; may increase to 40 qDay based on individual tolerability Chewtadzy: Not indicated for once daily use for ED because dosing is not possible (recommended dosage for this indication cannot be achieved with lowest available strength) Orphan designation for Duchenne muscular dystrophy (DMD) Eli Lilly and Company; Lilly Corporate Center; Indianapolis, IN 46285 Indicated for treatment of erectile dysfunction (ED) Cialis or generic equivalent only: No dosage adjustment is warranted solely on basis of age; however, greater sensitivity to medications in some older individuals should be considered Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, or generic equivalent only: Lower dose or reduced dosing frequency may be required in elderly because of decreased renal or hepatic clearance Allow 48h after last tadalafil dose before nitrate administration. Allow 48h after last tadalafil dose before nitrate administration. nitroglycerin rectaltadalafil increases effects of nitroglycerin rectal by additive vasodilation.