The lay of the land

Tadalafil, the active ingredient in Cialis, is available in standard tablets and in some markets as chewable or orally disintegrating "soft" formulations. These chewable products are designed to be chewed or allowed to dissolve in the mouth before swallowing.

The most common use is treatment of erectile dysfunction (ED) on an as-needed basis. Chewable strengths reported in various supplies include 20 mg and occasionally 40 mg. Higher doses should only be considered with medical supervision. For timing and stepwise dosing options, see the section on Use and Dosage.

  • Taken before sexual activity as needed.
  • Onset for many people can be within 15 to 30 minutes.
  • Effect may last up to about 36 hours in many users.

To review safety concerns or medicines that should not be combined with tadalafil, consult Safety guidelines and Drug Interaction Risks. For an alternate possibility ED options and benchmarking prices information, see Substitutes and Comparable Evaluations and Pricing Projections - USA.

A Guide to How It Works

Tadalafil belongs to the phosphodiesterase type 5 (PDE5) inhibitor class. When sexual stimulation occurs, tadalafil helps preserve cyclic GMP levels in penile tissue which leads to relaxation of vascular smooth muscle and increased blood flow into the penis. It does not itself trigger sexual desire and requires arousal to produce an erection.

Use and Dosing guidance

Instructions specific to chewable or orally dissolving tadalafil formulations:

  • How to take notes: chew the tablet or allow it to dissolve in the mouth; you may drink water afterward if you prefer. Most people can take it with or without food.
  • On-demand dosing: a frequently used starting point for adults is 20 mg taken about 15 to 30 minutes before sexual activity. Individual response and side effect tolerance determine adjustments.
  • Daily low-dose option: separate from on-demand use, a daily low-dose regimen (commonly 2.5 to 5 mg once daily) exists for continuous readiness and may help some men with urinary symptoms related to benign prostatic hyperplasia.
  • Frequency limit: do not take more than one dose in any 24-hour period.
  • Do not increase to higher strengths such as 40 mg without medical advice, especially if you have impaired kidney or liver function or heart disease.
  • Avoid grapefruit or grapefruit juice around the time of dosing because it can raise tadalafil blood levels; see Drug Interaction Studies.

If you experience fainting, new chest discomfort, severe dizziness, or sudden changes in vision or hearing after taking tadalafil, stop sexual activity and seek emergency care immediately.

Safety guidelines

Before you begin chewable tadalafil, tell your healthcare provider about any of the following conditions or history:

  • Penile abnormalities (for example, Peyronie disease) or a history of priapism.
  • Heart disease such as angina, prior heart attack, heart failure, uncontrolled high or low blood pressure, or arrhythmias.
  • Bleeding issues or active stomach ulcers.
  • The formal name for the disease is diabetes mellitus, elevated cholesterol, or other vascular risk factors.
  • Blood disorders like sickle cell disease.
  • Reduction in kidney or liver function.
  • A past episode of non-arteritic anterior ischemic optic neuropathy (NAION) or other serious eye disease.

Smoking, heavy alcohol use, and multiple vascular risks can raise the chance of vascular or visual adverse events. If you notice sudden loss of vision or sudden severe hearing loss, stop the medicine and get immediate medical attention. Never use tadalafil together with recreational nitrates. For full the context and details of the conversational exchange, see Drug Interaction Management and for absolute exclusions see Cautions against use due to medical reasons.

Inadvisable outward signs

  • Concurrent use of organic nitrates (for example, nitroglycerin, isosorbide mononitrate or dinitrate) due to risk of a severe drop in blood pressure.
  • Use together with riociguat or other soluble guanylate cyclase stimulators.
  • Known allergy to tadalafil or any ingredient in the product.

If you develop chest pain after taking tadalafil, do not self-administer nitrates. Contact emergency services and inform them that you have recently used tadalafil.

Secondary effects that may occur

Widespread reactions that most people find mild or moderate include:

  • Pain in the head
  • Acute facial flushing
  • Digestive unease or general stomach upset
  • Blocked nasal passages
  • Dull ache in the back with muscle soreness
  • Mild tiredness or flu-like sensations

Less frequent but important effects:

  • Low blood pressure leading to fainting or dizziness
  • Visual disturbances such as blurred vision or changes in color perception
  • Hearing problems, including tinnitus or sudden hearing loss
  • Changes in ejaculation

Serious emergencies that require immediate medical attention:

  • Erection lasting longer than four hours (priapism)
  • Sudden, severe vision loss
  • Severe chest pain or signs consistent with a heart attack

Discuss suitability of sexual activity with your healthcare provider if you have significant heart disease.

Potential Drug Interactive encounters

Avoid coadministration of tadalafil with drugs or substances that significantly lower blood pressure or alter tadalafil concentrations. Significant dialogues include:

  • Organic nitrates (for example, nitroglycerin, isosorbide dinitrate/mononitrate).
  • Riociguat and other stimulators of soluble guanylate cyclase.
  • Alpha-blockers used for prostate issues or high blood pressure (for example, doxazosin, terazosin) - combining may require careful keeping track of metrics.
  • Strong CYP3A4 inhibitors (for example, ketoconazole, itraconazole, some macrolides, certain HIV protease inhibitors) which can raise tadalafil exposure.
  • CYP3A4 inducers (for example, rifampin, carbamazepine, phenytoin, St. John's wort) which can reduce tadalafil levels.
  • Alcoholic drink and many antihypertensive agents, which may add to blood pressure lowering.
  • Grapefruit or grapefruit juice, which can increase tadalafil blood concentration.

If you use any listed medicines, your prescriber may advise a dose change or recommend a different therapy. For absolute exclusions, see Absolute conditions that rule out this therapy.

Skipped Dose and Overdose incident

Unadministered dose: for on-demand use there is no scheduled daily dose to miss. For a prescribed daily regimen, take the missed tablet when you remember unless the next dose is due soon; do not double up to compensate.

ODing: taking too much can intensify side effects such as severe a headache, dizziness, fainting, or dangerously low blood pressure. If taking an overdose is suspected, seek emergency medical care or contact poison control promptly. Avoid sexual activity until a clinician confirms it is safe.

Local archival storage refers to the act of keeping items or data for future use. care guidelines

  • Keep at normal indoor temperatures, ideally between 20 and 25 C (68 and 77 F).
  • Store in a dry place away from direct sunlight and in the original, closed container.
  • Keep all medications out of reach of children and pets.

Options and Comparisons

Other PDE5 inhibitors and treatment options for erectile dysfunction include the following. Each differs in onset, duration, adverse reactions, and cost:

  • Sildenafil (Viagra and generic sildenafil) - shorter duration, typically 4 to 6 hours; usually taken 30 to 60 minutes before sex.
  • Vardenafil (Levitra; Staxyn ODT) - onset and duration similar to sildenafil; orally disintegrating tablets are an option if swallowing is a concern.
  • Avanafil (Stendra) - often a faster onset (around 15 to 30 minutes) and duration typically 6 to 8 hours.
  • Daily low-dose tadalafil (for example, 2.5 to 5 mg once daily) - offers continuous readiness and can help with lower urinary tract symptoms.
  • Device and non-pill approaches - vacuum erection devices, intracavernosal injections (for example, alprostadil), intraurethral suppositories, and behavioral or psychological therapies.

Choosing among options should consider how quickly you want effect, how long you want it to last, cost, and your medical history. See Price Quotation Estimates - USA for approximate costs and Protective safety instructions for medical considerations.

Estimated Prices - USA

Prices for goods in the United States vary by pharmacy, insurance, quantity, and discount programs. The numbers below are approximate ranges and may change:

  • Chewable or soft tadalafil forms: when available, prices can be about $2 to $8 per 20 mg tablet from some pharmacies or online vendors; chewable forms are less commonly stocked and sometimes compounded.
  • Generic tadalafil 20 mg (standard tablet): roughly $1 to $5 per tablet with discount programs; single-tablet retail without discounts may range from $10 to $20.
  • Brand Cialis 20 mg: retail price often around $50 to $70 per tablet.
  • Generic sildenafil (50 to 100 mg): commonly $0.50 to $2 per tablet with discounts.
  • Generic vardenafil (10 to 20 mg): roughly $2 to $8 per tablet.
  • Avanafil (brand Stendra): brand custom pricing commonly $30 to $60 per tablet.

Using coupons, manufacturer savings, pharmacy discount cards, or comparing several pharmacies may reduce out-of-pocket costs. When buying online, confirm the pharmacy is licensed in the United States; see Legal and Access Management - USA to guide you.

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