What exactly is tadalafil?

Tadalafil is the active ingredient in the well-known erectile medication Cialis. It was launched in 2002 by the pharmaceutical company Lilly ICOS, four years after Viagra. Tadalafil stands out mainly because of its long duration of action - up to 36 hours - which quickly made it popular among men who wanted greater flexibility.

Since the Cialis patent expired in 2017, tadalafil has also been available as a generic medication. This means you can now get the same active ingredient at a lower price. Generic tadalafil is just as effective and safe as branded Cialis⁵ - the only differences are price and packaging.

How does tadalafil work in your body?

Like sildenafil, tadalafil belongs to a group of medicines called PDE5 inhibitors. Its mechanism is similar: by inhibiting the PDE5 enzyme, the substance cGMP remains active in your body for longer. This allows the blood vessels in the penis to relax so more blood can flow in.

When you become sexually aroused, your body naturally produces cGMP. This substance relaxes the smooth muscle in the blood vessels of the penis, creating room for increased blood flow. In erection problems, the PDE5 enzyme breaks down cGMP too quickly.

Tadalafil effectively blocks this PDE5 enzyme, allowing cGMP to remain active longer. The result: improved blood flow and a firmer erection. The main difference compared with sildenafil is duration⁸ - sildenafil works for about 4–6 hours, while tadalafil can remain active for up to 36 hours.

Important: just like sildenafil, tadalafil only works with sexual arousal. It does not automatically cause an erection - you still need sexual stimulation.

How long does tadalafil last?

The most notable feature of tadalafil is its duration of action: up to 36 hours. This does not mean you will have an erection for 36 hours - that would be dangerous. What it does mean is that during this period, it will be easier to get an erection when you are sexually aroused.

After taking tadalafil, it reaches its maximum concentration in the blood within about 2 hours. Its half-life is approximately 17.5 hours². This means that after 17.5 hours, half of the active substance is still present in your body - explaining the long duration.

This long-lasting effect makes tadalafil popular for men who want more spontaneity. You don’t need to precisely plan when you’ll have sex - a tablet on Friday evening can cover the whole weekend. That’s why tadalafil is often called the “weekend pill.”

Note: because tadalafil lasts so long, you should not use it more than once per day. With daily use, you take a lower dose (5 mg) at a fixed time every day.

Which dosage is right for you: on-demand or daily?

Tadalafil is unique because it can be used in two ways. The best choice depends on how often you have sex and your personal preference.

On-demand use (10 mg or 20 mg):

You take a tablet at least 30–60 minutes before planned sexual activity. The effect can last up to 36 hours, giving you a lot of flexibility within that window. The standard starting dose is 10 mg. If that’s not effective enough, your doctor may increase it to 20 mg³.

On-demand use may be suitable if you:

• Have sex less often (fewer than 2 times per week)

• Can plan sexual activity

• Only want to use medication when needed

• Prefer not to take a daily medication

Daily use (5 mg):

You take a low dose at the same time every day. After 4–5 days, a steady level of the active ingredient builds up in your body². This means you’re always ready for sexual activity, without needing to plan ahead.

This may be suitable if you:

• Have sex regularly (2+ times per week)

• Want maximum spontaneity

• Experience performance pressure with “taking it in the moment”

• Prefer a consistent, ongoing solution

Benefits of daily use

The biggest benefit is mental ease. You don’t have to think, “Did I take it in time?” or “Will it work?” For many men, this significantly reduces performance pressure. In addition, side effects are often milder because you’re using a lower daily dose.

What’s the best choice for you?

Most men start with 10 mg on-demand. It’s effective for most and helps you understand how tadalafil feels and works in your body¹. If you’re sexually active more than twice per week or experience a lot of stress around planning, daily use may be a better fit. At Menkind, your doctor can help you choose the right option.

What are the side effects of tadalafil?

Tadalafil is clinically proven to be safe and is used by millions of men worldwide¹. As with any medication, side effects can occur, but they are usually mild and temporary.

The most common side effects are:

• Headache

• Flushing (red face)

• Nasal congestion

• Back pain or muscle pain

• Indigestion

• Mild dizziness⁷

These side effects are usually strongest in the first hours after taking the medication and resolve on their own. With daily use, side effects often become milder after a few days as your body adjusts.

Serious side effects are very rare. Contact a doctor immediately if you experience:

• Chest pain

• An erection lasting longer than 4 hours (priapism)

• Sudden changes in vision or hearing

When should you not use tadalafil?

Although tadalafil is safe for most men, there are situations where you should not use it.

Do NOT use tadalafil if you:

• Use nitrates (medications for heart conditions)

• Have recently had a heart attack or stroke

• Have severe heart, liver, or kidney disease

• Have very low blood pressure

• Have certain inherited eye conditions

Be extra cautious and consult a doctor if you:

• Use other medications (check for interactions)

• Have cardiovascular disease

• Have a history of priapism

• Have stomach or intestinal problems

At Menkind, your medical situation is carefully reviewed by a registered doctor to ensure safe use.

How to use tadalafil effectively

For optimal results, it’s important to use tadalafil correctly. Tips differ depending on how you take it:

For on-demand use (10 mg / 20 mg):
Timing: Take at least 30 minutes before sex - ideally 1–2 hours beforehand. Full effect is usually reached after about 2 hours⁴, but it can remain effective for up to 36 hours.

Frequency: maximum one tablet per 24 hours. Since tadalafil remains effective for up to 36 hours.
Food: Can be taken with or without food. Fatty meals may slow the effect slightly, but less than with sildenafil.

Planning: Make use of the long window - you don’t need perfect timing. A tablet on Friday evening can cover the whole weekend.

For daily use (5 mg):

Consistency: Take it at exactly the same time every day. Choose a moment that’s easy to remember (for example, in the morning with breakfast).

Patience: It takes 4–5 days for the effect to become optimal. Don’t expect maximum effect immediately.

Continuity: Don’t skip days, even if you’re not planning sex. The steady effect is the advantage.

Spontaneity: No planning needed - you’re always ready.

General tips for both approaches:

Alcohol: Limit alcohol. Too much alcohol (more than 2–3 drinks) can reduce effectiveness and increase dizziness risk.

Sexual stimulation: Tadalafil does not work automatically - you need sexual arousal. The medication enables an erection but doesn’t cause one by itself.

First use: Give it time. Nervousness can make the first attempt less effective. Try it at least 3–4 times before deciding it does or doesn’t work.

Not effective enough? Discuss this with your doctor. A higher dose (on-demand) or a different dosing strategy may work better.
Interactions: Never use tadalafil with nitrates or recreational drugs such as poppers. This can be dangerous.

Conclusion

Tadalafil is a proven safe and effective treatment for erection problems, with the major advantage of a long duration of action - up to 36 hours. This provides more flexibility and spontaneity than sildenafil, which works for 4–6 hours.

You can choose between on-demand use (10 mg or 20 mg, shortly before sex) or daily use (5 mg, at the same time each day). Daily use is ideal if you’re sexually active regularly and want to avoid the pressure of planning.

Side effects are usually mild - such as headache, flushing, or nasal congestion - and resolve on their own. With daily use, side effects often become even milder after a few days.

At Menkind, after an online consultation with a registered doctor, you can receive both Cialis and generic tadalafil. Available in 10 mg and 20 mg for on-demand use, and 5 mg for daily use. All options are available as a one-time order or via subscription, with discreet home delivery.

References

1. Carson, C. C., et al. (2004). The efficacy and safety of tadalafil: an update. BJU International, 93(9), 1276-1281. https://pubmed.ncbi.nlm.nih.gov/15180622/

2. Coward, R. M., & Carson, C. C. (2008). Tadalafil in the treatment of erectile dysfunction. Therapeutics and Clinical Risk Management, 4(6), 1315-1330. https://pubmed.ncbi.nlm.nih.gov/19337438/

3. Porst, H. (2002). IC351 (tadalafil, Cialis): update on clinical experience. International Journal of Impotence Research, 14(Suppl 1), S57-S64. https://pubmed.ncbi.nlm.nih.gov/11850737/

4. Brock, G. B., et al. (2002). Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. The Journal of Urology, 168(4), 1332-1336. https://pubmed.ncbi.nlm.nih.gov/12352386/

5. Meuleman, E. J. (2003). Review of tadalafil in the treatment of erectile dysfunction. Expert Opinion on Pharmacotherapy, 4(11), 2049-2056. https://pubmed.ncbi.nlm.nih.gov/14596658/

6. Saigal, C. S., et al. (2006). Predictors and prevalence of erectile dysfunction in a racially diverse population. Archives of Internal Medicine, 166(2), 207-212. https://pubmed.ncbi.nlm.nih.gov/16432090/

7. Apotheek.nl. Tadalafil bijsluiter. https://www.apotheek.nl/medicijnen/tadalafil

8. Jackson, G., et al. (2005). Past, present, and future: a 7-year update of Viagra (sildenafil citrate). International Journal of Clinical Practice, 59(6), 680-691. https://pubmed.ncbi.nlm.nih.gov/15924597/