Tadalafil (Generic Cialis)

Both Tadalafil Daily and Tadalafil On-Demand contain the same active ingredient and work in the same way, but they are taken differently and suit different lifestyles.

Tadalafil On-Demand (10mg or 20mg) is taken as needed, at least 30 minutes before sexual activity, and the effects can last for up to 36 hours. This option is often called the 'weekend pill' because a tablet taken on a Friday evening can still be working on Sunday morning. It is generally suitable for men who anticipate sexual activity on up to two occasions a week, or who prefer the flexibility of only taking the medicine when needed.

Tadalafil Daily (2.5mg or 5mg) is taken every day, with or without food, at roughly the same time. The effect is continuous once the medicine has built up in the body over the first few days, which means there is no need to plan around individual doses. It is generally suitable for men who anticipate sexual activity at least twice a week, or who prefer a daily routine over timing each dose.

Recommended reading: Tadalafil Daily: Is it right for you?

Tadalafil On-Demand (10mg or 20mg) starts to work within 30 minutes to one hour of being taken, although for some men it may take up to two hours. Once active, the effects can last for up to 36 hours.

The active ingredient can remain effective for up to 36 hours after a single dose, which is longer than other PDE-5 inhibitors such as Sildenafil (which typically lasts four hours) or Spedra (which typically lasts up to six hours).

Tadalafil Daily (2.5mg or 5mg) does not work in the same way. Because it is taken every day, the active ingredient builds up in the body over the first five days and then remains at a steady level. Once that level has been reached, you will be able to get an erection in response to sexual stimulation at any point, without needing to plan around taking a tablet.

Clinical research supports Tadalafil as a well-established treatment for erectile dysfunction. Both the daily and on-demand dosing options have been studied extensively, and Tadalafil is recommended in both the NHS guidance on tadalafil and the British National Formulary (BNF) guidance as a first-line option for ED in adult men.

As with any medicine, individual response can vary, and how well Tadalafil works for a particular patient depends on factors such as the underlying cause of ED, overall health, the dose taken and lifestyle factors such as alcohol intake.

Tadalafil is also consistently among the most positively reviewed treatments at Pharmica, where the most common themes in customer feedback are the convenience of the longer window of action and the flexibility of being able to choose between daily and on-demand dosing.

If you have not responded as expected to a standard dose of Tadalafil, our prescribing team can review whether a different strength, a different dosing option or an alternative ED treatment may be more suitable for you.

If you have taken Tadalafil and not had the response you expected, there are several common reasons before assuming the medicine is unsuitable.

The most important factor to consider is that Tadalafil requires sexual stimulation to take effect and will not produce an erection on its own.

Other factors that can affect how well it works include drinking more than one or two units of alcohol, high stress or anxiety levels at the time, or simply not having waited long enough for the medicine to take effect.

Clinical guidance recommends trying an ED medicine on at least four to eight separate occasions before assessing whether it is working, as the response can improve with repeated use as the body and the patient become familiar with the medicine.

If Tadalafil has been tried several times without the expected result, the following options can be considered:

• Review the dose: if you have been taking on-demand 10mg and it has been well tolerated, our prescribing team may suggest moving to 20mg. If you have been taking daily 2.5mg, moving to 5mg can give a stronger effect
• Review the dosing mode: switching from on-demand to daily Tadalafil (or vice versa) may suit some patients better. Daily Tadalafil takes around five days to build up to a steady level, after which the effect is continuous
• Consider a different ED treatment: different PDE-5 inhibitors suit different patients. Sildenafil, Vardenafil and Avanafil (Spedra) all work in a similar way but have different durations, food interactions and side effect profiles. Our ED Trial Pack contains different treatments to be used on separate occasions, allowing you to see which works best for you
• Review lifestyle factors: alcohol, smoking, poor sleep and stress can all affect how well ED treatment works

Recommended reading: Which Erectile Dysfunction Treatment Is Best For Me?

Do not take more than one tablet in 24 hours or combine Tadalafil with another ED medicine. If Tadalafil has not worked for you after several attempts, contact us to discuss your options.

The maximum dosing frequency for Tadalafil is one tablet in any 24-hour period.

However, the 10mg and 20mg strengths are intended for on-demand use and should not be taken every day unless specifically advised by a prescriber. Daily Tadalafil should be taken only at the prescribed 2.5mg or 5mg strength.

The licensed strengths of Tadalafil for the treatment of erectile dysfunction are 2.5mg, 5mg, 10mg and 20mg. The 20mg dose is the highest strength used for on-demand treatment of ED. Doses higher than 20mg are sometimes used in the treatment of other conditions (such as pulmonary arterial hypertension) under medical supervision, but these are not appropriate to treat erectile dysfunction.

If 20mg on-demand has not given sufficient effect after several attempts and has been well tolerated, our prescribing team can suggest switching to a different ED medicine rather than a higher dose. Tadalafil should also not be combined with any other PDE-5 inhibitors such as Sildenafil, Vardenafil or Avanafil.

Tadalafil is suitable for many adult men with erectile dysfunction, but it is not appropriate for everyone. Some medical conditions and medicines can make Tadalafil unsuitable. We also apply additional eligibility criteria when prescribing through our online service.

This means we may not be able to prescribe Tadalafil if you have certain medical conditions or take certain medicines, even where treatment may be considered following a more detailed assessment with your GP or another healthcare professional. Your eligibility will be assessed as part of the online consultation.

Medical conditions that may mean Tadalafil is not suitable through Pharmica

We will not be able to prescribe Tadalafil if you:

• Are under 18 or over 75 years of age
• Have had an allergic reaction or serious side effect from tadalafil, sildenafil, vardenafil, avanafil or another erectile dysfunction medicine
• Have ever had a heart attack
• Have ever had a stroke
• Have unstable angina or angina that occurs during sexual activity
• Have been advised to avoid sexual activity or strenuous exercise, or would have difficulty walking quickly for five minutes because of breathlessness, chest pain, dizziness or another health problem
• Any heart problems including angina, chest pain, heart failure, irregular heartbeats, heart attack (myocardial infarction), left-ventricular outflow obstruction, cardiomyopathy or valvular heart disease (e.g. aortic stenosis)
• Have very low blood pressure
• Have been diagnosed with high blood pressure or take any medicine to treat high blood pressure
• Have any liver problem
• Have any kidney problem or are on dialysis
• Have experienced sudden loss of vision in one or both eyes, including sight loss caused by poor circulation, such as non-arteritic anterior ischaemic optic neuropathy (NAION)
• Have a condition that increases the risk of prolonged erections, such as sickle cell anaemia, leukaemia, multiple myeloma, Peyronie's disease or a previous erection lasting longer than four hours
• Have a bleeding disorder such as haemophilia, or an active stomach ulcer
• Have a known hereditary degenerative retinal disorder
• Have galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption, as Tadalafil tablets contain lactose
• Have any serious or unstable medical condition that may require urgent medical attention or hospital care

If you have ever had a heart attack or stroke, we will not be able to prescribe Tadalafil and recommend that you speak to your GP about whether treatment is suitable for you.

Medicines and recreational drugs that may mean Tadalafil is not suitable through Pharmica

Some medicines and recreational drugs can interact with Tadalafil, while others fall within our additional eligibility criteria for online prescribing.

We will not be able to prescribe Tadalafil if you take or use:

• Other erectile dysfunction treatments or products. Tell us about any ED treatment you use, including Viagra (sildenafil), Levitra (vardenafil), Cialis (tadalafil) or Spedra (avanafil), as these must be reviewed as part of your consultation
• Medicinal nitrates such as glyceryl trinitrate (GTN), isosorbide mononitrate or isosorbide dinitrate, including oral, transdermal and sublingual forms
• Recreational nitrates known as “poppers”, such as amyl nitrite, butyl nitrite or isobutyl nitrite
• Recreational drugs prohibited by law, including Class A, B or C drugs
• Alpha-blockers such as tamsulosin, doxazosin, prazosin, terazosin or indoramin, which may be used to treat high blood pressure or urinary symptoms associated with benign prostatic hyperplasia
• Medicines used to treat high blood pressure
• Warfarin
• Antiviral medicines including atazanavir, etravirine, fosamprenavir, indinavir, nelfinavir, ritonavir or saquinavir
• Nicorandil
• Antifungal medicines such as ketoconazole or itraconazole
• Quinidine, procainamide or amiodarone
• Theophylline
• Erythromycin, clarithromycin or cimetidine
• Phenobarbital, phenytoin or carbamazepine
• Riociguat
• Rifampicin
• Bosentan
• Forxiga (dapagliflozin), Jardiance (empagliflozin), Invokana (canagliflozin) or Steglatro (ertugliflozin)

Your eligibility will be determined through the online consultation. Our prescribing team will review your consultation answers before deciding whether Tadalafil can be prescribed safely through Pharmica.

If we are unable to prescribe Tadalafil through our online service, this does not necessarily mean that Tadalafil is unsuitable for you in every clinical setting. We may recommend that you speak to your GP or another healthcare professional who can assess your individual circumstances in more detail.

Like all medicines, Tadalafil can cause side effects, although not everyone gets them. Common side effects (affecting up to 1 in 10 people) include headache, indigestion, back pain, muscle aches, flushing of the face, nasal congestion, dizziness and limb pain.

Less common side effects (affecting up to 1 in 100 people) include blurred vision, palpitations, low blood pressure, sweating, skin rash and ringing in the ears.

Stop taking Tadalafil and seek medical advice promptly if you develop any of the following:

• An erection that lasts longer than four hours (known as priapism), which can damage the penis if not promptly treated
• Sudden loss or reduction of vision in one or both eyes
• Sudden loss or reduction of hearing, sometimes with dizziness or ringing in the ears
• Chest pain, irregular heartbeat or shortness of breath during or after sexual activity
• Signs of a serious allergic reaction, such as swelling of the face, lips, tongue or throat, difficulty breathing, or a widespread rash

If you experience an erection lasting longer than four hours, you should attend A&E immediately.

Official medicine information is also available in the Tadalafil Patient Information Leaflet on the electronic Medicines Compendium (eMC).

You can report suspected side effects to the MHRA through the Yellow Card Scheme.

Tadalafil is a prescription-only medicine in the UK, so it cannot be bought over the counter or on general sale. It can only be supplied against a valid prescription.

Pharmica is a UK-registered pharmacy (General Pharmaceutical Council registration number 9012030) that supplies Tadalafil following a short online consultation reviewed by a UK-based prescriber.

An over-the-counter version of tadalafil 10mg is sold in the UK under the brand name Cialis Together, which a pharmacist can supply following a consultation. It is only available at the 10mg strength.

Complete a short online consultation covering your symptoms, medical history and any other medicines you take.

Our UK-based prescriber will then review your answers, and if Tadalafil is suitable for you, a prescription will be issued and your order will be dispensed by our pharmacy team and dispatched in plain, discreet packaging.

If Tadalafil is not suitable for you, our prescribing team will explain why and, where appropriate, suggest an alternative treatment.

Yes. Tadalafil is the generic version of Cialis, and both treatments contain the same active ingredient at the same strengths.

Cialis is the original branded medicine, manufactured by Eli Lilly, and Tadalafil is the unbranded generic version produced by other licensed manufacturers (such as Teva, Mylan and Accord) since the Cialis patent expired in November 2017.

Because the active ingredient is identical, the clinical effect of Tadalafil is the same as that of Cialis when taken at the same strength. The main differences between them are the appearance of the tablet, the inactive ingredients used in the tablet coating, the packaging and the price. As Tadalafil is a generic treatment, it is significantly cheaper than branded Cialis.

Tadalafil and Sildenafil are both PDE-5 inhibitors and work in the same way, but Tadalafil lasts up to 36 hours, compared with up to four hours for Sildenafil, which is why Tadalafil is sometimes called the 'weekend pill'.

Tadalafil is also available as a daily low-dose tablet, whereas Sildenafil is taken on demand only. Neither medicine is better than the other, and the right choice depends on how often sexual activity is anticipated and how you respond to the treatment.

For a full comparison of duration, dosage and side effects, read our Sildenafil vs Tadalafil guide.

The timing of the daily dose matters less than taking it consistently at roughly the same time every day. Many men prefer to take it in the morning so that the medicine becomes part of their routine alongside other daily habits such as brushing teeth.

Others prefer taking the daily tablet in the evening, which can be a more natural fit alongside sexual activity later that night. Whichever time you choose, sticking to it allows the active ingredient to maintain a steady level in the body.

No. Generic Tadalafil is classified as a Prescription-Only Medicine (POM) in the UK. This means it cannot be supplied without a valid prescription and is not available on general sale or as a pharmacy medicine.

You can purchase Tadalafil from Pharmica after completing a short online consultation. The questionnaire asks about your symptoms, medical history and any other medicines you are taking. The information is reviewed by our UK-based prescribing team, who will issue a prescription if Tadalafil is appropriate for you. Orders are dispatched in plain, discreet packaging.

Tadalafil can be taken with a small amount of alcohol, but heavy drinking should be avoided. Larger amounts of alcohol can lower blood pressure further, which may lead to dizziness, fainting or headache, and can also make erectile dysfunction worse.

For most patients, keeping alcohol intake to a moderate level around the time of taking Tadalafil gives the most consistent results.

No. Tadalafil should not be combined with any other PDE-5 inhibitor, including Sildenafil, Viagra, Cialis, Levitra (Vardenafil) or Spedra (Avanafil). Combining two ED tablets does not increase the chance of getting an erection, but it does increase the likelihood of side effects, particularly low blood pressure, headache and dizziness.

Only one ED tablet of any type should be taken in any 24-hour period. If you would like to try more than one ED treatment to see which works best for you, the Pharmica ED Trial Pack contains different treatments that can be used on separate occasions.

Tadalafil is also not licensed for use as a treatment for premature ejaculation. If you experience both ED and premature ejaculation, our prescribing team can suggest a more suitable combination of treatments.

Store Tadalafil in its original packaging in a cool, dry place, out of the sight and reach of children. Do not use the tablets after the expiry date printed on the packaging.

If you no longer need the medicine, return it to a pharmacy for safe disposal rather than putting it in household waste or wastewater.