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    Tadalafil (Cialis) is used to treat erectile dysfunction (ED, impotence; inability to get or keep an erection), and the symptoms of benign prostatic hyperplasia (BPH; an enlarged prostate) which include difficulty urinating (hesitation, dribbling, weak stream, and incomplete bladder emptying), painful urination, and urinary frequency and urgency in adult men. Tadalafil (Adcirca) is used to improve the ability to exercise in people with pulmonary arterial hypertension (PAH; high blood pressure in the vessels carrying blood to the lungs, causing shortness of breath, dizziness, and tiredness). Tadalafil is in a class of medications called phosphodiesterase (PDE) inhibitors. It works to treat erectile dysfunction by increasing blood flow to the penis during sexual stimulation. Tadalafil treats PAH by relaxing the blood vessels in the lungs to allow blood to flow more easily. If you are taking tadalafil to treat erectile dysfunction, you should know that it does not cure erectile dysfunction or increase sexual desire. If you are taking tadalafil to treat erectile dysfunction, follow your doctor's directions and the guidelines in this paragraph. Tadalafil does not prevent pregnancy or the spread of sexually transmitted diseases such as human immunodeficiency virus (HIV). There are two different ways to take tadalafil, either daily or on an as needed basis. Talk to your doctor about which dosing schedule is right for you. The most common side effects include: headache, dyspepsia (i.e., pain or an uncomfortable feeling in the upper middle part of your stomach), back pain, myalgia (i.e., muscle pain), nasal congestion, flushing, and pain in limb. When Taken As Needed: The starting dose is usually 10 mg as needed prior to sexual activity but it depends on the individual. It has been shown to improve erectile function, compared to placebo, up to 36 hours post dose. When Taken Daily: The starting dose is 2.5 mg, taken at approximately the same time every day, without regard to timing of sexual activity. Based on effectiveness and tolerability, your physician may recommend an increase to 5 mg. Cialis has been shown to take effect in as little as 30 minutes. After single oral-dose administration, the maximum observed plasma concentration (Cmax) of tadalafil is achieved between 30 minutes and 6 hours (median time of 2 hours). Absolute bioavailability of tadalafil following oral dosing has not been determined.

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