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Tadalafil in the treatment of erectile dysfunction

In previous articles numerous issues and questions were raised about the two main ED drug treatments Cialis and Viagra with some mentions made of other similar drugs or those purported to have the same active ingredients as the two main drugs. In this fifth and last article of this series, we take a closer look at the role that active ingredient Tadalafil (Cialis) plays in the treatment of erectile dysfunction (ED).

A Synoptic Viewpoint

The ability of Tadalafil (Cialis) to become a proven treatment for erectile dysfunction is due mainly to the function which this marvelous drug is able to perform. It does so through its inner properties as a reversible phosphodiesterase type 5 or PDE5 inhibitor and in having this status approved as a recognized treatment for erectile dysfunction or ED in short.

The PDE5 inhibitors cling together as a class and comprise the active ingredients of tadalafil (Cialis) already alluded to, Sildenafil (Viagra) and vardenafil (Levitra), which all perform in similar fashion against the erectile dysfunction. They do so by enhancing the upsurge of an erection in answer to physical stimulation that increases the flow of blood flow to and inside the penis.

Of the three ED drug treatments, the active ingredient, tadalafil in Cialis lasts much longer than the active ingredients sildenafil or vardenafil present in Viagra and Levitra respectively.

Safety Issues and Counter Measures

The subject of side effects is always of paramount importance when medications are being discussed and this case is no exception. For tadalafil the active ingredient found in Cialis, the incidence of side effects as a result of its use is practically absent except when it is taken with other drugs.

For instance when taken with α1-adrenergic blockers such as doxazosin (Cardura), prazosin (Minipress), and terazosin (Hytrin) but not tamsulosin (Flomax)—tadalafil can cause a significant drop in blood pressure. Also the simultaneous taking of nitrates with tadalafil is ill-advised and should not be done.

Nitrates may be taken to prevent any life-threatening situation with the proviso that at least 4 days have gone by without the patient having ingested a dose of tadalafil or Cialis tablet. Another related requirement is that close hemodynamic monitoring can be performed.

When used with antihypertensive drugs the active ingredient tadalafil is capable of reducing blood pressure by 4 to 10 mm Hg which is not conducive to smooth blood flow.

To prevent any physical repercussions, a 10mg dose of tadalafil should be given for a 2 day period when patients are also taking drugs such as erythromycin, ketoconazole (Nizoral), itraconazole (Sporanox), protease inhibitors and other drugs that stop the function of the CYP3A4 system.

The safety of tadalafil for patients suffering from cardiovascular (heart and blood vessels) diseases is unknown and this population has not been included in any tadalafil studies.

It’s recommended that when patients experience chest pains during sex activity after taking tadalafil or other inhibitors, they need to contact emergency services to provide transport to the hospital.

Reports on a penile condition called “priapism” resulting from the use of these ED drugs have only been made on rare occasions and plans for long term safety have yet to be put in place. This is necessary because the potency of tadalafil remains active for a longer time (36 hours) than sildenafil (Viagra) or vardenafil (Levitra).

Levels of Tolerance

The level of tolerance to the effects of ED drug medications especially tadalafil are listed below:

  • Headache – the percentage of the studied population stands at 11 to 15 percent
  • Dyspepsia – this has been reported at 8 to 10 percent of the studied population
  • Back pain – given as 5 to 6 percent of the studied men. The pain should begin after one half or a whole day after taking the a dose with active potency lasting for two days. This may be compared with the rate of only 3 percent of men who received placebo having back pain.
  • Color vision – reported with the use of sildenafil (Viagra) but only 0.1 percent of patients taking tadalafil was reported in clinical trials.


The most appropriate questions to ask here is, “Have ED medications proved themselves as truly effective in treating erectile dysfunction? To give the right answer, we need to take a look at the outcomes of these ED treatments especially tadalafil (Cialis), namely:

  • An achievement of an erection
  • successful intercourse and
  • satisfaction with sexual function

Five studies were done to evaluate the efficacy of tadalafil (Cialis) with 5mg, 10mg and 20mg dosages while another group of men were given placebo.

 A group of 321 men was formed and given the more popular 10mg dosage of tadalafil and it was found that:

  • more than half of the men (68 to 77 percent) reported achieving an erection.
  • On the hand only 42 to 55 percent (average of 48 percent) of men given placebo achieved an erection.

For successful intercourse it was found that:

  • 51 to 70 percent of the men in the formed group enjoyed successful intercourse a slightly lower figure than the first. For satisfaction with intercourse the maximum score was 15 and the group scored 9.3 points
  • This can be compared with a 7.4 points out of the total 15 points for those receiving placebo

For overall satisfaction of sexual function it was found that:

  • Out of a possible score of 10 points for those who took tadalafil 6.7 reported achieving overall satisfaction
  • This can be compared with the 5.2 points out of the total 10 points scored by the men receiving

The Beauty of Simplicity

After establishing the effectiveness of tadalafil it should be realized that simplicity played a big role in making this ED medication a popular choice. You really have to focus on one tablet, the 10mg dosage of only one tablet per day period! Its effect will last for up to 36 hours and it can be increased to 20mg if needed.

For patients suffering for certain illnesses such as renal insufficiency, moderate hepatic dysfunction, the dosage can be adjusted downwards from 10mg say to the 5mg dosage but for those who have severe hepatic dysfunction they should not take Tadalafil tablets. It’s that simple!


For all intents and purposes, it has been clearly established in the above content that Tadalafil in the treatment of erectile dysfunction has been totally satisfactory. It has enabled men to have an erection, successfully enjoy sexual relations and achieve overall satisfaction as a result. For these reasons we can safely conclude that Tadalafil in the treatment of erectile dysfunction, is the way to go.

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