How to use Tadalafil?

User

Posted 15 Sep 2023 at 19:57

Dear all,

I haven’t been around for a while - hope all’s well with the “regulars”?

A question: nearly five years after RT I’ve been experiencing gradual ED issues and I have (today) been put onto 5mg daily Tadalafil (Cialis). My question is how do I actually use it? Can I just take a tablet first thing in the morning and forget about it, or is it necessary to take the tablet and then get an erection while the drug is still active for it to be beneficial for penile health? Nobody’s told me, and the leaflet in the box isn’t very helpful on the subject.

All advice is very welcome!

Thanks,

Chris

User

Posted 22 Sep 2023 at 12:26

Sorry Chris, I thought this was a forum where everybody discussed everything openly on any thread in the hope that it might be of help? I only tagged onto it because you were using the same drug that I have just been prescribed.

Maybe you should set up your own forum 'Chris' prostate cancer' may be a good name? You could then have complete autonomy and just talk about yourself

User

Posted 18 Sep 2023 at 16:58

Just to follow up on this, taking the tablet at bedtime is working much better for me. The side-effects have gone.

Chris

User

Posted 20 Sep 2023 at 19:22

I'm giving up the Tidalafil. Too many side effects. Headaches, nausea, and now back and leg muscle pain. It's just not worth it. Phoned the ED specialist nurse at the hospital and she agrees. I guess some things just aren't meant to be.

A piece of good news is that at long last I've got an appointment for the pump clinic on 1st November, so hopefully that will do me some good.

Chris

User

Posted 21 Sep 2023 at 15:18

I had a radical prostatectomy on the 21st June this year. My surgeon prescribed 10mg of Tadalafil twice a week starting two weeks ago. So far nothing has happened. Has anybody else had this treatment and if so with much success?

User

Posted 23 Sep 2023 at 14:35

Hi Chris,

My husband had cystoprostatectomy in August 2022. He took 5 mg daily tadalafil immediately after the intervention and had to stop this year in May , due to terrible acid reflux. At that time he took instead 100 mg sildenafil twice a week with excellent results and no side effect.

But the days without sildenafil the penis did not look so healthy and there was less spontaneity in relations, therefore he tried again tadalafil, but only 2.5 mg every day. And 3 weeks later again 5 mg. To date the side effects are not so bad as before and the expected results are encouraging (rigidity not totally full but penetration is possible and enjoyable for both of us). We feel that tadalafil is the best help for long-term because there is permanent body impregnation. He never tried pump or injections.

Don't give up and try anything that is acceptable for you.

Catherine

User

Posted 23 Sep 2023 at 21:51

All the PDE5 inhibitors can cause acid reflux, because your esophagus and lower esophageal sphincter also use PDE5 to contract, so the inhibitor can affect their ability to work properly. Usually this only happens in those who already have some level of acid reflux.

Snapping the tablets to take a half dose might not work in this case, because you break the film coating which is there to prevent the PDE5 inhibitor from coming in to contact with the esophagus. Both the 5mg daily low dose and the 20mg event dose are available in half doses (2.5mg and 10mg) for the case where they cause side effects, and often the half dose is still enough for the intended effect, but not the side effects.

You don't want to have frequent acid reflux, as it's a potential cause of esophageal cancer.

User

Posted 24 Sep 2023 at 20:34

Chris, the only thing I find that counters my acid reflux satisfactorily is Omeprazole. Unfortunately that means another prescription drug to take and my GP will not give it on repeat prescription. Acid reflux was not a problem for me until I started on Tadalafil. I have been taking half a 20 mg tablet every other day (which works very well for erections) but following Andy62's advice I've just started taking the full 20 mg dose. So far, I'm still getting acid reflux but also Tinnitus. The solution might be a 2.5 mg/5 mg daily dose but but I can't get that on the NHS in my area. I hope you manage to sort things out because if Tadalafil does the business for you it would be a shame to give up on it. Chris

User

Posted 26 Sep 2023 at 16:30

Cheshire Chris,

I was prescribed Sildenafil as soon as the catheter was removed and got a pump after three months. I’m now 9 months postoperative with the Sildenafil having some effect. The pump has been effective and has provided useable erections provided the rings are used. There is another contributor, Pratrap ( I hope I’ve spelled that correctly) who has a good thread about using pumps.

User

Posted 26 Sep 2023 at 20:26

Originally Posted by: Online Community Member

I've just started taking the full 20 mg [Tadalafil] dose. So far, I'm still getting acid reflux but also Tinnitus.

I think you should stop taking it if you get Tinnitus, as it can cause permanent deafness too.

Originally Posted by: Online Community Member

The solution might be a 2.5 mg/5 mg daily dose but but I can't get that on the NHS in my area.

This is illogical (but yes, I know it happens).

I don't know the mechanism for hearing damage, so I don't know how safe it is to take a lower dose to try avoiding this, but I certainly wouldn't continue taking it at a dose which gives hearing problems.

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User

Posted 16 Sep 2023 at 06:57

Hey Chris , Cialis or Tadalafil was nicknamed the Weekender. You took the 20mg tablet and it would stay in your system for the whole weekend helping you get an erection when stimulated. It could have ( like all the others ) bad side effects. The point of daily 5mg is to keep a lower dose permanently inside you. I noticed the effects within 2 weeks. More warmth , wood in the mornings , good erections as needed. I take it at night to negate some of the side effects whilst I’m sleeping. It can cause heartburn so you may need a PPI. Some people get a bad back and bad leg pain. Good luck 🤞

User

Posted 16 Sep 2023 at 06:59

Thanks, Chris. What is a PPI?

Chris

User

Posted 16 Sep 2023 at 07:54

The daily low dose gives you a permanent background level, although there will be a higher boost an hour or so after you took it. So if you are after erections at bedtime, I would take it late in the day, whereas if you after erections during the day, then maybe in the morning. If that's not the motivation, then in the evening, so you get better erections during REM sleep. The effect is going to be more beneficial if you do manage to get erections with it.

You may well find it makes no difference, and even the lower background level just before the next tablet is still plenty for whatever you're after. It doesn't usually make any difference if you take with food or not (which is not the case for Sildenafil, which works best on an empty stomach, and also when you haven't eaten fatty foods recently).

Edited by member 16 Sep 2023 at 07:59 | Reason: Not specified

User

Posted 16 Sep 2023 at 08:31

Thanks. Andy!

Chris

User

Posted 16 Sep 2023 at 08:34

Originally Posted by: Online Community Member

What is a PPI?

Proton Pump Inhibitor, to reduce acid levels in GI tract.

However, it's not obvious to me that a PPI would help with acid reflux, since a side effect of it is to weaken the lower esophageal sphincter, just like Tadalafil does, which is what causes the issue (usually only in men who already get acid reflux).

User

Posted 16 Sep 2023 at 12:22

I'm finding that the Tadalafil tablets are giving me quite unpleasant side effects: brain fog and a complete inability to concentrate on anything for several hours after taking the tablet. I'll change to taking one at bedtime rather than in the morning and see if that helps at all. I'll give them a couple of weeks, but I'm not going to stick with them if this persists.

Chris

User

Posted 16 Sep 2023 at 13:03

Chris, what dose are you on?

The two main doses, 5mg daily low dose and the 20mg event dose are both available as half doses if they're causing unacceptable side effects.

User

Posted 16 Sep 2023 at 13:08

It's 5mg, Andy. I took one about 9:30 this morning and an hour later I was feeling very odd, as if my head was stuffed with cotton wool. I was trying to rehearse some quite complicated music for a performance tomorrow, so not ideal. 1pm now and it's starting to wear off, but definitely not feeling normal. It's quite similar to the way I felt when I was on HT.

I think I'll skip tomorrow morning and take my next one at bedtime tomorrow and see how that goes.

Cheers,

Chris

User

Posted 18 Sep 2023 at 16:58

Just to follow up on this, taking the tablet at bedtime is working much better for me. The side-effects have gone.

Chris

User

Posted 20 Sep 2023 at 19:22

A piece of good news is that at long last I've got an appointment for the pump clinic on 1st November, so hopefully that will do me some good.

Chris

User

Posted 21 Sep 2023 at 15:18

User

Posted 21 Sep 2023 at 19:02

Hi John,

It is my understanding that you would be unlikely to notice any improvement in erectile dysfunction so soon after your surgery. As I understand it, Tadalafil is given after surgery to maintain blood flow to the penis while you are not getting natural erections. It may be many months more before you get any sign of an erection. In my own case, I am 15 months post-surgery and only now am I beginning to get 'stirrings' in my penis, but they are well short of what I would have previously called an erection 😀.

Best wishes,

JedSee.

Edited by member 21 Sep 2023 at 19:04 | Reason: Not specified

User

Posted 21 Sep 2023 at 19:42

Thanks Jed. I’ll just be patient and hope for the best

User

Posted 21 Sep 2023 at 20:57

John,

It does take a while. I am 20 months post surgery, and things are improving.

I see you are 3 months post RP. Have you been recommended to start using a vacuum pump for penile rehabilitation?

User

Posted 22 Sep 2023 at 08:53

Hi P. Thanks for your response. No I haven't used a pump yet. I'm hoping the tablets will work, the pump sounds a bit primitive.

User

Posted 22 Sep 2023 at 08:55

John,

I'd really appreciate it if you didn't "hijack" the thread that I created. Please create your own thread to talk about your issues.

Thanks,

Chris

User

Posted 22 Sep 2023 at 12:26

Maybe you should set up your own forum 'Chris' prostate cancer' may be a good name? You could then have complete autonomy and just talk about yourself

User

Posted 22 Sep 2023 at 12:29

John,

Please create your own thread to discuss your own problems. That's the way it's done.

Thanks,

Chris

User

Posted 22 Sep 2023 at 13:38

Got the long-awaited appointment through for the pump clinic this morning, so that's good news!

Chris

User

Posted 22 Sep 2023 at 18:10

Well John, I too thought that was the way it worked, people sharing their experiences in the hope that it helps others. But hey ho, every day's a school day they say.

User

Posted 22 Sep 2023 at 19:21

Thanks Speedster. We obviously got it wrong. I need to start a new thread exactly the same as Chris’ thread 😂

User

Posted 22 Sep 2023 at 23:50

Chris, Tadalafil can cause muscle pain because it's also a PDE11 inhibitor, and PDE11 is used in muscles (and lots of other places in the body). Actually, it's remarkable that Tadalafil is a usable drug because of this, but in actual fact, it is the most effective of the PDE5 inhibitors in terms of desired result and minimal side effects, but for some men, the side effects are too bad.

It may still be worth trying one of the other PDE5 inhibitors - as far as I know, none of the others inhibit PDE11 too (they all inhibit other PDEs instead).

User

Posted 23 Sep 2023 at 06:58

Thanks, Andy - that's very helpful.

Chris

User

Posted 23 Sep 2023 at 14:35

Hi Chris,

Don't give up and try anything that is acceptable for you.

Catherine

User

Posted 23 Sep 2023 at 19:44

Thanks, Catherine. Yes, acid reflux was one of the issues I was having, too. I was waking up in the middle of the night with my throat burning with stomach acid. Perhaps I should try taking half a tablet a day and see what happens.

Thank you very much for your helpful reply.

Chris

User

Posted 23 Sep 2023 at 21:51

You don't want to have frequent acid reflux, as it's a potential cause of esophageal cancer.

User

Posted 24 Sep 2023 at 20:34

User

Posted 24 Sep 2023 at 20:45

Thanks for sharing your experience, Chris. My ED approaching 5 years after RT is not too bad, but it would be nice to be a bit harder on occasions, which is why I thought the Tadalafil might help. I’m just not sure that the side-effects for me personally are worth it, unfortunately. I’ll have another chat with the very helpful nurses at the ED clinic and see what they advise.

Chris

User

Posted 26 Sep 2023 at 16:30

Cheshire Chris,

User

Posted 26 Sep 2023 at 20:26

Originally Posted by: Online Community Member

I've just started taking the full 20 mg [Tadalafil] dose. So far, I'm still getting acid reflux but also Tinnitus.

I think you should stop taking it if you get Tinnitus, as it can cause permanent deafness too.

Originally Posted by: Online Community Member

The solution might be a 2.5 mg/5 mg daily dose but but I can't get that on the NHS in my area.

This is illogical (but yes, I know it happens).

User

Posted 23 Feb 2026 at 11:32

Hi there! I’ve been taking daily Cialis (tadalafil) 5 mg only from - [supplier name removed by moderators], for a long time, and fortunately it’s been working very well for me.

Yes, you can simply take one tablet once daily at the same time (morning or evening, whatever suits you) and then forget about it. You don’t need to “force” an erection for the medication to be beneficial. The goal of daily tadalafil is to maintain steady blood flow, support penile tissue health, and make erections easier when sexual stimulation happens, not to cause constant erections.

In your situation after RT, consistency matters more than timing. I’d recommend taking it daily without skipping, giving it a few weeks to show full benefit, staying physically active, and avoiding heavy alcohol. If erections remain weak, some men do well adding occasional on-demand dosing (with doctor approval). Overall, you’re on a very reasonable and commonly used regimen.

Edited by moderator 02 Mar 2026 at 10:59 | Reason: Supplier name removed by moderators

User

Posted 25 Feb 2026 at 16:41

[Supplier link removed by moderators]. It claims its supplement can help individuals maintain erections and increase their sexual desire. Medical professionals recommend that people avoid buying sexual enhancement pills marketed as dietary supplements because they may contain hidden ingredients.

Edited by moderator 02 Mar 2026 at 11:10 | Reason: Supplier link removed by moderators

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