“The Weekender” ED Medication – A Real Thing or Hype?

Sexual wellness (ED) – Supports readiness and confidence, with flexible options for both on-demand and sustained, long-term support.

Side Effect	Severity	Frequency	Notes
Headache	Mild	Common	Often temporary
Flushing	Mild	Common	Due to vasodilation
Indigestion	Mild	Occasionally	Gastrointestinal discomfort
Dizziness	Mild	Less common	Especially when standing up

Urinary function (BPH/LUTS) – Daily dosing has been shown to improve lower urinary tract symptoms and quality of life for men managing both ED and BPH (benign prostatic hyperplasia).¹ Pulmonary arterial hypertension (PAH) – Benefit has been observed, although less prevalent in outpatient compounding settings.² Exercise training support and muscle recovery (emerging evidence) – PDE5 inhibitors are under exploration in preclinical and early clinical research.³ By positioning tadalafil as more than a one-off pill, providers can optimize sexual wellness, reduce stigma, and open new doors for patient adherence and health outcomes. The key to tadalafil’s flexibility lies in its dual dosing strategy. Supports improvement of urinary symptoms in BPH/LUTS.1 Offers consistent support for patients with ED who value spontaneity over planning.

• Tadalafil is often called the “weekend pill” due to its long effects.
• It improves erectile function for up to 36 hours.
• Taking tadalafil regularly can enhance overall erectile health.
• The medication does not cause immediate erections without arousal.
• It is considered safe when used properly under medical guidance.
• Some users may experience minor flushing or nausea.
• It’s important to avoid combining with other ED medications.
• Tadalafil can help restore sexual confidence.
• It’s available in various dosages depending on individual needs.
• Always use prescription medication responsibly.
• Be aware of potential side effects to act quickly.
• Keep informed about contraindications and precautions.

Taken by ~30 minutes before sexual activity.

• Tadalafil is commonly known as the weekend pill for erectile dysfunction.
• It is a long-acting medication effective for up to 36 hours.
• Tadalafil can be taken as a daily or as-needed pill.
• The typical dose for weekend use is 10-20 mg.
• It works by relaxing blood vessels in the penis.
• Tadalafil is available by prescription in many countries.
• The medication may cause side effects like headache or flushing.
• Alcohol can increase the risk of side effects when using tadalafil.
• Tadalafil is not suitable for individuals with certain heart conditions.
• It should be stored in a cool, dry place away from children.
• Always follow your healthcare provider’s dosage instructions.
• Do not combine tadalafil with nitrate medications.

Long half-life: efficacy lasting up to 36 hours (“the weekend pill”).10 Well-suited for patients preferring less frequent dosing. Tablets can be split into quarters for 5 mg titration increments. Allows fine-tuning based on patient tolerance and outcomes. Personalizes care, empowering providers to adjust while staying within suitable parameters. For patients using tadalafil for PAH, the recommended dose is 40 mg daily.2,10 For patients using tadalafil for PAH, the recommended dose is 40 mg daily.2,10 For patients using tadalafil for PAH, the recommended dose is 40 mg daily.2,10 Patients should be counseled carefully on max daily dosing to avoid adverse outcomes. Traditional tadalafil tablets work, but compounded formulations can improve both adherence and experience. Quick-dissolve sublingual delivery – Faster onset, bypassing some GI absorption variability. Mango flavor – May help reduce aversion, improve patient compliance, and lower the barrier for those hesitant to initiate the regimen. For providers, these differentiators may lead to better adherence, fewer missed doses, and ultimately, improved outcomes. As beneficial as tadalafil can be, caution and guardrails must always remain in place.

Tadalafil Dosing: Matching the Medication to the Moment

Sexual wellness (ED) – Supports readiness and confidence, with flexible options for both on-demand and sustained, long-term support. Urinary function (BPH/LUTS) – Daily dosing has been shown to improve lower urinary tract symptoms and quality of life for men managing both ED and BPH (benign prostatic hyperplasia).¹ Pulmonary arterial hypertension (PAH) – Benefit has been observed, although less prevalent in outpatient compounding settings.² Exercise training support and muscle recovery (emerging evidence) – PDE5 inhibitors are under exploration in preclinical and early clinical research.³ By positioning tadalafil as more than a one-off pill, providers can optimize sexual wellness, reduce stigma, and open new doors for patient adherence and health outcomes. The key to tadalafil’s flexibility lies in its dual dosing strategy. Supports improvement of urinary symptoms in BPH/LUTS.1 Offers consistent support for patients with ED who value spontaneity over planning. Taken by ~30 minutes before sexual activity.

Side effects and risks

Long half-life: efficacy lasting up to 36 hours (“the weekend pill”).10 Well-suited for patients preferring less frequent dosing. Tablets can be split into quarters for 5 mg titration increments. Allows fine-tuning based on patient tolerance and outcomes. Personalizes care, empowering providers to adjust while staying within suitable parameters. For patients using tadalafil for PAH, the recommended dose is 40 mg daily.2,10 For patients using tadalafil for PAH, the recommended dose is 40 mg daily.2,10 For patients using tadalafil for PAH, the recommended dose is 40 mg daily.2,10 Patients should be counseled carefully on max daily dosing to avoid adverse outcomes.

How to avoid Cialis side effects

Traditional tadalafil tablets work, but compounded formulations can improve both adherence and experience. Quick-dissolve sublingual delivery – Faster onset, bypassing some GI absorption variability. Mango flavor – May help reduce aversion, improve patient compliance, and lower the barrier for those hesitant to initiate the regimen. For providers, these differentiators may lead to better adherence, fewer missed doses, and ultimately, improved outcomes. As beneficial as tadalafil can be, caution and guardrails must always remain in place. Nitrates (e.g., nitroglycerin, isosorbide) → dangerous, potentially fatal hypotension.4 Excessive alcohol → increases dizziness, blood pressure swings. Hepatic or renal impairment → dose adjustment often required. Retinal disorders → risk of sudden vision changes. Sudden vision loss in one or both eyes may be a sign of nonarteritic anterior ischemic optic neuropathy (NAION). While a direct relationship has not been established, NAION has been reported tadalafil 2 5 mg in rare cases and may result in permanent vision loss. Patients should report any sudden loss of vision immediately. Pulmonary veno-occlusive disease (PVOD) → avoid use. Priapism – Requires emergency intervention if erection lasts >4 hours. Sudden hearing or vision loss – Counsel patients to discontinue immediately and seek evaluation. When patients understand possible side effects, they are more likely to report concerns early and use medications appropriately .

Product	Dosage	Quantity + Bonus	Price
Cialis Generic	10mg	60 + 6 Pills	105.81€ 100.77€	Buy
Cialis Generic	40mg	360 + 10 Pills	477.87€ 455.11€	Buy
Cialis Generic	40mg	180 + 10 Pills	277.29€ 264.09€	Buy
Tadalista Super Active	20mg	120 + 16 Pills	382.15€ 363.95€	Buy
Cialis Generic	10mg	120 + 6 Pills	178.49€ 169.99€	Buy
Cialis Generic	10mg	270 + 10 Pills	308.71€ 294.01€	Buy
Cialis Generic	20mg	20 Pills	54.72€ 52.11€	Buy
Cialis Generic	60mg	90 + 6 Pills	196.67€ 187.30€	Buy
Cialis Generic	60mg	20 Pills	65.61€ 62.49€	Buy
Cialis Generic	10mg	10 Pills	31.41€ 29.91€	Buy
Cialis Generic	20mg	90 + 6 Pills	154.71€ 147.34€	Buy
Tadalista Super Active	20mg	270 + 30 Pills	661.49€ 629.99€	Buy
Cialis Generic	5mg	20 Pills	41.99€ 39.99€	Buy
Cialis Generic	2.5mg	180 + 10 Pills	154.86€ 147.49€	Buy
Tadalista Super Active	20mg	60 + 8 Pills	230.32€ 219.35€	Buy
Cialis Generic	40mg	90 + 6 Pills	171.35€ 163.19€	Buy
Cialis Generic	40mg	270 + 10 Pills	382.19€ 363.99€	Buy

Tadalafil can be a sensitive conversation, but providers can normalize the dialogue with the right framing. Set Expectations – Sexual stimulation is required; tadalafil does not create arousal on its own. Reinforce Suitability – Remind patients of nitrate contraindication, caution with alcohol, and warning signs of priapism. Individualize Care – Use flex-dosing to find the lowest beneficial dose. Normalize Sexual Wellness – Position ED and urinary symptoms as part of whole-patient health, not isolated or shameful issues. This combination of clinical precision and empathetic counseling helps patients feel both supported and empowered. Many patients ask about the difference between tadalafil and sildenafil. Duration: Tadalafil lasts up to 36 hours vs. sildenafil’s 4–6 hours.6 Onset: Sildenafil often works slightly faster; sublingual tadalafil narrows this gap.11 Daily Use: Tadalafil is well-suited for once-daily dosing, especially when managing both ED and BPH.10 Tolerance: Potential side effect profiles overlap, but individual patient experience often determines preference.

STRONGER ERECTIONS, BETTER SEX

The information provided in this blog article is for informational and educational purposes only. Refer to the cited references for more information regarding the content presented. The information in this blog article is not intended as a substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking medical attention because of something you have read in this blog article. The creators of this content disclaim any liability for decisions made based on the information presented.

How is tadalafil supplied (dosage forms)?

Consult your healthcare provider before starting any over-the-counter (OTC) products or prescription medications. Always seek the advice of your healthcare provider for any questions you may have regarding a medical condition. Certain medications may interact with your current prescription medications, medical tadalafil online conditions, or other supplements. Your healthcare provider can provide guidance tailored to your specific health needs. Compounded medications are specially prepared for individual patient needs and, as such, have not been reviewed or approved by the U.S.

Cialis 5mg daily: How long before it works?

Food and Drug Administration (FDA). These statements have not been evaluated by the FDA. Brock G, Broderick G, Roehrborn CG, Xu L, Wong D, Viktrup L. Tadalafil once daily in the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in men without erectile dysfunction. 2013;112(7):990-997. Providers may find value in framing tadalafil as the “longer, steadier option” and sildenafil as the “shorter, quicker boost.” Both have their place; patient goals and lifestyle guide the choice. Preclinical studies suggest PDE5 inhibitors like tadalafil are being studied for broader health outcomes. Cardioprotective effects – Evidence suggests possible improvements in endothelial function and reduced risk of certain cardiovascular events.7 Neuroprotective effects –Early preclinical studies in mice suggest potential benefits in reducing inflammation and supporting cognitive function.8 Exercise and muscle recovery – PDE5 inhibitors may decrease muscle fatigue and stimulate protein synthesis, augmenting resistance training outcomes.9 While not yet a clinical standard of care, these findings are worth watching—and may shape the future conversation around tadalafil as more than a sexual health medication.

Understanding Tadalafil

Nitrates (e.g., nitroglycerin, isosorbide) → dangerous, potentially fatal hypotension.4 Excessive alcohol → increases dizziness, blood pressure swings. Hepatic or renal impairment → dose adjustment often required. Retinal disorders → risk of sudden vision changes. Sudden vision loss in one or both eyes may be a sign of nonarteritic anterior ischemic optic neuropathy (NAION). While a direct relationship has not been established, NAION has been reported tadalafil 2 5 mg in rare cases and may result in permanent vision loss.

Professional resources

Patients should report any sudden loss of vision immediately. Pulmonary veno-occlusive disease (PVOD) → avoid use. Priapism – Requires emergency intervention if erection lasts >4 hours. Sudden hearing or vision loss – Counsel patients to discontinue immediately and seek evaluation. When patients understand possible side effects, they are more likely to report concerns early and use medications appropriately .

What are the serious side effects of tadalafil?

Tadalafil can be a sensitive conversation, but providers can normalize the dialogue with the right framing. Set Expectations – Sexual stimulation is required; tadalafil does not create arousal on its own. Reinforce Suitability – Remind patients of nitrate contraindication, caution with alcohol, and warning signs of priapism. Individualize Care – Use flex-dosing to find the lowest beneficial dose. Normalize Sexual Wellness – Position ED and urinary symptoms as part of whole-patient health, not isolated or shameful issues. For providers new to compounding tadalafil—or expanding patient access to daily formulations—the following steps help ensure appropriate prescribing: Start Low, Adjust Thoughtfully – Begin with the lowest beneficial dose, titrate with flex-splitting as needed. Screen Thoroughly – Always confirm no nitrate use, assess CV status, and evaluate hepatic/renal function.5 Educate Patients Clearly – Sexual stimulation is required for tadalafil to work, possible side effects, and when to seek help. Consider Lifestyle Fit – Daily vs. on-demand is less about efficacy and more about patient preference.

The Problem of Erectile Dysfunction

Treasure Island, FL: StatPearls Publishing; 2025 Jan–. Taylor J, Baldo OB, Storey A, Cartledge J, Eardley I. Differences in side-effect duration and related bother levels between phosphodiesterase type 5 inhibitors. The association of tadalafil exposure with lower rates of major adverse cardiovascular events and mortality in a general population of men with erectile dysfunction. Gulati P, Singh N. Leverage Compounded Advantages – Sublingual, flavored formulations improve adherence and patient experience. For many patients, it represents freedom from rigid scheduling, relief from urinary symptoms, and improved confidence in daily life.5 For providers, it’s an opportunity to normalize sexual wellness, integrate urinary and pulmonary health into the conversation, and explore emerging cardiometabolic frontiers. When prescribed thoughtfully—with clear guardrails and patient-centered counseling—tadalafil becomes a flexible, powerful ally in whole-patient care. At Strive, we believe compounding isn’t about covering up symptoms; it’s about building something customized for patients who deserve more than short-term fixes and “one-size-fits-all” solutions. The information provided in this blog article is for informational and educational purposes only. Refer to the cited references for more information regarding the content presented. The information in this blog article is not intended as a substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking medical attention because of something you have read in this blog article.

Storage Condition	Details	Notes
Temperature	Keep at room temperature (20-25°C)	Protect from heat and moisture
Humidity	Avoid high humidity environments	Use dry places
Packaging	Store in original container	Keep out of reach of children
Expiry Date	Usually 2-3 years from manufacturing date	Check before use

The creators of this content disclaim any liability for decisions made based on the information presented.

Aspect	Description	Typical Dosage	Duration of Effect
Purpose	Treat erectile dysfunction and BPH	5 mg or 10 mg	Up to 36 hours
Common Brand Names	Cialis, Adcirca	N/A	N/A
Administration	Usually taken once a day or as needed	N/A	N/A

Consult your healthcare provider before starting any over-the-counter (OTC) products or prescription medications. Always seek the advice of your healthcare provider for any questions you may have regarding a medical condition.

Related Information

doi:10.1111/bju.12251 Arif SA, Poon H. Tadalafil: a long-acting phosphodiesterase-5 inhibitor for the treatment of pulmonary arterial hypertension. PDE5 inhibition alleviates functional muscle ischemia in boys with Duchenne muscular dystrophy. Kloner RA, Hutter AM, Emmick JT, Mitchell MI, Denne J, Jackson G. Time course of the interaction between tadalafil and nitrates. Certain medications may interact with your current prescription medications, medical tadalafil online conditions, or other supplements.

• Tadalafil's long half-life allows for weekend dosing.
• It is important to follow the doctor's prescription instructions.
• The medication can be used for both erectile dysfunction and BPH.
• Tadalafil may cause heartburn in some users.
• It is not intended for recreational use; misuse can be dangerous.
• Some users report improved confidence after taking tadalafil.
• Overdose symptoms include sudden vision loss or chest pain.
• Tadalafil should be used with caution in patients with kidney issues.
• Regular check-ups help monitor its effectiveness and safety.
• Store tadalafil at room temperature away from moisture.
• Report any unexpected side effects to your healthcare provider.
• Combining tadalafil with other ED meds is not advised.

Your healthcare provider can provide guidance tailored to your specific health needs.

• Tadalafil provides flexible timing for weekend plans.
• It has a quick onset of action, usually within 30 minutes.
• The long duration reduces the need for timing precision.
• Tadalafil can be taken with or without food.
• Do not take it more than once a day.
• It’s crucial to discuss any health concerns with your doctor.
• Tadalafil can be part of a broader treatment plan.
• It is not suitable for women or children.
• Always check for potential drug interactions.
• Use the medication according to prescribed guidelines.
• Report any persistent side effects immediately.
• Stay informed about new research and updates related to tadalafil.

Compounded medications are specially prepared for individual patient needs and, as such, have not been reviewed or approved by the U.S. Food and Drug Administration (FDA). These statements have not been evaluated by the FDA. Brock G, Broderick G, Roehrborn CG, Xu L, Wong D, Viktrup L.

Proper Use

This combination of clinical precision and empathetic counseling helps patients feel both supported and empowered. Many patients ask about the difference between tadalafil and sildenafil. Duration: Tadalafil lasts up to 36 hours vs. sildenafil’s 4–6 hours.6 Onset: Sildenafil often works slightly faster; sublingual tadalafil narrows this gap.11 Daily Use: Tadalafil is well-suited for once-daily dosing, especially when managing both ED and BPH.10 Tolerance: Potential side effect profiles overlap, but individual patient experience often determines preference. Providers may find value in framing tadalafil as the “longer, steadier option” and sildenafil as the “shorter, quicker boost.” Both have their place; patient goals and lifestyle guide the choice.

Key Takeaways

Preclinical studies suggest PDE5 inhibitors like tadalafil are being studied for broader health outcomes. Cardioprotective effects – Evidence suggests possible improvements in endothelial function and reduced risk of certain cardiovascular events.7 Neuroprotective effects –Early preclinical studies in mice suggest potential benefits in reducing inflammation and supporting cognitive function.8 Exercise and muscle recovery – PDE5 inhibitors may decrease muscle fatigue and stimulate protein synthesis, augmenting resistance training outcomes.9 While not yet a clinical standard of care, these findings are worth watching—and may shape the future conversation around tadalafil as more than a sexual health medication. For providers new to compounding tadalafil—or expanding patient access to daily formulations—the following steps help ensure appropriate prescribing: Start Low, Adjust Thoughtfully – Begin with the lowest beneficial dose, titrate with flex-splitting as needed. Screen Thoroughly – Always confirm no nitrate use, assess CV status, and evaluate hepatic/renal function.5 Educate Patients Clearly – Sexual stimulation is required for tadalafil to work, possible side effects, and when to seek help. Consider Lifestyle Fit – Daily vs.

Contraindications for Tadalafil and Sildenafil?

on-demand is less about efficacy and more about patient preference. Leverage Compounded Advantages – Sublingual, flavored formulations improve adherence and patient experience. For many patients, it represents freedom from rigid scheduling, relief from urinary symptoms, and improved confidence in daily life.5 For providers, it’s an opportunity to normalize sexual wellness, integrate urinary and pulmonary health into the conversation, and explore emerging cardiometabolic frontiers. When prescribed thoughtfully—with clear guardrails and patient-centered counseling—tadalafil becomes a flexible, powerful ally in whole-patient care. At Strive, we believe compounding isn’t about covering up symptoms; it’s about building something customized for patients who deserve more than short-term fixes and “one-size-fits-all” solutions. Tadalafil once daily in the treatment of lower urinary tract symptoms suggestive of benign prostatic hyperplasia in men without erectile dysfunction. 2013;112(7):990-997. doi:10.1111/bju.12251 Arif SA, Poon H. Tadalafil: a long-acting phosphodiesterase-5 inhibitor for the treatment of pulmonary arterial hypertension. PDE5 inhibition alleviates functional muscle ischemia in boys with Duchenne muscular dystrophy. Kloner RA, Hutter AM, Emmick JT, Mitchell MI, Denne J, Jackson G. Time course of the interaction between tadalafil and nitrates. Treasure Island, FL: StatPearls Publishing; 2025 Jan–. Taylor J, Baldo OB, Storey A, Cartledge J, Eardley I. Differences in side-effect duration and related bother levels between phosphodiesterase type 5 inhibitors.

Online Tadalafil Prescription

Neuroprotective effect of tadalafil, a PDE-5 inhibitor, and its modulation by L-NAME in a mouse model of ischemia-reperfusion injury. Indicated for treatment of erectile dysfunction (ED) Cialis (or generic equivalent) or Chewtadzy only PRN use: 10 mg PO initially before sexual activity, with or without food; may be increased to 20 mg or reduced to 5 mg on basis of efficacy and tolerability; in most patients, maximum dosing frequency is once daily Once-daily use (Cialis): 2.5 mg/day PO in single daily dose, without regard to timing of sexual activity, with or without food; may be increased to 5 mg/day on basis of efficacy and tolerability Indicated for treatment of signs and symptoms of benign prostatic hyperplasia (BPH); daily use also indicated for treatment of patients with both BPH and erectile dysfunction Cialis (or generic equivalent) or Chewtadzy only BPH with ED: 5 mg PO once daily, taken at approximately same time each day without regard to timing of sexual activity Coadministration with finasteride for BPH: Tadalafil 5 mg plus finasteride 5 mg PO once daily for ≤26 weeks; incremental benefit of tadalafil decreases from 4 weeks until 26 weeks, and the benefit beyond 26 weeks is unknown Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, Tadliq, or generic equivalent only 40 mg PO once daily; dividing dose for more frequent dosing is not recommended Patients also taking ritonavir: 20 mg PO once daily initially for ≥1 week; may be increased to 40 mg/day on basis of tolerability Cialis, Chewtadzy (PRN use)Mild (CrCl >50 mL/min): No dosage adjustment neededModerate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hrSevere (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Mild (CrCl >50 mL/min): No dosage adjustment needed Moderate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hr Severe (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Cialis (once daily use)ED (CrCl >50 mL/min): No dosage adjustment neededBPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual responseED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended ED (CrCl >50 mL/min): No dosage adjustment needed BPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual response ED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended Chewtadzy (once daily use)BPH, ED/BPHCrCl >50 mL/min: No dosage adjustment neededCrCl ≤50 mL/min or hemodialysis: Not recommended CrCl >50 mL/min: No dosage adjustment needed CrCl ≤50 mL/min or hemodialysis: Not recommended Adcirca, Alyq, TadliqMild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerabilitySevere (CrCl <30 mL/min and on hemodialysis): Avoid use Mild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerability Severe (CrCl <30 mL/min and on hemodialysis): Avoid use Cialis, Chewtadzy (PRN use)Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once dailySevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once daily Severe (Child-Pugh class C): Not recommended Cialis, Chewtadzy (once daily use)Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advisedSevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advised Severe (Child-Pugh class C): Not recommended Adcirca, Alyq, TadliqMild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once dailySevere (Child-Pugh class C): Avoid use Mild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once daily Severe (Child-Pugh class C): Avoid use ED PRN use: Not to exceed 10 mg/72 hr ED or The association of tadalafil exposure with lower rates of major adverse cardiovascular events and mortality in a general population of men with erectile dysfunction. Gulati P, Singh N. Neuroprotective effect of tadalafil, a PDE-5 inhibitor, and its modulation by L-NAME in a mouse model of ischemia-reperfusion injury. Indicated for treatment of erectile dysfunction (ED) Cialis (or generic equivalent) or Chewtadzy only PRN use: 10 mg PO initially before sexual activity, with or without food; may be increased to 20 mg or reduced to 5 mg on basis of efficacy and tolerability; in most patients, maximum dosing frequency is once daily Once-daily use (Cialis): 2.5 mg/day PO in single daily dose, without regard to timing of sexual activity, with or without food; may be increased to 5 mg/day on basis of efficacy and tolerability Indicated for treatment of signs and symptoms of benign prostatic hyperplasia (BPH); daily use also indicated for treatment of patients with both BPH and erectile dysfunction Cialis (or generic equivalent) or Chewtadzy only BPH with ED: 5 mg PO once daily, taken at approximately same time each day without regard to timing of sexual activity Coadministration with finasteride for BPH: Tadalafil 5 mg plus finasteride 5 mg PO once daily for ≤26 weeks; incremental benefit of tadalafil decreases from 4 weeks until 26 weeks, and the benefit beyond 26 weeks is unknown Indicated for pulmonary arterial hypertension (PAH) (WHO Group 1) to improve exercise ability; studies establishing effectiveness included predominately patients with NYHA Functional Class II – III symptoms and etiologies of idiopathic or heritable PAH (61%) or PAH associated with connective tissue diseases (23%) Adcirca, Alyq, Tadliq, or generic equivalent only 40 mg PO once daily; dividing dose for more frequent dosing is not recommended Patients also taking ritonavir: 20 mg PO once daily initially for ≥1 week; may be increased to 40 mg/day on basis of tolerability Cialis, Chewtadzy (PRN use)Mild (CrCl >50 mL/min): No dosage adjustment neededModerate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hrSevere (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Mild (CrCl >50 mL/min): No dosage adjustment needed Moderate (CrCl 30-50 mL/min): Not to exceed 5 mg PO once daily initially; maximum dosage, 10 mg PO q48hr Severe (CrCl <30 mL/min and on hemodialysis): Not to exceed 5 mg PO q72hr Cialis (once daily use)ED (CrCl >50 mL/min): No dosage adjustment neededBPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual responseED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended ED (CrCl >50 mL/min): No dosage adjustment needed BPH or BPH/ED (CrCl 30-50 mL/min): 2.5 mg/day starting dose recommended; may increase to 5 mg according to individual response ED or BPH (CrCl <30 mL/min or hemodialysis): Not recommended Chewtadzy (once daily use)BPH, ED/BPHCrCl >50 mL/min: No dosage adjustment neededCrCl ≤50 mL/min or hemodialysis: Not recommended CrCl >50 mL/min: No dosage adjustment needed CrCl ≤50 mL/min or hemodialysis: Not recommended Adcirca, Alyq, TadliqMild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerabilitySevere (CrCl <30 mL/min and on hemodialysis): Avoid use Mild-to-moderate (CrCl 31-80 mL/min): 20 mg PO once daily initially; may be increased to 40 mg once daily on basis of tolerability Severe (CrCl <30 mL/min and on hemodialysis): Avoid use Cialis, Chewtadzy (PRN use)Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once dailySevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Not to exceed 10 mg PO once daily Severe (Child-Pugh class C): Not recommended Cialis, Chewtadzy (once daily use)Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advisedSevere (Child-Pugh class C): Not recommended Mild-to-moderate (Child-Pugh class A or B): Data limited; caution advised Severe (Child-Pugh class C): Not recommended Adcirca, Alyq, TadliqMild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once dailySevere (Child-Pugh class C): Avoid use Mild-to-moderate (Child-Pugh class A or B): Consider starting dosage of 20 mg PO once daily Severe (Child-Pugh class C): Avoid use ED PRN use: Not to exceed 10 mg/72 hr ED or