Tadalafil is a prescription medication for erectile dysfunction (ED). It belongs to a class of drugs called PDE5 inhibitors, and it is the same active ingredient found in Cialis®. Tadalafil is known for its long duration, up to about 36 hours, which is why it's sometimes called the "weekend" option. Bayview compounds it in three forms: swallowed tablets, troches that dissolve between the cheek and gum, and rapid dissolve tablets (RDT) taken under the tongue.
Tadalafil is FDA-approved as a standard oral tablet. The compounded troche and rapid-dissolve forms, and any non-standard strengths, are prepared by a licensed pharmacy and are used off-label. A valid prescription is required, and only your provider can decide whether tadalafil is appropriate for you.
How does it work?
An erection happens when sexual stimulation releases nitric oxide in the penis, which raises a messenger called cGMP and relaxes the smooth muscle so blood flows in. An enzyme called PDE5 breaks cGMP back down. Tadalafil blocks PDE5, so cGMP lasts longer and blood flow is easier to achieve and maintain (StatPearls, PDE5 Inhibitors). It does not cause an erection on its own. Sexual stimulation is still needed. What sets tadalafil apart is how long it stays active.
What is it used for?
Tadalafil is prescribed for erectile dysfunction. Because it lasts so long, some providers prescribe it either on demand before activity or as a low daily dose that keeps you ready without timing each dose. PDE5 inhibitors are recommended as a first-line treatment for ED when they are not contraindicated (AUA Erectile Dysfunction Guideline). Only a licensed provider can decide whether it's right for you, and a valid prescription is required.
How does it compare to other ED treatments?
Tadalafil is one of several PDE5 inhibitors. The main practical difference is timing: tadalafil lasts far longer than the others. The table below is for education only.
| Medication | Onset | Typical duration |
|---|---|---|
| Tadalafil | About 30 to 60 minutes | Up to 36 hours |
| Sildenafil | About 30 to 60 minutes | About 4 to 6 hours |
| Vardenafil | About 30 to 60 minutes | About 4 to 6 hours |
This is for education only and is not a statement that one medication is better or stronger. Your provider selects the medication, form, and dose that are appropriate for you.
How is it used?
Depending on your provider's plan, tadalafil is taken either before sexual activity or as a low dose once a day. It can be taken with or without food. For the compounded forms: place a rapid dissolve tablet (RDT) under the tongue and let it dissolve for one to two minutes before swallowing; dissolve a troche between the cheek and gum. Use it exactly as directed and don't take more than prescribed. Your provider sets your strength, form, and schedule.
Side effects & safety
Common side effects include headache, indigestion, facial flushing, a stuffy or runny nose, and back or muscle aches (more typical of tadalafil than the shorter-acting options). Tell your provider about your heart health and all medications you take.
Who should not use it?
Tadalafil is not for everyone. Do not use it if you take nitrates or riociguat, or if you are allergic to tadalafil. Talk with your provider first if you have heart or blood-vessel disease, have had a recent heart attack or stroke, have very low or uncontrolled high blood pressure, take alpha-blockers or other blood-pressure medicines, have severe liver or kidney problems, or have a history of priapism or certain eye conditions. Your provider will confirm that sexual activity and this medication are safe for you.
How should it be stored?
Store as directed on your label, at room temperature away from heat and moisture, and keep it out of the reach of children and others. Do not share it, do not use it after the beyond-use date, and dispose of unused medication as directed.
Why is this compounded?
Compounding lets a licensed pharmacy prepare tadalafil in forms and strengths that aren't available off the shelf, troches and rapid dissolve tablets for people who prefer not to swallow a pill, and custom strengths a provider may want for daily or on-demand dosing. As a 503A compounding pharmacy, Bayview prepares each order under USP standards. Compounded preparations are not FDA-approved.
Clinical details for prescribers
Regulatory status. Tadalafil is not a controlled substance. It is FDA-approved as an oral tablet (Cialis® and generics); compounded troche, rapid-dissolve, and non-commercial strengths are prepared via 503A compounding and are not FDA-approved.
Mechanism & PK. Selective PDE5 inhibitor; potentiates NO-cGMP signaling with sexual stimulation. Onset ~30 to 60 min, duration up to ~36 h; minimal food effect. Dosed on-demand (typically 5 to 20 mg) or as low daily dose (StatPearls, PDE5 Inhibitors).
Compounded forms available:
- Tablets: 5, 10, 20 mg
- Troches: 5, 10, 20 mg, dissolve between cheek and gum
- Rapid dissolve tablets (RDT): 5, 10, 20 mg, under the tongue, dissolve 1 to 2 min before swallowing
Contraindications / cautions. Absolute contraindication with nitrates and guanylate cyclase stimulators (riociguat); the interaction window is longer given the ~36 h duration. Caution with alpha-blockers and antihypertensives, significant cardiovascular disease, hepatic/renal impairment, and predisposition to priapism. Counsel on priapism >4 h, sudden vision loss (NAION), and sudden hearing loss (AUA ED Guideline).
Non-controlled; e-prescribe or use the ED Orals order form. Licensed to dispense in RI, MA, CT, NY, NJ, NH, and FL.
This is a prescription compounded medication and is not FDA-approved. This information is educational and is not medical advice. Your provider determines whether it is appropriate and sets the formulation and dose.
