Most men take tadalafil as needed, but the tadalafil label also describes a second way to take it: a low dose, 2.5 mg or 5 mg, once a day at the same time each day. Taken that way it isn't timed to sex, which is the whole point for some men. Here is what the label says about the daily option, who tends to be prescribed it, what to expect in the first days, and what the daily plan costs at Pallas.
The short answer
Daily tadalafil is a low dose, 2.5 mg to 5 mg, taken once a day at roughly the same time, with or without food, and without regard to when you have sex. Tadalafil is a PDE5 inhibitor: it helps you get and keep an erection by increasing blood flow to the penis during sexual stimulation, and it doesn't work without stimulation. The label reports that blood levels reach a steady state within 5 days of daily dosing. A clinician decides whether the daily dose or an as-needed dose is appropriate for you.
Two ways to take tadalafil
Tadalafil (the generic for Cialis®) is the one PDE5 inhibitor with a once-daily dosing option on its label, and the two schedules are distinct prescriptions:
- As needed. The label describes a usual starting dose of 10 mg, taken before anticipated sexual activity; MedlinePlus adds at least 30 minutes before, and not more than once in 24 hours. Its effect has been observed up to 36 hours after a dose.
- Once daily. The label describes a starting dose of 2.5 mg taken at approximately the same time every day, without regard to the timing of sexual activity, within a range of 2.5 mg to 5 mg. It can be taken with or without food.
Both schedules use the same molecule. The daily dose is smaller because it is taken every day, so the medication stays in your system continuously rather than being timed to an occasion.
Who tends to be prescribed the daily dose
A clinician might consider the daily dose when sex is frequent or unplanned enough that timing a tablet is a nuisance, or when a man prefers not to connect taking a pill with having sex. The 5 mg daily dose is also FDA-approved for the urinary symptoms of benign prostatic hyperplasia, an enlarged prostate, and for men who have both erectile dysfunction and those symptoms. Which schedule fits you, and at what dose, is a prescribing decision: at Pallas the intake asks what you'd prefer, and a US-licensed clinician reviews your health history and your other medications and decides whether daily tadalafil is appropriate for you.
What to expect in the first days
Because the dose is small and taken every day, it builds up rather than hitting all at once. The label reports that steady-state blood levels are reached within 5 days of once-daily dosing, so the first few days are not a fair test of how it works for you. Pick a time you'll remember, morning or evening, and keep to it; the label's instruction is approximately the same time each day.
Side effects are the ones tadalafil is known for: headache, indigestion, flushing, a stuffy nose, and back pain or muscle aches, which the label notes usually appear 12 to 24 hours after a dose and typically resolve within 48 hours. The rare but serious effects apply to the daily dose as well: a sudden decrease or loss of vision or hearing, chest pain during sex, fainting, or an erection lasting longer than 4 hours, which is an emergency. Those are reasons to stop and get care right away.
If you miss a dose
MedlinePlus's guidance for a missed daily dose is to take it as soon as you remember, unless it is almost time for the next one, in which case you skip the missed dose and carry on with the usual schedule. Never take a double dose to make up for a missed one. If you miss several days in a row, message your care team before restarting so your clinician knows.
What it isn't combined with
Daily tadalafil carries the same interactions as any tadalafil dose. It is never taken with nitrates, the chest-pain medications such as nitroglycerin and isosorbide, or with riociguat. Alpha-blockers for prostate symptoms or blood pressure, strong CYP3A4 inhibitors such as ketoconazole and ritonavir, and alcohol all matter: the label notes that substantial alcohol, 5 units or more, with tadalafil may lead to low blood pressure. The full list is in our guide to what not to take with sildenafil or tadalafil, and the intake asks about every medication you take.
What daily tadalafil costs at Pallas
Daily tadalafil (Generic for Cialis®) starts at $25 a month on a 180-day supply, with 30-day and 90-day supplies also available. The 30-day plan is $59 every 4 weeks, charged once a clinician prescribes. Cancel anytime. One plan price covers the clinician review, check-ins, care-team messaging and the medication, shipped free by a US-licensed pharmacy in plain packaging. Cash-pay only; not billed to insurance. Every supply is on the erectile dysfunction treatment page, alongside the as-needed sildenafil and tadalafil plans. If you're weighing the two medications, start with sildenafil vs. tadalafil.
Bottom line: Daily tadalafil is a 2.5 mg to 5 mg dose taken once a day at the same time, with or without food, and not timed to sex. The label reports steady levels within 5 days, so give it that long before judging. The same interactions and the same stop-and-get-care symptoms apply as with any tadalafil dose, and whether the daily schedule fits you is your clinician's call.
