Tadalafil is the generic form of Cialis — a long-acting PDE5 inhibitor used for erectile dysfunction and benign prostatic hyperplasia (BPH). A single dose produces up to 36 hours of effect, which is why it's often called "the weekend pill." Bidwell reviews your intake same-day for $45 flat and sends the e-prescription to your pharmacy. Generic tadalafil costs roughly $0.80–$3 per tablet with a pharmacy discount card.
Tadalafil is a selective phosphodiesterase type 5 (PDE5) inhibitor, the same drug class as sildenafil, vardenafil, and avanafil. All PDE5 inhibitors work by preserving cyclic GMP in the smooth muscle of the corpus cavernosum, allowing blood to fill the penis during sexual arousal. What makes tadalafil distinctive is its 17.5-hour half-life — far longer than sildenafil's 4 hours — which gives a clinical window of up to 36 hours per dose. The FDA DailyMed label is the authoritative reference.
Eli Lilly marketed tadalafil as Cialis from 2003 until the U.S. patent expired in 2018. Since then, FDA-approved generic tadalafil has been widely available at a small fraction of brand Cialis pricing. A separate 20 mg formulation, Adcirca, is approved for pulmonary arterial hypertension. In 2017, a low-dose 5 mg daily formulation was approved for BPH — making tadalafil the only PDE5 inhibitor with a BPH indication.
Tadalafil is an appropriate first-line treatment for most adult men with ED, per the American Urological Association guideline. You can be prescribed tadalafil through Bidwell if you:
Tadalafil is often a better fit than sildenafil if you want a longer window, prefer daily dosing without planning, or also have BPH symptoms. It's less affected by food so you don't need an empty stomach.
Use caution with alpha-blockers for BPH — start at the lowest tadalafil dose and separate dosing. Patients on dialysis for end-stage kidney disease should not use daily tadalafil (once-daily data are limited). The NIH StatPearls review is a useful clinical reference.
| Regimen | Dose | When to use |
|---|---|---|
| Daily (low-dose) | 2.5 mg or 5 mg daily | Frequent activity, BPH symptoms, or you want spontaneity without planning |
| As needed (PRN) | 10 mg or 20 mg pre-activity | Infrequent use; take 30–45 min before. Max once per 24 hours. |
| BPH-focused | 5 mg daily | Urinary symptoms; onset takes 2–4 weeks of daily use |
For as-needed dosing, take tadalafil 30–45 minutes before anticipated activity. Unlike sildenafil, food doesn't meaningfully affect absorption — you can take it with or without a meal. Maximum one dose per 24 hours for PRN.
Daily dosing provides steady-state PDE5 inhibition. Most men on daily tadalafil find they don't need to "plan" around doses — if sex happens, the medication is already working. Daily dosing is also the only FDA-approved PDE5 regimen for BPH. The AUA BPH guideline includes tadalafil 5 mg daily as a first-line option, especially for men with both BPH and ED.
Tadalafil is generally well tolerated. Per the FDA label, the most common side effects are:
Serious but rare side effects: priapism (erection lasting more than 4 hours — medical emergency, go to the ER), sudden hearing loss, NAION (rare form of vision loss), severe allergic reactions. Stop the medication and seek urgent care for sudden vision or hearing changes.
Back pain and muscle aches are more associated with tadalafil than sildenafil, typically starting 12–24 hours after dosing and resolving on their own or with acetaminophen/ibuprofen. If persistent or severe, consider switching agents. For more detail, see our tadalafil side effects guide and the sildenafil vs tadalafil comparison.
| Strength | Tablets | Typical cash + discount |
|---|---|---|
| 5 mg (generic) | 30 daily tablets | ~$20–$50 |
| 10 mg (generic) | 10 PRN tablets | ~$15–$35 |
| 20 mg (generic) | 10 PRN tablets | ~$20–$45 |
| Cialis (brand) | 10 tablets | ~$600–$800 |
Branded Cialis is essentially never worth it for cash-pay patients — generic tadalafil is therapeutically equivalent and a small fraction of the price. Compare at GoodRx before filling. Some commercial insurers cover generic tadalafil with a low copay; Medicare Part D coverage varies. Your $45 Bidwell visit covers the prescription; the pharmacy fill is separate.
You must be physically located in one of these states at the time of your visit.
Yes. Tadalafil is not a controlled substance and is commonly prescribed via telehealth. Bidwell reviews intakes same-day for $45.
Main difference: duration. Sildenafil lasts 4–6 hours; tadalafil lasts up to 36. Tadalafil can be taken daily for continuous coverage (2.5 or 5 mg) and is FDA-approved for BPH. Sildenafil is shorter-acting and a bit more affected by food.
Daily (2.5 or 5 mg) is continuous — no planning. PRN (10 or 20 mg) is single-dose before activity. Daily also treats BPH. PRN costs fewer pills per month if you have sex less than daily.
With GoodRx or similar: $0.80–$3 per tablet. A 30-day supply of 5 mg daily typically runs $20–$50 cash. Branded Cialis still lists $60–$80 per tablet.
A single 20 mg dose has measurable clinical effect up to 36 hours in most men. Peak effect is at 2–3 hours. You still need sexual arousal for an erection.
Yes. 5 mg daily is FDA-approved for BPH and is a first-line option for men with both BPH and ED. Effect on urinary symptoms takes 2–4 weeks.
Light to moderate drinking is fine. Heavy drinking (4+ drinks) combined with tadalafil raises the risk of dizziness, headache, and blood-pressure side effects.
Yes — same active ingredient, same strengths, FDA-approved as therapeutically equivalent. Lilly's patent expired in 2018.
Yes. Many patients try both and stick with one. Common reasons to switch to tadalafil: want a longer window, more spontaneity, BPH symptoms. Common reasons to switch to sildenafil: back pain or muscle aches on tadalafil.
Yes. Unlike sildenafil, food doesn't meaningfully delay absorption. You can take it with or without a meal.