Tadalafil side effects: what to expect
Tadalafil side effects are often mild, but some need urgent care. See common symptoms, serious warnings, interactions, and when to call a clinician.
Key facts
- Tadalafil Daily is $129/month (billed $387 every 90 days), charged only after a clinician approves it.
- Answer a few health questions online. A licensed clinician reviews them. If approved, it ships to your door.
- Adults 18 or older. A licensed clinician reviews your health history and decides whether treatment is appropriate for you. Availability depends on the state you live in.
Tadalafil is a prescription medicine used for erectile dysfunction (ED) and also used for benign prostatic hyperplasia (BPH) symptoms. Like all medicines, it can cause side effects, ranging from mild and temporary to rare but serious reactions that need urgent care. This guide explains tadalafil side effects, what can make them more likely, and when to call a clinician. If you are trying to understand symptoms you are noticing, Vitals Vault can help you start with labs or questions to discuss with a clinician.
- Tadalafil side effects are usually mild, but some require urgent care.
- Common effects include headache, flushing, indigestion, back pain, and muscle aches.
- Do not take tadalafil with nitrates because it can cause dangerous low blood pressure.
- Seek urgent care for chest pain, sudden vision or hearing loss, or an erection lasting more than 4 hours.
Quick answer: what side effects can tadalafil cause?
Common vs serious tadalafil side effects (and what to do)
Headache
Headache is one of the most common side effects. It is related to tadalafil widening blood vessels (vasodilation). If headaches are frequent, severe, or come with chest pain, fainting, or neurologic symptoms, contact a clinician urgently.
Flushing and warmth
You may notice facial flushing, warmth, or redness. This is also due to blood vessel widening and often improves as the medicine wears off. If you also feel dizzy or faint, especially after alcohol, talk with a clinician.
Indigestion or reflux
Upset stomach, indigestion, or heartburn can happen. Eating patterns and alcohol can make this worse for some people. If you have severe abdominal pain or vomiting, or symptoms that feel like a heart problem, seek urgent evaluation.
Back pain and muscle aches
Back pain and muscle aches can occur, sometimes starting hours after a dose. The prescribing information notes these symptoms usually resolve within a couple of days. If pain is severe, persistent, or you have weakness, fever, or dark urine, contact a clinician.
Low blood pressure and fainting
Tadalafil can lower blood pressure. The risk is much higher if you take nitrates (for example nitroglycerin) or certain other blood pressure lowering medicines, and it can also increase with alcohol. Get urgent care for fainting, severe dizziness, or chest pain.
Priapism (erection more than 4 hours)
An erection lasting more than 4 hours is a medical emergency because it can permanently damage the penis. Stop sexual activity and seek emergency care right away. Tell the emergency team you took tadalafil.
Sudden vision loss
Rare cases of sudden vision loss have been reported with PDE5 inhibitors, including tadalafil. This can be related to a condition called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking the medicine and seek urgent medical care if you have sudden vision changes.
Sudden hearing loss or ringing
Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness, has been reported. Stop taking tadalafil and seek urgent evaluation if this happens. Prompt assessment matters because some causes are treatable.
Chest pain during sex
Sexual activity can strain the heart, especially if you have underlying cardiovascular disease. If you develop chest pain, nausea, or dizziness during sex after taking tadalafil, seek emergency care. Do not take nitrates to treat chest pain if you have used tadalafil.
Allergic reaction
Stop the medicine and get urgent care for swelling of the face, lips, tongue, or throat, trouble breathing, or widespread rash. These can be signs of a serious allergic reaction. Tell your clinician about any past medication allergies.
How long do tadalafil side effects last?
Most mild effects fade as it wears off
Many common effects, like flushing, nasal congestion, and indigestion, tend to improve as tadalafil levels fall. Tadalafil has a longer duration of action than some other ED medicines, so mild effects can last into the next day for some people.
Back and muscle pain can linger
The prescribing information notes that back pain and muscle aches typically resolve within 48 hours. If pain is severe, does not improve, or comes with other concerning symptoms, contact a clinician.
Serious symptoms are not wait-and-see
Chest pain, fainting, sudden vision or hearing changes, or an erection lasting more than 4 hours should be treated as urgent. Do not wait for these symptoms to pass on their own.
When to call a clinician or seek urgent care
| What you notice | How to respond |
|---|---|
| Chest pain, severe dizziness, fainting, or shortness of breath | Seek emergency care. Do not take nitrates if you used tadalafil. |
| Erection lasting more than 4 hours | Seek emergency care immediately (risk of permanent damage). |
| Sudden vision loss or major vision changes | Stop tadalafil and seek urgent evaluation. |
| Sudden hearing loss, ringing, or severe dizziness | Stop tadalafil and seek urgent evaluation. |
| Headache, flushing, indigestion, congestion that is bothersome | Contact your prescribing clinician to review triggers, interactions, and options. |
Tell your clinician about other medicines
Some medicines can raise tadalafil levels or increase blood pressure effects, including certain antifungals, antibiotics, and HIV medicines. Alpha-blockers and other blood pressure medicines can also increase dizziness or fainting risk. Always share your full medication list, including supplements.
Discuss heart and blood pressure history
ED can sometimes be an early sign of cardiovascular disease. If you have heart disease, uncontrolled blood pressure, or you get chest symptoms with exertion, ask a clinician whether sexual activity and ED medicines are safe for you.
Ask about tadalafil 5 mg side effects
Lower daily doses are sometimes used for ED or BPH, but side effects can still occur. If you are taking tadalafil daily and symptoms persist, a clinician can help decide whether timing, interactions, or another option is a better fit.
Practical tips to reduce side effects
Limit alcohol
Alcohol can increase dizziness, lightheadedness, and low blood pressure symptoms.
Hydrate and rise slowly
If you feel lightheaded, sit down and stand up slowly to reduce fainting risk.
Track what triggers symptoms
Note timing, meals, alcohol, and other meds so your clinician can spot patterns.
Do not mix ED medicines
Combining PDE5 inhibitors can increase side effects and is not advised without clinician direction.
Treat urgent symptoms as urgent
Priapism, chest pain, or sudden vision or hearing changes need immediate care.
Frequently Asked Questions
What are the most common tadalafil side effects?
The most common side effects include headache, flushing, indigestion, nasal congestion, back pain, and muscle aches. Many are related to blood vessel widening and often improve as the medicine wears off. If symptoms are severe or persistent, contact your clinician.
What are the serious side effects of tadalafil?
Serious risks include very low blood pressure (especially if taken with nitrates), priapism (erection lasting more than 4 hours), and sudden vision or hearing changes. Chest pain during sex is also an emergency. Seek urgent care for any of these symptoms.
Are tadalafil 5mg side effects different from higher doses?
The types of side effects are generally similar across doses, but how strongly you feel them can vary by person and by other medicines you take. Daily low-dose use can still cause side effects. A clinician can help review whether interactions or timing may be contributing.
Can tadalafil side effects last into the next day?
Yes. Tadalafil can last longer in the body than some other ED medicines, so mild effects like flushing or congestion may persist into the next day for some people. Back pain and muscle aches are noted in labeling to typically resolve within 48 hours.
Can I take tadalafil with nitroglycerin or other nitrates?
No. Tadalafil must not be taken with nitrates because the combination can cause a dangerous drop in blood pressure. If you have chest pain after taking tadalafil, seek emergency care and tell the medical team you used tadalafil.