Tadalafil Side Effects: How Long Do They Last?

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How Common Are Tadalafil Side Effects?

Tadalafil is generally well tolerated, and many men experience no side effects at all [4]. Clinical trials show that the most frequently reported side effects include headache, indigestion, back pain, muscle aches, flushing, and nasal congestion [4]. These effects are usually mild to moderate in intensity and tend to occur more often at higher doses.

Headache is the most common side effect, reported by around 1 in 10 men taking tadalafil [4]. Indigestion and back pain each affect roughly 1 in 10 to 1 in 100 men [4]. Muscle aches, flushing (redness of the face or neck), and a blocked or runny nose are also relatively common [4]. Serious side effects such as priapism (a prolonged erection lasting more than four hours) or sudden vision or hearing loss are rare but require urgent medical attention [4].

It's important to remember that not everyone will experience side effects, and for those who do, the effects are often temporary and manageable. If you have concerns about side effects, your prescriber can discuss whether a lower dose or a different treatment might be more suitable for you.

Why Does Tadalafil Cause Side Effects?

Tadalafil belongs to a class of medicines called PDE5 inhibitors, which work by relaxing blood vessels and increasing blood flow to the penis during sexual stimulation [4]. This same mechanism can affect blood vessels elsewhere in the body, leading to some of the common side effects [4].

For example, headache and flushing occur because tadalafil widens blood vessels in the head and face, increasing blood flow to these areas [4]. Back pain and muscle aches are thought to result from the relaxation of smooth muscle in other parts of the body [4]. Indigestion can happen because tadalafil may relax the muscle at the lower end of the oesophagus, allowing stomach acid to move upwards [4]. Nasal congestion is caused by increased blood flow to the nasal passages [4].

These effects are a direct result of how the medicine works and are not a sign that tadalafil is harming you. Understanding the mechanism can help you feel more confident about managing any side effects that do occur.

Individual Variation in Side Effects

Everyone's body responds differently to medicines. Factors such as your age, overall health, other medicines you take, and the dose of tadalafil can all influence whether you experience side effects and how severe they are [4]. Some men find that side effects lessen over time as their body adjusts to the medicine, while others may need to try a lower dose or a different treatment altogether.

When to get urgent help

• Erection lasting more than 4 hours (priapism) – call 999 or go to A&E immediately
• Sudden loss of vision in one or both eyes – seek urgent medical help
• Sudden decrease or loss of hearing, ringing in ears, or dizziness – contact a doctor urgently
• Chest pain during or after sexual activity – stop and seek emergency help
• Severe allergic reaction: difficulty breathing, swelling of face/lips/throat – call 999

Call 999 or go to A&E in an emergency, or contact NHS 111 for urgent advice.

Tadalafil Side Effects: How Long Do They Last?

Most common side effects of tadalafil, such as headache, flushing, indigestion, and nasal congestion, typically last for a few hours and resolve on their own as the medicine is metabolised and cleared from your body [4]. Tadalafil has a long half-life of about 17.5 hours, meaning it stays active in your system for up to 36 hours [4]. However, side effects do not usually persist for the entire duration of the medicine's effect.

Headaches and flushing often appear within one to two hours of taking the tablet and usually fade within a few hours [4]. Back pain and muscle aches can sometimes appear 12 to 24 hours after taking tadalafil and may last for up to 48 hours in some men, though this is less common [4]. Indigestion and nasal congestion typically resolve within a few hours as well [4].

If you experience side effects that last longer than a day or two, or if they are severe or distressing, contact your prescriber or pharmacist for advice. Persistent or worsening side effects may indicate that a lower dose or an alternative treatment would be more appropriate for you.

Daily Versus On-Demand Dosing

Tadalafil is available in two dosing regimens: on-demand (10 mg or 20 mg taken at least 30 minutes before sexual activity) and daily (2.5 mg or 5 mg taken once a day) [4]. With on-demand dosing, side effects are more likely to be noticeable around the time you take the tablet and typically resolve within hours. With daily dosing, lower doses are used and side effects may be milder or less frequent, though some men may experience ongoing mild effects while the medicine is in their system continuously [4].

Self-Care Tips to Manage Tadalafil Side Effects

If you experience a headache after taking tadalafil, drinking plenty of water and taking a simple painkiller such as paracetamol or ibuprofen (if suitable for you) can help [4]. Avoid taking aspirin if you are not already prescribed it, and always check with your pharmacist if you are unsure which painkiller is safe for you.

For indigestion, try taking tadalafil after a light meal rather than on an empty stomach, and avoid rich, fatty, or spicy foods around the time you take the tablet [4]. Over-the-counter antacids such as Gaviscon may provide relief, but speak to your pharmacist before using them regularly. If nasal congestion is bothersome, a saline nasal spray or steam inhalation can help clear your airways [4].

Back pain and muscle aches can often be eased with gentle stretching, a warm bath, or a simple painkiller [4]. Staying well hydrated and avoiding heavy alcohol consumption can also reduce the likelihood and severity of side effects [4]. If flushing is uncomfortable, staying in a cool environment and wearing light clothing may help. Remember, these side effects are usually temporary and manageable with simple measures.

At a glance

When to Seek Urgent Help with Tadalafil Side Effects

While most side effects of tadalafil are mild and short-lived, some symptoms require immediate medical attention [4]. If you develop an erection that lasts longer than four hours (priapism), you must seek emergency help immediately by calling 999 or going to A&E [4]. Priapism can cause permanent damage to the penis if not treated promptly.

Sudden loss of vision in one or both eyes, or sudden decrease or loss of hearing (which may be accompanied by ringing in the ears or dizziness), are rare but serious side effects that require urgent medical assessment [4]. If you experience chest pain during or after sexual activity, stop what you are doing and seek medical help straight away, as this could indicate a heart problem [4].

Severe allergic reactions to tadalafil are very rare but can include difficulty breathing, swelling of the face, lips, tongue, or throat, and severe skin rashes [4]. If you experience any of these symptoms, call 999 immediately. If you have any concerns about side effects that are not urgent but are persistent or troubling, contact your GP, pharmacist, or the prescriber who issued your treatment for advice.

Reporting Side Effects

If you experience a side effect that is not listed in the patient information leaflet, or if a known side effect becomes severe, you can report it via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or by searching for the MHRA Yellow Card app in your phone's app store [12]. Reporting helps improve the safety information available for all patients.

Alternatives If Tadalafil Side Effects Persist

If you find that side effects from tadalafil are persistent, bothersome, or interfere with your quality of life, there are several alternatives to consider [2]. Your prescriber may suggest trying a lower dose of tadalafil, switching to a different PDE5 inhibitor such as sildenafil (Viagra), vardenafil (Levitra), or avanafil (Spedra), or exploring non-tablet treatments [3][5][6].

Sildenafil has a shorter duration of action (around four to six hours) compared to tadalafil's 36 hours, which may result in a different side-effect profile [3]. Some men find that sildenafil causes fewer back or muscle aches, while others may experience more headaches or flushing [3]. Vardenafil and avanafil are also effective PDE5 inhibitors with slightly different characteristics, and your prescriber can help you find the option that works best for you [5][6].

Non-tablet options include Eroxon, a topical gel that works locally and does not enter the bloodstream, and prescription treatments such as Vitaros (alprostadil cream) or Caverject (alprostadil injection), which may be suitable if oral medicines are not tolerated or effective [7]. At Cured Pharmacy, our UK-registered prescribers review your medical history and current medicines during an online consultation to recommend the safest and most effective treatment for your individual needs. All prescription treatments are dispensed by our GPhC-registered pharmacy and delivered discreetly to your door.

Lifestyle Measures to Support ED Treatment

Alongside medication, lifestyle changes such as regular exercise, maintaining a healthy weight, reducing alcohol intake, stopping smoking, and managing stress can all improve erectile function and may reduce your reliance on medication or the dose you need [1][2]. If you have not already done so, see your GP to check for underlying conditions such as diabetes, high blood pressure, or high cholesterol, as treating these can improve ED and overall health [1][2].

In summary

• Most tadalafil side effects like headache and flushing resolve within a few hours.
• Back pain or muscle aches may last up to 48 hours but are usually mild.
• Simple measures like hydration and painkillers can ease common side effects.
• Seek urgent help for erections over four hours or sudden vision or hearing loss.
• Your prescriber can adjust your dose or suggest alternatives if side effects persist.

Frequently Asked Questions