Most people know tadalafil as a tablet taken before sex. But there is another way to use it: a small dose taken every day. Daily tadalafil is popular with men who want a more natural, unplanned sex life, and it is also used for urinary symptoms caused by an enlarged prostate. This guide explains how the daily dose works, who it suits and what to expect.

What is daily tadalafil?

Tadalafil is a PDE5 inhibitor. It relaxes the smooth muscle in blood vessels and helps blood flow into the penis when you are aroused. It stays in the body for a long time, which is why a single 10 mg or 20 mg dose can work for up to 36 hours.

With the daily approach, you take a lower dose, usually 5 mg once a day, sometimes 2.5 mg. Because the medicine builds up to a steady level in your body, it is always "on board". You do not need to time a tablet before sex.

What it is used for

• Erectile dysfunction (ED): daily 2.5 mg or 5 mg is licensed for men who expect to have sex at least twice a week, or who prefer not to plan.
• Benign prostatic hyperplasia (BPH): daily 5 mg is licensed to ease urinary symptoms such as a weak stream, getting up at night to pass urine, and feeling that the bladder has not fully emptied.
• Both together: many men have ED and prostate symptoms at the same time, and one daily tablet can help with both.

How to take it

• Take one tablet at roughly the same time every day, with or without food.
• It usually takes about five days of daily use to reach a steady level in the body. Many men notice the full effect for ED within the first week or two. Prostate symptoms may take longer, often a few weeks.
• Do not take an extra on-demand dose on top of your daily dose. Only one tadalafil dose in any 24 hours.
• If you miss a day, take the next tablet at the usual time. Do not double up.

Your doctor may review the dose after a few weeks. Some men do well on 2.5 mg. The highest licensed daily dose is 5 mg.

Benefits of the daily approach

• No planning: sex can happen whenever it happens.
• Less pressure: some men find that not having to think about a tablet reduces anxiety, which helps on its own.
• Steady effect: no peaks and drops, which some men prefer.
• Two problems, one tablet: for men with prostate symptoms too.

Possible downsides

• Cost: you take a tablet every day rather than only when needed. Generic tablets help a great deal here.
• Side effects: headache, indigestion, back ache, muscle aches, flushing and a blocked nose are the most common. They are often milder on the low daily dose and tend to fade after the first couple of weeks.
• Daily commitment: it works best when taken consistently.

Get urgent help for an erection lasting more than four hours, sudden loss of vision or hearing, or chest pain.

Who should not take it

• Men using nitrate medicines for chest pain, in any form
• Men taking riociguat
• Men with certain serious heart conditions, recent stroke or heart attack, or very low blood pressure, unless their doctor says it is safe

Tell your doctor about alpha-blockers, blood pressure medicines and medicines that can raise tadalafil levels, such as some antifungals and HIV treatments. Drinking a lot of alcohol with tadalafil can also lower blood pressure and make you dizzy.

Daily vs on-demand: a quick comparison

• On-demand 10 to 20 mg: taken before sex, works up to 36 hours, fewer tablets per month.
• Daily 2.5 to 5 mg: taken every day, works at any time, more tablets per month but often a lower dose each time.

The right choice depends on how often you have sex, whether you have prostate symptoms and how you feel about daily tablets.

Ordering daily tadalafil

Because daily tadalafil means 28 to 30 tablets a month, many men buy generic tadalafil online to keep costs down. This guide on buying tadalafil online explains strengths and pack sizes, and you can browse the wider men's health range. If you buy medicine online, make sure the store checks prescriptions and labels strengths clearly. A valid prescription is required for every order of a prescription medicine.

This is general information, not medical advice. Speak to your doctor or pharmacist before starting any medicine.