Tadalafil is a prescription medication used to treat erectile dysfunction or impotence.
It works by increasing blood flow to the penis. When used in combination with sexual stimulation, tadalafil can make it easier to achieve and maintain an erection during intercourse.
Tadalafil doesn’t stimulate an erection, men still need to be aroused for it to work. Instead, tadalafil facilitates the movement of blood into the erectile tissue.
There are many different versions of tadalafil made by different companies. In this guide we’ll cover all the different sources of tadalafil, including the dose and cost for each one.
Tadalafil was patented in 1994, which prevented any competitors from manufacturing or selling this product for 20 years. This is a standard practice done in the pharmaceutical industry to give a drug manufacturer a chance at earning a profit on their new invention before the drug is entered into the public domain.
The patents for this drug have since expired, which means any drug maker can apply to start producing their own version of the drug.
Drugs made by the original inventor and owner of the drug are referred to as brand name drugs. Duplicates made by third-party companies are referred to as generic drugs instead.
Today, there’s two brand name versions of tadalafil — both made by Eli Lilly. These medications are the most expensive, by far.
Beyond Eli Lilly, there are dozens of pharmaceutical companies that make generic versions of tadalafil at a fraction of the cost. The generic options available to you depend on where you live, and what the pharmacy you choose to buy your medications from have decided to offer.
Cialis is the original brand name version of tadalafil, made by the American Pharmaceutical giant Eli Lilly. It’s the second best-selling ED medication globally — second only to Viagra, which was the first erectile dysfunction medication ever created.
Cialis was originally patented in 1994 by a partnership of Eli Lilly and ICOS. Those patents have since expired, which is what allows other companies like Ajanta Pharma, Teva Pharmaceuticals, ot Camber Pharma, and others to make cheaper generic versions of the drug.
This drug can be expensive — costing between $12.70 and $103.01 per tablet depending on where you live and what discounts are available.
Ajanta Pharmaceuticals is an Indian contract manufacturing and generic drug manufacturer. They produce a broad range of erectile dysfunction medications, including Kamagra (sildenafil citrate), Lovegra (sildenafil citrate), Valif (vardenafil), and Tadalista (tadalafil).
Each pill comes with 20 mg of tadalafil along with the company’s proprietary blend of fillers and binding agents.
These are some of the cheapest tadalafil tablets available — costing between $0.98 and $1.33 per tablet depending on how many you buy at a time.
Teva Pharmaceuticals is an American Israeli pharmaceutical company with headquarters in both Petah Tikva, Israel and Parsippany, New Jersey. They’re on the Fortune 500 list as one of the largest companies in the world with over $92 billion in assets around the world.
This company make generic tadalafil in all four standard doses — 2.5 mg, 5 mg. 10 mg, and 20 mg.
The cost of Teva’s generic tadalafil is between $1.25 and $5.55 per tablet depending on the order quantity.
Adcirca is another version of tadalafil made by Eli Lilly. There’s no difference between this pill from the company’s other tadalafil tablet, Cialis, except for the shape, color, and approved uses.
Adcirca is not used for erectile dysfunction despite having the same dose and active ingredient. Instead, this drug was approved for the treatment of pulmonary hypertension.
Eli Lilly decided to create two separate versions of their drug in the mid 90s, and applied for FDA approval for each drug for different applications, rather than applying the same drug for both. Both drugs were ultimately approved, so now we have two versions of the same drug being prescribed for different applications.
Adcirca is an expensive medication, costing as much as $73 per pill.
This little yellow pill contains 20 mg of tadalafil. The maker of this generic drug, Torrent Pharmaceuticals, is an Indian generic drugmaker based out of Ahmedabad.
Like most generic medications, this form of tadalafil is cheap — costing anywhere between $1.22 and $6.75 per tablet.
If you’re living in the United States, this version of tadalafil is much more difficult to find. The manufacturer primarily sells these medications in Asia and only has a few distribution channels bring the drug into the United States.
Camber Pharmaceuticals is an American-based generic drugmaker. They’re one of the fastest growing generics companies in North America, which has etched out a presence in over 126 countries to date.
This brand makes all four doses of tadalafil — 2.5, 5, 10, and 20 mg tablets.
As an American-based company, the cost to produce this drug is a little bit higher than overseas companies, but with that come stronger regulations and oversight. These pills cost between $3.12 and $7.90 per tablet. They also make separate versions for use with pulmonary hypertension (20 mg only) and erectile dysfunction (all doses).
Dr Reddy’s Laboratories is an Indian-based pharmaceutical company servicing the United States market. They bake dozens of generic medications at a fraction of the cost compared to brand name products.
The company only recently launched its tadalafil generics in 2019.
Dr Reddy makes this pill in two doses (10, and 20 mg). Each order comes with 30 tablets.
The cost for these medications range from $2.49 for the 10 mg pills, to $4.53 for the 20 mg pills.
Chemo Biological is based out of Delhi, India. They’re a generic drug manufacturer primarily focused in the antibiotic, cardiac, and and-diabetic space.
These ED pills are cheap, but the quality and consistency from this company are questionable.
Sun Pharma is an Indian contract manufacturing company with an impressive portfolio of generic medications.
The company’s only erectile dysfunction drug is modelled after Eli Lilly’s Cialis. They call this drug Forzest.
This medication only comes in the 20 mg dose and costs about $0.90 per tablet. It may be difficult to find this particular medication if you live in the United States.
Jpee Drugs is a generic drug company based out of Haridwar, India. This company makes a long list of pharmaceutical and nutraceutical products for the international market, including this 10 mg tadalafil tablet the company calls Golmal.
This is one of the cheapest tadalafil options available, but the quality is hard to determine as there are very few reviews online for this product outside of India. You can get a tablet for as low as $0.89 from this company.
Manforce is a cheap generic version of tadalafil made by the New Delhi-based pharmaceutical company, Mankind Pharmaceuticals.
Like many generic versions of this drug, Mankind Pharmaceuticals only makes the high-dose version of this drug, with 20 mg of active tadalafil per tablet.
Manforce More is also the name of a condom brand — there’s no relation between the condoms and Mankind Pharmaceuticals.
Cipla is an indian multinational pharmaceutical company with headquarters in Mumbai, india. They produce generic medications that cover a wide range of uses, including erectile dysfunction.
In this category, Cipla makes several different products, including Tadicap (tadalafil), Erectalis (tadalafil), tadaflo (tadalafil), Endobloc T (tadalafil & ambrisentan), Pulmopres (tadalafil), and Assurance (sildenafil citrate).
This generic tadalafil is made by the Ahmedabad-based pharmaceutical company Zydus Cadila. Each pill contains 10 mg of tadalafil, which places them in the middle of the potency range. Most doctors will start by prescribing 10 mg of tadalafil before increasing to the 20 mg dose only if the pill doesn’t work.
This differentiates Zydalis from most of the other generic tadalafil tablets which usually only offer the 20 mg dose.
These pills remain on -par with the rest of the India-based generic tadalafil options in terms of cost. The average cost per pill for this medication is $2.33.
No matter which product you’re using, all tadalafil is used the same way and contains the same active ingredients.
The only differences in how you should use the drug come down to the reason you’re taking it:
For erectile dysfunction, tadalafil should be used 30 – 60 minutes before sexual activity to allow the drug to take effect. Once the drug starts working, it will remain active for up to 36 hours. Tadalafil is the longest-acting erectile dysfunction medication on the market — earning it the title of “the weekend pill.”
You should only take tadalafil when engaging in sexual activities and should avoid taking it on a daily basis for the purpose of treating erectile dysfunction (unless otherwise specified by your doctor).
You can take tadalafil with or without food, but avoid consuming any alcohol or other intoxicants while using this drug. Combining tadalafil with stimulants or alcohol can result in side effects — some of which can be severe (more on this later).
If using tadalafil for pulmonary hypertension, the dosage schedule is a little bit different.
The standard protocol is to take about 40 mg of tadalafil (2 – 4 tablets) everyday at the same time. Many people will take their tablet first thing in the morning, others prefer to take it at the end of the day before bed. The most important thing is that you take the pill at exactly the same time everyday. This allows concentrations of the drug to gradually build up in the body. After several days, concentrations of tadalafil will remain stable in the blood, providing all-day relief from symptoms of the condition.
If you miss a dose, take another tablet right away unless it’s you’re already close to taking your next dose. Never double dose tadalafil for any reason.
Tadalafil is considered safe in healthy individuals, but can lead to severe side effects if combined with certain medications or underlying health issues.
Due to this potential for risk, tadalafil is considered a prescription-only medication. This means a doctor needs to first assess your level of risk with using the drug (by reviewing medical and prescription history), and weighing the risk to benefit ratio for each person individually.
In many cases there are other steps that can be tried first before using pharmaceutical medications to manage symptoms. In some cases, using tadalafil won’t actually fix the cause for your condition, so your doctor may decide to prescribe something else instead.
Side Effects of Tadalafil Include:
- Back Pain
- Upper Respiratory Tract Infection
- Myalgia (muscle pain)
- Nasal Congestion
- Pain in the Extremities
- Gastroesophageal Reflux Disease
- Abdominal Pain
- Priapism (painful erection)
- Angina or Chest Pain
- Vision Disturbances
Certain medications will interact with tadalafil — leading to severe side effects.
The biggest concern is drugs that reduce blood pressure. When combined with tadalafil, which also reduces blood pressure, the effects of both drugs may become too strong — which can reduce blood pressure to the point where it becomes difficult for the body to supply sufficient blood and oxygen to the brain. This causes symptoms like dizziness or lightheadedness, and can result in fainting and serious injury.
Blood pressure medications to avoid when using tadalafil include:
- Nitrites (nitro glycerine)
- Alpha blockers
- Diuretic antihypertensives
- Alcohol (has blood-pressure reducing effects)
Other drugs that should never be used with tadalafil include antacids, certain antibiotics (such as ketoconazole), and grapefruit juice (can block the ability to metabolize the drug).
The original manufacturer of tadalafil — Eli Lilly — came out with four doses of the drug — 2.5 mg, 5 mg, 10 mg, and 20 mg.
The most common dose for erectile dysfunction is 10 mg. Most doctors will start with this dose and only increase to the 20 mg dosage if the desired effects aren’t achieved within a couple of weeks.
On the generic market, most companies will only make the 20 mg version of this pill. While the 20 mg pill works roughly 10% more often than the 10 mg option, it also brings an elevated risk of side-effects.
For pulmonary hypertension the standard dose is 40 mg per day (two 10 mg tablets).
Tadalafil is a common medication. Eli Lilly is reported to have earned nearly $1.5 billion from their brand name version, Cialis in 2019 alone. The generics market is likely to have earned a similar profit for 2019, but was split amongst over a dozen manufacturers.
You can find tadalafil at nearly every pharmacy in the United States, both online and in-store.
Most pharmacies will stock Cialis, as well as one or two generic options. However, some only carry the brand name version.
Most medicare coverage will cover part or all of the cost for Cialis, while only some will cover the cost of generic versions of the drug. It pays to know and understand what you’re covered for, and shop around for the best deals.