Tadalafil 20mg Tablets: Uses, Timing and Duration

Tadalafil 20mg is the maximum licensed on-demand dose for erectile dysfunction. It is taken at least 30 minutes before sexual activity, and can remain effective for up to 36 hours, which is longer than other medicines in its class.

Tadalafil relaxes blood vessels in the penis to increase blood flow, but it only works in response to sexual stimulation.

This guide explains how the 20mg tablet is used, when to take it, how long it lasts, possible side effects, how prescribing works, and the key safety points to know before using it.

What Tadalafil 20mg Is Used For

On-demand tadalafil treats erectile dysfunction, the persistent difficulty getting or keeping an erection firm enough for satisfactory activity.

20mg is the top of the licensed on-demand range. The usual starting dose is 10mg, and 10mg and 20mg are the two on-demand strengths, chosen according to your response and tolerability.

Tadalafil belongs to a group of medicines called PDE5 inhibitors, which increase blood flow to the penis in response to sexual stimulation. It has no effect without that stimulation.

Erectile dysfunction can have physical, general health or psychological causes, or a combination. Tadalafil supports the physical response, but it does not diagnose or treat the underlying cause, and how well it works can depend on that cause. That is why a proper assessment looks at your overall health rather than treating every case the same way.

Tadalafil is also prescribed in other settings, for benign prostatic hyperplasia and for pulmonary arterial hypertension, using different regimens.

How to Take It

Take one 20mg tablet before anticipated activity, and no more than once in any 24-hour period.

1. Swallow the tablet whole with a glass of water, following the instructions for your product
2. Take it at least 30 minutes beforehand
3. Take it with or without food. Unlike some other erectile dysfunction treatments, tadalafil's absorption is not significantly affected by a meal
4. Never take more than one tablet in 24 hours, whatever the outcome, even if the first tablet does not seem to have worked

Timing

Tadalafil needs time to reach its full effect, so it should be taken at least 30 minutes beforehand.

Because its effect can last up to 36 hours, there is more flexibility around exact timing than with shorter-acting alternatives. It still needs to be taken in advance rather than at the moment it is needed.

With or Without Food

This is a genuine practical advantage over some alternatives in the class, where a high-fat meal can delay how quickly the tablet starts working. There is no need to plan a meal around a tadalafil dose.

If It Does Not Seem to Work

Do not take another dose on the same day. Tadalafil still needs sexual stimulation to have any effect.

If it repeatedly does not work as expected, raise it with your prescriber rather than assuming the dose needs increasing, since 20mg is already the maximum for this pattern of use.

The First Time

The first dose does not always give a complete picture of how tadalafil will work for you. Response varies, and stimulation, stress, tiredness and general health can all affect the experience.

If it does not seem to work the first time, discuss it with your prescriber rather than changing anything yourself.

Storage

Store the tablets as directed on the packaging, generally somewhere cool and dry, away from direct sunlight and out of reach of children. Tadalafil does not need refrigerating.

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How Long Tadalafil 20mg Lasts

That duration does not mean a continuous, unprompted effect for 36 hours. Stimulation is still needed throughout. It means the medicine stays active in the body and ready to respond for a much longer window than alternatives such as sildenafil, which lasts around four hours.

The reason is tadalafil's half-life of roughly 17.5 hours, considerably longer than others in its class. That longer window is why some people prefer tadalafil when they want more flexibility around timing.

Is 20mg the Right Strength for You?

Not automatically, and it is not something you choose directly.

Most people start on 10mg, and a prescriber decides whether stepping up to 20mg is appropriate based on how that has worked. A higher dose does not guarantee a better result, and some people find 10mg is enough.

Generic Tadalafil 20mg and Cialis 20mg

Cialis is the original brand under which tadalafil was first licensed in the UK. A licensed generic must meet the MHRA's standard, including proven bioequivalence, before it can be sold. The active ingredient and strength are the same, while inactive ingredients and appearance can differ between manufacturers.

Possible Side Effects

Like all medicines, tadalafil 20mg can cause side effects, although not everyone gets them.

Common ones include headache, indigestion, back pain, muscle aches, flushing and a blocked or stuffy nose. Back pain and muscle aches usually settle on their own. Less common effects include dizziness and blurred vision.

Side effects can be more noticeable at 20mg than at a lower dose, although that is not the case for everyone. Drinking too much alcohol can also increase dizziness and lower blood pressure.

When to Seek Urgent Help

Stop taking tadalafil and get urgent medical attention for a sudden loss or decrease in vision, sudden hearing loss, chest pain, or an erection that lasts longer than four hours. These are uncommon, but serious.

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Getting Tadalafil 20mg Online

Tadalafil 20mg is a prescription medicine, so no legitimate UK provider can supply it without a proper clinical assessment first, however the order is placed.

1. An online consultation, covering your medical history, current medicines and what you want to treat
2. A clinical assessment by a UK registered prescriber, who decides whether tadalafil, and the 20mg strength specifically, is appropriate for you
3. Dispensing by a registered pharmacy, only once the prescriber has authorised it
4. Delivery in discreet packaging

Before ordering, check that the pharmacy is registered with the General Pharmaceutical Council on its public register, and that the service does not simply let you select a treatment without an assessment. A service supplying tadalafil with no prescribing step should be treated with caution.

Who Should Not Take Tadalafil 20mg

Nitrates: An Absolute No

Tadalafil must not be taken with nitrate medicines. The combination can cause a dangerous drop in blood pressure, and that applies at 20mg as much as at any other strength. Recreational nitrite products, known as poppers, should also be disclosed to a prescriber for the same reason.

Other Interactions and Precautions

Tell your prescriber about all the medicines you take, and about any history of heart disease, high or low blood pressure, a previous heart attack, or kidney or liver problems. In particular, mention:

• Alpha blockers, a type of blood pressure medicine, since combining them with tadalafil can lower blood pressure further
• Any other erectile dysfunction treatment, since tadalafil should not be combined with others
• Medicines affecting liver enzymes, which can change how much tadalafil builds up in the body

In severe kidney impairment, the maximum on-demand dose is 10mg, so 20mg would not be appropriate. Conditions such as sickle cell anaemia and multiple myeloma should also be disclosed before prescribing.

Medical Disclaimer

This article is for general information only and does not replace individual medical advice. Tadalafil 20mg is a prescription medicine and should only be taken under the guidance of an appropriately qualified prescriber, following a proper clinical assessment. Results and side effects vary between individuals.

If you experience chest pain, a sudden change in vision or hearing, an erection lasting longer than four hours, or any other symptom that concerns you, seek urgent medical attention or call 999.

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