The journey to once-daily dosing of tadalafil 5mg tablets

Tadalafil 5mg tablets ushered in a new era in the treatment of erectile dysfunction. At last, here was a treatment option for erectile dysfunction that didn’t require you to plan ahead for your sexual encounters. It gave men what they wanted most, a natural erection when they wanted it and not determined by when they took their on-demand tablets.
In this blog, we will revisit the journey that tadalafil took to becoming a man’s best friend.

Key takeaways

• Once-daily tadalafil 5mg tablets offer men with erectile dysfunction (ED) natural, spontaneous erections, whenever romance is in the air.
• Daily dosing means no more planning intimacy around a pill—sex can happen naturally, whenever the moment feels right.
• A daily dose of tadalafil 5mg tablets can also help with the bothersome urinary symptoms of an enlarged prostate.
• Daily tadalafil is well tolerated, with a proven track record in millions of men worldwide.
• Both clinical studies and real-world experience show that once-daily tadalafil improves quality of life for men and their partners.

PDE5 inhibitors: The start of a revolution in erectile dysfunction treatment

Male erectile dysfunction (ED) is a common condition characterised by a consistent difficulty in achieving and sustaining an erection adequate for satisfactory sexual activity [1].

For years, the first-line treatment for most men with erectile dysfunction (ED) has been the oral PDE5 inhibitor [2]. These medicines—including tadalafil, sildenafil, and vardenafil—are now considered safe and effective, helping between 60% and 70% of men who try them [3].

How do PDE5 inhibitors work?

Tadalafil 5mg and other medicines in the PDE5 inhibitor family (such as Sildenafil and Vardenafil) help treat erectile dysfunction (ED) by improving blood flow to the penis. They do this by blocking an enzyme called phosphodiesterase type 5 (PDE5) [4].

Normally, the PDE5 enzyme breaks down a chemical called cGMP, which controls blood flow in the penis. By stopping this enzyme, tadalafil allows cGMP and nitric oxide levels to rise, relaxing the blood vessels and increasing blood flow where it’s needed most. This helps men achieve and maintain a firm erection when sexually aroused [4].

The PDE5 enzyme also has an important safety role — it allows the erection to end once stimulation stops. Without it, blood could stay trapped in the penis, cutting off oxygen and nutrients and causing permanent damage.

The importance of the PDE5 enzyme

So, imagine a hypothetical situation where the human race was created without the phosphodiesterase type 5 enzyme in the penis. Without the phosphodiesterase enzyme, men would only be able to have one erection before their penis died and became a gangrenous lump hanging between their legs. Not good for the man and definitely not good for the propagation of the human race.

Luckily, PDE5 inhibitors only work temporarily, meaning erections form naturally and then subside safely once the medicine wears off.

What PDE5 normally does

• When you become sexually aroused, nitric oxide (NO) is released in the penis.
• This increases cGMP, which relaxes blood vessels, allowing more blood into the penis — causing an erection.
• Once stimulation ends, PDE5 breaks down cGMP, the blood vessels tighten again, and the erection subsides.

What would happen without PDE5

• cGMP would keep building up, and the blood vessels would stay relaxed.
• The penis would stay continuously erect, even without stimulation.
• Blood flow into the penis would eventually stop because the trapped blood couldn’t circulate properly.
• This would lead to oxygen starvation of penile tissue (ischaemia).
• If untreated, it could cause permanent damage, known medically as priapism, and ultimately, tissue death (gangrene).

On-demand tadalafil tablets

Tadalafil, one of the most popular options, is approved for use in over 100 countries and has helped more than 18 million men since its launch in February 2003 [5]. Like its PDE5 inhibitor cousins, sildenafil and vardenafil,  tadalafil was first developed for use on demand, meaning you took a pill before you planned to have sex  [5].

While this worked for many, it wasn’t perfect. Planning sex around a pill can feel awkward, and desire doesn’t always stick to a schedule. Some men and couples found that the need to take a tablet before intimacy made things feel less natural  [5],[6].

The limits of on-demand dosing: Why timing matters

With on-demand dosing, men needed to take their medication before sex—sometimes an hour in advance. This meant that intimacy could feel like an appointment, and spontaneity was often lost [7]. Tadalafil’s long action (lasting up to 36–48 hours) [8] made it a favourite for those who wanted a wider window of opportunity, but it still required some planning [9].

Studies showed that many men and their partners preferred tadalafil over other options because of its flexibility [9], [10], [11]. But for some, even this wasn’t quite enough—they wanted a way to separate pill-taking from intimacy altogether, to make sex feel as natural as possible.

Separating medicine from sex, the behavioural and psychological distress of using on-demand dosing

Some men using on-demand PDE5 inhibitors weren’t happy with their treatment. They wanted to enjoy their love life without having to plan around taking a pill. They wished they could separate their medication from sex, so they and their partners could feel free and spontaneous again. For these men, always having to take a pill before sex became stressful and even affected their feelings and behaviour.

As mentioned earlier, surveys of many men with ED showed that some didn’t respond well to on-demand treatments. This was often because they found it awkward or upsetting to take a pill right before sex, or because they couldn’t predict when they’d want to be intimate [14].

Even though many preferred on-demand tadalafil, it didn’t fully meet their needs since they still had to link taking the pill with sexual activity. They wanted a way to break that constant connection.

These challenges led doctors and specialists to look for a new way to treat ED. They developed a different dosing plan where tadalafil is taken regularly, three times a week, to see if this steady approach might be a better option for some men.

Do women prefer their partners to use tadalafil 5mg?

Most studies on erectile dysfunction (ED) have looked at things like how well the treatment works, how it affects a man’s self-esteem, and how it improves his quality of life. But it’s important to remember that ED can affect both partners, not just men. Experts now recommend that women should be involved in decisions about erectile dysfunction treatment, and that research should also look at how ED impacts couples, not just individuals [12].

In one recent study, women were asked for the first time which erectile dysfunction medicine they preferred their partners to use, and why. The results showed that most women (about 79%) preferred tadalafil, while only about 16% chose sildenafil [13]. The main reasons women gave were that tadalafil helped create a more relaxed and natural experience, made intimacy and enjoyment easier, lasted longer, allowed for more frequent sex, and offered more flexibility about when sex could happen [13].

Overall, the women’s views showed that there’s more to a satisfying relationship than just getting and keeping an erection—it’s also about feeling close, relaxed, and enjoying time together as a couple.

The move to scheduled and daily dosing: A new approach emerges

To give men more freedom, researchers explored scheduled dosing—taking tadalafil three times a week, regardless of when sex was planned.

The first big study to compare different ways of taking tadalafil was called the Scheduled Use versus on-demand Regimen Evaluation (SURE) study. It looked at over 4,200 men with erectile dysfunction (ED) and compared two options: taking a 20mg tablet just before sex (on-demand), or taking the tablet three times a week, no matter when sex was planned [15], [16].

Both ways of taking tadalafil worked well, with about 60% of men getting normal erection scores by the end of the study. Some men preferred the regular, three-times-a-week schedule (about 42%), while others liked the on-demand option (about 58%). Men who took tadalafil three times a week found they could have sex at different times, not just soon after taking the pill. In fact, 71% of their sexual activity happened more than four hours after a dose, often in the evening or morning, compared to 47% for the on-demand group [15], [16].

The main point of the study wasn’t to prove one way was better, but to show that both options give men and their partners more choice and flexibility. Importantly, taking tadalafil regularly was shown to be just as safe as taking it only when needed. Serious heart-related side effects were very rare, regardless of the schedule used, and were similar to those seen with placebo [15], [16].

Even though the three-times-a-week plan had some benefits, it wasn’t always easy for men to remember which days to take their medicine. Because of this, researchers began exploring a lower daily dose of tadalafil to make things even simpler and more flexible.

Licensing milestones: When daily tadalafil became reality

Tadalafil differs from the other two main ED medicines (sildenafil and vardenafil) because it has a unique structure and a longer duration of action. Tadalafil starts to work about 16 to 60 minutes after you take it, and it stays active in your body for up to 36 hours—much longer than sildenafil or vardenafil, which only last about 4 to 5 hours [17]. This means you have a wider window of time to enjoy intimacy and don’t need to rush. You can also take tadalafil with or without food, as food doesn’t affect how it works.

If you take tadalafil every day, it builds up to a steady level in your body after about five days. At this point, there’s about 1.6 times more medicine in your system than if you’d only taken a single dose [18].

After taking tadalafil every day for 5 days, the amount of medicine in your body builds up to an equivalent on-demand dose of 16mg if the tadalafil 10mg tablets were taken continuously for 5 days and 8mg if the tadalafil 5mg tablets were taken [19].

Because of its long-lasting effects and its tendency to build up in your body, tadalafil is an excellent choice for daily use, and studies have shown it’s safe and effective when taken this way.

The studies comparing on-demand dosing to daily dosing

Some studies compared daily tadalafil to on-demand use. In one, men who hadn’t had success with on-demand tadalafil tried taking 10mg every day. Many of them saw significant improvements in their erections compared to on-demand dosing, 69% versus 42% respectively, with 58% of sexual intercourse attempts being completed [20].

In another study, men were given either 20mg as needed or 10mg daily. The daily group achieved better results, and 72% of participants preferred the daily option [21].

Another large study with 268 men compared tadalafil 5mg and 10mg daily doses with placebo. The men taking daily tadalafil had much better erections, more successful sex, and more of them reached a point where they no longer had erectile dysfunction  [19]. The most common side effects were things like indigestion, headache, and back pain, but these were usually mild and didn’t make most men stop treatment  [19].

A more recent study checked if even lower daily doses (2.5mg or 5mg) worked well. Over 24 weeks, both doses improved erections and confidence compared to a placebo, with very few side effects. The study also found that the tadalafil 5mg dose was more effective than the tadalafil 2.5mg daily dose [22].

Tadalafil 5mg and tadalafil 2.5mg daily dosing becomes licensed

Because of all this research, the European Commission approved tadalafil (2.5mg and 5mg) for once-daily treatment of erectile dysfunction in June 2007, and the US Food and Drug Administration (FDA) did the same in January 2008 [5].

Taking tadalafil every day helps men enjoy sex whenever the moment feels right, without needing to plan ahead. Studies also show it stays safe and effective for up to two years, making it a strong alternative to on-demand tablets.

Why men (and their partners) prefer daily tadalafil 5mg tablets

Daily tadalafil 5mg tablets have become a favourite because they offer true spontaneity. No more awkward timing or scheduling; men can relax and enjoy intimacy whenever the mood strikes.

When you take tadalafil every day, you’re ready for sex at any time—you don’t need to plan ahead. The daily dose is usually 2.5mg or 5mg, and your doctor will help choose the right amount for you, depending on how well it works and if you have any side effects. This low daily dose is an excellent option for men who want to be able to have sex more often, like a couple of times a week or more.

Who should consider once-daily tadalafil?

Couples who want more freedom or would like to enjoy a more natural sex life often prefer this daily approach. Of course, for some men and their partners, taking tadalafil only when needed (on-demand) might still suit them best. It’s all about what works for you and your relationship.

A number of my patients who had difficulty gaining erections with on-demand dosing once switched to the tadalafil 5 mg daily dosing were able to achieve spontaneous erections more naturally. The feedback from these customers is always positive, and they always comment that they like the spontaneity and flexibility that the tadalafil 5mg daily dosing provides.

To order your tadalafil online, complete the erectile dysfunction online consultation form.

Safety, side effects, and what to expect

Most men tolerate daily tadalafil 5mg tablets well. The most common side effects are headache, indigestion, backache, and muscle aches, which are usually mild and go away on their own [5].

Like all other PDE5 inhibitors, tadalafil should not be used with nitrates or by men with certain heart conditions  [5].  Always check with your healthcare provider before starting treatment.

Another benefit of tadalafil is that, unlike sildenafil, food does not affect its absorption [23].

Practical tips for getting the most out of daily tadalafil 5mg tablets

• Take your tablet at the same time every day—this helps keep a steady level in your body.
• You don’t need to plan sex around your medication—enjoy intimacy whenever the moment feels right.
• If you miss a dose, take it as soon as you remember. Don’t double up.
• Unlike sildenafil, food does not affect the absorption of tadalafil, so you don’t have to factor in meal times
• Talk to your doctor if you have any concerns or side effects.

Frequently asked questions about tadalafil 5mg tablets

What is tadalafil 5mg daily dosing?

Tadalafil 5mg daily dosing means you take a low-dose tablet every day, rather than just before planned sexual activity, to help treat erectile dysfunction (ED) and sometimes urinary symptoms from an enlarged prostate.

How long does it take for daily tadalafil 5mg to start working?

You might notice some improvement within a few days, but it can take up to a week for the medicine to build up to steady levels in your body and work at its best.

Do I have to plan sex around taking my tablet?

No, that’s the big advantage! With daily dosing, you can be ready for sex at any time—no need to plan around taking a pill.

Can I take tadalafil 5mg tablets with food?

Yes—food doesn’t affect how well tadalafil works.

What if I miss a dose?

Take your next dose as soon as you remember, but don’t take two tablets at once.

Are daily tadalafil 5mg tablets safe for long-term use?

Yes. Studies show that men can safely take tadalafil 5mg daily for up to 2 years.

Can women take tadalafil?

Tadalafil 5mg tablets are not licensed for use in women.

Will I get side effects from daily tadalafil 5mg?

Most men don’t have any problems, but some may get mild side effects like headache, indigestion, back pain, or muscle aches. These usually go away on their own.

Who shouldn’t take daily tadalafil 5mg?

You shouldn’t take tadalafil 5mg tablets if you’re on nitrates (for chest pain), have certain heart conditions, or have been told by your doctor to avoid sexual activity. Always check with your GP or pharmacist first.

Conclusion: A new era of confidence and spontaneity

The journey to once-daily tadalafil 5mg tablets has changed the lives of millions of men—no more planning, no more pressure—just the freedom to enjoy intimacy naturally and confidently. If you’re considering treatment, talk to your doctor or pharmacist to see if daily tadalafil 5mg tablets could be right for you, or complete the Courier Pharmacy erectile dysfunction consultation form.

Disclaimer: This article is for informational purposes only and does not replace professional medical advice.

References

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