Tadalafil: uses, side effects and cost in the Philippines

What is tadalafil?

Tadalafil is the active ingredient in Cialis, a PDE5 inhibitor that treats erectile dysfunction (ED). It works like sildenafil (Viagra) but lasts much longer, which is why it was nicknamed "the weekend pill".

Eli Lilly launched Cialis in 2003. Philippine pharmacies now stock the originator and generics including Torfil, Tadah Forte and Thafil. All contain tadalafil. Tablets exist in 2.5 mg, 5 mg, 10 mg and 20 mg strengths, and one product, Thafil, comes as a film that dissolves in the mouth. Your doctor decides which strength and which way of using it suits you.

Tadalafil is one of two ED medicines you will realistically be offered in the Philippines, the other being sildenafil. Our ED medicines overview covers the full list, and sildenafil vs tadalafil compares them directly.

What is tadalafil used for?

Tadalafil is approved for three things: erectile dysfunction, the urinary symptoms of benign prostatic hyperplasia (BPH), and, as a separate product, pulmonary arterial hypertension.

Erectile dysfunction

This is the main use. Tadalafil helps men who have trouble getting or keeping an erection firm enough for sex. The European Association of Urology lists PDE5 inhibitors as a first-line treatment, and trials show tadalafil works for men with ED from many causes, including diabetes and high blood pressure, both common among Filipino men.

Like sildenafil, tadalafil does not increase desire, does not work without arousal, and does not treat the cause. A consultation is also a chance to check for what is behind the ED, because ED can be an early sign of heart or blood-sugar problems. See what causes erectile dysfunction.

Enlarged prostate (BPH)

Many men over 50 have a benign enlarged prostate. It causes a weak stream, frequent urination, waking at night to urinate, and a feeling the bladder has not emptied. Taken daily, tadalafil relaxes smooth muscle in the prostate and bladder neck and can ease these symptoms. It is approved for BPH alone and for men who have both BPH and ED.

This is the main reason some men are put on daily tadalafil: one tablet addresses both problems. If you already take an alpha blocker such as tamsulosin for your prostate, your doctor has to plan the combination carefully (see interactions below).

Pulmonary arterial hypertension

Under the brand Adcirca and as generics, tadalafil is prescribed by specialists for pulmonary arterial hypertension (PAH), high blood pressure in the arteries of the lungs. That is a separate product used at a different schedule under specialist care. If you take tadalafil for PAH, do not add an ED product.

How does tadalafil work?

Tadalafil blocks PDE5, the enzyme that ends an erection. With PDE5 blocked, the signal that keeps penile blood vessels relaxed lasts longer, so blood flows in more fully when you are aroused.

The chain of events is the same as for sildenafil. Arousal makes nerves release nitric oxide. Nitric oxide raises cGMP, which relaxes the smooth muscle in the arteries and spongy tissue. Blood fills the tissue. Then PDE5 breaks cGMP down and the erection subsides. Tadalafil slows that last step. Step through it below.

1. Arousal signal

Touch, thoughts or sight send a signal from the brain down the spinal cord to the nerves around the blood vessels of the penis.

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What makes tadalafil different is how long it stays in the body. Its half-life is about 17.5 hours, compared with about 4 hours for sildenafil. That long half-life is behind both its 36-hour window and the option of daily use. It also means that after a tablet, tadalafil is still in your body for two days or more, which matters for nitrates (see below).

How long does tadalafil last?

Tadalafil can help for up to 36 hours after a tablet. In the US FDA label trials, some men responded from 30 minutes, with the effect lasting to 36 hours.

The 36 hours are a window, not a continuous erection. Within that window, an erection is easier to get when you are aroused, and it goes down normally afterwards. An erection that will not go down after 4 hours is an emergency (see the safety box).

Why does tadalafil sometimes not work?

The usual reasons are too little sexual stimulation, high anxiety, heavy drinking, or judging it after only one or two attempts. Tadalafil, like sildenafil, amplifies a natural signal; it cannot create one.

Other causes are worth raising with your doctor: poorly controlled diabetes, low testosterone, a strength that does not suit you, or a medicine that speeds up tadalafil's breakdown, such as rifampicin. The fix is a follow-up visit, not doing more on your own. Your doctor may adjust the strength, move you between on-demand and daily use, switch you to sildenafil, or look again at the cause. Never increase the amount yourself, and never add a second ED medicine.

It also helps to keep a short note of each attempt: when you used it, what you ate and drank, how it went, and any side effects. Bring that to your appointment.

Does food affect tadalafil?

No, not meaningfully. The US FDA label says food does not change how much tadalafil is absorbed or how fast. That is a practical difference from sildenafil, which a heavy, high-fat meal can slow down.

For men whose evenings centre on a big family dinner, this can make tadalafil easier to live with. Alcohol is a different matter, covered below.

On-demand or daily tadalafil: what is the difference?

On-demand means a higher-strength tablet used only before sex; daily means a low-strength tablet every day, regardless of when you have sex. Both are approved, and your doctor decides which fits.

	On-demand tadalafil	Daily tadalafil
Strengths that exist for this use	10 mg, 20 mg	2.5 mg, 5 mg
When it is used	before sex, as your doctor directs	once a day, every day
Planning	some, but the 36-hour window is wide	none: the level stays steady
Also treats BPH symptoms	not the approved approach	yes
Monthly tablets	depends on how often you have sex	about 30
Who it may suit	sex a few times a month	sex twice a week or more, wish for spontaneity, BPH

The cost picture is different too. On-demand use is often cheaper for men who have sex a few times a month, because generic 10 mg and 20 mg tablets are available. Daily use means about 30 tablets a month, and in the Philippines we have a verified price for Cialis 5 mg (₱277 a tablet at Watsons) and for Torfil 2.5 mg (₱95), but not yet for a generic 5 mg. Our page on daily tadalafil works through monthly costs in detail.

Never switch between the two patterns on your own or use them together. Each is a separate plan your doctor sets.

Who should not take tadalafil?

Do not take tadalafil if you use any nitrate medicine, use riociguat, or have had a recent heart attack or stroke. Serious heart disease, very low blood pressure, severe liver or kidney disease and certain eye conditions also need a doctor's careful judgement.

The EMA product information and the US FDA label list these situations:

• Nitrates in any form: glyceryl trinitrate (nitroglycerin) under the tongue, isosorbide mononitrate or dinitrate, nitrate patches, and "poppers" (amyl nitrite). Together with tadalafil they can cause a dangerous fall in blood pressure. Because tadalafil lasts so long, the US label says at least 48 hours should pass after the last tadalafil before a nitrate is given, even in an emergency, and only under medical supervision.
• Riociguat, used for some types of pulmonary hypertension.
• A heart attack in the past 90 days, or a stroke in the past 6 months, unstable angina or angina during sex, uncontrolled irregular heartbeat, or heart failure that limits ordinary activity. The heart must be stable enough for sexual activity.
• Very low blood pressure (below 90/50) or uncontrolled high blood pressure.
• Severe liver disease, or severe kidney disease for daily use.
• A previous loss of sight in one eye from NAION, or a hereditary eye disease such as retinitis pigmentosa.
• Allergy to tadalafil or any ingredient.

Extra care is needed with a penis deformity such as Peyronie's disease, or a condition that raises the risk of priapism (sickle cell disease, multiple myeloma, leukaemia), and with a bleeding disorder or active stomach ulcer.

What medicines interact with tadalafil?

Nitrates and riociguat must never be combined with tadalafil. Alpha blockers, other blood pressure medicines, strong CYP3A4 inhibitors, some medicines that speed up tadalafil's breakdown, and grapefruit can all change its effect.

• Nitrates and riociguat: never (see above). If you have chest pain within two days of tadalafil, tell the emergency team the medicine and the time you took it.
• Alpha blockers such as tamsulosin, doxazosin, terazosin and alfuzosin, very common for prostate symptoms. The combination can cause dizziness or fainting on standing. Tadalafil is not recommended as a BPH treatment for men already on an alpha blocker; for ED the doctor plans the combination carefully.
• Blood pressure medicines (amlodipine, losartan, and others widely used in the Philippines) add a small extra drop in pressure. Usually manageable, but your doctor must know.
• Strong CYP3A4 inhibitors raise tadalafil levels: ritonavir and other HIV protease inhibitors, ketoconazole and itraconazole, and clarithromycin. Your doctor may limit the strength or choose another medicine.
• CYP3A4 inducers such as rifampicin (used in tuberculosis treatment, common in the Philippines) and some anti-seizure medicines lower tadalafil levels and can make it less effective.
• Grapefruit and grapefruit juice can raise tadalafil levels. Pomelo may do the same; ask your pharmacist.
• Other ED treatments, including sildenafil, vardenafil and "herbal" pills that may secretly contain a PDE5 inhibitor. Do not combine.

See ED medicine side effects and safety for the full picture across all ED medicines.

What are the side effects of tadalafil?

The common side effects are headache, indigestion, back pain, muscle aches, a blocked nose and flushing. Most are mild; serious side effects are rare but need urgent care.

Common side effects

• Headache, the most common. Water helps, especially in the heat.
• Indigestion or reflux.
• Back pain and muscle aches, more typical of tadalafil than of sildenafil. They usually begin 12 to 24 hours after a tablet and settle within about 48 hours. The US label notes they were generally mild and rarely led men to stop.
• Blocked or runny nose.
• Flushing of the face.
• Pain in the arms or legs.
• Dizziness, especially on standing.

Tadalafil affects the retina's PDE6 enzyme much less than sildenafil does, so blue-tinged vision is uncommon. With daily use, side effects tend to be less noticeable over time because the level in the blood is low and steady. If a side effect bothers you, tell your doctor; switching strength, pattern or medicine often helps.

Serious side effects: get urgent care

• An erection lasting more than 4 hours (priapism). Go to an emergency room.
• Sudden loss or reduction of vision in one or both eyes, which may be NAION.
• Sudden loss or reduction of hearing, sometimes with ringing in the ears or dizziness.
• Chest pain, fainting or an irregular heartbeat during or after sex. Tell responders you took tadalafil, and when.
• Severe allergic reaction: swelling of the face, lips or throat, difficulty breathing, or a severe rash.

Can you drink alcohol with tadalafil?

Small amounts are unlikely to cause problems for most men. Heavy drinking is riskier with tadalafil: in the US FDA label, 5 or more units of alcohol taken with tadalafil increased dizziness, faster heart rate and drops in blood pressure on standing.

Because tadalafil lasts so long, a tablet in the afternoon is still active through a night of drinking. Alcohol also works directly against erections. If you drink often, tell your doctor; it may change which medicine or pattern suits you.

Is tadalafil safe?

For most men who have been checked by a doctor, tadalafil has a well-established safety record since 2003. It is unsafe in specific situations, mainly nitrates, riociguat and unstable heart disease, which is why it needs a prescription.

Its long action is a convenience but also means that if you develop chest pain within two days of a tablet, emergency staff need to know. Carry a note or tell someone close to you. The other serious risk in the Philippines is counterfeit or unregistered product: "herbal" sex enhancers and marketplace pills are a known source of hidden or wrongly dosed tadalafil. Read how to spot fake ED pills.

Which tadalafil brands are sold in the Philippines?

Philippine pharmacies stock Cialis (the originator) and generics including Torfil, Tadah Forte and Thafil. All contain tadalafil.

A generic registered with the FDA Philippines must show it is bioequivalent to Cialis. You can check any product on the FDA Philippines verification portal. Brands differ in maker, appearance, form and price.

• Cialis: the Eli Lilly originator, in 5 mg and 20 mg at Watsons, Southstar Drug and Rose Pharmacy.
• Torfil: the main generic at Watsons, in 2.5 mg, 10 mg and 20 mg.
• Tadah Forte: a Philippine tadalafil brand listed on MIMS; we have not yet verified a retail price.
• Thafil: an orodispersible film that dissolves on the tongue; price still being checked.

How much does tadalafil cost in the Philippines?

A generic 20 mg tablet starts at ₱395 (Torfil, Watsons), while Cialis 20 mg runs up to ₱1,053.75 (Cialis, Southstar Drug). A 10 mg generic is ₱220 and Cialis 5 mg is ₱277.

The table below shows every verified tadalafil price we hold, with the pharmacy and the date checked.

Per tablet ↑

Medicine	Strength	Pharmacy	Price	Per tablet	Checked	Source
tadalafil (Torfil)	2.5 mg	Watsons	₱95	₱95	2026-10-27	watsons.com.ph
tadalafil (Torfil)	10 mg	Watsons	₱220	₱220	2026-10-27	watsons.com.ph
tadalafil (Cialis)	5 mg	Watsons	₱277	₱277	2026-10-27	watsons.com.ph
tadalafil (Torfil)	20 mg	Watsons	₱395	₱395	2026-10-27	watsons.com.ph
tadalafil (Cialis)	20 mg	Rose PharmacyOut of stock at time of check	₱982	₱982	2026-10-27	rosepharmacy.com
tadalafil (Cialis)	20 mg	Watsons	₱985.25	₱985.25	2026-10-27	watsons.com.ph
tadalafil (Cialis)	20 mg	Southstar Drug	₱1,053.75	₱1,053.75	2026-10-27	southstardrug.com.ph

• tadalafil (Torfil) 2.5 mg₱95
  WatsonsChecked 2026-10-27 · source
• tadalafil (Torfil) 10 mg₱220
  WatsonsChecked 2026-10-27 · source
• tadalafil (Cialis) 5 mg₱277
  WatsonsChecked 2026-10-27 · source
• tadalafil (Torfil) 20 mg₱395
  WatsonsChecked 2026-10-27 · source
• tadalafil (Cialis) 20 mg₱982
  Rose PharmacyChecked 2026-10-27 · source
• tadalafil (Cialis) 20 mg₱985.25
  WatsonsChecked 2026-10-27 · source
• tadalafil (Cialis) 20 mg₱1,053.75
  Southstar DrugChecked 2026-10-27 · source

Prescription required for every medicine listed. Last checked October 27, 2026

• At 20 mg, the originator costs about 3 times the cheapest generic.
• The Cialis 20 mg listing at Rose Pharmacy was out of stock when checked.
• We have no verified price yet for Tadah Forte, Thafil or a generic 5 mg tablet. See all prices for updates.

For more, see tadalafil prices in the Philippines and Cialis price and cheaper generics, or work out a monthly figure with the cost per dose calculator.

Do you need a prescription for tadalafil in the Philippines?

Yes. Tadalafil is a prescription medicine, and licensed pharmacies such as Watsons, Mercury Drug, Southstar Drug and Rose Pharmacy will ask for one.

Any licensed doctor can prescribe it after checking your heart, blood pressure and medicines. Men with prostate symptoms often see a urologist, who can assess the prostate and the ED together. Online consultations are a private option that works around office and night-shift hours; the doctor sends an e-prescription if tadalafil suits you. See is Viagra over the counter? for the prescription rules and online ED consultation for how it works.

What should you ask your doctor about tadalafil?

Ask whether on-demand or daily use fits your life and health, how it will interact with your other medicines, and what to do if it does not work. Bring a full list of everything you take.

1. Is tadalafil or sildenafil the better fit for me, and why?
2. Would daily or on-demand use suit me better?
3. I take medicine for blood pressure or my prostate: how do we plan around it?
4. Do my heart, liver or kidneys need checking first?
5. How long should I try it before we judge whether it works?
6. Should my blood sugar, cholesterol or testosterone be tested?

Frequently asked questions

What is tadalafil used for?+

Tadalafil treats erectile dysfunction and the urinary symptoms of an enlarged prostate (benign prostatic hyperplasia, or BPH), alone or together. Under a different product name it also treats pulmonary arterial hypertension.

How long does tadalafil last?+

Tadalafil can help for up to 36 hours after a tablet, much longer than sildenafil. That is a window in which an erection is easier to get when you are aroused, not a 36-hour erection.

What is Cialis daily?+

It is the use of a low strength of tadalafil once a day, every day, instead of a higher strength only before sex. Some men prefer it for spontaneity or for BPH symptoms. Your doctor decides whether it suits you.

Why does tadalafil cause back pain?+

Back pain and muscle aches are known tadalafil side effects, usually starting 12 to 24 hours after a tablet and settling within two days. The exact cause is not fully understood. Tell your doctor if it is severe.

Can I drink alcohol with tadalafil?+

Small amounts are unlikely to be a problem for most men, but in the US FDA label heavy drinking (5 units or more) with tadalafil increased dizziness and drops in blood pressure on standing. Alcohol also makes erections harder.

Do you need a prescription for tadalafil in the Philippines?+

Yes. Tadalafil is a prescription medicine in the Philippines. A licensed doctor can prescribe it after an in-person or online consultation.