Tadalafil Dosing and Efficacy

Introduction to Tadalafil

Higher doses of sildenafil show improved erectile function, but this dose-response relationship was not observed with tadalafil (20 mg vs 10 mg vs 5 mg) 1, 2

Once-daily dosing provides an alternative for couples who prefer spontaneous rather than scheduled sexual activity 3
The recommended dose for BPH treatment is 5 mg once daily, as recommended by the American Urological Association 4
Tadalafil 5 mg daily should be discussed as a treatment option for patients with LUTS/BPH regardless of comorbid erectile dysfunction, according to the European Association of Urology 5, 4

Clinicians should not offer the combination of low-dose daily 5 mg tadalafil with alpha blockers for LUTS/BPH as it offers no advantages in symptom improvement over either agent alone, as stated by the American Urological Association 5, 4

Most common adverse effects include headache, flushing, rhinitis, and dyspepsia, with a strength of evidence grade of high 1
Tadalafil significantly improves erectile function compared to placebo, with approximately 69% of men reporting improved erections versus 33% with placebo, based on moderate-strength evidence 2, 6
For BPH treatment, tadalafil 5 mg daily improves International Prostate Symptom Score (IPSS) compared to placebo, with a moderate level of evidence 4