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Tadalafil — telemedicine evaluation & patient education

Overview

Tadalafil

Understanding Tadalafil and Its Therapeutic Role

Tadalafil is a long-acting phosphodiesterase-5 (PDE5) inhibitor prescribed for erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and in some cases, combined erectile and urinary symptoms in aging men. Clinically known for its extended duration, tadalafil provides a unique advantage: it remains active in the bloodstream much longer than sildenafil, earning the popular nickname “the weekend medication.” Unlike short-acting ED treatments, tadalafil offers spontaneous sexual ability for up to 36 hours, allowing intimacy without time pressure.

For BPH, tadalafil reduces urinary frequency, urgency, and incomplete bladder emptying by relaxing smooth muscle in the prostate and bladder neck. This dual benefit makes tadalafil a preferred medication for men seeking both sexual and urinary function improvement.

Mechanism of Action: Sustained cGMP Enhancement and Smooth Muscle Relaxation

Tadalafil works by inhibiting PDE5, an enzyme that breaks down cyclic guanosine monophosphate (cGMP), a chemical responsible for relaxing smooth muscle in penile arteries. When sexual stimulation triggers nitric oxide release, cGMP levels rise naturally. PDE5 breaks down cGMP prematurely in men with ED, resulting in inadequate erectile response.

By blocking PDE5, tadalafil maintains elevated cGMP for much longer than other medications in its class—sometimes up to 36 hours. This results in improved blood flow, firmer erections, and more natural sexual performance.

For BPH, tadalafil relaxes smooth muscle in pelvic structures, reducing resistance in the bladder outlet and lowering urinary difficulty. This effect occurs even without sexual stimulation, making tadalafil a valuable non-surgical tool for urinary relaxation.

Dosage Options, Daily vs. As-Needed Use, and Onset

Tadalafil offers flexible dosing strategies that suit different lifestyles:

As-Needed Dosing (10 mg / 20 mg)

Taken 30–60 minutes before sexual activity. Effects last up to 36 hours, enabling a broad window for intimacy.

Daily Micro-Dose (2.5 mg / 5 mg)

Provides 24-hour steady erectile support and continual BPH relief. Ideal for men with frequent sexual activity or significant urinary symptoms.

Daily dosing produces consistent blood levels, leading to spontaneous erections anytime, without planning doses around intimacy.

Important Guidance:

Tadalafil often reaches peak performance after several doses, as anxiety decreases and blood flow pathways adapt.

Side Effects, Interactions, and Safety Considerations

Tadalafil is well tolerated by most men. Its long action, however, means side effects—if they occur—may last slightly longer than with short-acting ED medications. Common effects include:

Typically, these symptoms are temporary and dose dependent.

Serious Contraindications:

Tadalafil must never be taken with nitrates or nitric oxide donors due to severe blood pressure drops. Caution is required when used with alpha-blockers, significant heart disease, severe liver issues, or uncontrolled blood pressure.

Sudden vision or hearing changes are extremely rare but require immediate medical evaluation. Men with anatomical penile abnormalities or priapism risk factors should be monitored carefully.

Unique Benefits of Tadalafil Compared to Other ED Options

Tadalafil’s distinct advantages include:

Patients often describe a psychological benefit: reduced pressure, restored intimacy, and improved self-esteem.

Lifestyle Habits That Intensify Tadalafil Results

Because tadalafil enhances natural vascular function, lifestyle improvements further magnify its effects. Regular cardiovascular exercise, weight reduction, and smoking cessation significantly improve nitric oxide pathways. Adequate hydration and a Mediterranean-style diet improve vascular elasticity.

Stress, performance anxiety, and poor sleep reduce erectile response even with medication; stress-management techniques such as breathing exercises, therapy, or meditation may enhance results.

Men with metabolic conditions—diabetes, hypertension, cholesterol disorders—experience better response rates when these conditions are optimally managed.

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Drug information

Attribute Details
Generic / Brand Tadalafil
Class PDE5 inhibitor
Commonly discussed for erectile dysfunction (ED) and BPH symptoms
Controlled substance No
Telemedicine availability Considered when appropriate
Key counseling Benefits vs risks, interactions, alternatives, realistic expectations, and when to seek urgent care.

Medication Categories & Key Options

Category Related options
Main category PDE5 inhibitor
See also Sildenafil , Tadalafil , Vardenafil

Links to trusted sources

Telehealth FAQ

How long does tadalafil stay active?

Up to 36 hours, which is the longest duration among PDE5 inhibitors.

Can tadalafil be taken every day?

Yes — daily dosing is common for ED, BPH, or both.

Does tadalafil work without sexual stimulation?

No — sexual arousal is required for nitric oxide release.

Is tadalafil safe for older men?

Yes, with proper medical evaluation, especially for cardiac conditions.

Medically reviewed

Reviewed by: Dr. Hernando Pulido, DDS/MSD · Dr. Lina M. Pulido, DMD

Last reviewed: 2025-09-03

Education only. Prescriptions may be issued only after a good‑faith exam and when clinically appropriate.

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Where can i Buy Tadalafil (Cialis) Online with a Prescription from Dr. Pulido

Men who know how to take Cialis correctly live a full intimate life without erectile dysfunction, a feeling of embarrassment and shame in front of their partner. Not surprising because Cialis is one of the most effective drugs with the longest possible effect. The substance contained in such tablets (tadalafil) can eliminate the manifestations of erectile dysfunction even at the last stage of the disease.

Before using this potent stimulant, it is recommended that you carefully study the instructions that come with the drug. One tablet should be taken 40 minutes (maximum one hour) before planned intimacy. You need to take the MEDICINES ONLINE with plain water in sufficient quantity for you. If desired, you can take the tablets with another non-alcoholic liquid; this will not affect the effect of the product.

At Pulido Dental Care, we provide a secure and confidential way to access Tadalafil (Cialis) for erectile dysfunction and benign prostatic hyperplasia (BPH) through our professional online telemedicine service. Led by licensed provider Dr. Pulido, our virtual clinic evaluates your medical needs and, when appropriate, issues prescriptions that are filled and shipped by certified U.S. pharmacies—no in-person visits required.



What Is Tadalafil?

Tadalafil, sold under the brand name Cialis, is a long-acting PDE5 inhibitor used to treat:

  • Erectile dysfunction (ED)
  • Benign prostatic hyperplasia (BPH)
  • Combined ED and urinary symptoms

Known for its extended effectiveness (up to 36 hours), Tadalafil can be taken as needed or daily depending on your medical profile.

How Online Prescription Works with Dr. Pulido

  1. Confidential Health Intake: Submit a secure medical questionnaire detailing your symptoms, health history, and any medications you're taking.
  2. Telehealth Review: Dr. Pulido evaluates your case. If Tadalafil is safe and indicated, he issues a prescription in compliance with U.S. medical guidelines.
  3. Online Pharmacy Fulfillment: Your medication is dispensed by a licensed U.S. pharmacy and shipped discreetly to your home.

Who Can Benefit from Tadalafil?

  • Men with mild, moderate, or severe erectile dysfunction
  • Patients with enlarged prostate and urinary symptoms
  • Those seeking a long-acting alternative to Sildenafil (Viagra)
  • Individuals who prefer daily low-dose ED therapy

Dr. Pulido ensures every prescription is medically necessary, reviewed for contraindications, and monitored over time for safety.

Why Pulido Dental Care for Tadalafil?

  • Real telemedicine evaluation by Dr. Pulido
  • U.S.-licensed, FDA-approved pharmacy sources
  • 100% online and HIPAA-compliant
  • Fast, discreet delivery nationwide
  • Total privacy, no in-person appointments required

Ready to restore confidence and improve quality of life? Start your private consultation today and access safe, effective ED treatment with expert guidance.

General information

If you purchased Cialis in the soft version, you do not need to take these tablets with water; you just need to put one tablet under your tongue and wait for it to dissolve (this is the most convenient form of use).



The duration of action of the medication reaches 36 hours, depending on the consumption of heavy food, alcoholic beverages, the presence of other diseases and other individual factors.



How to determine the dosage?

The manufacturer produces this product for men in various dosages, the most common versions of the original drug are 20 and 40 mg. If you are taking Cialis for the first time, and erectile dysfunction began to bother you relatively recently, it is recommended to start with an amount of 5 mg. In rare cases, this concentration does not bring the desired effect, which means that the next day, you can increase the dosage to 40 mg in one day.



This is a universal rule; however, when calculating the optimal amount, it is recommended that you consult a doctor who will calculate the amount of the drug depending on your condition. Please note: you should not take the medicine in high dosages (more than 40 mg in one day). Otherwise, unfavorable symptoms and deterioration in well-being may occur.




How often can you take Cialis for potency?

Most experts are confident that tadalafil can be taken as often as your sexual activity requires (subject to therapeutic dosages). Since the medication does not cause drug dependence, it can be taken daily for a long time (over time, the effect will remain as pronounced as in the first days of use).



Useful recommendation: since the speed of action of the drug directly depends on the amount of food consumed, it is recommended to take the tablets on an empty stomach or after a small snack.



Are there any contraindications and restrictions?
Tadalafil is a safe component, but certain contraindications for men still exist. Below are the main restrictions:



  • Age under 18 years. The active components of Cialis Generic may have an adverse effect on incompletely formed reproductive function.
  • Hypersensitivity to active and other components of the tablets. Such individual intolerance to the drug can lead to severe allergic reactions.
  • Diseases of the heart and vascular system. These include arrhythmia, sudden changes in blood pressure, which must be constantly monitored with medications, heart defects, cardiac decompensation, and so on.
  • Pathologies of the liver and kidneys in the final stage (these may be malignant neoplasms, failure, cirrhosis).

Cialis 20mg should not be combined with other tablets for the treatment of erectile dysfunction, otherwise, an overdose may occur.



Severe pathologies of the circulatory system.
If the recommendations prescribed in the instructions are not followed or the dosage is violated, adverse reactions may occur, such as:



  • nausea that progresses to vomiting;
  • pain in the head, dizziness, muscle pain;
  • changes in blood pressure up or down, tachycardia, flushing of blood to the skin;
  • disruption of the functioning of the digestive system (constipation, diarrhea, bloating);
  • the manifestation of allergic reactions, which are characterized by a rash on the skin, redness of the epidermis, lacrimation, rhinitis, itching and other symptoms.

If allergic or other adverse reactions occur, it is recommended to stop taking the pills and contact a specialist who will adjust the dosage or select another drug for you.