How to Use Daily Tadalafil: A Complete Guide to the Latest Knowledge and Evidence
Daily therapy with tadalafil (taking tadalafil orally every day) is a form of ED treatment aimed at a state in which you can have sexual activity naturally at any time.
Its major features are that you do not need to worry about the timing of sexual activity and that it makes the state of erection easier to stabilize.
Furthermore, because benefit can be expected not only for improving ED but also for urinary problems due to benign prostatic hyperplasia, it is an extremely useful treatment for men who have more than one concern.
This article gives an easy-to-understand explanation of how daily tadalafil works, its effectiveness, how it differs from on-demand therapy, side effects, prices and the latest academic evidence.
We will also touch on the point that, even during daily therapy, ED Treatment Medication taken as needed (on-demand) can be used in combination depending on the situation.
We can provide a variety of ED treatment medications — Viagra (sildenafil), vardenafil, Cialis (tadalafil), avanafil, udenafil, etc. — matched to patients’ requests.
We can prescribe ED Treatment Medication on the same day.
ED Treatment Medication can also be used together with HIV prevention medication, premature ejaculation medication and AGA medication.
We can provide the latest ED Treatment Medication, such as the 4th-generation and 5th-generation medications avanafil and udenafil!
– Daily therapy with tadalafil is an ED treatment in which a small amount is taken every day to stabilize erectile function.
– It does not require you to watch the clock and take medication each time you have sexual activity, and it offers a high degree of freedom in that you can “start naturally whenever the mood strikes”.
– Multiple studies have shown clear improvement in the firmness and maintenance of erections (improvement in IIEF scores).
– Tadalafil 5mg is known to improve not only ED but also urinary problems such as frequent urination, nighttime urination and reduced urinary stream.
– Whether on-demand or daily is the better fit changes according to the frequency of sexual activity, lifestyle and the presence or absence of urinary symptoms. On-demand use during daily therapy is also possible.
Click any item in the table of contents to jump partway into the article.
What Is Daily Therapy with ED Treatment Medication?
What Is Daily Tadalafil?
Daily tadalafil is a treatment method in which 2.5 to 5mg of tadalafil is taken orally every day so that the blood concentration is kept constant.
By continuing to take it, in about 5 days a state in which “an erection comes easily at any time” is established, and there is no longer a need to take medication before sexual activity.
A major advantage is that there is none of the effort of “taking it 1 to 3 hours before sexual activity” as with as-needed dosing (on-demand), which makes it easier to lead to a more natural and spontaneous sex life.
Features: By taking it at the same time every day, a steady state is reached in about 5 days. It has the effect of improving ED for sex at any time of the day. Its efficacy for ED is considered comparable to as-needed (on-demand) intake, and daily tadalafil is particularly recommended for ED accompanied by urinary problems.
Meals: There is no problem taking it together with food, but it is more effective when used on an empty stomach.
Time until the effect appears: It is effective from 5 days after starting to take it. It is also possible to use ED treatment medication concurrently during daily tadalafil.
Duration of action: From 5 days after starting to take it onward, it is effective at any time.
– High frequency of sexual activity
– Difficult to predict the timing of sexual activity
– Not satisfied with as-needed dosing (on-demand)
– Prone to side effects (hot flushes, bloodshot eyes)
– Want to improve urinary problems at the same time, etc.
Action on Both ED and Urinary Problems
Tadalafil also has the effect of improving urinary problems due to benign prostatic hyperplasia (frequent urination, weak urinary stream, a feeling of incomplete emptying, nighttime urination and so on).
For that reason, for men troubled by both ED and urinary symptoms, it is considered an extremely good fit as a treatment in which a single medication can improve 2 symptoms.
Effectiveness of Daily Tadalafil
Effects on ED
Daily tadalafil has the effect of stabilizing the onset, firmness and maintenance of erections.
Many studies using the IIEF-EF score (0 to 30 points), one of the measures for evaluating erectile function, have reported results such as the following.
– With 12 weeks of daily dosing, the IIEF-EF score improved by an average of 4 to 6 points
– In a representative study (Porst et al. 2014), 5mg daily improved the IIEF-EF by an average of +5.6 points
– The rate of successful intercourse (SEP2/3) also improved significantly compared with the placebo group
– In an RCT in people who had not previously used PDE5 inhibitors (Montorsi et al. 2011) as well, clear improvement in erectile function was confirmed with 5mg daily
– In a meta-analysis comparing daily and on-demand use (Peng et al. 2017), the degree of ED improvement was roughly equivalent, but the rate of successful intercourse was slightly superior with daily use
From these results, in terms of “greater stability of erections”, “becoming easier to start sexual activity spontaneously” and “no longer needing to adjust timing”, daily therapy can be said to be a treatment with high satisfaction.
Effects on Urinary Problems and Benign Prostatic Hyperplasia
Daily therapy with tadalafil 5mg is also effective for the urinary symptoms accompanying benign prostatic hyperplasia (LUTS).
The symptoms for which improvement can be expected are as follows.
(In addition to ED symptoms)
– Needing the toilet often (frequent urination)
– Waking up many times during the night (nighttime urination)
– Weak urinary stream
– A feeling of incomplete emptying
In multiple clinical studies, using tadalafil 5mg every day for 12 weeks has produced
– The urinary symptom score (IPSS) improved by an average of 4 to 6 points
– Many people also begin to feel the effect within 1 to 2 weeks>
– Quality of life (QOL) also improved
these stable results.
In particular, for men who have ED and urinary symptoms at the same time, being able to “improve 2 concerns with 1 tablet a day” is a major benefit.
Differences Between Daily Therapy and As-Needed Dosing (On-Demand)
The differences between daily therapy and as-needed dosing (on-demand) are summarized below.
It is also possible to use as-needed dosing (on-demand) during daily therapy.
| Item | As-needed intake (on-demand) |
Daily intake (daily) |
|---|---|---|
| Timing of intake |
1 to 3 hours before sex | Take at the same time every day |
| Dose | 10 to 20 mg/time | 2.5 to 5 mg/day |
| Timing of effect |
Onset: 1 to 3 hours after intake Duration: 24 to 36 hours |
Any time from 5 days after intake |
| Suitable for | Low frequency of sex Easy to plan sex Want to keep cost and intake down |
High frequency of sex Hard to plan sex Want to be ready for sex at any time Want to treat urinary problems as well |
| Side effects | Hot flushes or headache may occur (relatively infrequent) |
Side effects are even fewer than with on-demand |
Evidence on Penis Size
ED Treatment Medication such as tadalafil has no effect of making the penis larger.
Even in a study of 15,000 or more people (Veale et al. 2015), only the average sizes were shown, and no enlarging effect from medication was confirmed.
The only approach for which a possibility of size improvement has been shown is “penile traction therapy (PTT)”, carried out under specific conditions such as after radical prostatectomy, but this is a treatment in which a dedicated device is used for long hours every day, and it is a different thing from ED Treatment Medication.
It is best to regard the role of ED Treatment Medication as strictly “improving firmness and maintenance”.
Side Effects and Precautions
The side effects of and precautions for ED treatment medication are as follows.
Hot flushes, headache, palpitations, nasal congestion, red eyes
Cialis (tadalafil), avanafil and udenafil have a lower frequency of side effects than the others.
Care is required if you are taking nitrates, are being treated for arrhythmia, are on dialysis, have a history of myocardial infarction, have high blood pressure or low blood pressure, or are elderly (65 years or older), so please consult with a doctor.
Prices
The prices and features of each ED treatment medication are as shown in the table.
All ED Treatment Medication is prescribed on a self-pay basis.
For those who would like to try various ED treatment medications to find what suits them best, we also offer affordable trial sets.
| Drug Name | Strength | Quantity | Fee (tax included) |
|---|---|---|---|
| (Brand) Viagra (Generic) Sildenafil |
Viagra 50mg | 1 tablet | 1,600 yen |
| 10 tablets | 14,000 yen | ||
| 30 tablets | 40,000 yen | ||
| Viagra OD Film 50mg | 1 tablet | 1,100 yen | |
| 10 tablets | 10,000 yen | ||
| 30 tablets | 27,000 yen | ||
| Sildenafil 50mg | 1 tablet | 1,000 yen | |
| 10 tablets | 9,000 yen | ||
| 30 tablets | 22,500 yen | ||
| (Brand) Levitra (Generic) Vardenafil |
*Levitra is not available | – | – |
| Vardenafil 10mg | 1 tablet | 1,500 yen | |
| 10 tablets | 13,000 yen | ||
| 30 tablets | 33,500 yen | ||
| Vardenafil 20mg | 1 tablet | 1,700 yen | |
| 10 tablets | 15,000 yen | ||
| 30 tablets | 39,500 yen | ||
| (Brand) Cialis (Generic) Tadalafil |
Cialis 10mg | 1 tablet | 1,800 yen |
| 10 tablets | 16,000 yen | ||
| 30 tablets | 45,000 yen | ||
| Cialis 20mg | 1 tablet | 2,000 yen | |
| 10 tablets | 18,000 yen | ||
| 30 tablets | 49,000 yen | ||
| Tadalafil 2.5mg (daily therapy) |
1 tablet | 300 yen | |
| 10 tablets | 2,500 yen | ||
| 30 tablets | 4,000 yen | ||
| 90 tablets | 10,000 yen | ||
| 180 tablets | 19,000 yen | ||
| 360 tablets | 35,000 yen | ||
| Tadalafil 5mg (daily therapy) |
1 tablet | 400 yen | |
| 10 tablets | 3,500 yen | ||
| 30 tablets | 8,000 yen | ||
| 90 tablets | 20,000 yen | ||
| 180 tablets | 38,000 yen | ||
| 360 tablets | 69,000 yen | ||
| Tadalafil OD 10mg | 1 tablet | 1,400 yen | |
| 10 tablets | 12,000 yen | ||
| 30 tablets | 31,500 yen | ||
| Tadalafil OD 20mg | 1 tablet | 1,600 yen | |
| 10 tablets | 14,000 yen | ||
| 30 tablets | 37,500 yen | ||
| (Brand) Stendra (Generic) Avanafil |
*Stendra is not available | – | – |
| Avanafil 100mg | 1 tablet | 1,100 yen | |
| 10 tablets | 9,000 yen | ||
| 30 tablets | 24,000 yen | ||
| Avanafil 200mg | 1 tablet | 1,200 yen | |
| 10 tablets | 10,000 yen | ||
| 30 tablets | 27,000 yen | ||
| (Brand) Zydena (Generic) Udenafil |
*Zydena is not available | – | – |
| Udenafil 100mg | 1 tablet | 1,100 yen | |
| 10 tablets | 9,000 yen | ||
| 30 tablets | 24,000 yen | ||
| Udenafil 200mg | 1 tablet | 1,200 yen | |
| 10 tablets | 10,000 yen | ||
| 30 tablets | 27,000 yen | ||
| Trial Set (Small) |
Sildenafil 50mg + Vardenafil 10mg + Tadalafil OD 10mg (3 types) |
1 set | 3,400 yen |
|
Sildenafil 50mg + Vardenafil 10mg + Tadalafil OD 10mg + Avanafil 100mg (4 types) |
1 set | 4,000 yen | |
|
Sildenafil 50mg + Vardenafil 10mg + Tadalafil OD 10mg + Avanafil 100mg + Udenafil 100mg (5 types) |
1 set | 4,500 yen | |
| Trial Set (Large) |
Sildenafil 50mg + Vardenafil 20mg + Tadalafil OD 20mg (3 types) |
1 set | 3,800 yen |
|
Sildenafil 50mg + Vardenafil 20mg + Tadalafil OD 20mg + Avanafil 200mg (4 types) |
1 set | 4,600 yen | |
|
Sildenafil 50mg + Vardenafil 20mg + Tadalafil OD 20mg + Avanafil 200mg + Udenafil 200mg (5 types) |
1 set | 5,400 yen |
Combined Use with Premature Ejaculation Medication Is Also Effective
For those with premature ejaculation, taking ED Treatment Medication increases firmness during erection and can be expected to extend the time until ejaculation.
Taking it together with medication for premature ejaculation poses no problem; rather, when premature ejaculation has multiple causes, taking them together can be expected to produce even greater effect.
Medication for premature ejaculation and ED treatment medication are not habit-forming, so using these medications does not mean you will become unable to have sex normally.
Premature ejaculation medication is not affected by food, but it is affected by alcohol to the same degree as, or more than, premature ejaculation medication, so caution is required.
Please also refer to the blog below. We can also prescribe it at the same time as ED Treatment Medication!
<Dr. Daisuke Shiojiri> Director of Personal Health Clinic, Doctor of Medical Science. At the National Center for Global Health and Medicine (Shinjuku Ward, Tokyo) and at Personal Health Clinic, he provides correct, evidence-based knowledge on HIV, PrEP and other topics related to STIs and STI testing, along with care that stays close to patients' hearts. Born in Japan but raised in Kenya, Africa, he also holds a medical license there and carries out medical assistance, educational assistance and other activities locally. He also sees patients at our clinic as a part-time doctor.
