The Independent Pharmacy

What To Expect In Your First Month On Tadalafil

Andy Boysan
Andy BoysanBPharmDirector & Superintendent Pharmacist

Reviewed on 22 Feb 2024

If your doctor has prescribed Tadalafil (Cialis) to treat erectile dysfunction (ED), you probably have some questions about what to expect in the first month of treatment.

Within the first month of taking the erectile dysfunction medication Tadalafil (Cialis), most men start to notice improvements in their ability to get and keep an erection. Tadalafil begins working in 30 to 60 minutes for most patients and provides up to 36 hours of improved erection function, which is why it’s also called the “weekend pill”.

It takes some adjustment to manage potential temporary side effects. But within a month, any side effects tend to resolve while you keep enjoying the benefits. After four weeks, most men find tadalafil helps create firmer, more sustained erections.

Let’s explore what you can expect in your first month on Tadalafil (Cialis) in more detail.

Tadalafil Tablets (10mg & 20mg)
Tadalafil Tablets (10mg & 20mg)
View Treatment

Key Findings

  • Tadalafil starts working quickly to improve erections, and the effects last for up to 36 hours.
  • Temporary minor side effects like headaches and indigestion usually resolve within one month. More serious reactions are very rare when following guidelines.
  • Pay attention to when positive impacts feel strongest and how long they last. Tracking this helps inform possible dosage adjustments.

What to Expect Week-by-Week

Week 1: Getting Started

When you first start taking Tadalafil, it begins working quickly to block phosphodiesterase-5 (PDE5), an enzyme that regulates blood flow. By inhibiting PDE5, the medicine enables increased blood circulation into the penis. For most men, a single dose starts improving their erection ability within 30 to 60 minutes.

If you don’t notice effects immediately after the first pill, there’s no need for concern. Tadalafil generally starts working within 30 to 60 minutes, but individual experiences can vary. It’s important to remember that these variations are normal, and you’re not alone in this experience.

It’s also common to temporarily experience mild headaches, muscle aches, indigestion, or dizziness in the first 1-2 weeks. These are harmless and fade as your body adjusts. If any side effects are worrying you or persist for more than a few days, please don’t hesitate to reach out to your doctor. Your comfort and well-being are paramount, and your doctor is there to support you.

Weeks 2-4: Finding Your Dose

In the second, third and fourth weeks, Tadalafil’s positive effects become more pronounced while side effects typically decrease. Most men notice a steady improvement in erection firmness and ability to engage in sexual activities.

During this period, pay attention to how a single dose of the prescribed amount impacts your erectile function. If a dose lasts less than the typical 36 hours, consult your doctor about increasing milligrams per dose. Do not increase pills or frequency without medical guidance.

Your doctor may also recommend trying Tadalafil daily rather than “as needed.” Taking it every 24 hours maintains constant therapeutic levels, which can further improve erectile responsiveness over time. But this depends on your specific health status.

Tadalafil Side Effects and Safety

Common Side Effects in the First Month

When first taking Tadalafil, some men experience minor temporary side effects as their body adjusts, which tend to resolve within 1-4 weeks. However, remember that everyone is different, and this time frame might not be accurate for some men. Headaches, back pain, muscle aches, indigestion, nasal congestion, and dizziness are the most commonly reported effects among patients starting treatment for erectile dysfunction with this medicine.

So, while frustrating initially, giving your system time to acclimate often diminishes discomfort rapidly. However, if side effects do continue or interfere with your lifestyle, promptly contact your doctor. Report any unusual symptoms right away as well, including chest pain following sexual activity or sudden vision changes, which could indicate rare issues needing attention. Clear communication ensures tadalafil remains a safe and effective erectile dysfunction solution.

Managing Side Effects

While most Tadalafil side effects go away on their own within 1-4 weeks for most patients, you can try things at home to feel better:

  • Drink plenty of water to help with headaches, muscle pains, or back aches. Staying hydrated is key.
  • Take over-the-counter antacids like Rennie if you have indigestion or stomach upset. These help.
  • If stuffy nose or sinus issues occur, use a saline nasal spray or an antihistamine (medicine often used to relieve allergy symptoms).
  • For muscle soreness, apply heating pads or creams to make it feel better.

Be sure to follow dosage directions on any over-the-counter meds you take. Check with your pharmacist if you are unsure whether something is safe for you.

Let your doctor know if annoying side effects haven’t gone away after trying home remedies for up to 4 weeks. A different medicine might work better long-term.

Dosage and Administration Guidelines

Recommended Starting Dosage

When prescribed Tadalafil for erectile dysfunction, most men start on a standard dose of 10 mg, taken as one pill about 30 minutes before anticipated sexual activity. Starting with 10 mg allows your doctor to assess effectiveness and adjust your personal dosage up or down accordingly after some trial and error. Never adjust how much or how often you take any medication without medical supervision.

The most common standard prescription for Tadalafil is based on 10 mg pills because research repeatedly confirms solid results for ED with this baseline amount. However, if you’re experiencing severe ED, your doctor might prescribe you a 20mg dose.

Some health care professionals move new patients to a higher 20 mg dose sooner if 10 mg alone doesn’t adequately treat ED symptoms after several tries. On the other hand, elderly patients or those with additional health conditions might be advised to start with only 5 mg doses. The proper individual prescription provides peak effects while minimising side effects. Stay in close contact with your provider during the first month to collaborate on any necessary adjustments.

Lifestyle and Tadalafil

Leading a healthy lifestyle can help tadalafil work better to improve erections. Here are some tips:

  • Get regular exercise. Staying active by walking briskly for 30+ minutes per day increases blood flow. This complements what tadalafil does.
  • Eat nutritious meals heavy in veggies, with lean protein and whole grains. A balanced diet fuels good circulation. Limit salty, sugary and fried foods, which can interfere.
  • Don’t smoke or vape. Tobacco narrows already compromised blood vessels, reducing tadalafil’s effectiveness. Talk to your doctor about quitting.
  • Limit alcohol to 1 drink per day maximum when taking tadalafil. Drinking too much can make this ED medicine not work as well.

Making positive lifestyle adjustments enhances results for those taking tadalafil for erection challenges. But always follow your doctor’s individualised guidance based on your health status.

Changing Your Treatment Plan If Needed

If, after four weeks of daily tadalafil treatment, your erectile dysfunction does not improve, promptly consult your doctor about adjusting medications or dosages. Self-adjusting is unsafe.

Based on your symptom evaluation surveys and other feedback, your doctor may:

  • Increase Tadalafil dosage to 20mg pills if the standard 10mg daily dose seems ineffective at firming erections. Higher amounts sometimes help when lower doses fail for erectile dysfunction.
  • Switch prescriptions to alternative erectile dysfunction medicines like Sildenafil (Viagra) or Vardenafil (Levitra), which are better suited to your medical conditions and body chemistry.
  • Combine Tadalafil with added therapies such as penile injection treatment or sexual counselling to boost erection results further via multiple medical or psychological approaches.
  • Halt Tadalafil entirely due to side effects, lacking positive response, or other risks a blood test identifies.

Staying in frequent contact with your physician determines the next best steps if your current Tadalafil plan fails to ease erectile challenges after an initial trial period. Be proactive in seeking modifications if erection function progress stalls after 4-6 weeks and you see little meaningful improvement. Various erectile dysfunction solutions exist to find one effective for you.

Take the Next Step With The Independent Pharmacy

Don’t just passively undergo erectile dysfunction treatment - actively participate in your journey instead. At The Independent Pharmacy, we urge men to inform themselves, speak up with doctors, and explore personalised solutions.

Start by taking our private online questionnaire covering ED symptoms, history, lifestyle, emotional state and goals. Then, our team will get back to you with the best medical treatment suggestions.

Our experts provide personalised advice on accredited medicines, realistic outcome expectations, side-effect coping methods and supplemental well-being tactics.

Whether recently diagnosed or struggling with treatment progress, know that expanding knowledge and inputs drives progress. Ask questions, track effectiveness metrics, and request modifications if not advancing. With reliable resources and self-advocacy, ED often improves dramatically. Don’t neglect the power of shared decisions with your care team.

So, get in touch with our team today.


Does tadalafil keep you hard after coming?

Maybe. Some men find taking Tadalafil allows getting another erection after already ejaculating once. However, being able to have multiple sessions varies a lot from patient to patient based on health and dose factors. Talk to your partner about realistic expectations.

When is the peak effect of Tadalafil?

Peak effects start about 2 hours after swallowing the pill as directed on an empty stomach. Pay attention to when positive impacts feel strongest and how long they last before fading. This helps decide if your dosage needs adjustment.

Does tadalafil increase arousal?

No. Tadalafil mainly improves blood flow to enable harder erections when aroused. But having reliable erections again often restores desire and confidence indirectly. If Tadalafil fails to adequately help after a fair trial, discuss additional options for treatment of erectile dysfunction with your doctor.

Why am I not getting hard on Cialis?

Reasons could include bad interactions with other medications or supplements, high anxiety interfering, or an ineffective dose amount unsuited to your body. If you’ve given tadalafil a fair try over several weeks and it’s not working as expected, please don’t feel discouraged. Your doctor is there to help and can work with you to find a more suitable solution.


About tadalafil - NHS (

Side effects of tadalafil - NHS (

Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence - PMC (

Need something else?

We stock 1058 treatments for 90 conditions

Or browse all treatments or conditions

A customer at the pharmacist looking for medication