FDA-approved generic · as-needed or daily tablet · prescription only
For erectile function. Taken as needed, one tablet covers a window of up to 36 hours; taken daily at a low dose, it keeps you ready without watching the clock — and eases the urinary symptoms of an enlarged prostate. 1 A licensed U.S. clinician reviews your history, confirms the regimen with you, and prescribes only when it's appropriate.
About eight minutes. A clinician reviews every answer, and your card is only charged if a prescription is issued.
one tablet · a window of up to 36 hoursFDA-approved generic · prescription only
Window
one tablet, a window of up to 36 hours
Daily option
a low dose every day — nothing to time
Terms
everything disclosed before you pay
About Tadalafil
What tadalafil does, and what to expect.
What it does
Tadalafil is a PDE5 inhibitor. With sexual stimulation, it relaxes the blood vessels in the penis so blood flows in more easily and an erection is easier to get and keep. 1 It works with arousal, not instead of it — it does not create desire.
How it's taken
As needed: one tablet before sex, with or without food, and a window of up to 36 hours — so there is no second dose to time. 1 Daily: one low-dose tablet at about the same time each day, so you are ready whenever the moment is; the same daily dose treats the urinary symptoms of an enlarged prostate. 1 Your clinician confirms the regimen with you.
What to expect
It works only with sexual stimulation. If a dose is not enough, or bothers you, your clinician adjusts it — you never have to guess. 1 The most common effects are headache, indigestion, back or muscle ache, a stuffy nose and flushing, usually mild; back ache tends to arrive 12 to 24 hours after a dose and pass within two days. 1 Never combine it with nitrate medicines. 1
The facts on this page come from the FDA prescribing information for tadalafil and from clinical guidelines. The sources are listed at the foot of the page.
The regimen
Two ways to take it. Your clinician confirms which.
Same FDA-approved generic tablet, prescribed two ways. Which one fits is a question about your week, not your body — and your clinician settles it with you.
As-needed
One tablet before sex, with or without food, and a window of up to 36 hours. 1 For men who like to plan an evening — or a weekend — and want nothing to think about in between.
Daily, low dose
One tablet at about the same time each day, so you are ready any day with nothing to time. 1 If you also have urinary symptoms of an enlarged prostate, the same daily dose treats those — one prescription, both jobs. 1
A rough guide: if it's a couple of times a week or more, or you'd rather not plan, daily usually fits. If it's occasional and you can see it coming, as-needed usually fits.
Started on one and want the other? Say so at your next check-in. Your clinician can change the prescription, and your plan and price change with it — with notice before your next billing.
Most men have tried something before they get here. Here is what each route leaves out — and what a prescription calibrated by a clinician adds.
What you may have tried
Why it stalls
Calibrated prescription care
What you may have tried
Gas-station pills and "male enhancement" supplements
Why it stalls
No approved active ingredient, no dose control — and the FDA keeps finding undeclared prescription drugs hidden in them. 3
Calibrated prescription care
FDA-approved generic tadalafil at a known dose, dispensed by a licensed U.S. pharmacy. The label says exactly what is in the bottle.
What you may have tried
A website that skips the prescription
Why it stalls
No one checked your heart, your blood pressure or your other medicines, and there is no way to know what is actually in the tablets. 4
Calibrated prescription care
A licensed clinician reads your history first. Nitrate medicines, some heart conditions and some prostate drugs change what is safe — that is the whole point of the intake.
What you may have tried
Waiting it out, or waiting for an appointment
Why it stalls
Erectile difficulty is common — about half of men between 40 and 70 report some degree of it — and putting it off treats nothing. 5 The urology visit takes weeks; the pharmacy counter takes nerve.
Calibrated prescription care
An eight-minute intake, a clinician's decision, and a plain box at your door. Nothing to say out loud to anyone.
What you may have tried
A one-size telehealth script
Why it stalls
A fixed dose in a fixed box, renewed on schedule, with no one to tell when it isn't working — or when the side effects are.
Calibrated prescription care
Your dose and regimen are your clinician's call, adjusted to your response at each check-in, with notice before anything changes and the price published before you pay.
How care works
Medicine, measured.
Results are personal, so treatment shouldn't be one-size. Here is the whole process, plainly.
01
An intake worth reading
About eight minutes of real questions — heart and blood-pressure history, every medicine you take, how things have been. It is the basis of every decision that follows.
02
A clinician decides
A licensed U.S. clinician reviews your answers and decides whether tadalafil is appropriate for you — and which regimen. Sometimes the answer is no. You'll hear it straight.
03
Prepared and delivered
If prescribed, a licensed U.S. pharmacy fills it and ships it in a plain box. Your card is only charged once the prescription is issued.
04
Calibrated over time
If a dose is not enough, or bothers you, your clinician adjusts it or changes the regimen — with notice before anything changes, and the option to hold where clinically appropriate.
Plans & pricing
Straight terms, before you pay.
Every plan includes the clinician's evaluation, shipping and follow-up. Two regimens, two prices — each shown in full, with what renews and when.
As-needed
For men who plan ahead — one tablet before, and a window of up to 36 hours with nothing to think about in between.
20 mg · monthly supply
Tadalafil 20mg
$79/ per month
renews at $79 per month · cancel anytime
One tablet before — a window of up to 36 hours
Nothing to time in between: plan an evening, or a weekend
FDA-approved generic tadalafil, as-needed tablet
Prescribed only when a licensed clinician confirms it's appropriate
Dispensed by a licensed U.S. pharmacy, shipped in a plain box
Cancel anytime — every term disclosed before you pay
20 mg · 3-month supply
Tadalafil 20mg
$219/ every 3 months
renews at $219 every 3 months · cancel anytime
One tablet before — a window of up to 36 hours
Nothing to time in between: plan an evening, or a weekend
FDA-approved generic tadalafil, as-needed tablet
Prescribed only when a licensed clinician confirms it's appropriate
Dispensed by a licensed U.S. pharmacy, shipped in a plain box
Cancel anytime — every term disclosed before you pay
Daily, low dose
For men who want to be ready any day — one low-dose tablet at the same time each day, nothing to time. Also treats the urinary symptoms of an enlarged prostate.
5 mg daily · monthly supply
Tadalafil 5mg
$99/ per month
renews at $99 per month · cancel anytime
One low-dose tablet a day — ready any day, nothing to time
Also treats the urinary symptoms of an enlarged prostate
FDA-approved generic tadalafil, daily tablet
Prescribed only when a licensed clinician confirms it's appropriate
Dispensed by a licensed U.S. pharmacy, shipped in a plain box
Cancel anytime — every term disclosed before you pay
5 mg daily · 3-month supply
Tadalafil 5mg
$269/ every 3 months
renews at $269 every 3 months · cancel anytime
One low-dose tablet a day — ready any day, nothing to time
Also treats the urinary symptoms of an enlarged prostate
FDA-approved generic tadalafil, daily tablet
Prescribed only when a licensed clinician confirms it's appropriate
Dispensed by a licensed U.S. pharmacy, shipped in a plain box
Cancel anytime — every term disclosed before you pay
Your price follows the prescription you're on. If your clinician changes your regimen or dose, your plan and price change with it — with notice before your next billing and the option to hold where clinically appropriate. Cancel anytime before your next billing date, from your account or by email. HSA/FSA cards accepted on eligible plans.
Eligibility
See if it's appropriate. That's the consult.
Tadalafil is prescribed to adults with erectile dysfunction when a licensed clinician confirms it fits your health and your other medicines. If you also have urinary symptoms of an enlarged prostate, say so in the intake — the daily regimen treats those too.
You may qualify if
You're an adult aged 18 or over
You have difficulty getting or keeping an erection — occasionally or often
A clinician confirms it fits your health profile and your other medicines
May not be suitable if
You take nitrate medicines (for chest pain), including "poppers", or a guanylate-cyclase stimulator such as riociguat
You have significant, uncontrolled heart or blood-pressure conditions, or have been told not to have sex for cardiac reasons
You have severe liver or kidney impairment
You have lost vision from NAION (a form of optic-nerve damage)
This is not an exhaustive list. Your clinician reviews your full history — and can say no. That is what the consult is for.
Before anything is prescribed
What the intake asks, and why.
Every question is there because it changes what is safe to prescribe. A licensed clinician reads every answer.
Heart and blood pressure — Tadalafil lowers blood pressure a little. Some heart conditions, and some blood-pressure medicines, make that unsafe. 1
Every medicine you take — Nitrate medicines are never combined with it. Alpha-blockers for the prostate and some antifungal or HIV medicines change what dose is safe. 1
Eyes, ears, liver, kidneys — Rare effects and dose limits depend on them. Answer fully — it is the difference between a safe prescription and a guess. 1
Every clinician who prescribes through LevelDose is licensed in the state where you are. The roster and licence numbers are public on our Providers page.
See the providers
Safety & honesty
The effects, the rare ones, and what to do.
Most men take tadalafil without trouble. Here is what the FDA label says to expect, and the few things that should never wait. 1
Common, usually mild, usually passing
Headache — the most common effect; usually mild
Indigestion — heartburn or an upset stomach
Back ache or muscle ache — tends to arrive 12 to 24 hours after a dose and pass within two days; on the daily regimen, tell your clinician if it lingers
Stuffy nose, flushing — brief, and more noticeable with alcohol
Do not wait on these
An erection lasting longer than four hours — seek urgent medical care — untreated, it can cause lasting damage
Sudden loss or change of vision — stop taking it and seek care
Sudden loss or change of hearing, ringing, dizziness — stop taking it and seek care
Chest pain, faintness or a racing heart during sex — stop, and seek care
Not prescribed if
You take nitrate medicines in any form, including "poppers"
You take a guanylate-cyclase stimulator such as riociguat
Your clinician finds a heart condition, or a level of liver or kidney impairment, that makes it unsafe
Medicines that need care
Alpha-blockers for the prostate, and blood-pressure medicines — together they can lower blood pressure too far; your clinician sets the dose with that in mind
Some antifungal and HIV medicines — they raise tadalafil levels in the blood, so the safe dose is lower
Alcohol — a drink or two is fine for most men; heavy drinking with tadalafil can cause dizziness and faintness
What it is for
Erectile dysfunction, and on the daily regimen the urinary symptoms of an enlarged prostate. It is not a treatment for low desire, and it does not protect against sexually transmitted infections. 1
Results vary. No outcome is guaranteed — your clinician will discuss what's realistic for you.
Effects and warnings above are from the FDA prescribing information for tadalafil. Incidence figures for the common effects are in source 1.
After you're prescribed
What arrives, and the first week.
The part nobody explains: what shows up, what the first dose is like, and when to message your clinician.
01
The first dose
As needed: take it before you expect to need it, with or without food, and give it time — its window is long, so there is no second dose to time. 1 Daily: the same time each day; it reaches a steady level in about five days. 1 Either way, it works with arousal, not instead of it.
02
The first week
Judge it over several attempts, not one — how it is taken is the usual reason a first dose disappoints. 8 Note what worked and what didn't — timing, food, alcohol — and bring that to your check-in. Mild headache, indigestion, back ache or a stuffy nose usually pass on their own. 1
03
When to message
If it isn't enough, or a side effect lingers, tell your clinician — the dose or the regimen can change. 1 An erection that lasts longer than four hours, or any sudden change in vision or hearing, needs urgent medical care; do not wait for a message back. 1
What arrives
The box
Plain, with only your name and address on it. Nothing on the outside says what is inside.
The bottle
Your tablets in the pharmacy's own labelled bottle. The label names the licensed U.S. pharmacy that filled it.
Your plan, in writing
What was prescribed, how to take it, and when your plan renews.
Tadalafil is an FDA-approved generic medication, dispensed by a licensed U.S. pharmacy when prescribed. It is not habit-forming, and it does not work without sexual stimulation. 1
FDA-approved generic, filled by a licensed U.S. pharmacy named on your label
Questions, answered plainly
Questions about tadalafil
As-needed or daily — which should I choose?
As-needed suits men who can see it coming: one tablet before, and a window of up to 36 hours. Daily suits men who would rather not plan, or who want it a couple of times a week or more — one low-dose tablet a day, nothing to time. Daily is also the regimen that treats urinary symptoms of an enlarged prostate. Your clinician confirms the regimen with you, and you can switch later. 1
What happens if it doesn't work the first time?
A dose that misses is often a matter of timing, food, or too few tries — not the verdict; the guidelines say incorrect use and too little information are the main reasons these tablets seem not to work. 8 Give it a fair trial: several attempts, with arousal, following the timing your clinician gave you. If it still isn't enough, message your care team — your clinician can adjust the dose or change the regimen, so you are never left to guess. 1
Will it work if the problem is stress or nerves?
It can. Clinical guidelines recommend PDE5 inhibitors as the first-line treatment for erectile dysfunction, and they do not limit that to physical causes; tadalafil works with arousal. 28 If anxiety or a new relationship is the main driver, say so in the intake — the same guidelines recommend addressing that alongside the medication, and your clinician can point you to it.
Can I drink alcohol with it?
In moderation, yes. Heavy drinking with tadalafil can drop your blood pressure — dizziness, a racing heart, light-headedness on standing — so keep it to a drink or two. 1
Can I take it with my other medications?
Never with nitrate medicines for chest pain, and never with "poppers". Alpha-blockers and some blood-pressure medicines need care, and some antifungal or HIV medicines lower the dose that is safe. List everything you take in the intake — your clinician checks each one before prescribing. 1
How is tadalafil different from sildenafil?
Both are FDA-approved generic PDE5 inhibitors and both need arousal to work. Sildenafil is taken about an hour before, is slowed by a heavy meal, and lasts around four hours. Tadalafil can be taken with or without food, its window is up to 36 hours, and it has a daily option. 16 Your clinician helps you choose; sildenafil has its own page.
Who fills my prescription, and what will the bottle say?
A licensed U.S. pharmacy fills your prescription, and its name is on the label — that is how you can check it. The outer box carries only your name and address. Your card statement shows LEVELDOSE.COM, not the medication.
What if I want to stop, pause or switch?
Cancel anytime before your next billing date, from your account or by email; we confirm every cancellation in writing. Switching between as-needed and daily is a message to your clinician: your plan and price change with the prescription, with notice before you are billed.
Is this really tadalafil?
Yes. A licensed U.S. pharmacy fills your prescription for tadalafil tablets at the strength your clinician prescribed, and the pharmacy's name and the medication are on the label — that is how you check it. Nothing is dispensed until a licensed clinician has prescribed it for you, and your plan in writing states exactly what was prescribed.
How does the telemedicine process work?
You complete an online intake, a licensed provider reviews your case, and if appropriate your treatment plan is prescribed and delivered directly to your door.
Do I need to visit a doctor in person?
No. All consultations, prescriptions, and follow-ups are handled 100% online through our secure telehealth platform.
Are the doctors licensed?
Yes. Every provider in our network is licensed and experienced in evaluating patients through compliant telemedicine workflows.
Is my personal information secure?
Your information is protected through secure systems and privacy-first processes designed to support HIPAA-aligned care delivery.
How is my medication delivered?
Approved medications are shipped discreetly to your home, with updates and follow-up support handled online for convenience.
Sources
What this page is based on.
8 sourcesshowhide
Every factual line above carries a number. These are the sources.
U.S. Food and Drug Administration. Tadalafil tablets — prescribing information for the FDA-approved reference product: indications, dosage and administration, contraindications, warnings and precautions, adverse reactions, clinical pharmacology. dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=tadalafil
American Urological Association. Erectile Dysfunction: AUA Guideline (2018), statements 6, 8 and 9: men with erectile dysfunction should be informed of the option of an FDA-approved PDE5 inhibitor unless contraindicated; instructions to maximise benefit; mental-health support where anxiety contributes. auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Journal of Urology, 1994 — about half of men aged 40 to 70 reported some degree of erectile dysfunction. pubmed.ncbi.nlm.nih.gov/8254833/
European Association of Urology. Guidelines on Sexual and Reproductive Health, pocket edition (2025): PDE5 inhibitors as first-line therapy for erectile dysfunction; incorrect use and inadequate information as the main causes of a lack of response; psychological approaches combined with medical treatment. d56bochluxqnz.cloudfront.net/documents/EAU-Pocket-on-Sexual-Reproductive-Health-2025.pdf
The right level. The right dose. For you.
Start the intake — a licensed
clinician will take it from there.
Eligibility screening and a prescription are required for prescription
treatments. Individual results vary and no specific outcome is guaranteed. A licensed clinician
determines whether treatment is appropriate — treatment is not guaranteed.
Tadalafil is an FDA-approved generic medication, dispensed by a licensed
U.S. pharmacy when prescribed.
