Tadalafil 10mg and 20mg: On-Demand Treatment Overview

Tadalafil 10mg and 20mg represent the standard on-demand treatment approach for erectile dysfunction. Unlike daily low-dose regimens, these higher strengths are taken before anticipated sexual activity. This guide explains how doctors prescribe on-demand tadalafil and what this treatment approach involves.

Understanding On-Demand Tadalafil

On-demand treatment means taking medication only when needed, rather than daily. For tadalafil, this typically involves:

Taking a tablet before anticipated sexual activity
Using the medication intermittently rather than continuously
Relying on tadalafil’s long duration of action (up to 36 hours)
Adjusting frequency based on individual needs and sexual activity patterns

Tadalafil 10mg: The Standard Starting Dose

Why Doctors Often Start with 10mg

Most prescribers begin on-demand tadalafil treatment with 10mg because:

It provides effective treatment for many men
It allows assessment of individual response
It minimises potential side effects compared to higher doses
It can be adjusted up or down based on effectiveness and tolerability
Clinical guidelines often recommend starting at this level

Who Might Use 10mg

Tadalafil 10mg is commonly prescribed for:

Men trying on-demand ED treatment for the first time
Those who haven’t responded to lower daily doses
Individuals with moderate ED symptoms
People who prefer taking medication intermittently
Those without significant health complications

Effectiveness of 10mg

Clinical studies indicate that 10mg tadalafil:

Improves erectile function for a significant proportion of men with ED
Begins working within 30-60 minutes for most users
Maintains effectiveness for up to 36 hours
Works across different age groups and ED severities

Individual response varies, and some men may require dose adjustment.

Tadalafil 20mg: The Higher Strength Option

When Doctors Prescribe 20mg

Prescribers may recommend 20mg when:

10mg proves insufficient after adequate trial
More severe ED requires higher doses
Individual metabolism requires larger amounts for effectiveness
Previous successful use at this dose has been established
No problematic side effects occurred at 10mg

The maximum recommended dose for on-demand use is 20mg in a 24-hour period.

Not a First-Line Choice

Doctors typically don’t start treatment with 20mg unless:

The patient successfully used this dose previously
Particular medical circumstances warrant it
Lower doses have demonstrably failed

Starting with a lower dose and adjusting upward allows better assessment of the minimum effective dose.

Effectiveness and Considerations

Tadalafil 20mg:

Provides maximum strength for on-demand treatment
Increases likelihood of effectiveness for those who didn’t respond to 10mg
May produce more noticeable side effects than lower doses
Costs more per dose in most UK outlets
Requires the same timing considerations as 10mg

Timing On-Demand Tadalafil

When to Take the Medication

General timing principles include:

Take at least 30 minutes before anticipated sexual activity
Effects may begin as early as 16 minutes for some individuals
Maximum effect typically occurs after 2 hours
Planning ahead by 1-2 hours often works well
Can be taken with or without food

Individual variation means optimal timing differs between users. Some men find taking tadalafil the evening before morning sexual activity works well, utilising its long duration.

Duration of Effect

Both 10mg and 20mg tadalafil can remain effective for up to 36 hours, though:

Individual duration varies
Effectiveness may diminish towards the end of this period
Multiple erections are possible within the effective window
One dose only - don’t take another dose within 24 hours

For more detailed information about duration, see our guide on tadalafil dosage and how long it lasts.

Comparing 10mg vs 20mg

Effectiveness

Studies show:

Both doses are effective for most men with ED
20mg provides slightly higher success rates overall
Individual response varies more than average dose comparisons suggest
Some men respond excellently to 10mg; others need 20mg

Side Effects

Higher doses generally mean:

Increased likelihood of side effects
More noticeable effects when they occur
But many men tolerate 20mg without problems

Common side effects at both doses include headache, indigestion, back pain, and nasal congestion.

Cost

20mg tablets typically cost more per dose than 10mg
Generic versions of both are less expensive than branded Cialis
Splitting 20mg tablets (if prescribed and appropriate) is sometimes done but should only be upon medical advice

For current UK pricing, see our tadalafil prices guide.

On-Demand vs Daily Treatment

Why Choose On-Demand

The on-demand approach suits people who:

Have sexual activity less than twice weekly
Prefer not taking daily medication
Want to minimise overall medication exposure
Don’t mind planning around medication timing
Respond well to higher doses

When Daily Might Be Better

Doctors might suggest daily low-dose tadalafil for those who:

Have frequent sexual activity (more than twice weekly)
Value spontaneity highly
Experience side effects from higher doses
Also have BPH symptoms
Prefer routine medication-taking

For information about the daily approach, see our guide on tadalafil 5mg daily treatment.

Medical Assessment for On-Demand Tadalafil

Before Prescribing

Doctors will typically:

Take comprehensive medical history
Review all current medications (including over-the-counter products and supplements)
Assess cardiovascular health
Discuss sexual history and ED symptoms
Evaluate kidney and liver function if relevant
Consider psychological factors
Set realistic expectations

Cardiovascular Considerations

Particular attention goes to heart health because:

Sexual activity itself represents physical exertion
Tadalafil affects blood pressure
Some heart medications (especially nitrates) interact dangerously with tadalafil
Certain cardiovascular conditions may make ED treatment risky

Only a qualified healthcare professional can assess these risks appropriately.

Drug Interactions

Tadalafil can interact with:

Nitrates (used for angina) - dangerous interaction, absolutely contraindicated
Alpha-blockers (used for blood pressure and prostate problems) - blood pressure can drop excessively
Some antibiotics and antifungals
HIV medications
Other ED medications

Always inform prescribers of all medications, including those bought without prescription.

Using On-Demand Tadalafil Safely

Important Safety Rules

Never take more than one dose in 24 hours
Don’t combine with other ED medications
Avoid with nitrates or recreational drugs containing nitrates (poppers)
Limit alcohol consumption when using tadalafil
Store medication properly
Don’t share medication with others
Purchase only from legitimate UK pharmacies

When to Seek Urgent Medical Attention

Contact emergency services if you experience:

Erection lasting more than 4 hours (priapism)
Sudden vision loss
Sudden hearing loss
Chest pain during or after sexual activity
Severe allergic reaction

Adjusting Your Dose

When Adjustment Might Be Needed

Doctors may modify dosing if:

Initial dose proves insufficient
Side effects are problematic
Health status changes
New medications are started
Kidney or liver function changes

Never Self-Adjust

Only change tadalafil dosing under medical supervision. Taking more than prescribed can be dangerous, while taking less might mean inadequate treatment.

Lifestyle Factors and On-Demand Tadalafil

Alcohol

Moderate alcohol intake is generally acceptable
Heavy drinking may reduce effectiveness
Alcohol combined with tadalafil can increase risk of dizziness and low blood pressure
Some men find limiting alcohol improves results

For more information, see our guide on tadalafil, alcohol and blood pressure.

Food

Tadalafil can be taken with or without food
Heavy, fatty meals might slightly delay absorption
This effect is less pronounced than with some other ED medications

Exercise and Health

Regular exercise may improve ED
Maintaining healthy weight supports treatment effectiveness
Managing stress and sleep quality can help
Smoking cessation often improves response

Frequently Asked Questions

Can I take 10mg and 20mg on different occasions?

Your doctor may prescribe flexibility to adjust between these doses based on circumstances, but this should be explicitly discussed and approved. Don’t switch doses without medical guidance.

How quickly does tadalafil 10mg or 20mg work?

Effects typically begin within 30-60 minutes, though some men notice changes as early as 16 minutes. Maximum effect usually occurs around 2 hours after taking the tablet. Individual timing varies.

Can I split a 20mg tablet to get two 10mg doses?

Only if your doctor specifically instructs this and the tablets are scored for splitting. Many tadalafil tablets are film-coated and shouldn’t be split. Doing so without medical approval may affect dosing accuracy and medication stability.

What if 20mg doesn’t work for me?

If 20mg proves insufficient despite proper use and adequate trial, your doctor will reassess. They may investigate underlying causes more thoroughly, consider whether psychological factors are involved, or suggest alternative treatments. Simply increasing above 20mg isn’t recommended.

Is tadalafil 20mg safe for older men?

Age alone doesn’t preclude tadalafil use, but older men often have health conditions or take medications that require careful assessment. Doctors may start with lower doses in older patients and monitor more closely. Individual health status matters more than age itself.

Can I take tadalafil every day even though I have the 10mg or 20mg tablets?

The 10mg and 20mg doses are intended for on-demand use, not daily administration. If you’re taking medication every day, discuss with your doctor whether a daily low-dose regimen (2.5mg or 5mg) might be more appropriate.

For additional context about tadalafil treatment:

Tadalafil Dosage and How Long It Lasts - Comprehensive dosing guide
How Does Tadalafil Work? - Mechanism of action
Tadalafil Side Effects - Safety information
Tadalafil vs Sildenafil - Comparing ED medications