Generic Cialis (Tadalafil, PDE5 Inhibitor)

  • Published: March 14, 2025
  • By Pete Thomson
  • American Medical Student Association
  • Email: pr@amsascorecard.org
  • Phone: 703-665-4786

Key points to understand:

  • Tadalafil is a strong, long-acting drug used to relieve erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) symptoms by improving circulation and relaxing muscles in the prostate and bladder.
  • Data from the Cleveland Clinic indicates that approximately 52% of men will experience some degree of erectile dysfunction at some point in their lives. The prevalence increases with age, leading many to seek treatment options.
  • Unlike short-acting ED drugs, tadalafil lasts up to 36 hours, offering greater flexibility and reducing the need for precise timing.
  • Generic Cialis retains the same properties and effectiveness as the brand-name drug but allows you to reduce costs by 60-85% when purchasing in the USA.
  • A study in the Journal of Sexual Medicine found that Tadalafil is particularly effective for men with diabetes-related erectile dysfunction, delivering better results than other ED treatments.
  • Cheap Tadalafil can be legitimately available for purchase through online services – low prices don’t always mean counterfeit products. Just stay cautious and verify the credibility of the source before making a purchase.

We’ll break down the essential details on where to purchase it, both online and in stores, and discuss whether setting up a recurring order could be a smart choice for convenience and cost savings.

What Are The Main Differences Between Tadalafil and Brand Name Drug?

The differences between them go beyond just branding and price. Manufacturing processes, inactive ingredients, regulatory oversight, and even patient perception play a role in determining which option may be more suitable.

Regulatory Approval and Bioequivalence

The FDA requires that generic drugs demonstrate bioequivalence to the brand-name version. This means that tadalafil must match Cialis in dosage form, strength, route of administration, and performance in the body. In clinical testing, generic tadalafil must achieve at least 80% to 125% of the brand drug’s absorption rate (AUC and Cmax), ensuring similar efficacy and safety. However, even within this approved range, minor differences in how the body processes the medication can exist, though they are generally not clinically significant for most users.

Manufacturing and Quality Control

Cialis is manufactured exclusively by Eli Lilly, which maintains tight control over production, sourcing of ingredients, and distribution. In contrast, generic tadalafil is produced by multiple pharmaceutical companies worldwide. While all must adhere to FDA regulations, differences in manufacturing facilities, quality control protocols, and sourcing of inactive ingredients can lead to slight variations in tablet composition, dissolution rate, and shelf stability. In the USA, Teva Pharmaceuticals, Aurobindo Pharma, and Camber Pharmaceuticals are among the FDA-approved manufacturers of generic Tadalafil. These companies must pass stringent Current Good Manufacturing Practices (cGMP) inspections, but variability in excipients (inactive ingredients), coatings, and binding agents can result in some users reporting a different experience between brand and generic versions.

Differences in Inactive Ingredients

While the active ingredient is identical, inactive ingredients vary between brand and generic version. These include fillers, binders, coatings, and preservatives, which do not affect efficacy but may influence:

  • Absorption rate – Some generics may dissolve slightly faster or slower than Cialis.
  • Tolerance – Sensitive individuals may react differently to certain fillers.
  • Shelf life – Variations in preservatives can impact storage stability.

Although uncommon, a small percentage of patients report differences in side effects when switching from Cialis to Tadalafil, often due to variations in these excipients rather than the active ingredient itself.

Packaging, Appearance, and Branding

Brand tablets are distinct in their yellow, almond-shaped design with clear imprinting. Generics, however, come in various shapes, colors, and packaging styles, depending on the manufacturer. This can sometimes lead to patient confusion or concerns about authenticity, particularly when switching between different generic brands.

How Much Does Tadalafil Cost?

Tadalafil_tabletThe primary reason patients switch to Tadalafil is cost. Once Cialis’ patent exclusivity expired in 2018, multiple generics entered the market, drastically reducing prices. The cost of generic version varies depending on dosage, pharmacy, and insurance coverage. Without insurance, prices typically range from $8 to $42 per pill, but actual costs depend on where it is purchased. According to SingleCare, Tadalafil prices start at $8.71 per pill, while Blink Health lists options between $9 and $34.

For those with insurance, out-of-pocket costs are determined by copay structures, formulary tiers, and coverage policies. Some insurers apply a flat copay regardless of dosage, while others adjust costs based on strength and frequency of use. Patients prescribed daily Tadalafil (2.5mg or 5mg) may have a different cost structure compared to those taking as-needed doses (10mg or 20mg).

Pharmacy pricing also varies, making price comparison essential. Many patients lower costs by using discount cards, manufacturer coupons, or online savings programs from providers such as WellRx, ScriptSave, or GoodRx. In some cases, larger quantities or 90-day supplies offer better per-pill pricing. Checking multiple sources, including local and online pharmacies, can help secure the most cheaper option.

Which Companies Manufacture Generic Tadalafil in the USA and Canada?

  • Several pharmaceutical companies produce generic versions of this medication in the United States and Canada. In the USA, manufacturers include Teva Pharmaceuticals, Aurobindo Pharma, Cipla, Dr. Reddy’s Laboratories, and Lupin Limited, all of which have received FDA approval for their formulations. These companies operate under strict cGMP (Current Good Manufacturing Practice) regulations, ensuring product consistency and quality.
  • In Canada, Pharmaris and Auro Pharma are among the primary producers. Generic medications in Canada must comply with Health Canada’s Therapeutic Products Directorate (TPD) standards, ensuring they meet bioequivalence requirements relative to the original formulation.

Though the active ingredient remains the same, inactive components such as binders, fillers, and coatings may vary between manufacturers, potentially affecting dissolution rates, absorption speed, and tolerability for some users.

Is the Generic Version More Effective Than the Brand?

According to FDA regulations, generics must match the brand in dosage, strength, and absorption rate. The active ingredient is delivered into the bloodstream at nearly the same rate, ensuring comparable effects. However, bioequivalence standards allow for a 10-15% variation in absorption, which is considered clinically insignificant but may contribute to minor differences in onset or duration for some users.

Why Do Some Patients Report Differences?

  1. Inactive Ingredients. The original is produced by a single manufacturer, ensuring consistent formulation. Generic versions are made by different companies, each using its own binders and fillers. While these do not affect the primary function, they can influence how the tablet dissolves or how well it is tolerated.
  2. Absorption Variability. Some patients notice that the original has a more predictable onset and duration, while the generic may take longer to start working or wear off sooner. This is not due to differences in the active ingredient but rather how excipients affect drug release and metabolism.
  3. Psychological Factors. Brand-name medications often create greater confidence, which can enhance perceived effectiveness. The placebo effect is well-documented in pharmaceuticals and may contribute to the belief that the original performs better, even when clinical studies show no difference.

What Do Clinical Studies Say?

A Journal of Urology study found that over 90% of patients using the generic reported the same improvement in function as those taking the brand. When differences occur, switching between manufacturers of generics often resolves the issue, indicating that variability is due to formulation differences rather than the active compound itself.

Conclusion

In terms of effectiveness, there is virtually no difference. Any variations are typically due to the specific manufacturer of the generic Tadalafil, as the overall composition of the tablet can differ significantly from the brand, potentially affecting its properties. Another factor is the placebo effect, which influences many patients and may not reflect actual performance differences.

Is a Prescription Required?

In the United States, a prescription is mandatory for obtaining this medication, regardless of whether it is the brand-name version or a generic alternative. The FDA classifies it as a prescription-only drug due to its potential interactions with other medications, particularly nitrates and blood pressure treatments, which can lead to serious health risks.

To get a prescription, a licensed healthcare provider must assess whether the medication is safe based on a patient’s medical history, cardiovascular health, and current medications. Many telehealth platforms, such as Sesame, Roman, and GoodRx Care, offer online consultations, allowing patients to obtain a prescription without visiting a doctor’s office.

While some international markets allow over-the-counter sales, most Western countries, including Canada, the UK, and Australia, also require a prescription. In Mexico, it is sometimes available without one, but importing it into the USA without a valid prescription is illegal under FDA regulations.

Some online pharmacies claim to sell it without a prescription, but these sites often operate outside regulatory oversight, increasing the risk of counterfeit or low-quality products. The National Association of Boards of Pharmacy (NABP) warns that many unverified sources sell medications that do not meet USA safety standards.

What Are the Precautions Before First Use?

Before starting a course of Tadalafil, patients should discuss their current medications with a healthcare provider. Certain pharmaceutical drugs, like nitrates used for chest pain or alpha-blockers prescribed for treating high blood pressure, may interact adversely with Tadalafil. Other unsafe drug interactions might include certain antibiotics and antifungals, HIV protease inhibitors, CYP3A4 inhibitors, and the drug called Riociguat, which helps manage pulmonary hypertension.

Another crucial aspect to discuss with the prescribing physician is the patient’s medical history. This step allows the healthcare provider to better understand the patient’s unique needs and individual health limitations and make well-informed decisions regarding the suitability of Tadalafil. The medical conditions in which Tadalafil might be contraindicated or require individual dose adjustment are hypertension, cardiovascular diseases, liver or kidney disorders, and any history of priapism or retinitis pigmentosa.

Is It Safe to Buy This Medication Online?

The market for counterfeit ED medications is massive, and without proper precautions, patients may end up with ineffective or even dangerous products.

Risks of Buying Tadalafil from Unregulated Websites

The FDA and the National Association of Boards of Pharmacy (NABP) report that nearly 95% of online pharmacies selling tadalafil operate illegally or fail to comply with US pharmacy regulations. The biggest risks include:

  • Counterfeit Medications – Unregulated sites often sell fake Tadalafil that may contain incorrect dosages, harmful additives, or completely different active ingredients. Some counterfeits have been found to contain antidepressants, amphetamines, or even paint chemicals.
  • Inconsistent Dosage and Purity – Even if an online pharmacy claims to sell FDA-approved generic Tadalafil, many operate from countries with minimal quality control, leading to doses that are too strong, too weak, or contaminated.
  • Lack of Prescription Requirement – Tadalafil requires a valid prescription, and websites that sell it without one are likely bypassing legal safety measures. Without proper medical screening, users risk dangerous interactions with nitrates, alpha-blockers, or blood pressure medications.
  • Financial and Data Theft – Many rogue pharmacies collect credit card information and personal data to sell or use for fraudulent purposes. If a website does not have secure payment processing, it is a red flag.

How to Safely Choose Tadalafil Online

To avoid these risks, purchase from verified online pharmacies that follow FDA and Health Canada regulations:

  • Check for VIPPS Accreditation – The Verified Internet Pharmacy Practice Sites (VIPPS) program lists legitimate online pharmacies in the USA.
  • Look for a Physical Address and Licensed Pharmacist – A legitimate pharmacy should list a US or Canada-based location and a licensed pharmacist for consultation.
  • Verify the Source – If the price seems too good to be true, it likely is. The average cost of FDA-approved Tadalafil ranges from $1 to $3 per pill, while branded medication remains significantly higher.

How to Reduce the Cost of Tadalafil?

  1. Choose the Generic Over the Brand. I think you understand the point here – it’s simple. Just find the generic version at a more affordable price by comparing offers from different companies and services.
  2. Use Discount Programs and Coupons. Pharmacies frequently mark up cash prices, but prescription discount cards like GoodRx, SingleCare, and WellRx negotiate lower rates. These programs work even without insurance and can cut costs by 50% or more. Prices fluctuate, so checking multiple discount providers before purchasing is essential.
  3. Compare Prices Across Pharmacies. Medication costs vary widely between major chains, independent pharmacies, and online providers. Warehouse clubs like Costco and Sam’s Club often have lower prices, even without a membership. Online tools like ScriptSave WellRx and Blink Health allow patients to compare pharmacy prices in real time, ensuring they pay the lowest possible amount.
  4. Check Insurance and Prescription Assistance Programs. Coverage varies by plan and provider, but many insurers require prior authorization for coverage. Some plans offer tiered pricing, making a generic prescription more affordable than a brand-name option. For those without coverage, manufacturer discount programs and state-run prescription assistance programs can provide significant financial relief.
  5. Explore Telehealth and Online Services. Licensed telemedicine services like Roman, Hims, and Lemonaid Health often provide lower prices than retail pharmacies due to direct supplier partnerships. Accredited online pharmacies, particularly those verified by the National Association of Boards of Pharmacy (NABP), offer legitimate cost savings and home delivery for added convenience.

Where Can I Find Genuine Reviews of the Generic Version?

One of the most reliable ways to gather real feedback is pharmacy review sections, where verified buyers leave comments about effectiveness, side effects, and overall satisfaction. Large online pharmacies often allow users to rate their experience after purchasing, offering insight into different manufacturers.

Medical forums and patient communities provide unfiltered discussions on treatment outcomes. Users share details on dosage effectiveness, side effects, and comparisons between brands. These platforms are valuable for understanding how different formulations affect real patients over time.

Health-focused websites with FDA-approved drug listings often include patient reviews alongside medical information. These platforms provide a mix of clinical data and firsthand user experiences, helping potential buyers compare expectations with real-world results.

For your convenience, below is a list of six authentic resources where you can find real patient reviews on Tadalafil:

  • https://www.drugs.com/comments/tadalafil/
  • https://reviews.webmd.com/drugs/drugreview-77875-tadalafil-oral
  • https://connect.mayoclinic.org/discussion/cialis-5mg/
  • https://www.theindependentpharmacy.co.uk/erectile-dysfunction-ed/guides/tadalafil-customer-reviews
  • https://www.doctorfox.co.uk/product-reviews/tadalafil
  • https://e-surgery.com/reviews/tadalafil/

What are the Potential Side Effects and Risks?

The most frequently reported effects include headache, nasal congestion, indigestion, muscle pain, and back pain. According to clinical data from the Mayo Clinic, up to 15% of users experience headaches due to the drug’s vasodilatory effect, which expands blood vessels and lowers blood pressure. Flushing and dizziness are also common, particularly when standing up too quickly.

Some users report vision changes, including a bluish tint, increased light sensitivity, or blurred vision. These effects are linked to PDE5 enzyme inhibition in the retina and typically resolve once the drug leaves the system. In rare cases, sudden hearing loss has been documented, requiring immediate medical attention.

A prolonged or painful erection lasting over four hours (priapism) is a medical emergency that requires urgent treatment to prevent permanent tissue damage. Cardiovascular risks are also a concern, particularly for individuals with heart disease, hypertension, or those taking nitrates. The FDA warns that combining this drug with nitrate-based medications can cause a life-threatening drop in blood pressure.

Men with severe heart conditions, uncontrolled hypertension, or advanced liver or kidney disease should consult a specialist before use. The Cleveland Clinic recommends caution for those with recent strokes or heart attacks, as PDE5 inhibitors can impact cardiovascular function.

How to Choose the Right Dosage?

This medication is available in 2.5mg, 5mg, 10mg, and 20mg strengths, each serving different needs. Understanding the differences helps optimize effectiveness while minimizing side effects.

Daily vs. As-Needed Use

The lower doses (2.5mg and 5mg) are intended for daily use, maintaining a steady level in the body. This option benefits individuals seeking spontaneity, eliminating the need for pre-planning. It is also prescribed for benign prostatic hyperplasia (BPH), as regular intake reduces urinary symptoms over time. Higher doses, 10mg and 20mg, are designed for on-demand use, typically taken 30 to 60 minutes before activity. The effects last up to 36 hours, earning the nickname “weekend pill”. This regimen is suitable for those who don’t require daily medication but want a longer window of effectiveness.

Factors That Influence Dosage Selection

  • First-time users usually start with 10mg as needed. If the response is insufficient, a doctor may increase the dose to 20mg.
  • Patients with underlying health conditions, particularly liver or kidney impairment, may require a lower dose to reduce the risk of side effects.
  • Individuals on medications that affect metabolism, such as CYP3A4 inhibitors (ketoconazole, ritonavir), may need dose adjustments due to prolonged drug activity in the system.

Adjustments Based on Tolerance and Effectiveness

Some men experience mild side effects, such as headache, flushing, or muscle pain, particularly with higher doses. In these cases, a reduction to 5mg or 2.5mg may improve tolerance without sacrificing effectiveness. Conversely, if a lower dose does not provide the desired effect, increasing the strength may be necessary under medical supervision.

Consulting a Healthcare Provider

Since this medication affects blood pressure and vascular function, selecting the right dosage requires professional guidance. Regular evaluations ensure the safest and most effective treatment plan based on individual response and health status.

How to Maximize the Effectiveness of the Medication?

  • Take It at the Right Time. The drug typically starts working 30 to 60 minutes after ingestion, but absorption varies. Taking it on an empty stomach can lead to faster onset, as high-fat meals delay absorption by up to an hour, according to research in the Journal of Clinical Pharmacology.
  • Avoid Alcohol and Certain Medications. Alcohol acts as a vasodilator, which can exaggerate blood pressure drops, leading to dizziness and reduced effectiveness. Excessive drinking – more than five units – has been linked to weaker results. Additionally, medications like nitrates, alpha-blockers, and CYP3A4 inhibitors (such as ketoconazole or ritonavir) alter how the drug is metabolized, requiring dosage adjustments to avoid interactions.
  • Maintain Cardiovascular Health. The drug relies on strong blood flow, meaning overall vascular health plays a role in effectiveness. Regular exercise, a balanced diet, and managing conditions like diabetes or hypertension help ensure consistent results. A study in the American Journal of Cardiology found that men with controlled cardiovascular health had a 25% higher response rate.
  • Consistent Use for Best Results. For those prescribed low-dose daily therapy, consistent use improves baseline blood circulation, leading to better long-term outcomes. Missing doses reduces the cumulative effect, making scheduled intake essential for steady results.

About AMSA Scorecard

AMSA Scorecard is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing the concerns of physicians-in-training.