10mg vs 20mg Tadalafil: Which Dose Is Right for You?
Updated December 2025 • 8 min read
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If you've been prescribed tadalafil (the active ingredient in Cialis) for erectile dysfunction, you've probably wondered whether 10mg or 20mg is the right dose for you. It's a common question, and the answer isn't always straightforward.
The good news is that both doses are well-studied, effective, and safe for most men. The key is finding the dose that works for your specific situation while minimizing side effects. This guide breaks down everything you need to know to have an informed conversation with your healthcare provider.
Tadalafil at a Glance
36 hrs
Duration of effect (both doses)
68-85%
Success rate in clinical trials
30-60 min
Time to start working
$2-12
Per-dose cost (generic)
Understanding Tadalafil Dosing Options
Tadalafil comes in four main doses: 2.5mg, 5mg, 10mg, and 20mg. The lower doses (2.5mg and 5mg) are typically prescribed for daily use, while 10mg and 20mg are designed for "as-needed" use before sexual activity.
For as-needed dosing, 10mg is the standard starting dose recommended by most healthcare providers. This approach allows your doctor to assess how your body responds to the medication before considering any adjustments.
Tadalafil 10mg: The Standard Starting Dose
The 10mg dose is where most men begin their tadalafil journey. Clinical studies show that 10mg provides significant improvement in erectile function for the majority of men with mild to moderate ED.
When 10mg Makes Sense:
- First time using tadalafil or switching from another ED medication
- Mild to moderate erectile dysfunction
- Men over 65 (lower doses often recommended as a starting point)
- Those taking medications that may interact with tadalafil
- Men concerned about minimizing potential side effects
In clinical trials, 68-77% of men taking 10mg tadalafil reported successful intercourse, compared to just 30-32% on placebo. That's a substantial improvement that works well for many men.
Tadalafil 20mg: The Maximum Dose
The 20mg dose is the maximum recommended for as-needed use. It's typically considered when the 10mg dose isn't providing sufficient results, or for men with more severe ED.
When 20mg May Be Appropriate:
- 10mg didn't produce desired results (after multiple attempts)
- Severe erectile dysfunction
- ED with organic comorbidities (diabetes, cardiovascular issues)
- Men who tolerated 10mg well but need stronger effects
Research shows that men with severe ED who take 20mg experience greater improvements compared to 10mg. In one study, the IIEF-EF domain improvement was 13.6 for 20mg versus 10.4 for 10mg in men with severe ED—a statistically significant difference.
10mg vs 20mg: Head-to-Head Comparison
| Factor | 10mg | 20mg |
|---|---|---|
| Success Rate | 68-77% | 76-85% |
| Duration | Up to 36 hours | Up to 36 hours |
| Onset Time | 30-60 minutes | 30-60 minutes |
| Side Effect Risk | Lower | Higher |
| Best For | Mild-moderate ED | Severe ED |
| Typical Cost | $2-8/dose | $3-12/dose |
Side Effects: What to Expect
Both doses can cause similar side effects, but they tend to be more common and pronounced at the higher 20mg dose. The most frequently reported side effects include:
- • Headache (1-14% depending on dose)
- • Dyspepsia/Indigestion (1-11%)
- • Facial flushing (7-8%)
- • Nasal congestion (6-7%)
- • Back pain (2-11%)
- • Muscle aches (1-5%)
Because tadalafil stays in your system longer than other ED medications (half-life of about 17.5 hours), any side effects you experience may also last longer. This is worth considering when choosing between doses.
When to Consider Switching Doses
From 10mg to 20mg:
- You've tried 10mg at least 4-8 times without adequate results
- Erections aren't firm enough for satisfying intercourse
- You tolerate the 10mg dose well with minimal side effects
- Your healthcare provider agrees it's appropriate
From 20mg to 10mg:
- You're experiencing bothersome side effects at 20mg
- 20mg works well and you want to try a lower dose
- Your ED has improved and you may not need the higher dose
- Cost considerations (lower doses are often cheaper)
Consider Daily Dosing as an Alternative
If as-needed dosing isn't working well for you, daily low-dose tadalafil (2.5mg or 5mg) may be worth discussing with your provider. Research shows that daily dosing can produce a significantly higher IIEF erectile function domain score compared to as-needed dosing for some men.
Daily Tadalafil Benefits:
- ✓ Always ready for spontaneous sex
- ✓ No need to plan around a pill
- ✓ Steady medication levels in your system
- ✓ Can also help with BPH symptoms
- ✓ May work better for some men than as-needed dosing
How to Get Started with Tadalafil
The easiest way to get a tadalafil prescription is through a telehealth platform. These services offer discreet consultations with licensed providers who can evaluate your situation and prescribe the appropriate dose.
Ready to Find Your Right Dose?
Online ED clinics make it easy to get started with a licensed provider who can help determine whether 10mg or 20mg is right for you.
Key Takeaways
- 1 Start with 10mg — It's the recommended starting dose for most men and works well for mild to moderate ED.
- 2 Give it time — Try your dose 4-8 times before concluding it doesn't work.
- 3 Consider 20mg if needed — For severe ED or if 10mg isn't sufficient, the higher dose may help.
- 4 Higher dose = more side effects — Balance effectiveness with tolerability.
- 5 Talk to your provider — Never adjust your dose without medical guidance.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting any new medication or adjusting your current dose. ED can be a sign of underlying health conditions that require evaluation.