Tadalafil Stopped Working? Here's What to Do Next
Updated December 2025 • 9 min read
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You've been taking tadalafil (Cialis) and it worked great—until suddenly, it didn't. If this sounds familiar, you're not alone. Many men experience a decline in their ED medication's effectiveness over time.
The frustrating reality is that no medication works 100% of the time for 100% of people. But before you give up on tadalafil, there are several troubleshooting steps worth trying. In many cases, simple adjustments can get your treatment working again.
Key Facts About ED Treatment Response
20-30%
Men who don't respond to PDE5 inhibitors
56-81%
Treatment failures due to incorrect use
8-10
Attempts recommended before switching
77%
Response rate after proper re-education
Why Tadalafil May Stop Working
Understanding why your medication stopped working is the first step toward fixing the problem. Here are the most common reasons:
1. Incorrect Usage
This is far more common than most men realize. According to research, more than half of men who report that ED medications don't work are actually using them incorrectly.
Common Mistakes:
- Not waiting long enough: Tadalafil needs 30-60 minutes to take effect. Taking it and immediately trying to have sex won't work.
- Expecting automatic erections: PDE5 inhibitors require sexual stimulation to work—they don't cause spontaneous erections.
- Heavy meals: While tadalafil is less affected by food than sildenafil, high-fat meals can still delay absorption.
- Alcohol: Drinking too much significantly reduces the medication's effectiveness and your body's natural erectile response.
- Giving up too soon: Experts recommend trying a medication 8-10 times before concluding it doesn't work.
2. Worsening Underlying Conditions
ED is often a symptom of other health issues. If those conditions worsen, your medication may become less effective—not because the drug stopped working, but because the underlying problem got worse.
Conditions That Can Progress:
- Cardiovascular disease: Progressive atherosclerosis (plaque buildup in arteries) directly affects blood flow to the penis
- Diabetes: Poorly controlled blood sugar damages blood vessels and nerves over time
- High blood pressure: Uncontrolled hypertension worsens vascular function
- High cholesterol: Contributes to arterial stiffness and reduced blood flow
- Weight gain: Obesity is strongly linked to worsening ED
3. Hormonal Changes
Low testosterone can significantly reduce how well ED medications work. PDE5 inhibitors rely on adequate androgen levels to function properly. If your testosterone has declined, even maximum doses of tadalafil may underperform.
Research shows that men with low baseline testosterone are much more likely to regain erectile function after adding testosterone therapy to their treatment plan.
4. New Medications or Interactions
If you've started any new medications since tadalafil stopped working, they could be interfering. Some common culprits:
- Antidepressants (SSRIs, SNRIs)
- Blood pressure medications
- Antihistamines
- Prostate medications
- Opioid pain medications
5. Psychological Factors
Mental health and erectile function are deeply connected. Stress, anxiety, depression, relationship problems, or even anxiety about ED itself can suppress your body's natural erectile response—regardless of medication.
Performance anxiety can create a vicious cycle: ED causes anxiety, which makes ED worse, which causes more anxiety. Breaking this cycle sometimes requires addressing the psychological component alongside the physical treatment.
What to Do When Tadalafil Stops Working
Before giving up on your medication, work through these solutions systematically:
Step 1: Review Your Usage
Make sure you're taking tadalafil correctly:
- ✓ Wait at least 30-60 minutes after taking it before sexual activity
- ✓ Ensure you're sexually aroused—foreplay matters
- ✓ Avoid heavy meals and limit alcohol
- ✓ Try the medication on your own first to reduce performance pressure
- ✓ Give it multiple attempts—don't give up after one or two failures
Step 2: Consider a Dose Adjustment
If you're on 10mg and it's not working, your provider may increase you to 20mg. Don't adjust your dose without medical guidance, but this is often the first thing a provider will try.
Alternatively, if you're using as-needed dosing, switching to daily low-dose tadalafil (5mg) can provide more consistent results for some men. Daily dosing maintains steady medication levels and removes the pressure of timing pills around sex.
Step 3: Address Underlying Health Issues
Work with your healthcare provider to optimize your overall health:
- ✓ Get your testosterone levels checked
- ✓ Ensure blood pressure and cholesterol are well-controlled
- ✓ If diabetic, work on blood sugar management
- ✓ Consider losing weight if overweight
- ✓ Review all medications for possible interactions
Step 4: Try a Different ED Medication
If tadalafil truly isn't working, switching to a different PDE5 inhibitor often helps. Options include:
- Sildenafil (Viagra): Faster onset, shorter duration—good for planned encounters
- Vardenafil (Levitra): Similar to sildenafil but may work better for some men
- Avanafil (Stendra): Fastest-acting option, can work in as little as 15 minutes
Some providers now offer combination therapy (sildenafil + tadalafil together) for men who don't respond adequately to single-drug treatment.
Step 5: Consider Alternative Treatments
If oral medications aren't cutting it, other options exist:
- Shockwave therapy: Non-invasive treatment that can restore natural erectile function for some men
- Injection therapy (Trimix): Works for about 80% of men who don't respond to pills
- Vacuum erection devices: Mechanical option that doesn't require medication
- Penile implants: Permanent solution for severe, treatment-resistant ED
Lifestyle Changes That Can Help
Regardless of what medication you're taking, these lifestyle factors significantly impact erectile function:
Do More:
- Regular cardiovascular exercise
- Maintain healthy weight
- Get adequate sleep (7-8 hours)
- Eat a heart-healthy diet
- Manage stress effectively
Do Less:
- Smoking (quit if possible)
- Excessive alcohol
- Recreational drugs
- Sedentary behavior
- Pornography overuse
When to See a Doctor
Schedule an appointment with your healthcare provider if:
- Tadalafil stopped working after previously being effective
- You've tried proper usage techniques without improvement
- You're experiencing new symptoms alongside ED
- You haven't had blood work done recently
- You're interested in trying alternative treatments
Ready to Explore Your Options?
Telehealth platforms make it easy to connect with a licensed provider who can help troubleshoot your ED treatment or explore alternatives.
Key Takeaways
- 1 Don't panic — ED treatment failure is common and often fixable.
- 2 Review your usage — Over half of "treatment failures" are actually usage errors.
- 3 Address underlying health — Worsening conditions often explain declining medication effectiveness.
- 4 Consider dose or medication changes — Your provider can adjust your treatment.
- 5 Alternatives exist — If pills don't work, other effective options are available.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider about changes to your ED treatment. ED can be a sign of underlying health conditions that require evaluation.