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Tadalafil is a reversible selective inhibitor of specific phosphodiesterase type 5 (PDE-5) cyclic guanosine monophosphate (cGMP). When sexual arousal causes local release of nitric oxide, inhibition of PDE-5 by tadalafil leads to an increase in cGMP concentration in the cavernous body of the penis. The result is a relaxation of the smooth muscles of the arteries and blood flow to the tissues of the penis, which causes an erection. Tadalafil has no effect in the absence of sexual arousal.
 
Tadalafil improves erection and increases the possibility of having full sexual intercourse. In order to assess the impact of daily intake of tadalafil on spermatogenesis, several studies have been conducted. None of the studies observed an undesirable effect on the morphology of spermatozoa and their mobility. One study found a decrease in the average sperm concentration compared to placebo. A decrease in sperm concentration was associated with a higher frequency of ejaculation. In addition, no adverse effect was observed on the average concentration of sex hormones, testosterone, luteinizing hormone and follicle-stimulating hormone when taking tadalafil compared with placebo.
 
The efficacy and safety of Cialis ® 5 mg has been studied in clinical studies. Improvement in erection was noted in patients with erectile dysfunction of all degrees of severity while taking tadalafil once a day. In primary efficacy studies using 5 mg of tadalafil, most attempts at sexual intercourse were successful. Taking 5 mg of tadalafil significantly improved erectile function within 24 hours between doses. After ingestion tadalafil is rapidly absorbed. The average maximum concentration (Cmax) in plasma is achieved on average 2 hours after ingestion. The speed and extent of absorption of tadalafil do not depend on the intake, so Cialis can be used regardless of the intake.

The time of administration (in the morning or in the evening) did not have a clinically significant effect on the rate and extent of absorption. Equilibrium plasma concentrations are achieved within 5 days while taking the drug once a day.
The pharmacokinetics of tadalafil in patients with erectile dysfunction is similar to the pharmacokinetics of the drug in individuals without erectile dysfunction.