Tadalafil (Cialis) is an FDA-approved PDE5 inhibitor (approved 2003), used for erectile dysfunction and benign prostatic hyperplasia. It works by slowing the breakdown of cGMP, promoting smooth-muscle relaxation and blood flow to the penis. Its defining pharmacological difference from sildenafil is duration: roughly a 17.5-hour half-life vs. sildenafil's ~4 hours, which is why it's sometimes marketed for next-day effect rather than same-session use.
As an approved drug with a full label, known risks include headache, flushing, and — the most safety-critical interaction — dangerous blood pressure drops when combined with nitrates (used for chest pain/heart conditions), which is an absolute contraindication, not a minor caution.
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