Tadalafil + Sildenafil Chewable
Two ED medicines, in one chewable tablet. Tadalafil and sildenafil have both been prescribed for erectile dysfunction for more than 20 years. Here a licensed pharmacy combines them in one chewable tablet, tadalafil 18 mg and sildenafil 10 mg, taken as needed. The combination hasn’t been tested in trials, so a provider decides whether it’s right for you.
- Tadalafil 18 mg and sildenafil 10 mg in one tablet
- Chewed, as needed, before sex
- A discreet bottle, shipped in plain packaging
Chewable tablet · from $48/mo. Prices are preliminary.
How to use it
- Chew the tablet completely, then swallow.
- Take it 30 minutes to a few hours before sex, as your provider directs. It only works when you’re aroused.
- Take no more than one tablet a day, and no other ED medicine alongside it, including Sildenafil Film.
- Form
- Chewable tablet
- Strength
- Tadalafil 18 mg and sildenafil 10 mg per tablet
- Typical use
- As needed, 30 minutes to a few hours before sex; one tablet a day at most
- Pack
- A bottle of 8 tablets, or 4 on the smaller plan
- Who it’s for
- Adult men with erectile dysfunction
Two actives, both PDE5 inhibitors.
- Tadalafil (18 mg): A PDE5 inhibitor. When you’re aroused, it helps the arteries in the penis relax and fill with blood. It stays in the body a long time, with a half-life of about 17.5 hours: in trials of the approved 10 and 20 mg doses, it still improved erections 36 hours after a dose.
- Sildenafil (10 mg): The same kind of medicine, but quicker to peak and to wear off: its level in the blood peaks about an hour after a dose, with a half-life of about 4 hours. 10 mg is less than the lowest approved dose of sildenafil on its own, 25 mg.
What the research does and doesn’t show
What it shows: each medicine works on its own. Tadalafil taken as needed was tested in 12-week, placebo-controlled trials of more than 1,500 men. On 10 or 20 mg, 50 to 78% of attempts at sex succeeded, against 23 to 43% on a placebo, and in one study it still helped 36 hours after a dose. In trials of sildenafil, 63 to 82% of men on 25 to 100 mg said their erections improved, against 24% on a placebo.
Together: in one study of 180 men taking a low daily dose of tadalafil, adding sildenafil as needed improved erection scores further only for men with severe erectile dysfunction, with no more side effects. A 2019 review found tadalafil alone and tadalafil with sildenafil improved erection scores about the same.
What it doesn’t show: no trial has tested tadalafil and sildenafil taken together as needed, this 18 mg and 10 mg combination, or this compounded chewable. The labels for both medicines say combining them hasn’t been studied and isn’t recommended. Chewing hasn’t been shown to make either work faster.
So the evidence is for tadalafil and sildenafil on their own, not for this tablet.
Studies: Cialis (tadalafil) prescribing information, Lilly, DailyMed 2026: as-needed use, 7 placebo-controlled 12-week trials in general erectile dysfunction (402 men in the US, 1,112 outside); successful intercourse in 50 to 78% of attempts on 10 or 20 mg vs 23 to 43% on placebo; timing study of 483 men, 56% and 62% at 36 hours on 10 and 20 mg vs 33%; peak blood level at a median of 2 hours; half-life 17.5 hours; headache in 11% and 15% on 10 and 20 mg vs 5%, indigestion 8% and 10% vs 1%; combinations with other PDE5 inhibitors or ED treatments “have not been studied.” Viagra (sildenafil citrate) prescribing information, DailyMed: improved erections in 63%, 74% and 82% on 25, 50 and 100 mg vs 24% on placebo; doses 25 to 100 mg; peak at a median of 60 minutes; half-life about 4 hours; combinations with other PDE5 inhibitors or ED treatments “have not been studied… the use of such combinations is not recommended.” Cui 2015, Andrologia (PubMed 24387078): 180 men, tadalafil 5 mg daily alone or with sildenafil 50 mg as needed; higher IIEF-5 scores with the combination only in severe ED, no difference in adverse events. Munk 2019, Sex Med Rev (PubMed 30711478): systematic review; tadalafil alone or with sildenafil on demand gave similar IIEF-5 improvements. Yoo 2017, Transl Clin Pharmacol (PubMed 32095467): 60 men, a 100 mg chewable sildenafil tablet bioequivalent to the brand tablet, peak at a median of 1 hour vs 45 minutes. No study found of an 18 mg + 10 mg combination or of a compounded combined chewable (PubMed and ClinicalTrials.gov, Sep 30, 2026).
What to expect
- The first time
- Take it well ahead and give it time: it only works with arousal. Don’t take a second tablet the same day, even if the first didn’t seem to work.
- The first few weeks
- It can take a few tries to find the timing that works for you. Headache, indigestion, flushing and back or muscle aches are the most common side effects, and they usually pass.
- Ongoing
- Your provider checks how it’s working and whether it’s still the right choice, or whether one medicine would do. Refills ship in plain packaging.
Important safety information
Before you start
Your provider reviews your health history, medicines and allergies before prescribing, and prescribes only if it’s right for you. Tell your care team about any side effect, and get emergency care for chest pain, trouble breathing, or swelling of the face, lips or throat.
Side effects, and when to get help
The most common are headache, indigestion, back pain, muscle aches, a stuffy nose and flushing. In trials of tadalafil taken as needed, about 1 in 7 men on 20 mg had a headache (1 in 20 on a placebo) and 1 in 10 had indigestion (1 in 100 on a placebo). Sildenafil can briefly cause a blue tinge, blurred vision or more sensitivity to light. Most side effects pass on their own. Stop and get care right away for an erection that lasts more than 4 hours, sudden loss of vision in one or both eyes, sudden hearing loss or ringing in the ears, chest pain, fainting, or swelling of the lips, face or throat.
Rules that keep it safe
Never take this tablet with nitrate heart medicines, such as nitroglycerin or isosorbide, with poppers, or with riociguat or vericiguat: the drop in blood pressure can be dangerous. Tadalafil lasts, so at least 48 hours should pass after a tablet before a nitrate is given, and only under medical supervision; if you need emergency care for chest pain, tell the staff you’ve taken tadalafil and sildenafil, and when. Take no more than one tablet a day, and don’t add any other ED medicine, including Sildenafil Film, vardenafil, avanafil, Revatio or Adcirca. With ritonavir (including Paxlovid for COVID), ketoconazole or itraconazole, tadalafil is limited to 10 mg once every 3 days, so this tablet isn’t used; with moderate or severe kidney disease or liver disease, the limit is also below one tablet, so check with your provider first. Alpha-blockers and blood pressure medicines add to the drop in blood pressure. Don’t use it if a doctor has told you your heart isn’t healthy enough for sex, and keep alcohol to a drink or two.
Is it FDA-approved?
No. This chewable is compounded: prepared by a licensed pharmacy for you, and not reviewed by the FDA for safety, effectiveness or quality. Tadalafil and sildenafil are each FDA-approved for erectile dysfunction as tablets, but no FDA-approved product combines them, and this tablet hasn’t been compared with them in a trial. If one approved medicine suits you better, your provider can talk it through.
About Tadalafil + Sildenafil Chewable
Why two medicines in one tablet?
Sildenafil works for a few hours; tadalafil lasts much longer. Some providers combine them, hoping to get both. But no trial has tested the two taken together as needed, or this dose, so it isn’t known whether the combination works better than either one alone.
Is it safe to take two ED medicines together?
It hasn’t been well studied. The labels for both medicines say combining them with another ED medicine hasn’t been studied and isn’t recommended, because together they may lower blood pressure further. Your provider weighs this against your health history, and may suggest one medicine instead.
How long does it last?
Sildenafil wears off over about 4 hours. In trials of tadalafil on its own, it still improved erections 36 hours after a dose. That’s a window, not a long erection: erections still come with arousal and go down after sex. How long this tablet works hasn’t been tested.
What are the side effects?
Headache, indigestion, back pain, muscle aches, a stuffy nose and flushing are the most common. In trials of tadalafil taken as needed, about 1 in 7 men on 20 mg had a headache (1 in 20 on a placebo). Get medical help right away for an erection that lasts more than 4 hours, or sudden loss of vision or hearing.
How is it different from Sildenafil Film?
Sildenafil Film is one medicine, 50 mg of sildenafil, in a film that dissolves under your tongue, and it helps for up to about 4 hours. This tablet has much less sildenafil, 10 mg, plus tadalafil, which lasts longer, and you chew it. Your provider helps you choose.
Is there an FDA-approved version?
No FDA-approved product combines tadalafil and sildenafil. Each is FDA-approved on its own, as tablets. If one approved medicine suits you better, your provider can talk it through.
Does it protect against STIs?
No. Tadalafil and sildenafil don’t protect against sexually transmitted infections, including HIV.
Is it FDA-approved?
No. Compounded medications are prepared by a licensed pharmacy for an individual patient and are not reviewed by the FDA for safety, effectiveness or quality.