Similar to sildenafil and vardenafil, tadalafil is a selective phosphodiesterase (PDE) type 5 inhibitor. Male erectile dysfunction (ED), pulmonary arterial hypertension (PAH), benign prostatic hypertrophy (BPH), or the simultaneous therapy of ED and BPH, are all treated with it orally. Tadalafil does not suppress prostaglandins like some impotence medications do (e.g., alprostadil). Tadalafil, which is more selective for PDE5 than for PDE6 found in the retina and differs from sildenafil in that it has not been linked to reports of visual abnormalities. Tadalafil appears to have a longer half-life of effect (up to 36 hours) than sildenafil and vardenafil for the treatment of ED. Since erections are only induced by PDE inhibitors when there is sexual stimulation, tadalafil’s extended half-life permits more spontaneity in sexual engagement. Oral phosphodiesterase type 5 inhibitors (PDE5 inhibitor) are regarded as first-line therapy for treating ED. 1 Phase II trials for the treatment of female erectile dysfunction with tadalafil were conducted, however further research was halted. Male erectile dysfunction (ED) medication received FDA approval in November 2003, and once-daily use without respect to sexual activity time received FDA approval in January 2008. In May 2009, the FDA approved tadalafil (Adcirca) for the treatment of pulmonary arterial hypertension (PAH). Tadalafil-treated patients in clinical studies of patients with pulmonary arterial hypertension (PAH) had greater exercise capacity and less clinical deterioration compared to placebo-treated patients. Tadalafil obtained FDA approval in October 2011 for the management of benign prostatic hyperplasia (BPH) signs and symptoms as well as the co-management of erectile dysfunction and BPH.