Tadalafil, like sildenafil and vardenafil, is a selective phosphodiesterase (PDE) type 5 inhibitor. It is used orally and is used to treat male erectile dysfunction (ED), pulmonary arterial hypertension (PAH), benign prostatic hypertrophy (BPH), or both erectile dysfunction and BPH. Tadalafil does not suppress prostaglandins like certain impotence medications (e.g., alprostadil). Visual problems have not been recorded with tadalafil, which is more selective for PDE5 than PDE6 in the retina, unlike sildenafil. Tadalafil appears to have a longer duration of action (up to 36 hours) than sildenafil and vardenafil for the treatment of ED. Because PDE inhibitors only enhance erections in the presence of sexual stimulation, tadalafil’s longer duration of action allows for greater spontaneity in sexual engagement. Oral phosphodiesterase type 5 inhibitors (PDE5 inhibitors) are regarded first-line medication in ED treatment guidelines. 1 Tadalafil was in phase II studies for the treatment of female sexual dysfunction, but further research was halted. In November 2003, the FDA approved it for the treatment of male erectile dysfunction (ED), then in January 2008, it was approved for once-daily usage without respect to sexual activity timing. Tadalafil (Adcirca) was approved by the FDA in May 2009 for the treatment of pulmonary arterial hypertension (PAH). Tadalafil-treated participants in clinical studies with pulmonary arterial hypertension (PAH) had greater exercise capacity and less clinical deterioration compared to placebo. Tadalafil was approved by the FDA in October 2011 for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH) as well as the combined treatment of erectile dysfunction and BPH.