Does tadalafil make you gain weight? This is a common concern amongst men prescribed this phosphodiesterase type 5 (PDE5) inhibitor for erectile dysfunction or benign prostatic hyperplasia. Weight gain is not listed as a recognised side effect in UK product information for tadalafil, and clinical trials have not established a causal link between the medication and increased body weight. Tadalafil works by relaxing smooth muscle in blood vessels to improve blood flow, without directly affecting metabolic processes, appetite regulation, or fat storage. If you notice weight changes whilst taking tadalafil, other factors such as lifestyle modifications, concurrent medications, or underlying health conditions are far more likely explanations.

Does Tadalafil Make You Gain Weight?

Weight gain is not listed as a side effect in the UK product information for tadalafil used for erectile dysfunction or benign prostatic hyperplasia. Clinical trial data and post-marketing surveillance have not established a link between tadalafil use and increases in body weight. Tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor, works by relaxing smooth muscle in blood vessels to improve blood flow. This mechanism of action does not directly influence metabolic processes, appetite regulation, or fat storage.

Extensive clinical trials conducted during tadalafil's development and ongoing pharmacovigilance by the MHRA (Medicines and Healthcare products Regulatory Agency) have not identified weight gain as a common or even uncommon adverse reaction. The drug is primarily metabolised by the liver and excreted through faeces and urine, without significant effects on hormonal pathways that regulate body composition.

If you notice weight changes whilst taking tadalafil, it is important to consider other factors that may be responsible. Lifestyle modifications, dietary changes, reduced physical activity, underlying health conditions, or other medications are far more likely explanations for weight fluctuation. Some men may experience improved quality of life and confidence after successfully treating erectile dysfunction, which could indirectly influence eating habits or activity levels, but this is not a pharmacological effect of the medication itself.

Patients concerned about weight changes should maintain a balanced perspective and avoid discontinuing prescribed medication without medical advice. A thorough assessment by your GP can help identify the actual cause of any weight gain and ensure your treatment remains appropriate and effective.

Common Side Effects of Tadalafil

Tadalafil is generally well tolerated, but like all medications, it can cause side effects in some individuals. The most frequently reported adverse effects are mild to moderate and typically resolve without intervention. Understanding these common reactions helps patients distinguish between expected medication effects and symptoms requiring medical attention.

Common side effects (affecting up to 1 in 10 people) include:

• Headache – the most frequently reported side effect, usually mild and transient

• Dyspepsia (indigestion) – may present as discomfort or burning in the upper abdomen

• Back pain and myalgia (muscle aches) – typically appearing 12–24 hours after dosing and resolving within 48 hours

• Nasal congestion – due to vasodilation of nasal blood vessels

• Flushing – warmth or redness in the face, neck, or chest

• Dizziness – particularly when standing up quickly due to blood pressure effects

These side effects result from tadalafil's vasodilatory properties extending beyond the intended target tissues. The medication's long half-life (approximately 17.5 hours) means effects and potential side effects persist longer than with shorter-acting PDE5 inhibitors.

Less common but important side effects include blurred vision or visual disturbances (uncommon), palpitations, and hypotension (low blood pressure). Rarely, serious adverse events such as priapism (prolonged erection lasting over four hours), sudden hearing loss, or sudden vision loss may occur. Cardiovascular events have been reported, mainly in those with pre-existing risk factors; a causal relationship with tadalafil has not been established.

Important safety information: Tadalafil must not be used with nitrate medications (including recreational 'poppers') or riociguat. Use with caution if taking alpha-blockers. Discuss with your doctor if you take strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) and avoid grapefruit juice while taking tadalafil.

Most side effects diminish with continued use as the body adjusts to the medication. However, persistent or troublesome symptoms warrant discussion with your GP, who may adjust the dose or consider alternative treatments. Never exceed the prescribed dose, as this increases the risk of adverse effects without improving efficacy. Report suspected side effects via the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk).

Factors That May Affect Weight While Taking Tadalafil

When patients notice weight changes coinciding with tadalafil treatment, several alternative explanations should be considered. Understanding these factors helps avoid incorrectly attributing weight gain to the medication itself.

Lifestyle and behavioural changes often accompany treatment for erectile dysfunction. Improved sexual function and confidence may lead to changes in social activities, dining habits, or alcohol consumption. Some men report increased appetite or altered eating patterns as their quality of life improves, which can contribute to gradual weight gain unrelated to the medication's pharmacological properties.

Concurrent medications represent another important consideration. Many men taking tadalafil also use treatments for conditions such as hypertension, diabetes, or depression. Medications known to cause weight gain include:

• Beta-blockers (e.g., atenolol, bisoprolol) for high blood pressure

• Certain antidepressants, particularly mirtazapine and some SSRIs

• Corticosteroids for inflammatory conditions

• Insulin and some oral hypoglycaemic agents for diabetes (though metformin and SGLT2 inhibitors may have different effects)

• Antipsychotic medications

The weight impact differs within drug classes, so review medicines with your clinician before making any changes.

Underlying health conditions may also contribute to weight fluctuation. Hypothyroidism, Cushing's syndrome, and heart failure can all cause weight gain. Additionally, reduced physical activity due to cardiovascular disease, arthritis, or other comorbidities commonly seen in men prescribed tadalafil may lead to weight increase.

Age-related metabolic changes naturally slow metabolism and alter body composition, with men typically experiencing gradual weight gain and muscle loss from their forties onwards. This physiological process often coincides with the age at which erectile dysfunction treatments are initiated.

Fluid retention is a particularly important consideration. If you notice sudden weight increase accompanied by swelling in the ankles, legs, or abdomen, contact your GP promptly. This may indicate heart or kidney problems requiring urgent assessment rather than true weight gain from fat accumulation. Home weight monitoring may be advisable if you have risk factors for heart failure.

When to Speak to Your GP About Tadalafil

Regular communication with your GP ensures safe and effective use of tadalafil. Certain situations warrant prompt medical review, whilst others may be addressed during routine follow-up appointments.

Seek urgent medical attention (call 999 or attend A&E) if you experience:

• Chest pain, particularly during or after sexual activity

• Priapism – an erection lasting more than four hours, which requires emergency treatment to prevent permanent damage

• Sudden loss of vision in one or both eyes

• Sudden decrease or loss of hearing, possibly with tinnitus or dizziness

• Severe allergic reactions (difficulty breathing, facial swelling, severe rash)

Contact your GP within 24–48 hours if you notice:

• Persistent or troublesome side effects that don't improve after the first few doses

• Significant weight gain (more than 2–3 kg in a week) accompanied by breathlessness, ankle swelling, or reduced exercise tolerance, which may indicate fluid retention or heart problems

• Tadalafil becoming less effective, which may require dose adjustment or investigation of underlying causes

• New medications prescribed by other healthcare providers, as drug interactions may occur

Schedule a routine review if:

• You have concerns about gradual weight gain and wish to discuss contributing factors and management strategies

• You're experiencing mild side effects and want to explore dose adjustment or alternative treatments

• Your cardiovascular risk factors have changed (new diagnosis of diabetes, hypertension, or high cholesterol)

• You wish to discuss lifestyle modifications to support erectile function, including weight management, exercise, smoking cessation, or alcohol reduction

Important safety information: Never use tadalafil with nitrate medications or recreational nitrites ('poppers') – this combination can cause a dangerous drop in blood pressure. Do not use with riociguat. Seek advice if you take alpha-blockers, and avoid nitrates for at least 48 hours after taking tadalafil.

Your GP can conduct a comprehensive assessment including blood pressure measurement, cardiovascular risk evaluation, and review of concurrent medications. NICE Clinical Knowledge Summary on erectile dysfunction advises assessment of cardiovascular risk and follow-up to review response and adverse effects. Never discontinue tadalafil abruptly without medical advice, and always inform healthcare providers about all medications you're taking, including over-the-counter products and supplements, to avoid potentially dangerous interactions.

Frequently Asked Questions