Public record

Tadalafil: the public record

10 tables from US federal sources. Latest data date: Nov 11, 2026.

Each table is computed from the named federal dataset as of its data date; the method is under each one.

Label

FDA label facts for tadalafil

The FDA label read for tadalafil (Cialis, application NDA021368) was last revised on 2026-06-03. It carries no boxed warning. Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.

FDA label facts for tadalafil: the figures
MeasureValueNote
Label revision date2026-06-03
Label readCialisNDA021368, brand-name application
Boxed warningNo
Pregnancy sectionPresent
Lactation sectionPresent
Pediatric use sectionPresent
Geriatric use sectionPresent

Source: FDA drug label via openFDA, viewable on NIH DailyMed, data as of Nov 11, 2026

How this was calculated

Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.

Scope: One label: the newest prescription label for single-ingredient tadalafil from an original manufacturer, matched to Cialis

Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.

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Approvals

FDA approval history for tadalafil

The earliest FDA approval on file for a tadalafil product is 2003-11-21. Drugs@FDA lists 48 applications for it and 53 approved supplements, the most recent on 2026-08-25.

FDA approval history for tadalafil: the figures
MeasureValueNote
Earliest FDA approval on file2003-11-21
Applications with an approval on file48
New drug applications (NDA)4
Generic applications (ANDA)44
Approved supplements53label, manufacturing and efficacy changes
Most recent supplement approval2026-08-25
Sponsoring companies33

Source: FDA, Drugs@FDA, data as of Nov 11, 2026

How this was calculated

Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.

Scope: Applications with a single-ingredient tadalafil product in Drugs@FDA, all sponsors and strengths

Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.

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Patents and generics

Patents and generic approvals for tadalafil

The FDA Orange Book lists 44 approved generic applications for tadalafil, the first approved on 2018-05-22. 9 listed patents on specific brand products have not yet expired, the last on 2038-12-24; generics of other versions are already approved.

Patents and generic approvals for tadalafil: the figures
MeasureValueNote
Brand-name applications (NDA)4
Approved generic applications (ANDA)44first approved 2018-05-22
Companies with a generic not marked discontinued28
Listed patents not yet expired9
Latest listed patent expiry2038-12-24on any product; may cover only one brand formulation
Earliest approval date on file2003-11-21
Products not marked discontinued122 of 136

Source: FDA, Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), data as of Oct 9, 2026

How this was calculated

Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.

Scope: All single-ingredient tadalafil products in the Orange Book, every brand and strength, files dated 2026-10-09

An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.

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Medicare Part D

Medicare Part D claims for tadalafil by age group

Of 378,720 Medicare Part D claims for tadalafil in 2024, 335,712 (88.6%) were for enrollees aged 65 and over and 43,008 were for enrollees under 65.

Medicare Part D claims for tadalafil by age group: the figures
MeasureValueNote
All Part D claims, 2024378,720
Claims for enrollees aged 65 and over335,712
Claims for enrollees under 6543,008mostly people who qualify through disability
Share of claims for enrollees aged 65 and over88.6%share of claims, not of patients

Source: CMS, Medicare Part D Prescribers by Geography and Drug, data as of 2024

How this was calculated

Summed the national rows for every brand and generic row with this generic name. Claims under 65 are total claims minus claims for enrollees 65 and over.

Scope: National Part D claims for single-ingredient tadalafil products, 2024, split at age 65

Medicare mostly covers people 65 and over, so this split describes Medicare enrollees and not use in the general population.

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Medicare Part D

Medicare Part D spending on tadalafil

Medicare Part D spending on tadalafil products was $109.3M in 2024 across 378,785 claims, compared with $132.3M in 2023 (-17.4%). Average spending per claim was $288, before rebates.

Medicare Part D spending on tadalafil: the figures
MeasureValueNote
Total spending, 2024$109.3M
Total spending, 2023$132.3M
Change in spending, 2023 to 2024-17.4%
Claims (prescription fills), 2024378,785
Average spending per claim, 2024$288
Tadalafil: spending, 2024$80.9M365,541 claims
Adcirca: spending, 2024$23.8M5,153 claims
Cialis: spending, 2024$3.7M7,402 claims

Source: CMS, Medicare Part D Spending by Drug, data as of 2024

How this was calculated

Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.

Scope: Every single-ingredient tadalafil product in Part D (Tadalafil, Adcirca, Cialis), 2024. Not limited to Cialis.

Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.

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Medicaid

Medicaid prescriptions for tadalafil by state

State Medicaid programmes paid for 54,283 tadalafil prescriptions in 2025, with $22.1M reimbursed before rebates. California reported the most (12,953), followed by North Carolina (4,015) and Texas (2,870); 47 states and territories reported any.

Medicaid prescriptions for tadalafil by state: the figures
MeasureValueNote
Prescriptions paid by Medicaid, 202554,283
Total reimbursed before rebates, 2025$22.1M
States and territories reporting47with at least one count CMS did not suppress
California12,953 prescriptions$3.0M reimbursed
North Carolina4,015 prescriptions$644,067 reimbursed
Texas2,870 prescriptions$4.5M reimbursed
Ohio2,790 prescriptions$719,578 reimbursed
Oregon2,782 prescriptions$86,560 reimbursed

Source: CMS, Medicaid State Drug Utilization Data 2025, data as of 2025

How this was calculated

Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.

Scope: All single-ingredient tadalafil products in the FDA NDC Directory, fee-for-service and managed care, 2025

Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.

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Pharmacy cost

Pharmacy acquisition cost (NADAC) for tadalafil

Retail pharmacies paid an average of $0.1448 per unit for TADALAFIL 20 MG TABLET as of 2026-11-11, compared with $0.2116 twelve months earlier (-31.6%). This is a pharmacy purchase cost, not a patient price.

Pharmacy acquisition cost (NADAC) for tadalafil: the figures
MeasureValueNote
TADALAFIL 20 MG TABLET$0.1448 per unit12 months earlier $0.2116 (-31.6%)
TADALAFIL 5 MG TABLET$0.1078 per unit12 months earlier $0.1227 (-12.2%)
TADALAFIL 10 MG TABLET$0.1533 per unit12 months earlier $0.1546 (-0.8%)
TADALAFIL 2.5 MG TABLET$0.1203 per unit12 months earlier $0.1245 (-3.4%)
ALYQ 20 MG TABLET$0.1448 per unit12 months earlier $0.2038 (-28.9%)

Source: CMS, National Average Drug Acquisition Cost (NADAC), data as of Nov 11, 2026

How this was calculated

Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.

Scope: Generic versions of tadalafil in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12

NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.

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Adverse event reports

Most reported events in FDA adverse event reports for tadalafil

Through 2026-10-28, FDA had received 88,905 adverse event reports for tadalafil, 54,807 of them marked serious by the reporter. The symptom terms named most often were dyspnoea (11,474), headache (10,355) and diarrhoea (7,973).

Most reported events in FDA adverse event reports for tadalafil: the figures
MeasureValueNote
All reports received88,905
Reports the reporter marked serious54,807death, hospitalisation, disability or similar outcome
Dyspnoea11,474 reports
Headache10,355 reports
Diarrhoea7,973 reports
Nausea6,527 reports
Fatigue5,885 reports

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug.

Scope: Reports where FDA recorded tadalafil as a single-ingredient active substance (any brand, not only Cialis), all years to 2026-10-28

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

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Recalls

FDA drug recalls naming tadalafil

FDA enforcement reports list 25 drug recall entries naming tadalafil from 2015 to 2026-08-19. 16 of them are for compounded or other unlisted products and 9 for products FDA lists under a label. The most common stated reason was manufacturing practice deviations (11 of 25).

FDA drug recalls naming tadalafil: the figures
MeasureValueNote
Recall entries on record25
For products FDA lists under an approved or registered label9
For compounded or other unlisted products16matched by the name in the product description
Class I (most serious)0
Class II23
Class III2
Most recent recall reported2026-08-19
Most common stated reasonmanufacturing practice deviations11 of 25 entries

Source: FDA, Enforcement Reports (drug recalls) via openFDA, data as of Nov 10, 2026

How this was calculated

Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.

Scope: Recalls of single-ingredient tadalafil products, plus compounded or unlisted products whose description names it

Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.

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Clinical studies

Registered clinical studies of tadalafil

ClinicalTrials.gov lists 291 registered studies that name tadalafil as an intervention as of 2026-11-11. Of these, 23 are recruiting, 185 are completed and 71 are phase 3 studies.

Registered clinical studies of tadalafil: the figures
MeasureValue
Registered studies291
Recruiting now23
Not yet recruiting10
Completed185
Terminated, withdrawn or suspended29
Phase 3 (including phase 2/3)71
Phase 2 (including phase 1/2)51
Phase 142

Source: NIH National Library of Medicine, ClinicalTrials.gov, data as of Nov 11, 2026

How this was calculated

Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.

Scope: Studies whose intervention field matches tadalafil, any condition, any country, all statuses

A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.

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