Tadalafil, the prescription medicine best known under the brand name Cialis, is attracting interest in wellness and biohacking circles as a possible longevity drug, but researchers say the available human evidence does not show that taking it will extend a person’s life.
The drug is approved to treat erectile dysfunction and symptoms of benign prostatic hyperplasia, or an enlarged prostate. Tadalafil is also sold under another brand for pulmonary arterial hypertension, a form of high blood pressure affecting the lungs. It is not approved by the Food and Drug Administration to prevent heart attacks, strokes or dementia, or to slow aging.
Tadalafil belongs to a class of medicines called phosphodiesterase-5 inhibitors, which also includes sildenafil, the active ingredient in Viagra. The drugs prevent the breakdown of a signaling molecule that helps relax smooth muscle and widen blood vessels. That effect explains their established uses and has prompted researchers to ask whether they might also benefit blood vessels, inflammation and cardiovascular health more broadly.
Several large studies have found that men prescribed these medicines had lower rates of cardiovascular events and death. A 2024 analysis in Clinical Cardiology compared 8,156 men with erectile dysfunction who used tadalafil with 21,012 closely matched men who did not use a PDE-5 inhibitor. Tadalafil exposure was associated with a 19% lower adjusted rate of major cardiovascular events, a 55% lower rate of cardiovascular death and a 44% lower rate of death from any cause during the study period.
Those numbers describe an association, not proof of cause and effect. The study looked backward at insurance claims rather than randomly assigning people to tadalafil or a placebo. Men who seek erectile-dysfunction treatment may differ from nonusers in health, income, access to care, relationships, exercise or other factors that records cannot fully capture. A separate analysis of more than 500,000 patients also found lower rates of death, cardiovascular disease and dementia among users, but it carried the same basic limitation.
Dr. Robert Kloner of the Huntington Medical Research Institutes told NPR that the consistency of the findings creates an interesting signal that deserves more study. Other specialists were more cautious. Dr. Steve Nissen of the Cleveland Clinic said off-label preventive use is difficult to justify without randomized controlled trials. Such trials would be needed to determine whether the medicine itself produces the apparent benefit, which patients might benefit and what long-term risks accompany regular use.
Tadalafil is not appropriate for everyone. FDA-approved labeling says it must not be used with nitrate drugs such as nitroglycerin because the combination can cause a dangerous drop in blood pressure. It is also contraindicated with guanylate cyclase stimulators such as riociguat and can interact with alpha blockers, blood-pressure medicines, some strong CYP3A4 inhibitors and substantial alcohol use. Common adverse effects include headache, indigestion, back pain, muscle aches, flushing and nasal congestion. A prolonged erection, sudden vision loss or sudden hearing loss requires urgent medical attention.
People interested in tadalafil for a purpose beyond its approved uses should discuss the evidence, medication list and cardiovascular history with a licensed clinician. Erectile dysfunction itself can be an early sign of blood-vessel disease, so an evaluation may uncover risks that require established preventive measures such as blood-pressure control, cholesterol treatment, diabetes care, exercise or smoking cessation. Current research does not support buying tadalafil online or taking someone else’s prescription as a shortcut to longevity.
Sources: NPR, Clinical Cardiology and FDA-approved prescribing information. Original NPR report published Aug. 17, 2026.
