Tadasiva
✅ Dual action
✅ Enhanced efficacy
✅ Increased duration
✅ Improved satisfaction
✅ Versatile performance
Tadasiva contains Sildenafil and Tadalafil.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Tadasiva?
Tadasiva contains sildenafil 100 mg + tadalafil 20 mg and is used for erectile dysfunction (for men seeking both fast onset and extended coverage, or unresponsive to single-agent PDE5 therapy). Available in sildenafil 100 mg + tadalafil 20 mg. Clinical effect lasts around up to 36 hours. Manufactured by RSM Enterprises.
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Tadasiva is an unusual dual-PDE5 tablet combining sildenafil 100 mg and tadalafil 20 mg. Both are PDE5 inhibitors — and clinically, PDE5 inhibitors are not normally combined. The rationale for this product is to pair sildenafil’s fast onset (30–60 minutes) with tadalafil’s extended 36-hour window, either as a salvage approach for men unresponsive to single-agent therapy or for men wanting both quick initial effect and long-duration cover.
Manufactured by RSM Enterprises, Tadasiva should be used only under medical supervision because of the amplified cardiovascular and side-effect load of combining two PDE5 inhibitors with overlapping but different half-lives.
What Is Tadasiva?
Tadasiva contains two PDE5 inhibitors with complementary time profiles:
- Sildenafil 100 mg — the classic short-acting PDE5 inhibitor; onset 30–60 minutes, ~4-hour half-life, clinical window ~4–6 hours
- Tadalafil 20 mg — the long-acting PDE5 inhibitor; ~17-hour half-life, clinical window up to 36 hours
The theoretical benefit is that sildenafil provides the fast initial response while tadalafil provides sustained coverage through the next day. In practice, this is also used as a salvage approach for men who are incomplete responders to either drug alone.
How Does Tadasiva Work?
Both components act via the same cGMP pathway:
- Sexual stimulation releases nitric oxide in penile tissue
- Nitric oxide activates guanylate cyclase, raising cyclic GMP
- cGMP relaxes smooth muscle, increasing arterial inflow to the corpus cavernosum
- Both sildenafil and tadalafil block PDE5, prolonging cGMP action
The combination provides additive PDE5 blockade with a unique time profile — sildenafil delivers the first few hours of effect, and tadalafil maintains a clinical window into the next day. Onset is 30–60 minutes, but meaningful pharmacological activity extends up to 36 hours due to the tadalafil component.
Warning: because two PDE5 inhibitors are stacked, side-effect risk is amplified — headache, flushing, blood-pressure drop, and priapism risk all rise. Use only with close medical oversight.
Uses and Indications
- Erectile dysfunction unresponsive to single-agent PDE5 therapy — salvage use
- Men wanting both fast onset AND extended duration in a single tablet
- Not recommended as first-line treatment — single-agent trial should precede this product
Tadasiva Dosage and Administration
| Scenario | Recommended Approach | Notes |
|---|---|---|
| Standard dose | 1 tablet (sildenafil 100 + tadalafil 20) on-demand | 30–60 min before activity; max 1 tablet per 72 h |
| First-time use | Consider halving the tablet if scored | Due to dual-drug side-effect risk |
| Elderly (65+) | Not recommended | Amplified side-effect risk with dual PDE5 |
| Hepatic or renal impairment | Not recommended | Use single-agent lower-dose alternative |
| Maximum | 1 tablet per 72 hours | Tadalafil’s long half-life requires a longer dosing gap than single-agent sildenafil |
How to Take Tadasiva Properly
- Swallow whole with water, ideally on an empty stomach (fatty meals slow sildenafil absorption)
- Allow 30–60 min before intended activity
- Do not re-dose within 72 hours — tadalafil’s long half-life means residual drug is still present
- Do not combine with any other PDE5 inhibitor
- Limit alcohol strictly — combined vasodilation risk
Side Effects of Tadasiva
Side effects are the sum of both components — and often more intense due to simultaneous and prolonged PDE5 blockade.
| Severity | Side Effect |
|---|---|
| Common | Headache (often more intense than monotherapy), flushing, nasal congestion, dyspepsia, back pain, muscle aches (from tadalafil) |
| Uncommon | Visual disturbance (especially blue-tinted vision from sildenafil’s PDE6 effect), dizziness, orthostatic hypotension, palpitations |
| Rare | Priapism (elevated risk with dual PDE5), sudden vision loss (NAION), sudden hearing loss |
Priapism warning: dual PDE5 blockade carries a meaningfully higher priapism risk than monotherapy. An erection lasting more than 4 hours is a medical emergency — seek urgent care.
Warnings and Precautions
- Cardiovascular fitness for sex — sexual activity places cardiac demand on the heart. Men with active angina, recent MI (within 90 days), uncontrolled arrhythmia, or severe heart failure should have a cardiac assessment before starting a PDE5 inhibitor
- Blood pressure — PDE5 inhibitors cause mild, transient reductions in BP; use with caution if taking multiple antihypertensives
- Priapism — higher risk in men with sickle-cell disease, multiple myeloma, or leukaemia; seek urgent care if an erection lasts more than 4 hours
- Vision — discontinue and seek review if sudden visual changes occur; rare cases of non-arteritic anterior ischaemic optic neuropathy (NAION) have been reported
- Hearing — rare reports of sudden sensorineural hearing loss — stop and consult a doctor if affected
- Alcohol — significant alcohol intake combined with any PDE5 inhibitor can compound dizziness, headache, and low blood pressure
- Grapefruit juice — inhibits CYP3A4 and can raise blood levels
Contraindications — Who Should NOT Take This Medication
- Concurrent use of any nitrate — GTN, isosorbide mono/dinitrate, nicorandil, amyl nitrite (“poppers”)
- Concurrent use of guanylate cyclase stimulators such as riociguat
- Recent heart attack (within 90 days), unstable angina, or angina during intercourse
- NYHA Class II or greater heart failure within the last 6 months
- Uncontrolled arrhythmia, hypotension (BP <90/50) or uncontrolled hypertension (BP >170/100)
- Stroke within the last 6 months
- Known non-arteritic anterior ischaemic optic neuropathy (NAION) in one or both eyes
- Severe hepatic impairment (Child-Pugh C)
- Hypersensitivity to the active ingredient or any excipient
Drug Interactions
| Drug / Class | Interaction |
|---|---|
| Nitrates (GTN, ISMN, ISDN, amyl nitrite/”poppers”) | Absolute contraindication — severe, potentially fatal hypotension |
| Alpha-blockers (doxazosin, tamsulosin, alfuzosin) | Additive blood-pressure lowering — stabilise alpha-blocker dose first, start at lowest PDE5 dose |
| CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, clarithromycin) | Raise PDE5 plasma levels — reduce dose or avoid combination |
| CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John’s wort) | Lower PDE5 plasma levels — efficacy may be reduced |
| Riociguat and other sGC stimulators | Contraindicated — severe hypotension risk |
| Other PDE5 inhibitors | Do not combine — additive side effects without extra efficacy |
| Antihypertensives | Small additive BP reduction — usually clinically insignificant |
| Grapefruit juice | Inhibits CYP3A4 — avoid large or regular intake |
Always share a full list of your current medications, including over-the-counter products, recreational drugs, and herbal supplements, with your prescriber before starting this medication.
What to Do in Case of Overdose
Symptoms of a PDE5 overdose include severe headache, marked hypotension, dizziness, back or muscle pain, and prolonged erection. Management is supportive, with fluid resuscitation and cardiac monitoring. Contact your local poisons service or emergency department immediately if an overdose is suspected.
Storage Instructions
- Store below 30 °C in a dry place, away from direct sunlight
- Keep in the original blister packaging until use
- Keep out of reach of children and pets
- Do not use after the expiry date printed on the pack
- Dispose of unused tablets via a pharmacy take-back scheme where available
Related Alternatives on MedsBase
Looking for related ED or sexual-health treatment options?
- Modula — tadalafil 5 mg, ideal for once-daily low-dose therapy
- Vidalista — Centurion Labs tadalafil, 2.5 to 80 mg
- Tadacip — Cipla tadalafil 20 mg
- Megalis — Macleods tadalafil 10 mg / 20 mg
- Suhagra — Cipla sildenafil 25/50/100 mg
- Browse all Erectile Dysfunction treatments →
Frequently Asked Questions
Why combine sildenafil and tadalafil?
Two reasons: (1) time-profile stacking — sildenafil provides the first 4–6 hours of effect while tadalafil maintains a clinical window up to 36 hours; (2) salvage therapy — men incomplete-responsive to either drug alone may respond to the combination. It is not a first-line option.
How long does Tadasiva last?
The clinical window is up to 36 hours due to the tadalafil component. Peak effect from sildenafil is in the first 1–2 hours; tadalafil’s effect persists far longer.
Is Tadasiva safe?
Only under medical supervision. Stacking two PDE5 inhibitors amplifies cardiovascular, visual, and priapism risks — and tadalafil’s long half-life means the dual-blockade persists for more than a day. Do not use this product if you have not already trialled single-agent PDE5 therapy with guidance.
How often can I take Tadasiva?
No more than once per 72 hours. Tadalafil’s 17-hour half-life means drug is still present in significant amounts the day after — taking another tablet risks cumulative PDE5 exposure.
Who should NOT take Tadasiva?
First-line ED patients who haven’t tried monotherapy. Men over 65. Anyone with heart disease, hepatic or renal impairment, or on nitrates. Anyone taking another PDE5 inhibitor or CYP3A4-inhibiting drug.
What if Tadasiva causes a bad headache?
Headache is much more common with dual PDE5 than monotherapy. If it persists or is severe, switch to single-agent therapy — either sildenafil (Suhagra, Malegra) or tadalafil (Vidalista, Modula) at a standard dose.
Is there a simpler alternative for extended cover?
Yes — tadalafil alone at 20 mg gives the same 36-hour window without the dual-PDE5 side-effect burden. Or daily low-dose tadalafil 5 mg (Modula) for continuous readiness.
Can I drink alcohol with Tadasiva?
Strictly limit alcohol. Dual PDE5 amplifies vasodilation; alcohol compounds the risk of dizziness, fainting, and severe headache — and tadalafil’s long half-life means the interaction persists well into the next day.
Does Tadasiva work for diabetic ED?
Possibly — sildenafil and tadalafil both have solid diabetic-ED data, and dual blockade may rescue incomplete responders. However, a single-agent trial of tadalafil should precede combination therapy.
What if Tadasiva doesn’t work?
If dual PDE5 fails, specialist urology referral is the next step. Options beyond oral therapy include intracavernosal injections (alprostadil), vacuum erection devices, or penile implants.
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