I hate to make any type of suggestions as I have taken other meds from India without any issues. I was taking 2.5 everyday but now I take 5 every other day. I don’t remember the India manufacturer but I will try to find the invoice and I will update this post if I find it
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The eye effects are due to cross reactivity with pde6. At least blue vision. Blurry or other effects are less linked to pde6. Tadalafil has less cross reactivity compared to Viagra. Tadalafil is the most selective so Viagra should be worse in this case.
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Thanks for explanation. Interesting cause I had come to sort of same conclusion (anecdotally) by trial and error. If I take Viagra for few days in a row I tend to have vision issues, whereas with Cialis not so much unless it happens little by little and over an extended period of time in which case it would be harder to quantify.
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Curious how many folks who take Tadalafil cycle it? I take daily and don’t cycle.@Agetron? etc?
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I take 5 mg daily about 4 years… no issues.
Always ready to perform… morning and night.
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Daily Low-Dose Tadalafil Enhances Cerebral Blood Flow and Cognitive Scores in Older Men
In an eight-week open-label clinical investigation, researchers evaluated whether daily administration of 5 mg tadalafil, a long-acting phosphodiesterase type 5 (PDE5) inhibitor, could improve cerebral hemodynamics and cognitive performance in 25 older men diagnosed with comorbid erectile dysfunction and mild cognitive impairment. Participants demonstrated a statistically significant increase of 2.88 points on the Montreal Cognitive Assessment (MoCA), alongside regional perfusion increases in the precuneus, brainstem, and postcentral gyrus detected via single-photon emission computed tomography (SPECT). However, the investigation documented an unexplained reduction in hippocampal perfusion, lacked a placebo control arm, and enrolled a small cohort, requiring measured interpretation of its therapeutic promise.
The vascular hypothesis of neurodegeneration posits that microvascular dysfunction, arterial stiffening, and impaired cerebral blood flow precede clinical cognitive decline. Erectile dysfunction and mild cognitive impairment share identical vascular risk profiles, frequently co-occurring as manifestations of systemic endothelial breakdown. The core concept explored in this clinical trial is whether repurposing tadalafil, a selective PDE5 inhibitor widely prescribed for urological conditions, can restore microvascular cerebral perfusion and remediate early neurocognitive deficits.
Tadalafil functions by inhibiting the PDE5 enzyme, preventing the degradation of cyclic guanosine monophosphate (cGMP). Elevated intracellular cGMP promotes vascular smooth muscle relaxation and nitric oxide-mediated vasodilation. Unlike short-acting alternatives such as sildenafil, tadalafil possesses an elimination half-life of roughly 17.5 hours, providing continuous systemic exposure with once-daily dosing. Animal studies have shown that tadalafil crosses the blood-brain barrier, stimulates angiogenesis, promotes hippocampal synaptic plasticity, and restores cognitive performance. This trial sought to translate those preclinical findings into human patients with manifest vascular and cognitive deficits.
Twenty-five men completed the eight-week intervention of 5 mg daily tadalafil. Cognitive screening scores shifted upward: average MoCA scores rose from a baseline of 18.92 to 21.80, with significant improvements occurring across attention, language, abstraction, naming, and delayed recall domains. Neuroimaging using 99mTc-HMPAO SPECT confirmed concurrent alterations in regional perfusion. Perfusion increased significantly in the left postcentral gyrus, the brainstem, and the right precuneus. The precuneus serves as a central hub within the default mode network, coordinating episodic memory and visuospatial integration, and routinely suffers hypoperfusion during early cognitive decline.
The findings also revealed a paradox. Perfusion within the right hippocampus declined relative to baseline. The investigators attribute this anomaly to technical limitations of SPECT gamma cameras, which struggle to resolve tracer uptake in small, tortuous hippocampal vessels, though a hemodynamic steal phenomenon cannot be ruled out.
Because the trial omitted a parallel placebo arm to avoid repetitive radioactive tracer exposure in healthy controls, the absolute cognitive gains remain vulnerable to practice effects and subjective expectation. Reduced psychological stress resulting from improved erectile function may have also contributed to cognitive performance. While these findings offer an encouraging preliminary signal for repurposing PDE5 inhibitors in neurovascular health, definitive confirmation awaits rigorous placebo-controlled trials utilizing high-resolution magnetic resonance perfusion imaging.
Actionable Insights
For individuals evaluating vascular strategies for brain health, this trial indicates that low-dose daily tadalafil (5 mg once daily) can modulate cerebral blood flow and improve measurable cognitive metrics in men with baseline vascular impairment. The cognitive benefit showed an absolute increase of 2.88 points on the 30-point MoCA scale, reflecting a 15.22 percent relative gain from baseline. This corresponds to a calculated standardized effect size of Cohen’s d = 1.79, indicating a large statistical effect. Concurrently, erectile function scores improved by 71.81 percent (an absolute gain of 5.40 points on the IIEF-5 scale; Cohen’s d = 0.83).
These effect sizes must be interpreted with caution. Without a placebo control group, a substantial portion of the 2.88-point cognitive gain likely reflects test familiarity from repeating the MoCA eight weeks later. Mild adverse events, including muscle aches and dizziness, led to a 13.3 percent discontinuation rate. It should be viewed as an experimental microvascular adjunct rather than a substitute for established lifestyle longevity practices such as blood pressure normalization, zone 2 aerobic exercise, and metabolic optimization.
Context and Source
- Full Title: The Effect of Daily Low Dose Tadalafil on Cerebral Perfusion and Cognition in Patients with Erectile Dysfunction and Mild Cognitive Impairment
- Institution: Departments of Urology, Nuclear Medicine, Neurology, and Radiology, Bucheon St. Mary’s Hospital and Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea
- Country: South Korea
- Journal Name: Clinical Psychopharmacology and Neuroscience
- Impact Evaluation: The impact score of this journal is 3.4, evaluated against a typical high-end range of 0–60+ for top general science, therefore this is a Medium impact journal.
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Both heads alert… 
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