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What is tadalafil Tadalafil is a phosphodiesterase type 5 (PDE-5) inhibitor originally developed for the treatment of erectile dysfunction (ED) and pulmonary arterial hypertension (PAH). It works by relaxing vascular smooth muscle and improving blood flow through enhanced nitric oxide (NO)–cGMP signaling. Compared to similar compounds such as sildenafil, tadalafil has a longer half-life, providing sustained vasodilatory activity for up to 36 hours. In sports physiology, tadalafil has been stu..